bluuebunny/crossref_metadata_2025_split huggingface dataset:
Disc Herniation and Cyst Gas: A Rare Association Causing Radicular Compression
Authors: Mandour Cherkaoui , Gazzaz Miloudi , Mostarchid Brahim 
Published: June 2017

Introduction Intraspinal gas is a common clinical finding, but an epidural gas pseudocyst in association with lateral disc herniation compressing a nerve root is an exceptional observation.
Case Report A 49-year-old man was admitted to our department presenting with sciatica. The neurological examination demonstrated moderate lumbar pain without neurological deficit. A lumbosacral computed tomography showed the presence of degenerated disc herniation and epidural gas collection.
Discussion The pathological association between the cyst and the hernia is probably due to the migration of gas pumped from the intervertebral space through a breaking point or lower in the annulus fibrosis, involving its contiguity with the herniated disc.
Conclusion An association between a disc herniation and a gas pseudocyst can be a cause of sciatica.
Augmentation bei proximalen Femurfrakturen
Authors: Pfeufer Daniel , Neuerburg Carl , Mehaffey Stefan , Böcker Wolfgang , Kammerlander Christian 
Published: June 2017

Zusammenfassung
Hintergrund Die häufigsten und vital bedrohlichsten Fragilitätsfrakturen sind die proximalen Femurfrakturen. Aufgrund der demografischen Entwicklung sind sie von zunehmender Bedeutung. Fragestellung Die hüftgelenksnahen Femurfrakturen sind überwiegend osteoporoseassoziiert und stellen oftmals eine chirurgische Herausforderung dar. Erhalt der Funktion und Selbstständigkeit sind die wesentlichen Behandlungsziele der Therapie von orthogeriatrischen Patienten. Die Stabilität der Osteosynthese kann durch Augmentationstechniken zusätzlich optimiert werden.
Material und Methode Das am häufigsten angewendete Augmentationsverfahren ist die Zementaugmentation des proximalen Femurnagels Antirotation (PFNA) bei pertrochantären Femurfrakturen. Hiermit soll die Voraussetzung zur sofortigen vollbelastenden Mobilisation geschaffen werden.
Ergebnisse Die gute Frakturheilung der PFNA-Marknagelosteosynthese ohne Hinweise auf zementassoziierte Komplikationen konnte in klinisch-prospektiven Studien gezeigt werden.
Schlussfolgerung Die Sekundärprävention stellt neben der optimalen operativen Versorgung den entscheidenden Behandlungspfeiler zur Prävention weiterer Frakturen dar. Auf Basis der aktuellen Literatur soll dieser Artikel einen Überblick über die Zementaugmentation zur Behandlung proximaler Femurfrakturen bieten.
Hohe Prävalenz der Verwendung von Antipsychotika bei Demenzpatienten in deutschen neurologischen und psychiatrischen Praxen
Authors: Bohlken Jens , Booker Anke , Kostev Karel 
Published: June 2017

Zusammenfassung
Hintergrund Das Ziel der vorliegenden Studie ist es, sowohl in Pflegeheimen als auch zu Hause lebende Patienten in Bezug auf die Häufigkeit der Verwendung von Antipsychotika zu untersuchen und die Faktoren zu bestimmen, die zur erstmaligen Verwendung von Antipsychotika nach einer Demenzdiagnose führen.
Methoden Diese Studie umfasste Patienten im Alter ab 60 Jahren mit einer Erstdokumentation einer Demenz beliebigen Ursprungs (Indexdatum) durch neuropsychiatrische Fachärzte in der Disease-Analyzer-Datenbank (IMS Health). Der Hauptzielparameter war der Anteil der Patienten, die nach dem Indexdatum zum ersten Mal eine Antipsychotikaverordnung erhielten. Mithilfe von Kaplan-Meier-Analysen wurde die Zeit bis zur Einleitung der Antipsychotikatherapie in Abhängigkeit von Alter und Unterbringung in einem Pflegeheim untersucht. Ein Cox-Proportional-Hazards-Regressionsmodell wurde verwendet, um das Verhältnis zwischen der Wahrscheinlichkeit der Therapieeinleitung und den vordefinierten demografischen und klinischen Variablen abzuschätzen.
Ergebnisse Insgesamt wurden 14 915 Patienten mit Demenz (Durchschnittsalter 80,3 Jahre, 34,7 % männlich, 53,3 % in Pflegeheimen untergebracht) in die Studie eingeschlossen. Innerhalb von zwei Jahren nach dem Indexdatum wurden 47,7 % der Demenzpatienten mit Antipsychotika behandelt. Unterbringung in Pflegeheimen, höheres Alter, organisch bedingte psychische Störungen, organisch bedingte Persönlichkeitsstörungen, vaskuläre Demenz und Privatversicherungsstatus waren positiv mit der Einleitung einer Antipsychotikabehandlung assoziiert.
Schlussfolgerung Die Prävalenz der Verwendung von Antipsychotika bei Demenzpatienten ist, insbesondere bei Patienten in Pflegeheimen, sehr hoch. Weitere Studien, einschließlich qualitativer Untersuchungen, sind nötig, um die Gründe für dieses Verordnungsverhalten zu verstehen und zu erklären.
Neue Aspekte in der Therapie des metastasierten Prostatakarzinoms
Authors: von Amsberg Gunhild , Bokemeyer Carsten 
Published: June 2017

