bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prestin as an Otologic Biomarker of Cisplatin Ototoxicity in a Guinea Pig Model
Authors: Naples James , Cox Robert , Bonaiuto Gregory , Parham Kourosh 
Published: November 2017

ObjectiveTo evaluate (1) whether changes in serum prestin aid in early detection of cisplatin ototoxicity, (2) the role of diltiazem as an otoprotectant, and (3) whether prestin levels are sensitive to effects of diltiazem.Study DesignExperimental animal study.SettingTranslational research laboratory.SubjectsTwenty female guinea pigs.MethodsTwo groups of 10 guinea pigs were used. The relationship between serum prestin levels and auditory brainstem response (ABR) thresholds was compared between the groups. All animals had baseline blood draws and ABR thresholds recorded prior to cisplatin administration. Intraperitoneal cisplatin bolus (8 mg/kg) was administered followed by 5 consecutive days of intratympanic (IT) diltiazem (2 mg/kg) or sham IT‐saline injection. Serum prestin levels and ABR thresholds were measured at days 1, 2, 3, 7, and 14 postcisplatin.ResultsIn sham, IT‐saline–treated animals, mean prestin levels were elevated above baseline on days 1 to 7. The prestin levels were significantly elevated from baseline on day 1 (P <. 001), while significant ABR threshold elevations did not occur until day 2 (P =. 028) for click‐evoked ABRs and day 3 (P =. 041) for tones. In diltiazem‐treated animals, prestin levels were not elevated above baseline but ABR thresholds were elevated on days 1 to 3. However, the thresholds returned toward baseline on days 7 and 14.ConclusionChanges in serum prestin levels were detectable prior to shifts in ABR thresholds in a guinea pig cisplatin ototoxicity model. These changes did not occur in diltiazem‐treated animals. Prestin may serve as a biomarker of cochlear injury that is sensitive to therapeutic interventions in cisplatin ototoxicity.
Comparison of fall prediction by the Hessisch Oldendorf Fall Risk Scale and the Fall Risk Scale by Huhn in neurological rehabilitation: an observational study
Authors: Hermann Olena , Schmidt Simone B , Boltzmann Melanie , Rollnik Jens D 
Published: November 2017

Objective: To calculate scale performance of the newly developed Hessisch Oldendorf Fall Risk Scale (HOSS) for classifying fallers and non-fallers in comparison with the Risk of Falling Scale by Huhn (FSH), a frequently used assessment tool. Design: A prospective observational trail was conducted. Setting: The study was performed in a large specialized neurological rehabilitation facility. Subjects: The study population ( n = 690) included neurological and neurosurgery patients during neurological rehabilitation with varying levels of disability. Around the half of the study patients were independent and dependent in the activities of daily living (ADL), respectively. Interventions: Fall risk of each patient was assessed by HOSS and FSH within the first seven days after admission. Main measures: Event of fall during rehabilitation was compared with HOSS and FSH scores as well as the according fall risk. Scale performance including sensitivity and specificity was calculated for both scales. Results: A total of 107 (15.5%) patients experienced at least one fall. In general, fallers were characterized by an older age, a prolonged length of stay, and a lower Barthel Index (higher dependence in the ADL) on admission than non-fallers. The verification of fall prediction for both scales showed a sensitivity of 83% and a specificity of 64% for the HOSS scale, and a sensitivity of 98% with a specificity of 12% for the FSH scale, respectively. Conclusion: The HOSS shows an adequate sensitivity, a higher specificity and therefore a better scale performance than the FSH. Thus, the HOSS might be superior to existing assessments.
Monitoring of water spectral patterns of lactobacilli development as a tool for rapid selection of probiotic candidates
Authors: Slavchev Aleksandar , Kovacs Zoltan , Koshiba Haruki , Bazar Gyorgy , Pollner Bernhard , Krastanov Albert , Tsenkova Roumiana 
Published: November 2017

