bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surgical treatment of mucoepidermoid carcinoma of the lung: 20 years’ experience
Authors: Yamamoto Takayoshi , Nakajima Takahiro , Suzuki Hidemi , Tagawa Tetsuzo , Iwata Takekazu , Mizobuchi Teruaki , Yoshida Shigetoshi , Nakatani Yukio , Yoshino Ichiro 
Published: February 2016

Background Pulmonary mucoepidermoid carcinoma is a rare salivary gland-type neoplasm. We aimed to elucidate the optimal management of this rare condition by reviewing the treatment outcomes of patients at our institution with mucoepidermoid carcinoma of the lung. Methods We performed a retrospective review of all patients with pulmonary mucoepidermoid carcinoma who underwent surgical treatment between January 1993 and December 2012. We reviewed the patients’ clinical characteristics and the therapeutic interventions undertaken. Results Nine patients were evaluated in this study, 7 of whom were female. The median age of all patients was 54 years (range 10–72 years). Six patients had tumors of a low histologic grade, and the other 3 had high-grade malignancies. Prior to surgery, 2 patients required endobronchial intervention for obstructive pneumonia. Eight patients underwent lobectomy, and one had a bilobectomy. Two patients required bronchoplasty, and one required resection of the left atrium for complete resection of the primary neoplasm. Two patients with advanced disease and high-grade tumors died due to cancer progression. The overall 5-year survival rate was 72.9%. One patient with a high-grade malignancy demonstrated exon 21 mutation of the epidermal growth factor receptor gene. Conclusions Complete surgical resection is important for long-term survival in patients with pulmonary mucoepidermoid carcinoma. The techniques of bronchoplasty and extended resection may contribute to better surgical management of this disease. Endobronchial interventions may be considered for the management of obstructive pneumonia prior to surgery.
Progress and divergence in palliative care education for medical students: A comparative survey of UK course structure, content, delivery, contact with patients and assessment of learning
Authors: Walker Steven , Gibbins Jane , Barclay Stephen , Adams Astrid , Paes Paul , Chandratilake Madawa , Gishen Faye , Lodge Philip , Wee Bee 
Published: February 2016

Background: Effective undergraduate education is required to enable newly qualified doctors to safely care for patients with palliative care and end-of-life needs. The status of palliative care teaching for UK medical students is unknown. Aim: To investigate palliative care training at UK medical schools and compare with data collected in 2000. Design: An anonymised, web-based multifactorial questionnaire. Settings/participants: Results were obtained from palliative care course organisers at all 30 medical schools in 2013 and compared with 23 medical schools (24 programmes) in 2000. Results: All continue to deliver mandatory teaching on ‘last days of life, death and bereavement’. Time devoted to palliative care teaching time varied (2000: 6–100 h, mean 20 h; 2013: 7–98 h, mean 36 h, median 25 h). Current palliative care teaching is more integrated. There was little change in core topics and teaching methods. New features include ‘involvement in clinical areas’, participation of patient and carers and attendance at multidisciplinary team meetings. Hospice visits are offered (22/24 (92%) vs 27/30 (90%)) although they do not always involve patient contact. There has been an increase in students’ assessments (2000: 6/24, 25% vs 2013: 25/30, 83%) using a mixture of formative and summative methods. Some course organisers lack an overview of what is delivered locally. Conclusion: Undergraduate palliative care training continues to evolve with greater integration, increased teaching, new delivery methods and wider assessment. There is a trend towards increased patient contact and clinical involvement. A minority of medical schools offer limited teaching and patient contact which could impact on the delivery of safe palliative care by newly qualified doctors.
Patient and caregiver perspectives on managing pain in advanced cancer: A qualitative longitudinal study
Authors: Hackett Julia , Godfrey Mary , Bennett Michael I 
Published: February 2016

