bluuebunny/crossref_metadata_2025_split huggingface dataset:
Failure of Conservative Treatment of Acute Diverticulitis with Extradigestive Air
Authors: Colas P. A. , Duchalais E. , Duplay Q. , Serra‐Maudet V. , Kanane S. , Ridereau‐Zins C. , Lermite E. , Aubé C. , Hamy A. , Venara A. 
Published: March 2017

AbstractBackground
Medical management for perforated diverticulitis without abscess or peritonitis (PDwAP) has a success rate of 40–70%. Identifying patients with a risk of medical treatment failure would improve outcomes. The aim of this study was to identify the risk factors for failure of medical treatment in patients admitted with PDwAP.MethodsThis multicenter retrospective observational study included all consecutive patients admitted for PDwAP and not surgically treated over a 7‐year period. Peritonitis classified on the Hinchey scale was excluded. Potential clinical, biological and radiological risk factors for medical treatment failure were collected and compared between the group of patient with a failure of medical treatment (F) and the group in which treatment did not fail. Data were collected at referral.ResultsNinety‐one patients were included, and 29 had a failure of treatment (31.9%). The median heart rate was different between the two groups (p < 0.001), at approximately 100/min in the F group. A blood level of C‐reactive protein (CRP) ≥150 mg/mL was associated with a higher rate of failure (p = 0.021), but it was not confirmed in multivariate analysis. Pneumoperitoneum ≥5 mm and intraperitoneal liquid located in the pouch of Douglas were more likely to be present in the F group (respectively, p = 0.001 and p < 0.001). A multivariate analysis showed independent risk factors as being the highest pneumoperitoneum diameter >5 mm (OR 5.193; p = 0.015) and peritoneal fluid location in the pouch of Douglas (OR 4.103; p = 0.036).ConclusionThe severity of sepsis (tachycardia and CRP ≥150 mg/mL) and of imaging signs (pneumoperitoneum ≥5 mm and peritoneal fluid in the pouch of Douglas) were risk factors for medical treatment failure of PDwAP requiring special supervision so as not to lose time in undertaking surgical management.
Gastroesophageal Reflux and Idiopathic Pulmonary Fibrosis
Authors: Allaix Marco E. , Rebecchi Fabrizio , Morino Mario , Schlottmann Francisco , Patti Marco G. 
Published: March 2017

AbstractBackgroundIdiopathic pulmonary fibrosis (IPF) is a progressive interstitial lung disease of unknown origin that affects about 40,000 new patients every year in the USA. Albeit the disease is labelled as idiopathic, it is thought that pathologic reflux, often silent, plays a role in its pathogenesis through a process of microaspiration of gastric contents.AimsThe aim of this study was to review the available evidence linking reflux to IPF, and to study the effect of medical and surgical therapy on the natural history of this disease.ResultsMedical therapy with acid‐reducing medications controls the production of acid and has some benefit. However, reflux and aspiraion of weakly acidic or alkaline gastric contents can still occur. Better results have been reported after laparoscopic anti‐reflux surgery, as this form of therapy re‐establishes the competence of the lower esophageal sphincter, therefore stopping any type of reflux.ConclusionsA phase II NIH study in currently in progress in the USA to determine the role of antireflux surgery in patients with GERD and IPF. The hope is that this simple operations might alter the natural history of IPF, avoiding progression and the need for lung transplantation.
Surface‐Active Properties of Solvent‐Extracted Panax ginseng Saponin‐Based Surfactants
Authors: Mesgarzadeh Iraj , Akbarzadeh Ali Reza , Rahimi Rahmatollah 
Published: March 2017

AbstractIn this study, saponins were extracted from Panax ginseng root powder. The crude solvent‐extracted saponins containing triterpenoid glycosides and terpenes that were identified by TLC techniques. The critical micelle concentrations (CMC) of the saponins were determined by measuring the change in (a) the UV‐visible spectrum of iodine due to the micelle‐iodine complexation, (b) the absorption intensity of aqueous alpha‐lipoic acid due to the micellar solubilization of the drug, and (c) the surface tension due to the abrupt change in the air/liquid interface saturation by surfactants monomers. The development of new absorption peak due to the micelle‐iodine complexation, enhancement in the absorbance due to the micelle‐solubilized lipoic acid, and displacement of monomer‐micelle equilibrium to micelle formation in higher monomer concentration region are some of the physicochemical properties in which CMC could be determined. We found a CMC of 0.009% w/v.
Safety of disclosing amyloid status in cognitively normal older adults
Authors: Burns Jeffrey M. , Johnson David K. , Liebmann Edward P. , Bothwell Rebecca J. , Morris Jill K. , Vidoni Eric D. 
Published: March 2017