Nowadays a quick and inexpensive method, which allows rapid, in vivo comprehensive probiotic bacteria identification, is needed. To elucidate a new concept to evaluate probiotic bacteria, near infrared spectroscopy with aquaphotomics were applied to monitor the growth of eight Lactobacillus bulgaricus and one Lactobacillus gasseri bacteria strains. Their resistance to low pH (1.8) in the presence of pepsin and bile were measured and further used as reference data for analysis of the simultaneously acquired spectral data. The acquired spectral data in the region of 1100–1300 nm were subjected to various methods for multivariate data analyses—principal component analysis, linear discriminant analysis, soft independent modeling of class analogy, and partial least squares regression. The results showed high accuracy of bacteria strains classification according to their resistance and the potential of the tested wavelength region for rapid selection and prediction of some basic phenotypic characteristics of probiotic candidates. Results of the current study also revealed different suitability of each growth stage when using near infrared spectra for the classification of bacteria strains.
Initial Fibular Displacement as a Predictor of Medial Clear Space Widening in Weber B Ankle Fractures
Authors: Cavanaugh Zachary S. , Gupta Simran , Sathe Vinayak M. , Geaney Lauren E. 
Published: November 2017

Background: The diagnosis of medial ankle instability in Weber B ankle fractures remains controversial. Manual stress and gravity stress radiographs as well as magnetic resonance imaging (MRI) are used, but there is no consensus gold standard. The purpose of this study was to determine the relationship between initial fibular displacement and medial clear space widening on a gravity stress radiograph as a predictor of instability. Methods: A retrospective review was conducted of all patients with isolated Weber B ankle fractures with both initial injury radiographs and gravity stress view from August 1, 2014, through April 1, 2016. A total of 17 patients were identified. On the mortise view of initial injury radiographs, medial clear space (MCS), superior clear space, lateral fibular displacement (LFDP), and fibular shortening (FS) were measured, and on the lateral view, anterior to posterior fibular gap (A to P FG) was measured. MCS was again measured on the gravity stress view (MCS-W). Statistical analyses identified the correlations of each displacement variable relative to MCS-W as well as the sensitivity and specificity of each parameter. Results: A cutoff point for MCS-W was set as less than 5.0 mm (n = 8) and 5.0 mm or more (n = 9). Strong significant correlations with MCS-W were found for A to P FG (0.84, P < .001), with a trend for LFDP (0.62, P = .008), but no significance with FS (0.38, P = .84). Linear regression analysis revealed significant ability to predict MCS-W for both LFDP ( P = .002) and A to P FG ( P = .001) but not FS. Receiver operating characteristic analysis for A to P FG using a threshold value of 1.0 mm yielded sensitivity and specificity of 100% in predicting an MCS-W of 5.0 mm or more. Conclusion: The initial fibular displacement was a strong predictor of MCS-W in Weber B ankle fractures. On lateral radiographs, an A to P FG greater than 1.0 mm showed a sensitivity and specificity of 100% in predicting an MCS-W of 5.0 mm or more on gravity stress view. Level of Evidence: Level III case series, prognostic.
Comparison of Visual Analog Pain Score Reported to Physician vs Nurse
Authors: Martin Kevin D. , Van Buren J. Preston , Wake Jeffrey , Dawson Laura 
Published: November 2017

Background: The visual analog scale (VAS) is considered a reliable and validated measure of patient-reported acute pain. Patient-reported outcome measures are becoming the standard of care throughout the orthopedic community, but interpretation and clinical applications are still under investigation. The aim of the current study was to compare preoperative patient-reported VAS scores reported at the same visit to nursing staff and the treating surgeon. Our hypothesis was that there would be no difference in the scores reported. Methods: This study is a retrospective cohort of 201 consecutive foot and ankle patients treated by a single surgeon. The patients were asked to rate their pain intensity by the nursing staff and then by the surgeon using a standard horizontal VAS 0 to 10, from “no pain” to the “worst pain.” Differences in reported pain values were analyzed. Results: The results demonstrate that patients reported higher pain scores to the surgeon in 81% of the encounters, nursing staff 8%, and equal 11%. On average, the VAS score reported to the surgeon was significantly ( P < .05) higher than that reported to the nursing staff. Conclusion: The current study found a statistically significant higher patient-reported pain score to the treating surgeon compared to the nursing staff. While the exact cause is unclear, the discrepant pain scores call into question the validity of the VAS, considered a fifth vital sign and standard outcome measure in an outpatient clinic setting. Level of Evidence: Level III, comparative study.
Implementation of clinical pharmacy services in an academic oncology practice in India
Authors: Patel Himanshu , Gurumurthy Parthasarathi 
Published: November 2017