Was ist neu?
Hormon-Chemotherapie in der hormonsensitiven Situation Basierend auf den Ergebnissen dreier großer, randomisierter Studien (STAMPEDE, CHAARTED und GETUG15) sollte Patienten mit metastasiertem, hormonsensitivem Prostatakarzinom (PCa) eine kombinierte Hormon-Chemotherapie mit Docetaxel 75 m/qm alle 3 Wochen über 6 Zyklen angeboten werden.
Cabazitaxel bei metastasiertem, kastrationsresistentem Prostatakarzinom (mCRPC) Eine Reduktion der Cabazitaxel-Dosierung von 25 mg/qm auf 20 mg/qm als Zweitlinien-Chemotherapie nach Docetaxel scheint ohne wesentlichen Wirkverlust möglich zu sein, bei zugleich deutlich besserer Verträglichkeit. Die Gabe von Cabazitaxel vor Docetaxel bei kastrationsrefraktärem PCa hat keinen Zusatznutzen.
Androgenrezeptor (AR)-gerichtete Behandlungen bei mCRPC Die AR-gerichteten Medikamente Enzalutamid und Abirateron stellen interessante Behandlungsalternativen zur klassischen Chemotherapie dar, da der AR trotz Kastrationsresistenz eine Schlüsselrolle bei der Tumorprogression innehat.
Einsatz von Radium-223 bei ossär metastasierten Patienten Als erstes Medikament dieser Substanzklasse führte Radium-223 bei Patienten mit rein ossär metastasiertem, kastrationsresistentem Prostatakarzinom zu einer signifikanten Verlängerung des Gesamtüberlebens.
Entscheidungshilfen für die Medikamentenauswahl Erkrankungs- und patientenspezifische Charakteristika sollten bei der Auswahl des richtigen Medikaments berücksichtigt werden.
Auf die innere Haltung kommt es an
Authors: Schröder Jörg-Peter , Stolz Karl-Heinz 
Published: June 2017

Zusammenfassung
Konfliktprävention im OP als Führungsaufgabe Unsicherheit, hohe
Belastungen, Stress und mangelhafte Kommunikation im OP führen schnell zu einem
Konflikt: Dies schadet sowohl dem Teamgeist als auch dem Patienten. Damit
Unstimmigkeiten gar nicht erst auftreten, ist eine systemische
Konfliktprävention sinnvoll. Wichtig sind hier vor allem die Aspekte Haltung,
Verhalten und Verhältnisse und eine effektive Kommunikation.
Gelebte Vielfalt
Authors: Welk Ina 
Published: June 2017

Zusammenfassung
Einführung Die Zahl von Menschen mit Migrationshintergrund nimmt stetig
zu. Deshalb müssen sich auch Kliniken auf eine interkulturelle
Patientenversorgung und die Integration ausländischer Mitarbeiter einstellen.
Die Herausforderung besteht in einem offenen, respektvollen und toleranten
Umgang miteinander, um insbesondere fachliche, kulturelle und sprachliche
Barrieren zu überwinden. Im Schwerpunkt lesen Sie, wie die interkulturelle
Versorgung und Zusammenarbeit gelingt und eine Kultur der gegenseitigen
Akzeptanz und Wertschätzung entwickelt werden kann.
Safety and efficacy of simultaneous colorectal ESD for large synchronous colorectal lesions
Authors: Chiba Hideyuki , Tachikawa Jun , Kurihara Daisuke , Ashikari Keiichi , Goto Toru , Takahashi Akihiro , Sakai Eiji , Ohata Ken , Nakajima Atsushi 
Published: June 2017