AbstractIntroductionDisclosing amyloid status to cognitively normal individuals remains controversial given our lack of understanding the test's clinical significance and unknown psychological risk.MethodsWe assessed the effect of amyloid status disclosure on anxiety and depression before disclosure, at disclosure, and 6 weeks and 6 months postdisclosure and test‐related distress after disclosure.ResultsClinicians disclosed amyloid status to 97 cognitively normal older adults (27 had elevated cerebral amyloid). There was no difference in depressive symptoms across groups over time. There was a significant group by time interaction in anxiety, although post hoc analyses revealed no group differences at any time point, suggesting a minimal nonsustained increase in anxiety symptoms immediately postdisclosure in the elevated group. Slight but measureable increases in test‐related distress were present after disclosure and were related to greater baseline levels of anxiety and depression.DiscussionDisclosing amyloid imaging results to cognitively normal adults in the clinical research setting with pre‐ and postdisclosure counseling has a low risk of psychological harm.
‘MY GARDEN IS NOT PRISTINE’: AN INTERVIEW WITH LINDA CATLIN SMITH
Authors: Höstman Anna 
Published: March 2017

ABSTRACTLinda Catlin Smith was born in 1957 and grew up in New York. She studied composition in New York and at the University of Victoria, before settling in Toronto in 1981. Linda has received Canada's prestigious Jules Léger prize for her work Garland (2005). She was the Artistic Director of Toronto's contemporary ensemble Arraymusic (1988–93), and a founding member of the interdisciplinary collective Urge (1992–2006). She currently teaches composition at Wilfrid Laurier University. I sat down with Linda in the summer of 2016 at her home in the Trinity Bellwoods neighbourhood of Toronto to ask her about her life and work.
Screening for Cerebellopontine Angle Tumours: Conventional MRI vs T2 Fast Spin Echo MRI
Authors: Dort Joseph C. , Sadler David , Hu William , Wallace Carla , La Forge Pierre , Sevick Robert 
Published: March 2017

ABSTRACT:Background:Unilateral audiovestibular symptoms are commonly seen in clinical practice and are rarely caused by retrocochlear pathology. However, clinicians are often required to rule out potentially serious causes of these unilateral symptoms. Gadolinium enhanced magnetic resonance imaging (GdMRI) is the most accurate test for detecting small cerebellopontine angle lesions and also screens the adjacent CNS structures. Its main disadvantage is the cost of the procedure.Methods:We studied 100 consecutive patients with both GdMRI and a newer MRI screening study utilizing unenhanced T2-weighted fast spin echo (fse) MRI. Acquired images were randomly assessed by a panel of three neuro-radiologists.Results:We found that the screening (fse) MRI was as sensitive and specific when detecting cerebellopontine angle tumors.Conclusions:We conclude that T2-weighted fse MRI is a safe and cost-effective alternative to GdMRI and offers better diagnostic utility when compared to auditory brain stem response (ABR) and CT scans.
A Founder Mutation in French-Canadian Families with X-linked Hereditary Neuropathy
Authors: Dupré Nicolas , Cossette Louise , Hand Collette K. , Bouchard Jean-Pierre , Rouleau Guy A , Puymirat Jack 
Published: March 2017

ABSTRACT:Background:The aim of the present study was to identify the mutations in the connexin 32 gene in French-Canadian families with X-linked Charcot-Marie-Tooth disease (CMTX).Methods:Molecular analysis was performed by nonisotopic single strand conformation polymorphism (SSCP) analysis and sequencing. Clinical evaluation was carried out according to the scale defined by the European Hereditary Motor and Sensory Neuropathy Consortium.Results:In one family, the mutation Arg142Trp was located in the transmembrane domain III whereas, in four other families we identified a novel mutation (Ser26Trp) located in the transmembrane domain I of the connexin 32 gene. Haplotype analysis revealed that these four families are related and suggests a founder mutation. Sixteen patients from these four families were studied. As expected, all the affected males were more clinically affected than the females and all affected patients exhibited some electrophysiological characteristics of demyelination.Conclusion:Our study suggests that the Ser26Trp mutation may cause a primary demyelinating neuropathy that is not associated with a specific clinical phenotype. We also find evidence that the majority of kindreds share a common ancestor.
Treatment Costs for Glioblastoma Multiforme in Nova Scotia
Authors: Mendez Ivar , Jacobs Philip , MacDougall Andrea , Schultz Margarita 
Published: March 2017

