bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors Leading to Transmission Risk of Acinetobacter baumannii*
Authors: Thom Kerri A. , Rock Clare , Jackson Sarah S. , Johnson J. Kristie , Srinivasan Arjun , Magder Laurence S. , Roghmann Mary-Claire , Bonomo Robert A. , Harris Anthony D. 
Published: April 2017

Objectives:
To identify patient and healthcare worker factors associated with transmission risk of Acinetobacter baumannii during patient care.

Design:
Prospective cohort study.

Setting:
ICUs at a tertiary care medical center.

Patients:
Adult ICU patients known to be infected or colonized with A. baumannii.

Measurements and Main Results:
Cultures of skin, respiratory tract, and the perianal area were obtained from participants and evaluated for the presence of A. baumannii. Healthcare worker-patient interactions were observed (up to five interactions/patient) and activities were recorded. Healthcare worker hands/gloves were sampled at room exit (prior to hand hygiene or glove removal) and then evaluated for the presence of A. baumannii. Two hundred fifty-four healthcare worker-patient interactions were observed among 52 patients; A. baumannii was identified from healthcare worker hands or gloves in 77 (30%) interactions. In multivariate analysis, multidrug-resistant A. baumannii (odds ratio, 4.78; 95% CI, 2.14–18.45) and specific healthcare worker activities (touching the bed rail [odds ratio, 2.19; 95% CI, 1.00–4.82], performing a wound dressing [odds ratio, 8.35; 95% CI, 2.07–33.63] and interacting with the endotracheal tube or tracheotomy site [odds ratio, 5.15; 95% CI, 2.10–12.60]), were associated with hand/glove contamination.

Conclusions:
Healthcare worker hands/gloves are frequently contaminated with A. baumannii after patient care. Patient-level factors were not associated with an increased transmission risk; however, having multidrug-resistant-A. baumannii and specific healthcare worker activities led to an increased contamination risk. Our findings reveal a potential selective advantage possessed by multidrug-resistant-A. baumannii in this environment and suggest possible areas for future research.
Collagenoma in a Patient With Down Syndrome: A Case Report and Review of the Literature
Authors: Choi Sun Young , Park Sanghui 
Published: April 2017

Abstract:
A 26-year-old woman with Down syndrome presented with a 4-cm-sized palpable mass in the sacrococcygeal region. Histologic evaluation of the specimen revealed densely packed collagen fibers in the dermis, which is consistent with a collagenoma. Masson trichrome staining showed dense fibrosis, and elastic Van Gieson staining revealed a significant decrease in elastic tissue. The clinicopathologic characteristics of this patient and 4 previously reported cases are discussed in detail.
A New Enzyme-Linked Immunosorbent Assay for a Total Anti-T Lymphocyte Globulin Determination: Development, Analytical Validation, and Clinical Applications
Authors: Montagna Michela , La Nasa Giorgio , Bernardo Maria E. , Piras Eugenia , Avanzini Maria A. , Regazzi Mario , Locatelli Franco 
Published: April 2017

Background:
Anti-T lymphocyte globulin (ATLG) modulates the alloreactivity of T lymphocytes, reducing the risk of immunological posttransplant complications, in particular rejection and graft-versus-host disease, after allogeneic hematopoietic stem cell transplantation (HSCT). We developed and validated a new enzyme-linked immunosorbent assay (ELISA) method to measure serum levels of total ATLG and evaluate the pharmacokinetics (PK) of the drug in children with β-Thalassemia, receiving allogeneic HSCT.

Methods:
Diluted serum samples were incubated with Goat-anti-Rabbit IgG antibody coated on a microtiter plate and then, with Goat-anti-Human IgG labeled with horseradish peroxidase. After incubation and washings, substrate solution was added and absorbance was read at 492 nm. ATLG concentrations in samples were determined by interpolation from a standard curve (range: 200–0.095 ng/mL), prepared by diluting a known amount of ATLG in phosphate-buffered saline (PBS). Low, medium, and high-quality control concentrations were 1.56, 6.25, and 25 ng/mL, respectively. This method was developed and validated within the acceptance criteria in compliance with the Guidelines for a biological method validation: the sensitivity of the method was 0.095 ng/mL. We analyzed serum samples from 14 children with β-Thalassemia who received ATLG (Grafalon) at a dose of 10 mg/kg administered as intravenous (IV) infusion on days −5, −4, and −3 before HSCT (day 0). Blood sampling for PK evaluation was performed on days −5, −4, and −3 before and after drug infusion; and then from day −2 to +56.