Abstract
Background and study aims Multiple large colorectal lesions are sometimes diagnosed during colonoscopy. However, there have been no investigations of the feasibility of simultaneous endoscopic submucosal dissection (ESD) for multiple lesions. This study aims to reveal the strategy of simultaneous ESD for multiple large colorectal lesions.
Patients and methods 246 patients who underwent ESD for 274 colorectal lesions were retrospectively evaluated in this study. Fifty-one large colorectal lesions among 23 patients were treated by ESD simultaneously (simultaneous group), and 223 patients were treated with ESD for a single lesion (single group).
Results En-bloc resection and curative resection rates did not differ. Compared with the single group, each procedure time was faster (31.8 ± 23.6 min vs. 45.8 ± 44.8, P = 0.002), but total procedure time was significantly longer in the simultaneous group (70.6 ± 33.4 vs. 45.8 ± 44.8 min, P = 0.01). Rates of adverse events including bleeding and perforation were not higher in the simultaneous group but the mean blood pressure, incidence of bradycardia and the amount of sedative drug used during ESD were significantly higher in the simultaneous group. Multiple logistic regression analysis identified non-experienced physician, lesion size ≥ 40 mm and submucosal fibrosis as an independent risk factor for procedure duration (≥ 90 min) (Odds ratio 11.852, 18.280, and 3.672; P < 0.05, respectively).
Conclusions Simultaneous ESD for multiple synchronous colorectal lesions is safe and feasible compared with single ESD and can reduce the burden to patients, length of hospital stay and medical expense. These results need to be elucidated by further studies.
The Roma as ultimate European minority and ultimate outsider?
Authors: Delcour Chloë , Hustinx Lesley 
Published: June 2017

Abstract
In order to understand the paradoxical position of the Roma as the subject of both European inclusion programmes and persistent exclusionary practices, this chapter focuses on the interaction of both inclusionary and exclusionary frames used in discussions in the Flemish newspaper media following a human-rights violation. The case concerns the Belgian government’s expulsion of Slovak Roma migrants in 1999 (the Čonka case). Proceeding from the sociology of human rights and the principles of critical discourse analysis (CDA), we analyse 212 newspaper articles from the period 1999–2002. Based on this analysis, we identify the following connections between the inclusionary and exclusionary conceptualizations of Roma migrants: (1) an emphasis on the excluded character of the Roma, (2) the possibility that they are “deserving” of expulsion and (3) the dominance of the nation-state model within the context of migration. These results illustrate the complexity with which inclusionary and exclusionary discourses can be intertwined, thereby contributing to sociological research concerning human-rights practices and advancing CDA research on “discursive othering” beyond a sole focus on exclusionary discourses.
Trajectories of Work Disability and Economic Insecurity Approaching Retirement
Authors: Shuey Kim M , Willson Andrea E 
Published: June 2017

AbstractObjectivesIn this article, we examine the connection between trajectories of work disability and economic precarity in late midlife. We conceptualize work disability as a possible mechanism linking early and later life economic disadvantage.MethodsWe model trajectories of work disability characterized by timing and stability for a cohort of Baby Boomers (22–32 in 1981) using 32 years of data from the Panel Study of Income Dynamics and latent class analysis. Measures of childhood disadvantage are included as predictors of work disability trajectories, which are subsequently included in logistic regression models predicting four economic outcomes (poverty, asset poverty, home ownership, and pension ownership) at ages 54–64.ResultsChildhood disadvantage selected individuals into five distinct classes of work disability that differed in timing and stability. All of the disability trajectories were associated with an increased risk of economic insecurity in late midlife compared to the never work disabled.DiscussionThis study contributes to the aging literature through its incorporation of the early life origins of pathways of disability and their links to economic outcomes approaching retirement. Findings suggest work disability is anchored in early life disadvantage and is associated with economic insecurity later in life.
Context-Dependent Drivers of Discretionary Debt Decisions: Explaining Willingness to Borrow for Experiential Purchases
Authors: Tully Stephanie M , Sharma Eesha 
Published: June 2017