ABSTRACT:Background:Glioblastoma Multiforme (GBM) is the most common and malignant brain tumor in adults. The median survival in patients harboring this neoplasm is 12 months irrespective of any form of therapy. Health care costs of illnesses with high mortality rates, such as GBM, are of particular interest in times of constrained health care resources. No information regarding costs for the treatment of patients with GBM is available in Canada. The aim of this study was to conduct an analysis of the costs of treatment of GBM in Nova Scotia.Methods:Patients with histologically proven GBM during a three year period (1996-1998) in Nova Scotia were included in the study. Analysis was based on hospital costs supplemented by data on additional medical services received following discharge for the primary intervention.Results:The mean cost of medical care per patient from the time of diagnosis to death was $ 17,149. The highest costs were related to hospitalization with ward costs alone accounting for 48% of all costs. Radiotherapy costs were 25%, surgery costs were 16% and chemotherapy costs were 7% of all costs. Costs for diagnostic procedures were 6% of the total costs.Conclusion:Our data reflect the costs and practice pattern in the treatment of GBM in Nova Scotia and may be of value as an initial attempt to analyze costs of treatment of GBM in Canada.
The Spectrum of Electrophysiological Abnormalities in Bell's Palsy
Authors: Hill Michael D. , Midroni Gyl , Goldstein Warren C. , Deeks Shelley L. , Low Donald E. , Morris Andrew M. 
Published: March 2017

ABSTRACT:Background:As part of an investigation of a suspected "outbreak" of Bell's palsy in the Greater Toronto Area, a population-based sample of patients with Bell's palsy was investigated electrophysiologically to help understand the spectrum of abnormalities that can be seen in this setting.Methods:Two hundred and twenty-four patients were surveyed, of whom 91 underwent formal neurological assessment. Of the latter, 44 were studied electrophysiologically using standard techniques. Thirty-two of the 44 patients fulfilled clinical criteria for Bell's palsy.Results:A wide range of electrophysiological changes was observed. Blink responses were the most useful test showing diagnostic sensitivity of 81% and specificity of 94% compared to the contralateral control side. Needle electromyography was additionally helpful in only one patient of six with normal conduction studies.Conclusions:There is a wide spectrum of electrophysiological abnormalities in Bell's palsy. Blink reflex latencies may be under-utilized in the assessment of the facial nerve in Bell's palsy. Facial EMG is not generally useful in routine assessment.
Effect of Corticosteroid Therapy on Serum and CSF Malondialdehyde and Antioxidant Proteins in Multiple Sclerosis
Authors: Keles M.S. , Taysi S. , Sen N. , Aksoy H. , Akçay F. 
Published: March 2017

ABSTRACT:Objective:Multiple sclerosis (MS) is a disease characterised by perivascular infiltrates and demyelination of the white matter in the central nervous system. Although the precise cause of MS remains unknown, some investigations have been carried out on antioxidant mechanisms in these patients.Methods:In this study, malondialdehyde (MDA), as a lipid peroxidation marker, and ceruloplasmin (Cp) and transferrin (Trf), as antioxidant proteins, levels were determined in cerebrospinal fluid (CSF) and serum of 30 MS patients before and after corticosteroid therapy and in 20 control subjects. Transferrin and Cp levels were measured by the nephelometric method and MDAwas measured spectrophotometrically.Results:Mean MDAserumand MDACSFlevels were found to be highest in the pretreatment group and lowest in the control group. Although there was no significant difference in terms of serum Trf level, serum Cp was found higher in pre- and posttreatment groups than in the control groups. Ceruloplasmin and Trf levels of CSF were not detectable using the nephelometric method. A significant correlation was found between MDACSFand MDAserumin the pretreatment group (r=0.58).Conclusions:These data revealed that lipid peroxidation was increased in serum and particulary in CSF of MS patients and was reduced with corticosteroid therapy.
Sarcoidosis Presenting as an Intramedullary Spinal Cord Lesion
Authors: Maroun F.B. , O'Dea F.J. , Mathieson G. , Fox G. , Murray G. , Jacob J.C. , Reddy R. , Avery R. 
Published: March 2017