Results:
The median total ATLG levels pre-IVand post-IV were 0 and 118 mcg/mL on day −5; 85.9 and 199.2 mcg/mL on day −4; 153 and 270.9 mcg/mL on day −3, respectively. The median PK values of CL was 0.0029 (range: 0.0028–0.0057) L·kg−1·d−1, Vd was 0.088 (range: 0.025–0.448) L/kg and t1/2 was 20.2 (range: 5.8–50.2) days.

Conclusions:
These data suggest that given the marked interindividual variability of total ATLG disposition, the development of a validated ELISA method and the possibility to measure PK parameters in paediatric populations are essential steps to optimize drug therapeutic regimens.
Physiologically assessed hot flashes and endothelial function among midlife women
Authors: Thurston Rebecca C. , Chang Yuefang , Barinas-Mitchell Emma , Jennings J. Richard , von Känel Roland , Landsittel Doug P. , Matthews Karen A. 
Published: April 2017

Abstract

Objective:
Hot flashes are experienced by most midlife women. Emerging data indicate that they may be associated with endothelial dysfunction. No studies have tested whether hot flashes are associated with endothelial function using physiologic measures of hot flashes. We tested whether physiologically assessed hot flashes were associated with poorer endothelial function. We also considered whether age modified associations.

Methods:
Two hundred seventy-two nonsmoking women reporting either daily hot flashes or no hot flashes, aged 40 to 60 years, and free of clinical cardiovascular disease, underwent ambulatory physiologic hot flash and diary hot flash monitoring; a blood draw; and ultrasound measurement of brachial artery flow-mediated dilation to assess endothelial function. Associations between hot flashes and flow-mediated dilation were tested in linear regression models controlling for lumen diameter, demographics, cardiovascular disease risk factors, and estradiol.

Results:
In multivariable models incorporating cardiovascular disease risk factors, significant interactions by age (P < 0.05) indicated that among the younger tertile of women in the sample (age 40-53 years), the presence of hot flashes (beta [standard error] = −2.07 [0.79], P = 0.01), and more frequent physiologic hot flashes (for each hot flash: beta [standard error] = −0.10 [0.05], P = 0.03, multivariable) were associated with lower flow-mediated dilation. Associations were not accounted for by estradiol. Associations were not observed among the older women (age 54-60 years) or for self-reported hot flash frequency, severity, or bother. Among the younger women, hot flashes explained more variance in flow-mediated dilation than standard cardiovascular disease risk factors or estradiol.

Conclusions:
Among younger midlife women, frequent hot flashes were associated with poorer endothelial function and may provide information about women's vascular status beyond cardiovascular disease risk factors and estradiol.
Effects of a 6-month caloric restriction induced-weight loss program in obese postmenopausal women with and without the metabolic syndrome: a MONET study
Authors: Ghachem Ahmed , Prud’homme Denis , Rabasa-Lhoret Rémi , Brochu Martin 
Published: April 2017

Abstract

Objective:
To compare the effects of a caloric restriction (CR) on body composition, lipid profile, and glucose homeostasis in obese postmenopausal women with and without metabolic syndrome (MetS).

Methods:
Secondary analyses were performed on 73 inactive obese postmenopausal women (age 57.7 ± 4.8 years; body mass index 32.4 ± 4.6 kg/m2) who participated in the 6-month CR arm of a study of the Montreal-Ottawa New Emerging Team. The harmonized MetS definition was used to categorize participants with MetS (n = 20, 27.39%) and without MetS (n = 53, 72.61%). Variables of interest were: body composition (dual-energy X-ray absorptiometry), body fat distribution (computed tomography scan), glucose homeostasis at fasting state and during a euglycemic/hyperinsulinemic clamp, fasting lipids, and resting blood pressure.

Results:
By design, the MetS group had a worse cardiometabolic profile, whereas both groups were comparable for age. Fifty-five participants out of 73 displayed no change in MetS status after the intervention. Twelve participants out of 20 (or 60.0%) in the MetS group had no more MetS after weight loss (P = NS), whereas 6 participants out of 53 (or 11.3%) in the other group developed the MetS after the intervention (P = NS). Overall, indices of body composition and body fat distribution improved significantly and similarly in both groups (P between 0.03 and 0.0001). Furthermore, with the exception of triglyceride levels and triglycerides/high-density lipoprotein cholesterol ratio, which decrease significantly more in the MetS group (P ≤ 0.05), no difference was observed between groups for the other variables of the cardiometabolic profile.

