bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Role of Infant Pain Behaviour in Predicting Parent Pain Ratings
Authors: Riddell Rebecca Pillai , Flora David B , Stevens Sara , Greenberg Saul , Garfield Hartley 
Published: March 2016

BACKGROUND: Research investigating how observers empathize or form estimations of an individual experiencing pain suggests that both characteristics of the observer (‘top down’) and characteristics of the individual in pain (‘bottom up’) are influential. However, experts have opined that infant behaviour should serve as a crucial determinant of infant pain judgment due to their inability to self‐report.OBJECTIVE: To predict parents’ immunization pain ratings using archival data. It was hypothesized that infant behaviour (‘bottom up’) and parental emotional availability (‘top down’) would directly predict the most variance in parent pain ratings.METHODS: Healthy infants were naturalistically observed during their two‐, four‐, six‐ and/or 12‐month immunization appointments. Cross‐sectional latent growth curve models in a structural equation model context were conducted at each age (n=469 to n=579) to examine direct and indirect predictors of parental ratings of their infant’s pain.RESULTS: At each age, each model suggested that moderate amounts of variance in parent pain report were accounted for by models that included infant pain behaviours (R2=0.18 to 0.36). Moreover, notable differences were found for older versus younger infants with regard to parental emotional availability, infant sex, caregiver age and amount of variance explained by infant variables.CONCLUSIONS: The results of the present study suggest that parent pain ratings are not predominantly predicted by infant behaviours, especially before four months of age. Current results suggest that recognizing infant pain behaviours during painful events may be an important area of parent education, especially for parents of very young infants. Further work is needed to determine other factors that predict parent judgments of infant pain.
Community‐Associated Methicillin‐Resistant Staphylococcus aureus Necrotizing Pneumonia without Evidence of Antecedent Viral Upper Respiratory Infection
Authors: Toro Cristina Moran , Janvier Jack , Zhang Kunyan , Fonseca Kevin , Gregson Dan , Church Deirdre , Laupland Kevin , Rabin Harvey , Elsayed Sameer , Conly John 
Published: March 2016

BACKGROUND: USA300 community‐associated (CA) methicillin‐resistant Staphylococcus aureus (MRSA) strains causing necrotizing pneumonia have been reported in association with antecedent viral upper respiratory tract infections (URI).METHODS: A case series of necrotizing pneumonia presenting as a primary or coprimary infection, secondary to CA‐MRSA without evidence of antecedent viral URI, is presented. Cases were identified through the infectious diseases consultation service records. Clinical and radiographic data were collected by chart review and electronic records. MRSA strains were isolated from sputum, bronchoalveolar lavage, pleural fluid or blood cultures and confirmed using standard laboratory procedures. MRSA strains were characterized by susceptibility testing, pulsed‐field gel electrophoresis, spa typing, agr typing and multilocus sequence typing. Testing for respiratory viruses was performed by appropriate serological testing of banked sera, or nucleic acid testing of nasopharyngeal or bronchoalveloar lavage specimens.RESULTS: Ten patients who presented or copresented with CA necrotizing pneumonia secondary to CA‐MRSA from April 2004 to October 2011 were identified. The median length of stay was 22.5 days. Mortality was 20.0%. Classical risk factors for CA‐MRSA were identified in seven of 10 (70.0%) cases. Chest tube placement occurred in seven of 10 patients with empyema. None of the patients had historical evidence of antecedent URI. In eight of 10 patients, serological or nucleic acid testing testing revealed no evidence of acute viral coinfection. Eight strains were CMRSA‐10 (USA300). The remaining two strains were a USA300 genetically related strain and a USA1100 strain.CONCLUSION: Pneumonia secondary to CA‐MRSA can occur in the absence of an antecedent URI. Infections due to CA‐MRSA are associated with significant morbidity and mortality. Clinicians need to have an awareness of this clinical entity, particularly in patients who are in risk groups that predispose to exposure to this bacterium.
Pain Assessment Using The Adolescent Pediatric Pain Tool: A Systematic Review
Authors: Fernandes Ananda Maria , De Campos Catarina , Batalha Luis , Perdigão Ana , Jacob Eufemia 
Published: March 2016