ABSTRACT:Objectives:Meige syndrome is a movement disorder that includes blepharospasm and oromandibular dystonias. Its etiology may be idiopathic (primary) or it may arise secondary to focal brain injury. Acute respiratory distress as a feature of such dystonias occurs infrequently. A review of the literature on Meige syndrome and the relationship between dystonias and respiratory compromise is presented.Methods:A 60-year-old woman suffered a cerebral anoxic event secondary to manual strangulation. She developed progressive blepharospasm combined with oromandibular and cervical dystonias. Neuroimaging demonstrated bilateral damage localized to the globus pallidus. Years later, she presented to the emergency department in intermittent respiratory distress associated with facial and cervical muscle spasms.Results and conclusions:Increasing frequency and severity of the disorder was noted over years. The acute onset of respiratory involvement required intubation and eventual tracheotomy. A partial therapeutic benefit of tetrabenazine was demonstrated.
Meige Syndrome Secondary to Basal Ganglia Injury: A Potential Cause of Acute Respiratory Distress
Authors: Kirton C. Adam , Riopelle Richard J. 
Published: March 2017

ABSTRACT:Background:Meige syndrome is a movement disorder that includes blepharospasm and oromandibular dystonias. Its etiology may be idiopathic (primary) or it may arise secondary to focal brain injury. Acute respiratory distress as a feature of such dystonias occurs infrequently. A review of the literature on Meige syndrome and the relationship between dystonias and respiratory compromise is presented.Methods:A 60-year-old woman suffered a cerebral anoxic event secondary to manual strangulation. She developed progressive blepharospasm combined with oromandibular and cervical dystonias. Neuroimaging demonstrated bilateral damage localized to the globus pallidus. Years later, she presented to the emergency department in intermittent respiratory distress associated with facial and cervical muscle spasms.Results:Increasing frequency and severity of the disorder was noted over years. The acute onset of respiratory involvement required intubation and eventual tracheotomy. A partial therapeutic benefit of tetrabenazine was demonstrated.Conclusions:This case highlights two interesting aspects of Meige's syndrome: (1) Focal bilateral basal ganglia lesions appear to be responsible for this patient's movement disorder which is consistent with relative overactivity of the direct pathway from striatum to globus pallidus internal and substantia nigra pars reticularis; (2) Respiratory involvement in a primarily craniofacial dystonia to the point of acute airway compromise.
The impact of poor asthma control among asthma patients treated with inhaled corticosteroids plus long-acting β2-agonists in the United Kingdom: a cross-sectional analysis
Authors: Pavord Ian D. , Mathieson Nicola , Scowcroft Anna , Pedersini Riccardo , Isherwood Gina , Price David 
Published: March 2017

AbstractThere are several new treatment options for patients whose asthma remains uncontrolled on free-dose and fixed-dose combinations of inhaled corticosteroids plus long-acting β2-agonists (ICS+LABA). In order to evaluate the likely impact of these treatments, we assessed the effect of uncontrolled asthma on healthcare and patient burden within the UK among adult patients treated with ICS+LABA. Data obtained from 2010–2011 UK National Health and Wellness Surveys identified 701 patients treated with ICS+LABA. Patients with not well-controlled asthma (Asthma Control Test™ score <20) were compared with well-controlled asthma (score ≥ 20) patients on multiple measures. Cost burden was calculated using healthcare resource utilisation models and work productivity and impairment questionnaire. Overall, 452 and 249 patients reported not well-controlled and well-controlled asthma, respectively. A greater proportion of not well-controlled patients visited the accident & emergency department (21 vs. 14%, P = 0.016), were hospitalised (13 vs. 8%, P = 0.022) and had lower mental and physical health-related quality of life (P < 0.001) and impaired work productivity and activity scores: presenteeism (23 vs. 11%, P < 0.001), work impairment (29 vs. 17%, P < 0.001) and activity impairment (46 vs. 24%, P < 0.001). Calculated direct and indirect yearly costs/person doubled among not well-controlled compared to well-controlled asthma patients (£6592 vs. £3220). Total cost to society was estimated at £6172 million/year (direct costs, £1307 million; indirect costs, £4865 million). In conclusion, not well-controlled asthma is common among UK adults treated with ICS+LABA, resulting in impairments across a number of important health outcomes and represents a significant unmet need and resource burden.
Raising awareness of bronchiectasis in primary care: overview of diagnosis and management strategies in adults
Authors: Chalmers James D. , Sethi Sanjay 
Published: March 2017