Objective This study was conducted to investigate medication-related problems after implementation of clinical pharmacy services at a speciality oncology care setting. Methods It was a prospective interventional study conducted for a period of three years at a private academic oncology care setting. Paper-based medical records and medication orders were reviewed and patients and care givers were interviewed to understand the treatment plan. All the medication-related problems were identified by clinical pharmacists by performing drug therapy review. Patients were also followed up at ambulatory care and in-patient units to ensure appropriate administration of anti-cancer drugs by nurses. All the medication-related problems were discussed with the concerned clinicians and then were resolved with the interventions of clinical pharmacists. Clinical significance of these interventions were assessed and classified as “Major”, “Moderate “and “Minor”. Educational, clinical and system-based interventions were developed and implemented to minimize medication-related problems at the study site. Results A total of 1359 medication-related problems were identified from 2120 medication orders reviewed of 1362 patients followed during the study period. The most common medication-related problems were lack of suboptimal supportive care (17.95%), inappropriate administration of medications (14.56%), untreated indication (14.20%), wrong dosing calculations (12.21%), drug–drug interactions (11.62%) and sub-therapeutic dose (11.11%). Clinical pharmacy interventions were made to resolve all the medication-related problems. Clinical significance of majority (n = 504, 37.08%) of medication-related problems was “Moderate” followed by “Major” (n = 434, 31.93%) and “Minor” (n = 421, 30.97%). Conclusion The study has demonstrated the importance of clinical pharmacy services in improving quality and safe use of medicines in oncology practice. Positive feedback of clinicians on clinical pharmacy services was a reflection of acceptance of clinical pharmacy interventions by clinicians.
Clostridium difficile treatment in neutropenic patients: Clinical outcomes of metronidazole, vancomycin, combinations, and switch therapy
Authors: Tieu Jennifer D , Schmidt Sarah A , Miller Jamie L , Kupiec Katherine E , Skrepnek Grant H , Liu Connie , Smith Winter J 
Published: November 2017

Background Clostridium difficile infection treatment guidelines exist for immunocompetent patients; however, there is a paucity of data evaluating clinical outcomes and time to C. difficile-associated diarrhea resolution in neutropenic patients. Objective To assess clinical outcomes in neutropenic patients treated with metronidazole, oral vancomycin, the combination of metronidazole plus oral vancomycin, and switch of metronidazole to oral vancomycin. Methods This retrospective, observational cohort study assessed adult neutropenic inpatients with C. difficile-associated diarrhea treated with metronidazole, oral vancomycin, combination (metronidazole and oral vancomycin), or switch therapy (metronidazole to oral vancomycin). The primary outcome was time to diarrhea resolution based on treatment regimen. Secondary outcomes included C. difficile-associated diarrhea resolution of diarrhea by day 14, recurrence, and occurrence of major complications. Results Overall, 44 patients met full inclusion criteria (52.2% metronidazole monotherapy, 22.7% combination, and 25.0% switch therapy). Two patients on oral vancomycin monotherapy were excluded due to insufficient sample size. Overall time to C. difficile-associated diarrhea resolution was 9.1 ± 10.7 days. The Cox regression results suggested both switch and combination therapy were associated with 65.5% (p = 0.002) and 65.9% (p = 0.046) longer time to C. difficile-associated diarrhea resolution compared to metronidazole monotherapy, respectively. An increasing absolute neutrophil count was associated with an increase in C. difficile-associated diarrhea resolution (p = 0.007). Conclusion Switch or combination therapy was associated with a prolonged time to C. difficile-associated diarrhea resolution. The decision to use switch or combination therapy may represent a surrogate marker for more severe disease and need for therapy escalation. It is unknown if initial therapy with oral vancomycin would provide better outcomes as this could not be assessed.
Determinants of electronic cigarette use among Finnish adults
Authors: Ruokolainen Otto , Ollila Hanna , Karjalainen Karoliina 
Published: November 2017