Abstract
Mental accounting research suggests that consumers prefer borrowing for longer-lasting purchases in order to receive benefits from the purchases as they pay for them. In contrast, two sets of archival data and five lab studies show that consumers are more willing to borrow for experiential versus material purchases, even though experiential purchases tend to have a shorter physical duration. Further, framing the same purchase as more experiential than material increases willingness to borrow. This effect occurs because purchase timing is more important for experiential purchases—a function of consumers’ aversion to missing out on planned consumption. Thus, we moderate the proposed effect by varying whether the borrowing decision impacts planned consumption. Other differences between material and experiential purchases, such as scarcity or expected happiness, cannot similarly explain our results. Moreover, our conceptualization allows us to reconcile the apparent contradiction between the previous and current research by examining the relative impact of purchase-timing importance and payment-benefit duration matching in different contexts (i.e., “purchasing” and “source-of-funding” decisions).
Strong suppression of star formation and spiral arm formation in disc galaxies with counter-rotating gas discs
Authors: Osman Omima , Bekki Kenji 
Published: June 2017

Abstract
Galaxy-wide star formation can be quenched by a number of physical processes such as environmental effects (e.g. ram pressure stripping) and supernova feedback. Using numerical simulations, we here demonstrate that star formation can be severely suppressed in disc galaxies with their gas discs counter-rotating with respect to their stellar discs. This new mechanism of star formation suppression (or quenching) does not depend so strongly on model parameters of disc galaxies, such as bulge-to-disc ratios and gas mass fractions. Such severe suppression of star formation is largely due to the suppression of the gas density enhancing mechanism, i.e. spiral arm formation in disc galaxies with counter-rotating gas. Our simulations also show that molecular hydrogen and dust can be rather slowly consumed by star formation in disc galaxies with counter-rotating gas discs (i.e. long gas depletion time-scale). Based on these results, we suggest that spiral and S0 galaxies with counter-rotation can have rather low star formation rate for their gas densities. Also, we suggest that a minor fraction of S0 galaxies have no prominent spiral arms because they have a higher fraction of counter-rotating gas. We predict that poststarburst ‘E+A’ disc galaxies with cold gas could have counter-rotating gas.
Clinical Updates in Women’s Health Care Summary: Gynecologic and Obstetric Care for Breast Cancer Survivors
Authors: Miller Jennifer Griffin 
Published: June 2017

Abstract
Breast cancer treatment has an impact on the physical, psychologic, sexual, and reproductive aspects of women’s lives. Therefore, it is important for obstetrician–gynecologists to be well versed in the screening, diagnosis, and management of breast cancer. This monograph is an overview of critical issues related to the provision of ongoing care to breast cancer survivors.
Management of 30 infected nonunited tibial fractures by Ilizarov external fixator with acute shortening distraction technique with consideration of the causative organism
Authors: Barakat Ahmed Samir , Elguindy Ahmed , Elazab Mohamed , Hegazy Mohamed , Abdel-Meguid Kamal M.S. , Elbarbary Hassan 
Published: June 2017

Background:
Long-standing infected nonunion and gap nonunion tibial fractures are difficult to treat and pose a challenging problem to orthopaedic surgeons. They may lead to residual deformity, persistent infection, knee or ankle contracture, and, at worst, can result in a painful and useless limb requiring amputation.

Methods:
This prospective study involved 30 patients (27 males and three females) with infected tibial nonunions treated by Ilizarov external fixation with acute shortening and distraction. The mean age was 40 yr with an average bone defect of 3.85 cm (range 2.5 cm to 6 cm). The duration of nonunion before treatment ranged from 6 to 48 mo with an average of 14 mo. The average number of prior surgeries was 1.5 (range 1 to 4). Eleven (36.66%) of the 30 patients had overlying soft-tissue compromise. The causative bacteria were identified and treated with the appropriate antibiotic for at least 6 wk (range 6 to 12 wk).

Results:
Most infected nonunited fractures in this series (86.66%) occurred in the productive age (four in the 3rd, eight in the 4th, nine in the 5th, and 5 in the 6th decades of life) indicating the socioeconomic impact of this severe injury. The time to consolidation ranged from 3.5 mo to 9 mo, with an average of 6 mo. All fractures united except one (3.33%), with 19 (63.27%) and eight (26.64%) patients having an excellent and good result and two (6.66%) patients having a fair result when applying the Association for the Study and Application of the Method of Ilizarov (ASAMI) classification. Functional results per ASAMI were 12 (39.96%), and 14 (46.62%) patients had excellent and good results. Twenty-seven (89.91%) had bony consolidation with complete remission of infection. The most common isolated bacteria were Staphylococcus aureus (10 patients) and Staphylococcus epidermis (four patients). The most common complication was pin track infection which occurred in all patients. All were uneventfully treated with proper wire/pin care and the appropriate antibiotics.