BACKGROUND: The Adolescent Pediatric Pain Tool (APPT) is a multidimensional pain assessment tool designed to assess pain location (body outline diagram), intensity (word graphic rating scale) and quality (list of pain descriptors) in hospitalized children eight to 17 years of age.OBJECTIVES: To identify the age range, health conditions, settings and purpose for which APPT has been used; the components of the APPT that have been used; and the reported clinical and research utility of the APPT.METHODS: A systematic review of published studies using the APPT was performed. Studies were identified through electronic searches in CINAHL, Medline, PubMed, SciELO and PsycInfo.RESULTS: Twenty‐three studies were analyzed. APPT has been used in patients between two and 68 years of age, with various acute and chronic conditions, in and out of hospital. All but six studies used the three components of the APPT. Most of the studies used the total number of sites marked, mean pain intensity and mean number of pain descriptors selected as main outcome measures; however, scoring methods varied. Studies report that the use of the APPT is relevant for clinical practice and for research.CONCLUSION: Obtaining self‐report of pain using the APPT may help clinicians to tailor pain management interventions. It may also be used in studies to provide a deeper understanding of the pain experience and to examine the effectiveness of pain management interventions. However, outcome measures and methods of scoring the different components of the APPT need to be clearly identified.
Reference Values for Maximal Inspiratory Pressure: A Systematic Review
Authors: Pessoa Isabela MB Sclauser , Parreira Verônica Franco , Fregonezi Guilherme AF , Sheel A William , Chung Frank , Reid W Darlene 
Published: March 2016

BACKGROUND: Maximal inspiratory pressure (MIP) is the most commonly used measure to evaluate inspiratory muscle strength. Normative values for MIP vary significantly among studies, which may reflect differences in participant demographics and technique of MIP measurement.OBJECTIVE: To perform a systematic review with meta‐analyses to synthesize MIP values that represent healthy adults.METHODS: A systematic literature search was conducted using Medline, EMBASE, Cochrane, Cumulative Index to Nursing and Allied Health (CINAHL) and Sport Discus databases. Two reviewers identified and selected articles, and abstracted data. Methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool. A random‐effects model was used to calculate overall means and 95% CIs.RESULTS: Of 22 included articles, MIP data were synthesized according to age group and sex from six reports (n=840) in the meta‐analyses. The mean QUADAS score was 3.5 of 7. The age range was between 18 and 83 years (426 men, 414 women). MIP began to decrease with age in the 40 to 60 years age range and continued to fall progressively with age. For the same age group, men tended to have higher MIPs than women. Sensitivity analysis of withdrawing studies from the meta‐analysis identified one study that contributed more to heterogeneity in some age groups.DISCUSSION: MIP was higher in men and decreased with age, which was initially apparent in middle age. Several characteristics of participants and MIP technique influence values in healthy individuals.CONCLUSIONS: The present meta‐analysis provides normative MIP values that are reflective of a large sample (n=840) and likely represents the broadest representation of participant characteristics compared with previous reports of normative data.
Diagnosis and Management of Asthma in Preschoolers: A Canadian Thoracic Society and Canadian Paediatric Society Position Paper
Authors: Ducharme Francine M , Dell Sharon D , Radhakrishnan Dhenuka , Grad Roland M , Watson Wade TA , Yang Connie L , Zelman Mitchell 
Published: March 2016