Background: Electronic cigarette (e-cigarette) use is rising in the Western world, but studies from the Nordic countries are lacking. Many countries are implementing policy changes, brought about for example by the 2014 European Tobacco Products Directive, and monitoring e-cigarette use is considered important. The aim of this article is to account for the prevalence of e-cigarette use among the Finnish adult population and to examine correlates of ever use and current use of e-cigarettes prior to some changes in the Finnish regulatory scheme. Methods: A population-based survey was conducted in 2014. A representative random sample ( N = 7000) of Finnish people aged 15–69 years was drawn from the Finnish Population Information System. Data were collected by self-administered anonymous online/postal questionnaire. The response rate was 50% ( n = 3485). A multinomial logistic regression model was used to estimate the association between e-cigarette use and different explanatory variables. Results: Of all participants, 2% were current and 12% were ever users of e-cigarettes. Younger age and current or previous tobacco use increased the odds for both current and ever use of e-cigarettes when compared with never users. Unemployment and lower education were associated with current e-cigarette use and being a student was associated with ever use of e-cigarettes. Conclusions: The current use of e-cigarettes in the adult population is low in Finland, having at least tried is more common. Both types of e-cigarette use are concentrated to groups considered to be more vulnerable, such as younger people and those with a lower socioeconomic position. Further monitoring of e-cigarette use is needed in view of Finland’s aim to become nicotine and tobacco free by 2030.
Medications for Sleep Schedule Adjustments in Athletes
Authors: Baird Matthew B. , Asif Irfan M. 
Published: November 2017

Context: Sleep schedule adjustments are common requirements of modern-day athletes. Many nonpharmacologic and pharmacologic strategies exist to facilitate circadian rhythm shifts to maximize alertness and performance during competition. This review summarizes the evidence for commonly used pharmacologic agents and presents recommendations for the sports medicine provider. Evidence Acquisition: MEDLINE searches were performed using the following keywords: sleep aids, circadian rhythm adjustment, athletes and sleep, caffeine and sports, melatonin and athletes, and sleep aids and sports. Pertinent articles were extracted and discussed. Study Design: Clinical review. Level of Evidence: Level 2. Results: There are very few available studies investigating pharmacologic sleep aids in athletes. Data from studies involving shift workers and airline personnel are more abundant and were used to formulate recommendations and conclusions. Conclusion: Melatonin, caffeine, and nonbenzodiazepine sleep aids have a role in facilitating sleep schedule changes in athletes and maximizing sports performance through sleep enhancement.
Medication use and falls: Applying Beers criteria to medication review in Parkinson’s disease
Authors: Yusupov Eleanor , Chen Davina , Krishnamachari Bhuma 
Published: November 2017

Objectives: Our goal was to assess the association between potentially inappropriate medication use and risk of falls in the Parkinson’s disease population. Methods: This was a retrospective cohort study conducted at an outpatient Parkinson’s Disease Treatment Center. Individuals 65 years of age or older, diagnosed with Parkinson’s disease who attended at least three visits in 2015 for physical, occupational therapy, or physician’s visits were included in the study. Electronic medical records were utilized to perform chart reviews, and medications were analyzed to identify prescription medications, combination preparations, over-the-counter medications, and dietary supplements. The goal of this study was to test the following hypothesis: elderly individuals with Parkinson’s disease who take multiple potentially inappropriate medications are more likely to experience a fall compared to elderly individuals with Parkinson’s disease who do not take multiple potentially inappropriate medications. Results: A higher mean number of prescription medications were associated with falls in elderly Parkinson’s disease patients (6.53 vs 5.21, p < 0.01). Polypharmacy (taking five or more prescription and nonprescription medications) was not significantly associated with falls. Patients taking potentially inappropriate medications specifically contraindicated for those with a history of falls and fractures were more likely to report falls (p < 0.04). Analysis of the specific therapeutic medication categories demonstrated no significant differences between those who did and did not report falls. Conclusion: A future prospective study at Parkinson’s disease center should include an electronic medical record–based intervention to reduce the total number of medications, as well as to minimize the use of high-risk medications.
Comparison of structural magnetic resonance imaging findings between neuropsychiatric systemic lupus erythematosus and systemic lupus erythematosus patients: A systematic review and meta-analysis
Authors: Amin Omed , Kaul Arvind , Smith Toby O , Howe Franklyn A , Sofat Nidhi 
Published: November 2017