Conclusions:
Ilizarov fixation with acute shortening distraction technique is a safe and reliable method for treatment of infected tibial nonunion, however, with the potentially devastating complication of vascular injury during acute compression. The amount of acute shortening is done on an individualized basis as we could not identify safe limits for acute shortening. This technique deals with soft-tissue defects that may require treatment and precludes the need for complex microvascular procedures and secondary bone grafting at the fracture site.
A High-throughput HPLC-MS/MS Assay for the Detection, Quantification and Simultaneous Structural Confirmation of 136 Drugs and Metabolites in Human Urine
Authors: Klepacki Jacek , Davari Baharak , Boulet Marion , Lizarraga Ryan , Christians Uwe 
Published: June 2017

Background:
Because of its superior sensitivity and specificity, multianalyte high-performance liquid chromatography coupled with tandem mass spectrometry has become the gold standard in clinical toxicology. Although several qualitative and quantitative liquid chromatography coupled with tandem mass spectrometry assays on various mass spectrometry platforms have been described in the literature, most methods either analyze only a limited number of compounds and/or require tedious and time-consuming sample preparation.

Methods:
A major challenge in urine toxicology screening is the minimization of false-negative and false-positive results. This was addressed by screening for a comprehensive panel of 136 compounds of importance for pain and drug addiction clinics, using high-end, high-sensitivity, fast-scanning mass spectrometry in combination with simultaneous structural confirmation based on ion ratios. The assay was validated and successfully participated in proficiency challenges.

Results:
The assay met all predefined acceptance criteria. The lower limit of quantifications ranged from 10 to 100 ng/mL. Interday trueness and imprecisions ranged from 73.8% to 116.2% and 2.4%–20.0%, respectively. The total assay run time was 10 minutes.

Conclusions:
We developed and successfully validated a robust, sensitive, and specific liquid chromatography coupled with tandem mass spectrometry-based urine toxicology screening platform that allows for the addition of drugs to quickly adjust to new clinical needs. To date, more than 3000 clinical samples have successfully been analyzed. Our results also indicated that such a quantitative multianalyte assay is pushing against the limits of current fast-scanning MS/MS instrumentation and that the number of analytes and their internal standards must be balanced with acceptable sensitivity, reproducibility, structural confirmation, and the ability to reliably quantify, all of which was achieved.
Outbreak Caused by Escherichia coli O18:K1:H7 Sequence Type 95 in a Neonatal Intensive Care Unit in Barcelona, Spain
Authors: Sáez-López Emma , Bosch Jordi , Salvia Maria Dolors , Fernández-Orth Dietmar , Cepas Virginio , Ferrer-Navarro Mario , Figueras-Aloy Josep , Vila Jordi , Soto Sara M. 
Published: June 2017

Background:

Escherichia coli is one of the most frequent causes of late-onset neonatal sepsis. The aim of this study was to characterize an outbreak of neonatal sepsis occurring in the neonatal intensive care unit of the Hospital Clinic of Barcelona from April to August 2013.

Methods:
After presentation of the index case, all E. coli isolates from previously hospitalized neonates, health-care workers and neonates admitted to the neonatal intensive care unit from April to October 2013 were tested for K1 antigen positivity and epidemiologically compared by pulse-field gel electrophoresis. Furthermore, the E. coli K1 strains collected from neonates during this period were analyzed by different methods (serotyping, phylotyping, polymerase chain reaction of virulence factors, antimicrobial resistance and “in vitro” assays in Human Brain Microvascular Endothelial Cells (HBMEC)).

Results:
An E. coli O18:K1:H7 sequence type 95 and phylogenetic group B2 strain was the cause of the outbreak involving 6 preterm neonates: 1 with late septicemia because of a urinary focus and 5 with late-onset septicemia and meningitis, 3 of whom died. All showed the same pulsotype, full resistance to ampicillin and intermediate resistance to gentamicin. The outbreak strain carried the pathogenicity island (PAI) IIJ96-like domain that could explain the high-grade bacteremia necessary to develop meningitis.

Conclusions:
All the E. coli isolates responsible for this outbreak belonged to a single clone suggesting a common source of infection, and it was categorized as O18:K1:H7. Despite the bacteria’s pathogenicity has an important role in the severity of infection, the host-associated factors were crucial for the fatal outcomes.