Asthma often starts before six years of age. However, there remains uncertainty as to when and how a preschool-age child with symptoms suggestive of asthma can be diagnosed with this condition. This delays treatment and contributes to both short- and long-term morbidity. Members of the Canadian Thoracic Society Asthma Clinical Assembly partnered with the Canadian Paediatric Society to develop a joint working group with the mandate to develop a position paper on the diagnosis and management of asthma in preschoolers.In the absence of lung function tests, the diagnosis of asthma should be considered in children one to five years of age with frequent (≥8 days/month) asthma-like symptoms or recurrent (≥2) exacerbations (episodes with asthma-like signs). The diagnosis requires the objective document of signs or convincing parent-reported symptoms of airflow obstruction (improvement in these signs or symptoms with asthma therapy), and no clinical suspicion of an alternative diagnosis. The characteristic feature of airflow obstruction is wheezing, commonly accompanied by difficulty breathing and cough. Reversibility with asthma medications is defined as direct observation of improvement with short-acting ß2-agonists (SABA) (with or without oral corticosteroids) by a trained health care practitioner during an acute exacerbation (preferred method). However, in children with no wheezing (or other signs of airflow obstruction) on presentation, reversibility may be determined by convincing parental report of a symptomatic response to a three-month therapeutic trial of a medium dose of inhaled corticosteroids with as-needed SABA (alternative method), or as-needed SABA alone (weaker alternative method). The authors provide key messages regarding in whom to consider the diagnosis, terms to be abandoned, when to refer to an asthma specialist and the initial management strategy. Finally, dissemination plans and priority areas for research are identified.
Psychological Distress and Stressful Life Events in Pediatric Complex Regional Pain Syndrome
Authors: Wager Julia , Brehmer Hannah , Hirschfeld Gerrit , Zernikow Boris 
Published: March 2016

BACKGROUND: There is little knowledge regarding the association between psychological factors and complex regional pain syndrome (CRPS) in children. Specifically, it is not known which factors precipitate CRPS and which result from the ongoing painful disease.OBJECTIVES: To examine symptoms of depression and anxiety as well as the experience of stressful life events in children with CRPS compared with children with chronic primary headaches and functional abdominal pain.METHODS: A retrospective chart study examined children with CRPS (n=37) who received intensive inpatient pain treatment between 2004 and 2010. They were compared with two control groups (chronic primary headaches and functional abdominal pain; each n=37), who also received intensive inpatient pain treatment. Control groups were matched with the CRPS group with regard to admission date, age and sex. Groups were compared on symptoms of depression and anxiety as well as stressful life events.RESULTS: Children with CRPS reported lower anxiety and depression scores compared with children with abdominal pain. A higher number of stressful life events before and after the onset of the pain condition was observed for children with CRPS.CONCLUSIONS: Children with CRPS are not particularly prone to symptoms of anxiety or depression. Importantly, children with CRPS experienced more stressful life events than children with chronic headaches or abdominal pain. Prospective long‐term studies are needed to further explore the potential role of stressful life events in the etiology of CRPS.
Serum Endocan as a Survival Predictor for Patients with Liver Cirrhosis
Authors: Toshikuni Nobuyuki , Ozaki Kazuaki , George Joseph , Tsutsumi Mikihiro 
Published: March 2016

BACKGROUND: The relationship between endocan expression and outcome in patients with chronic liver disease is not fully understood.OBJECTIVE: To examine whether serum endocan level is predictive of outcome in patients with liver cirrhosis.METHODS: A total of 68 patients with liver cirrhosis were enrolled. Outcome predictors were analyzed using the Cox proportional hazards model. The overall survival rates were calculated using the Kaplan-Meier method, and differences were evaluated using the log-rank test.RESULTS: During the median follow-up period (7.1 years), nine patients had hepatocellular carcinoma (HCC) and 10 patients died. Of the deceased patients, nine died due to hepatic decompensation or associated conditions. No significant factors were found to be predictive of the occurrence of HCC. In contrast, an elevated serum endocan level (≥2.0 ng/mL; HR 2.34 [95% CI 1.05 to 7.03]; P=0.037) and high Child-Pugh grade B/C (HR 2.65 [95% CI 1.30 to 6.89; P=0.006) were predictive of poor survival. Kaplan-Meier analysis revealed that the respective cumulative survival rates at five and 10 years were 97.1% and 87.4% in patients with serum endocan levels <2.0 ng/mL and 85.8% and 64.4% in patients with levels ≥2.0 ng/mL (P=0.009), respectively. Moreover, the cumulative survival rates were significantly different among the patient groups divided according to serum endocan level and Child-Pugh grade (P=0.002).CONCLUSION: These findings suggest that serum endocan level may be a survival predictor for patients with liver cirrhosis.
Pain Management Strategies and Lessons from the Military: A Narrative Review
Authors: Vallerand April Hazard , Cosler Patricia , Henningfield Jack E. , Galassini Pam 
Published: March 2016