Introduction: Neuropsychiatric systemic lupus erythematosus is often clinically challenging to diagnose, treat and monitor. Although brain magnetic resonance imaging is frequently performed before lumbar puncture in neuropsychiatric systemic lupus erythematosus, it is not clear from the literature whether specific brain magnetic resonance imaging findings are associated with distinct clinical features of neuropsychiatric systemic lupus erythematosus. Methods: We conducted a systematic review and meta-analysis on published studies of neuropsychiatric systemic lupus erythematosus including brain magnetic resonance imaging and the 1999 American College of Rheumatology-defined clinical neuropsychiatric systemic lupus erythematosus syndromes to determine their relationship. Pooled prevalence and risk ratio for distinct neuropsychiatric systemic lupus erythematosus associations were determined with 95% confidence intervals. Results: Of 821 studies screened, 21 fulfilled inclusion criteria. A total of 818 participants were evaluated (91% female) with 1064 neuropsychiatric systemic lupus erythematosus episodes assessed. Neuropsychiatric systemic lupus erythematosus features included headache (24%), seizures (19%), cerebrovascular disease (18%), cognitive dysfunction (15%) and acute confusional state (14%). Normal magnetic resonance imaging was significant for anxiety disorder (risk ratio: 9.00; 95% confidence interval: 2.40, 33.79), autonomic disorder (risk ratio: 7.00; 95% confidence interval: 0.51, 96.06) and plexopathy (risk ratio: 5.00; 95% confidence interval: 0.81, 31.00). Highest risk ratio of neuropsychiatric systemic lupus erythematosus syndrome with abnormal magnetic resonance imaging was observed for cerebrovascular disease (risk ratio: 0.15; 95% confidence interval: 0.10, 0.24) and demyelination (risk ratio: 0.11; 95% confidence interval: 0.02, 0.72). Conclusion: Normal magnetic resonance imaging in neuropsychiatric systemic lupus erythematosus was the most significant correlate from our meta-analysis for psychological symptoms including anxiety and peripheral nerve features of autonomic disorder and plexopathy. The main abnormal brain magnetic resonance imaging correlates included cerebrovascular disease and demyelination. Brain magnetic resonance imaging correlates poorly with neuropsychiatric systemic lupus erythematosus features, and specific clinical symptoms should be the main determinants of performing magnetic resonance imaging rather than presence of neuropsychiatric systemic lupus erythematosus per se.
Risk factors and clinical outcomes of delirium in osteoporotic hip fractures
Authors: Kim Joon Yub , Yoo Jeong Hyun , Kim Eugene , Kwon Ki Bum , Han Byeong-Ryong , Cho Yongun , Park Jai Hyung 
Published: November 2017

Purpose: This study is performed to identify risk factors for delirium in osteoporotic hip fractures and to evaluate the hospitalization cost and clinical outcomes of delirium in osteoporotic hip. Methods: A total of 221 patients with osteoporotic hip fractures were assessed for eligibility between 2010 and 2014. Among them, 37 patients with delirium were allocated into the delirium group (group D) and 37 patients without delirium were allocated into the non-delirium group (group ND) by matching demographic factors. Risk factors such as time between admission and operation, body mass index, American Society of Anesthesiologists status, cognitive impairment, preoperative urinary catheter, electrolyte imbalance, preoperative hemoglobin, polymedication (medications > 5), pneumonia, anesthesia time, operation time, estimated blood loss, and total amount of transfusion were evaluated for correlation with incidence of delirium. The hospitalization cost was evaluated, and clinical outcomes such as readmission, mortality, and activity level at 1-year follow-up were evaluated. Results: In multivariate analysis, polymedication ( p = 0.028) and preoperative indwelling urinary catheter insertion status ( p = 0.007) were related to the incidence of delirium in patients with osteoporotic hip fractures. Group D showed a significantly higher hospitalization cost compared to group ND. However, delirium did not have a significant effect on length of hospital stay, readmission rate, postoperative 1-year mortality, and activity level. Conclusions: Polymedication and preoperative urinary catheter were related to perioperative delirium. In addition, delirium in osteoporotic hip fractures may not have a detrimental effect on clinical outcomes; however, hospitalization cost seemed to be increased due to delirium.