Background: Despite advances in treatment of pain in advanced cancer, it remains a major source of suffering with adverse effects on patients’ life quality. There is increasing understanding of its multi-dimensional nature and the variable responsiveness of medication to complex pain. Less clear is how patients and their caregivers respond to and manage pain complexity. Aim: To explore patients’ and carers’ experiences of advanced cancer pain and the processes that they engage in to manage pain. Design: Qualitative study employing face-to-face interviews at two time points and audio diaries. Data were analysed using grounded theory strategies. Setting/participants: Purposive sample of 21 advanced cancer patients and 16 carers from oncology outpatients in a tertiary cancer centre and a hospice. Results: Three distinct patterns of pain were discerned in patients’ accounts, distinguishable in terms of complexity, severity, transiency and degree of perceived control over pain. Pain was dynamic reflecting changes in the disease process, access to and effectiveness of pain relief. For patients and carers, neither pain relief nor expertise in pain management is secured once and for all. The main drivers of help-seeking and action by patients to manage pain were the sensory experiences of pain and meaning attached to it, not beliefs about analgesia. Conclusion: The complex and dynamic nature of pain and how it was understood shaped help-seeking and pain management. Variable effectiveness of pain relief for different pain types were challenging for patients and professionals in achieving relief.
Graft Utilization in the Augmentation of Large-to-Massive Rotator Cuff Repairs
Authors: Ferguson Devin P. , Lewington Matthew R. , Smith T. Duncan , Wong Ivan H. 
Published: February 2016

Background: Current treatment options for symptomatic large-to-massive rotator cuff tears can reduce pain, but failure rates remain high. Surgeons have incorporated synthetic and biologic grafts to augment these repairs, with promising results. Multiple reviews exist that summarize these products; however, no systematic review has investigated the grafts’ ability to maintain structural integrity after augmentation of large-to-massive rotator cuff repairs. Purpose: To systematically review and evaluate the effectiveness of grafts in the augmentation of large-to-massive rotator cuff repairs. Study Design: Systematic review. Methods: A comprehensive search of 4 reputable databases was completed. Inclusion criteria were (1) large-to-massive rotator cuff tear, (2) graft augmentation of primary repairs ± primary repair control group, and (3) minimum clinical and radiologic follow-up of 12 months. Two reviewers screened the titles, abstracts, and full articles and extracted the data from eligible studies. Results were summarized into evidence tables stratified by graft origin and level of evidence. Results: Ten studies fit the inclusion criteria. Allograft augmentation was functionally and structurally superior to primary repair controls, with intact repairs in 85% versus 40% of patients ( P < .01). This was supported by observational study data. Xenograft augmentation failed to demonstrate superiority to primary repair controls, with worse structural healing rates (27% vs 60%; P =.11). Both comparative studies supported this finding. There have also been many reports of inflammatory reactions with xenograft use. Polypropylene patches are associated with improved structural (83% vs 59% and 49%; P < .01) and functional outcomes when compared with controls and xenograft augmentation; however, randomized data are lacking. Conclusion: Augmentation of large-to-massive rotator cuff repairs with human dermal allografts is associated with superior functional and structural outcome when compared with conventional primary repair. Xenograft augmentation failed to demonstrate a statistically significant difference and may be associated with worse rerupture rates and occasional severe inflammatory reactions. Polypropylene patches have initial promising results. Research in this field is limited; future researchers should continue to develop prospective, randomized controlled trials to establish clear recommendations.
Formation mechanism and biological activity of novel thiolated human-like collagen iron complex
Authors: Zhu Chenhui , Liu Lingyun , Deng Jianjun , Ma Xiaoxuan , Hui Junfeng , Fan Daidi 
Published: February 2016

To develop an iron supplement that is effectively absorbed and utilized, thiolated human-like collagen was created to improve the iron binding capacity of human-like collagen. A thiolated human-like collagen-iron complex was prepared in a phosphate buffer, and one mole of thiolated human-like collagen-iron possessed approximately 28.83 moles of iron. The characteristics of thiolated human-like collagen-iron were investigated by ultraviolet–visible absorption spectroscopy, Fourier transform infrared spectroscopy, circular dichroism, and differential scanning calorimetry. The results showed that the thiolated human-like collagen-iron complex retained the secondary structure of human-like collagen and had greater thermodynamic stability than human-like collagen, although interactions between iron ions and human-like collagen occurred during the formation of the complex. In addition, to evaluate the bioavailability of thiolated human-like collagen-iron, an in vitro Caco-2 cell model and an in vivo iron deficiency anemia mouse model were employed. The data demonstrated that the thiolated human-like collagen-iron complex exhibited greater bioavailability and was more easily utilized than FeSO4, ferric ammonium citrate, or ferrous glycinate. These results indicated that the thiolated human-like collagen-iron complex is a potential iron supplement in the biomedical field.
Chemotherapy-Induced Fatigue Correlates With Higher Fatigue Scores Before Treatment
Authors: Araújo José Klerton Luz , Giglio Adriana del , Munhoz Bruna Antenusse , Fonseca Fernando Luiz Affonso , Cruz Felipe Melo , Giglio Auro del 
Published: February 2016