Conclusions:
Despite no overall significant effects on MetS, heteregeneous results were obtained in response to weight loss in the present study, with some improving the MetS, whereas other displaying deteriorations. Further studies are needed to identify factors and phenotypes associated with positive and negative cardiometabolic responses to CR intervention.
Ocular Argyrosis Mimicking Conjunctival Melanoma
Authors: Tendler Irwin , Pulitzer Melissa P. , Roggli Victor , Abramson David H. , Marr Brian P. 
Published: April 2017

Purpose:
To present a novel case of ocular argyrosis mimicking conjunctival melanoma.

Methods:
A 48-year-old man who is a jewelry manufacturer presented with raised pigmented lesions in the inferior fornices of both eyes. Brown-black colored, follicle-like, masses were observed in both fornices.

Results:
An incisional biopsy confirmed the presence of silver and the diagnosis of ocular argyrosis.

Conclusions:
Despite its limited negative health effects, ocular argyrosis should be considered in the differential diagnosis of conjunctival pigmented lesions because of the potential for misidentification of neoplastic growth.
Comparative Evaluation of Tacrolimus Versus Interferon Alpha-2b Eye Drops in the Treatment of Vernal Keratoconjunctivitis: A Randomized, Double-Masked Study
Authors: Zanjani Habibollah , Aminifard Mohammad Naim , Ghafourian Abdolhossein , Pourazizi Mohsen , Maleki Alireza , Arish Mohammed , Shahrakipoor Mahnaz , Rohani Mohammad Reza , Abrishami Mojtaba , Khafri Zare Ehsan , Barzegar Jalali Farhad 
Published: April 2017

Purpose:
Vernal keratoconjunctivitis (VKC) is a bilateral, chronic, external ocular inflammatory disorder that mainly affects patients in their first or second decade. This study was designed to compare tacrolimus and interferon alpha-2b (IFN alpha-2b) eye drops in the treatment of VKC.

Methods:
In this randomized, double-masked clinical trial, 40 consecutive patients with VKC were sent to a referral eye hospital in a tropical region southeast of Iran. Patients were randomly assigned to receive either 0.005% tacrolimus or IFN alpha-2b (1,000,000 units/cc). Chi-square and t tests were used for comparison of outcomes between both groups.

Results:
Mean ± SD age was 11.1 ± 5.2 years. Thirty-one patients (77.5%) were male. The mean duration of disease was 3.4 ± 2.9 years. In this study, the signs and symptoms were significantly reduced in patients after treatment in both groups (P = 0.0001). In the tacrolimus group, all patients responded to treatment whereas only one subject in the IFN group failed to respond (P = 0.99). Side effects in both groups were mild and tolerable.

Conclusions:
This study indicated that both 0.005% tacrolimus and IFN alpha-2b are effective and appear to be safe in treatment of recalcitrant VKC.
Emotion Regulation and Perceptions of Illness Coherence and Controllability on Regimen Adherence and Negative Cardiac Health Events in African American Women With Heart Failure
Authors: Wierenga Kelly L. 
Published: April 2017

Background:
African American women with heart failure (HF) have stressors that negatively impact HF self-management adherence and heighten the occurrence of negative cardiac health events. Perceptions of illness coherence and controllability and emotion regulation are known to facilitate self-management in the face of stressors.

Objective:
The aim of this study was to determine whether difficulties with emotion regulation and negative perceptions of illness coherence and controllability are detrimental to adherence and increase negative cardiac health events in this patient population.

Methods:
African American women (n = 54) with HF, aged 49 to 84 years, participated in this longitudinal descriptive correlational study. Using convenience sampling, we recruited patients from hospitals and HF clinics. They completed interviews at intake and 30 days, and their medical records were reviewed at 90 days. Linear and logistic regression models were used to assess predictors of general adherence and negative cardiac health events.

Results:
Of 54 patients who participated in the study, 28 experienced a negative health event during 90 days, and 57% of these events were cardiac related. The only clear predictor of these events was greater New York Heart Association functional classification (β = 1.47, P = .027). No associations were found between predictors (emotion regulation, controllability, coherence, age, education) and general adherence.