AbstractBronchiectasis is a chronic lung disease characterised by recurrent infection, inflammation, persistent cough and sputum production. The disease is increasing in prevalence, requiring a greater awareness of the disease across primary and secondary care. Mild and moderate cases of bronchiectasis in adults can often be managed by primary care clinicians. Initial assessments and long-term treatment plans that include both pharmacological and non-pharmacological treatments, however, should be undertaken in collaboration with a secondary care team that includes physiotherapists and specialists in respiratory medicine. Bronchiectasis is often identified in patients with other lung diseases, such as chronic obstructive pulmonary disease, asthma, and in a lesser but not insignificant number of patients with other inflammatory diseases, such as rheumatoid arthritis and inflammatory bowel disease. Overall goals of therapy are to prevent exacerbations, improve symptoms, improve quality of life and preserve lung function. Prompt treatment of exacerbations with antibiotic therapy is important to limit the impact of exacerbations on quality of life and lung function decline. Patient education and cooperation with health-care providers to implement treatment plans are key to successful disease management. It is important for the primary care provider to work with secondary care providers to develop an individualised treatment plan to optimise care with the goal to delay disease progression. Here, we review the diagnosis and treatment of bronchiectasis with a focus on practical considerations that will be useful to primary care.
Environmental filtering structures tree functional traits combination and lineages across space in tropical tree assemblages
Authors: Asefa Mengesha , Cao Min , Zhang Guocheng , Ci Xiuqin , Li Jie , Yang Jie 
Published: March 2017

AbstractEnvironmental filtering consistently shapes the functional and phylogenetic structure of species across space within diverse forests. However, poor descriptions of community functional and lineage distributions across space hamper the accurate understanding of coexistence mechanisms. We combined environmental variables and geographic space to explore how traits and lineages are filtered by environmental factors using extended RLQ and fourth-corner analyses across different spatial scales. The dispersion patterns of traits and lineages were also examined in a 20-ha tropical rainforest dynamics plot in southwest China. We found that environmental filtering was detected across all spatial scales except the largest scale (100 × 100 m). Generally, the associations between functional traits and environmental variables were more or less consistent across spatial scales. Species with high resource acquisition-related traits were associated with the resource-rich part of the plot across the different spatial scales, whereas resource-conserving functional traits were distributed in limited-resource environments. Furthermore, we found phylogenetic and functional clustering at all spatial scales. Similar functional strategies were also detected among distantly related species, suggesting that phylogenetic distance is not necessarily a proxy for functional distance. In summary, environmental filtering considerably structured the trait and lineage assemblages in this species-rich tropical rainforest.
Different definitions of esophagus influence esophageal toxicity prediction for esophageal cancer patients administered simultaneous integrated boost versus standard-dose radiation therapy
Authors: Huang Bao-tian , Huang Rui-hong , Zhang Wu-zhe , Lin Wen , Guo Long-jia , Xu Liang-yu , Lin Pei-xian , Chen Jian-zhou , Li De-rui , Chen Chuang-zhen 
Published: March 2017

AbstractWe aim to evaluate whether different definitions of esophagus (DEs) impact on the esophageal toxicity prediction for esophageal cancer (EC) patients administered intensity-modulated radiation therapy with simultaneous integrated boost (SIB-IMRT) vs. standard-dose IMRT (SD-IMRT). The esophagus for 21 patients diagnosed with primary EC were defined in the following four ways: the whole esophagus, including the tumor (ESOwhole); ESOwhole within the treatment field (ESOinfield); ESOinfield, excluding the tumor (ESOinfield-tumor) and ESOwhole, excluding the tumor (ESOwhole-tumor). The difference in the dose variation, acute esophageal toxicity (AET) and late esophageal toxicity (LET) of four DEs were compared. We found that the mean esophageal dose for ESOwhole, ESOinfield, ESOinfield-tumor and ESOwhole-tumor were increased by 7.2 Gy, 10.9 Gy, 4.6 Gy and 2.0 Gy, respectively, in the SIB-IMRT plans. Radiobiological models indicated that a grade ≥ 2 AET was 2.9%, 3.1%, 2.2% and 1.6% higher on average with the Kwint model and 14.6%, 13.2%, 7.2% and 3.4% higher with the Wijsman model for the four DEs. A grade ≥ 3 AET increased by 4.3%, 7.2%, 4.2% and 1.2%, respectively. Additionally, the predicted LET increased by 0.15%, 0.39%, 1.2 × 10−2% and 1.5 × 10−3%. Our study demonstrates that different DEs influence the esophageal toxicity prediction for EC patients administered SIB-IMRT vs. SD-IMRT treatment.