Purpose: Cancer chemotherapy can induce fatigue in about 20% to 30% of patients. So far, there is very little information as to the predictors of chemotherapy-induced fatigue (CIF). We evaluated potential predictors of CIF in a sample of patients with cancer with several types of solid tumors scheduled to receive chemotherapy according to institutional protocols. Methods: Before their first and second chemotherapy cycles, patients answered to the Brief Fatigue Inventory (BFI), Chalder, Mini Nutritional Assessment (MNA), Stress thermometer, and HADS questionnaires as well as provided blood samples for inflammatory markers. Results: We evaluated 52 patients, 37 (71%) were female and mean age was 53 years. The most common tumors were breast cancer 21 (40%) and gastrointestinal tumors 12 (23%). Although 14 (25.2%) patients had an increase in their fatigue BFI scores equal or above 3 points from baseline, we observed no significant overall differences between BFI scores before and after chemotherapy. The only 2 factors associated with an increase of 3 points in the BFI scores after chemotherapy were race and higher baseline BFI levels. By multivariate analysis, overall BFI and Chalder scores after chemotherapy also correlated significantly with their respective baseline scores before treatment. HADS scores before treatment correlated with overall BFI scores postchemotherapy, whereas MNA scores before chemotherapy and female sex correlated with higher Chalder scores after treatment. Conclusion: We conclude that fatigue induced by chemotherapy is common and consistently associated with higher fatigue scores before treatment. Screening for fatigue before chemotherapy may help to identify patients who are prone to develop CIF.
Use of Apremilast in Combination With Other Therapies for Treatment of Chronic Plaque Psoriasis
Authors: AbuHilal Mohn’d , Walsh Scott , Shear Neil 
Published: February 2016

Background: Apremilast is an oral phosphodiesterase 4 inhibitor that has been approved as monotherapy for the treatment of moderate to severe chronic plaque psoriasis. No data exist on the safety or efficacy of apremilast as a component of combination therapy with either phototherapy or conventional systemic or biological therapies. Objective: To evaluate the short term-efficacy and safety of apremilast in combination with at least one form of photo-, systemic, or biologic therapy in the treatment of chronic plaque psoriasis. Methods: A retrospective chart review was conducted for patients who received apremilast in addition to systemic, biologic, or phototherapy. The primary outcome was the proportion of patients achieving at least 75% improvement in Psoriasis Area and Severity Index score (PASI-75). Results: A total of 81 patients with plaque psoriasis were treated with apremilast in combination with at least 1 other therapy (NB-UVB, methotrexate, acitretin, cyclosporin, etanercept, adalimumab, infliximab, or ustekinumab). Fourteen patients (17%) discontinued treatment before completion of 12 weeks of apremilast therapy. Sixty-seven patients continued on drug past 12 weeks. Of these patients, 81% achieved PASI-75 at week 12 after apremilast was added to an existing therapy. Nausea and/or diarrhea were reported in 25% of these patients, and weight loss was observed in 15%. Conclusion: Apremilast can be safely and effectively combined with phototherapy, systemic, and/or biological agents in patients with plaque psoriasis not responding adequately to these agents alone. Gastrointestinal side effects were manageable in the majority of patients.
Radiation-Induced Breast Angiosarcoma
Authors: Peterson Cheryl Brus , Beauregard Solange 
Published: February 2016