Conclusions:
Emotion regulation showed a possible greater impact on negative cardiac health events than on general adherence. Perceived illness coherence showed less impact on negative cardiac health events than on general adherence.
Multimodal Hyperspectroscopic Imaging for Detection of High-Grade Cervical Intraepithelial Neoplasia
Authors: Ebisch Renée M.F. , Hermens Marjolein , van den Akker Petronella A.J. , Massuger Leon F.A.G. , Melchers Willem J.G. , Bekkers Ruud L.M. 
Published: April 2017

Objective
Numerous new alternative digital colposcopy techniques have been developed, of which multimodal hyperspectroscopy (MHS) showed a high sensitivity in previous studies. The objective of this prospective single-center cohort study was to evaluate the clinical value of MHS for detecting high-grade cervical intraepithelial neoplasia in a colposcopy referral population and colposcopy follow-up population, to assess whether MHS could be safely used to improve care for women at risk for high-grade cervical intraepithelial neoplasia.

Materials and Methods
A total of 125 women from a colposcopy referral population and colposcopy follow-up population were evaluated with MHS and tested for the presence of high-risk human papillomavirus (HPV) with HPV-16/18 genotyping. Spectroscopic measurements of the cervix were taken and compared with an end point based on histology, high-risk HPV, and cytology. Evaluable data for analysis were collected from 102 of the subjects. Sensitivity, specificity, and predictive values were calculated for MHS and colposcopic impression based on conventional colposcopic examination.

Results
From the total study population of the 102 patients, 47 were enrolled in the colposcopy referral group and 55 in the colposcopy follow-up group. The MHS yielded a sensitivity of 93.6% (95% CI = 78.6–99.2), with a corresponding specificity of 42.3% (95% CI = 30.6–54.6) in the group with a composite end point. No adverse effects occurred, and patient acceptability was high.

Conclusions
Multimodal hyperspectroscopy is a digital colposcopy technique that offers an easy, rapid, well-tolerated point-of-care assessment with a high sensitivity for the presence of high-grade cervical intraepithelial lesions, however, with a low specificity, resulting in limited clinical value.
Sepsis in Obstetrics
Authors: Parfitt Sheryl E. , Bogat Mary L. , Roth Cheryl 
Published: April 2017

Abstract
Sepsis during pregnancy is one of the five leading causes of maternal mortality worldwide. Early recognition and prompt treatment of maternal sepsis is necessary to improve patient outcomes. Patient education on practices that reduce infections may be helpful in decreasing rates of sepsis. Education of nurses about early signs and symptoms of sepsis in pregnancy and use of obstetric-specific tools can assist in timely identification and better outcomes. Although the Surviving Sepsis Campaign (SSC) criteria for diagnosis of sepsis in the general population are not pertinent for obstetric patients, their treatment bundles (guidelines) are applicable and can be used to guide care of obstetric patients who develop sepsis.
This article is the third in a series of three that discuss the importance of sepsis and septic shock in pregnancy. This article includes case studies, treatment, prognosis, education, and prevention of maternal sepsis.
Sharp Force Trauma Death in a Young Individual From Medieval Gloucester
Authors: Valoriani Satu , Eliopoulos Constantine , Borrini Matteo 
Published: April 2017

Abstract
The authors of the present work evaluate the trauma observed on the skeletal remains of an individual from medieval Gloucester and reconstruct the events that led to his death. The almost complete skeleton was recovered from the cemetery of St Owen and dates to the late medieval period. Several methods were used to determine the sex and age of the individual. The anthropological examination showed that the remains belonged to a young male, between the ages of 17 and 19 years. The young man also had antemortem pathologies that were related to his diet and lifestyle, as he appears to have had iron-deficiency anemia and Schmorl nodes. The trauma observed on the remains consisted of 3 cut marks located on the cranium, left radius, and right scapula. The cuts seem to have been inflicted by a heavy weapon, such as a sword. The trauma pattern observed is consistent with defensive action, and the fact that this skeleton was the only one in the collection that has evidence of trauma suggests that this was a case of interpersonal violence.
Acute-Onset Chest Pain in a 17-Year-Old Female Adolescent With Systemic Lupus Erythematosus
Authors: Mangus Courtney W. , Fatusin Oluwatosin , Ngo Thuy L. 
Published: April 2017