Importance: Radiation-induced angiosarcoma after conservative treatment of breast cancer affects a small percentage of patients but has a significant impact on survival. Early detection requires a high index of suspicion and is important for optimal management of this aggressive disease. Observations: The patient reported here presented with radiation-induced angiosarcoma of the left breast 14 years after radiation therapy. Histopathology was positive for anti-CD31, anti-CD34, D2-40, and anti–factor VIII (von Willebrand). She underwent a total mastectomy and is still in remission 20 months later. The authors present a review of the clinical presentation, diagnostic methods, and treatment options. Conclusions: This case report demonstrates the importance of long-term follow-up and investigation of even the subtlest cutaneous changes in the breast after radiation treatment, because radiation-induced angiosarcoma is a very aggressive disease that could benefit from early diagnosis and management.
Hyperconnectivity of the dorsolateral prefrontal cortex following mental effort in multiple sclerosis patients with cognitive fatigue
Authors: Pravatà Emanuele , Zecca Chiara , Sestieri Carlo , Caulo Massimo , Riccitelli Gianna Carla , Rocca Maria Assunta , Filippi Massimo , Cianfoni Alessandro , Gobbi Claudio 
Published: February 2016

Objective: To investigate the dynamic temporal changes of brain resting-state functional connectivity (RS-FC) following mental effort in multiple sclerosis (MS) patients with cognitive fatigue (CF). Methods: Twenty-two MS patients, 11 with (F) and 11 without CF, and 12 healthy controls were included. Separate RS-FC scans were acquired on a 3T MR scanner immediately before ( t0), immediately after ( t1) and 30 minutes after ( t2) execution of the paced auditory serial addition test (PASAT), a cognitively demanding task. Subjectively perceived CF after PASAT execution was also assessed. RS-FC changes were investigated by using a data-driven approach (the Intrinsic Connectivity Contrast-power), complemented by a priori defined regions of interest analyses. Results: The F-group patients experienced stronger RS-FC at t2 between the left superior frontal gyrus (L-SFG) and occipital, frontal and temporal areas, which increased over time after PASAT execution. In the F-group patients, the L-SFG was hyperconnected at t1 with the left caudate nucleus and hypoconnected at t2 with the left anterior thalamus. These variations were correlated with both subjectively perceived and clinically assessed CF, and—for the left thalamus—with PASAT performance. Conclusion: The development of cortico–cortical and cortico–subcortical hyperconnectivity following mental effort is related to CF symptoms in MS patients.
Treatment of complex aortic aneurysms with fenestrated endografts and chimney stent repair: Systematic review and meta-analysis
Authors: Yaoguo Yang , Zhong Chen , Lei Kou , Yaowen Xiao 
Published: February 2016

Objective We reviewed data pertaining to fenestrated endograft technique and chimney stent repair of complex aortic aneurysm for comparative analysis of the outcomes. Methods A comprehensive search of relevant databases was conducted to identify articles in English, related to the treatment of complex aortic aneurysm with fenestrated endovascular aneurysm repair and chimney stent repair, published until January 2015. Results A total of 42 relevant studies and 2264 patients with aortic aneurysm undergoing fenestrated endovascular aneurysm repair and chimney stent repair were included in our review. A total of 4413 vessels were involved in these processes. The cumulative 30-day mortality was 2.4% and 3.2% ( p = 0.459). The follow-up aneurysm-related mortality was 1.4% and 3.2% ( p = 0.018), and target organ dysfunction was 5.0% and 4.0% in fenestrated endovascular aneurysm repair and chimney stent repair, respectively ( p = 0.27). A total of 156 vessels showed restenosis or occlusion after primary intervention (3.6% and 3.4% in fenestrated endovascular aneurysm repair and chimney stent repair, respectively, p = 0.792). The cumulative type I endoleak was 2.0% (38/1884) after fenestrated endovascular aneurysm repair compared with 3.4% (13/380) after chimney stent repair ( p = 0.092), and the type II endoleak was 5.4% (102/1884) and 5.3% (20/380), respectively ( p = 0.905). Approximately, 1.1% and 1.6% increase in aneurysm was observed following fenestrated endovascular aneurysm repair and chimney stent repair, respectively ( p = 0.437). The re-intervention frequency was 205 and 19 cases after fenestrated endovascular aneurysm repair and chimney stent repair, respectively (11.7%, 5.6%, p = 0.001). Conclusions Fenestrated endovascular aneurysm repair and chimney stent repair are safe and effective in treating patients with complex aortic aneurysm. A higher aneurysm-related mortality was observed in chimney stent repair while fenestrated endovascular aneurysm repair was associated with a higher re-intervention rate.
Feasibility of an Orthogonal Redundant Sensor incorporating Optical plus Redundant Electrochemical Glucose Sensing
Authors: McAuley Sybil A. , Dang Tri T. , Horsburgh Jodie C. , Bansal Anubhuti , Ward Glenn M. , Aroyan Sarkis , Jenkins Alicia J. , MacIsaac Richard J. , Shah Rajiv V. , O’Neal David N. 
Published: February 2016

Background: Orthogonal redundancy for glucose sensing (multiple sensing elements utilizing distinct methodologies) may enhance performance compared to nonredundant sensors, and to sensors with multiple elements utilizing the same technology (simple redundancy). We compared the performance of a prototype orthogonal redundant sensor (ORS) combining optical fluorescence and redundant electrochemical sensing via a single insertion platform to an electrochemical simple redundant sensor (SRS). Methods: Twenty-one adults with type 1 diabetes wore an ORS and an SRS concurrently for 7 days. Following sensor insertion, and on Day 4 with a standardized meal, frequent venous samples were collected for reference glucose measurement (laboratory [YSI] and meter) over 3 and 4 hours, respectively. Between study visits reference capillary blood glucose testing was undertaken. Sensor data were processed prospectively. Results: ORS mean absolute relative difference (MARD) was (mean ± SD) 10.5 ± 13.2% versus SRS 11.0 ± 10.4% ( P = .34). ORS values in Clarke error grid zones A and A+B were 88.1% and 97.6%, respectively, versus SRS 86.4% and 97.8%, respectively ( P = .23 and P = .84). ORS Day 1 MARD (10.7 ± 10.7%) was superior to SRS (16.5 ± 13.4%; P < .0001), and comparable to ORS MARD for the week. ORS sensor survival (time-averaged mean) was 92.1% versus SRS 74.4% ( P = .10). ORS display time (96.0 ± 5.8%) was equivalent to SRS (95.6 ± 8.9%; P = .87). Conclusions: Combining simple and orthogonal sensor redundancy via a single insertion is feasible, with accuracy comparing favorably to current generation nonredundant sensors. Addition of an optical component potentially improves sensor reliability compared to electrochemical sensing alone. Further improvement in optical sensing performance is required prior to clinical application.
Müller-Weiss Syndrome
Authors: Welck Matthew J. , Kaplan Jonathan , Myerson Mark S. 
Published: February 2016

Müller-Weiss disease (MWD) is a rare condition that results in dorsolateral collapse of the navicular associated with rotation of the talar head and subtalar varus deformity. There are also varying degrees of midfoot collapse and associated loss of the medial arch in more advanced cases. The characteristic deformities and classification have been described on weightbearing radiographs. While early stage disease can be detected on magnetic resonance imaging and bone scan, there are considerable advantages to computed tomography (CT) scanning, in particular, weightbearing CT for further evaluation of this condition. We describe the imaging findings of this condition, and present 3 cases where weightbearing CT was used in the context of MWD. This is the first time the use of weightbearing CT scan has been reported for diagnosis and treatment of this condition. Levels of Evidence: Diagnostic, Level IV: Case series
The polymorphisms in angiotensin-converting enzyme and angiotensin-converting enzyme 2 are not associated with thoracic aortic diseases and coronary heart disease
Authors: Li Yang , Zhang Er Yong , Wu Zhong 
Published: February 2016

Introduction: The polymorphisms of the angiotensin-converting enzyme (ACE) and angiotensin-converting enzyme 2 (ACE2) genes have been demonstrated to be involved in some cardiovascular diseases. We hypothesised that the polymorphisms of ACE and ACE2 relate to the formation of thoracic aortic diseases and coronary heart disease. Methods: A total of 86 patients (four groups: thoracic aortic dissection; thoracic aortic aneurysm; coronary heart disease; and control group) were recruited. The ACE I/D polymorphism and the ACE2 (A8790G) polymorphism were measured in all patient samples. Results: There were no significant differences in groups with regard to either the ACE I/D polymorphism or the ACE2 (A8790G) polymorphism. Conclusion: The polymorphisms of the ACE and ACE2 genes are not associated with thoracic aortic dissection, thoracic aortic aneurysm and coronary heart disease.