Abstract
We report the case of a 17-year-old adolescent girl with systemic lupus erythematosus with disseminated pneumococcal infection leading to purulent pericarditis with cardiac tamponade. Although pericarditis is not an uncommon entity in autoimmune diseases such as systemic lupus erythematosus, purulent pericarditis is a rare cause (<1%) of this presentation.
Diagnosis of Ingested Foreign Body in the Stomach by Point-of-Care Ultrasound in the Upright and Slightly Forward Tilting Position (Bowing Position)
Authors: Yamamoto Motoyoshi , Koyama Toru , Agata Masahiro , Ouchi Kenjiro , Kotoku Takayuki , Mizuno Yuta 
Published: April 2017

Abstract
We report a case involving accidental ingestion of a marble that was detected by point-of-care ultrasonography of the abdomen with the patient in the upright and slightly forward tilting position, which we term the “bowing position.” Using this position for abdominal ultrasonography may be more useful than the usual supine position for such patients.
Point-of-Care Ultrasound Diagnosis of Traumatic Abdominal Wall Hernia
Authors: Bjork Lori B. , Bellew Shawna D. , Kummer Tobias 
Published: April 2017

Abstract
Traumatic abdominal wall hernias due to blunt abdominal trauma in pediatric patients can pose a diagnostic challenge because of spontaneous hernia reduction. Ultrasonography may be superior to computed tomography for this indication in some cases because of the ability to dynamically and repeatedly assess the area of injury. Herniation can be induced or exaggerated via Valsalva maneuvers, which can facilitate its detection during dynamic assessment. We present the case of a 3-year-old boy who sustained blunt abdominal trauma, with a resultant abdominal wall hernia that was diagnosed using point-of-care ultrasound imaging. This hernia was not visualized with computed tomography, and point-of-care ultrasonography expedited admission for operative repair.
Supraventricular Tachycardia Associated With Severe Anemia
Authors: Corwin Daniel J. , Scarfone Richard J. 
Published: April 2017

Abstract
We present the unusual case of a 7-year-old girl with severe iron-deficiency anemia who concurrently was determined to be in a supraventricular tachycardia (SVT) rhythm. To our knowledge, the association of anemia with SVT has not been reported previously. We review the presentation of SVT, management strategies for treating both severe anemia and SVT, risks and benefits of using the classic treatments for SVT in a severely anemic patient and discuss iron-deficiency anemia–related cardiac disease.
Prevention of HIV in Adolescent Girls and Young Women: Key to an AIDS-Free Generation
Authors: Abdool Karim Quarraisha , Baxter Cheryl , Birx Deborah 
Published: April 2017

Abstract:
The Global Plan towards the elimination of new HIV infections among children by 2015 and keeping their mothers alive (Global Plan) has ensured that more infants in high-HIV burden countries survive childhood HIV-free. Although equal numbers of boy and girl children have survived to age 10, a gender divergence starts to emerge as they enter adolescence. Up to 3 times as many young women aged 15–24 years in eastern and southern Africa are living with HIV compared with their male peers. Further, more adolescent girls and young women are sick and/or dying from AIDS-related or HIV-related complications during pregnancy and in the postpartum period, underscoring the importance of strengthening HIV treatment and prevention services for this group. Failure to prevent HIV in adolescent girls and young women and keep them alive will reverse the infant HIV prevention and survival gains made under the Global Plan. The promising global declines in HIV infection in young women need to be strengthened to realize the goals of an AIDS-free generation. The DREAMS initiative of the United States President's Emergency Plan for AIDS Relief (PEPFAR), which specifically addresses adolescent girls and young women at highest risk of HIV acquisition, brings new hope for meeting the prevention and care needs of this important and vulnerable population through political commitment, leadership, financial and human resource investments, advocacy efforts, and a focus on the highest priority settings. Importantly, to achieve the goal of keeping mothers alive, we have to place more emphasis on access to sexual and reproductive health services that (1) include HIV prevention and treatment services for adolescent girls and young women; (2) increase male/paternal responsibility in mother and infant health; and (3) ensure a supportive social environment that enables young women to grow up into young adults who are free to graduate from high school and plan their pregnancies, ultimately entering adulthood safe, healthy, and free from HIV.