BACKGROUND: Wounded soldiers often experience substantial pain, which must be addressed before returning to active duty or civilian life. The United States (US) military has instituted several guidelines and initiatives aimed at improving pain management by providing rapid access to medical care, and developing interdisciplinary multimodal pain management strategies based on outcomes observed both in combat and hospital settings.OBJECTIVE: To provide a narrative review regarding US military pain management guidelines and initiatives, which may guide improvements in pain management, particularly chronic pain management and prevention, for the general population.METHODS: A literature review of US military pain management guidelines and initiatives was conducted, with a particular focus on the potential of these guidelines to address shortcomings in chronic pain management in the general population.DISCUSSION: The application of US military pain management guidelines has been shown to improve pain monitoring, education and relief. In addition, the US military has instituted the development of programs and guidelines to ensure proper use and discourage aberrant behaviours with regard to opioid use, because opioids are regarded as a critical part of acute and chronic pain management schemes. Inadequate pain management, particularly inadequate chronic pain management, remains a major problem for the general population in the US. Application of military strategies for pain management to the general US population may lead to more effective pain management and improved long‐term patient outcomes.
Continuous Assessment of Labour Pain using Handgrip Force
Authors: Wickboldt Nadine , Savoldelli Georges , Rehberg-Klug Benno 
Published: March 2016

BACKGROUND: Assessment of dynamic changes in painful experiences, such as labour, using conventional rating scales (eg, numerical rating scale [NRS]) has limitations. An alternative for continuous pain evaluation could be a signal generated by voluntary action of the parturient. Remifentanil administration for obstetric analgesia could be improved by these dynamic measures of labour pain. In the present study, handgrip force was measured by a dynamometer to signal labour pain.OBJECTIVES: To evaluate: whether continuous monitoring of labour pain using handgrip force allows for determination of pain measurement during contractions; and the correlation between handgrip force and pain intensity on NRS.METHODS: The present observational, single‐centre study included 43 parturients. After calibration of the dynamometer for individual hand muscle strength, pain was recorded during early and late labour using a dynamometer and an NRS. The primary end point was the correlation coefficient between NRS ratings and peak intensity recorded by the dynamometer.RESULTS: All dynamometer‐registered readings were also registered by the external tocogram. All contractions recorded by external tocogram were also registered by the dynamometer. Handgrip force was moderately correlated with pain scores on the NRS. Mean handgrip force during contractions had the highest correlation coefficient (Pearson’s r=0.67) compared with peak handgrip force (r=0.56) and area under the curve of handgrip force (r=0.55).CONCLUSIONS: Pain intensity and duration can be assessed continuously using handgrip force measured via a dynamometer. The feedback of intensity and duration of pain could optimize patient‐controlled remifentantil application for obstetric analgesia and other situations of highly variable pain intensity.
Comparison of Four Different Pain Relief Methods during Hysterosalpingography: A Randomized Controlled Study
Authors: Unlu Bekir Serdar , Yilmazer Mehmet , Koken Gulengul , Arioz Dagistan Tolga , Unlu Ebru , Baki Elif Dogan , Kurttay Cemile , Karacin Osman 
Published: March 2016

BACKGROUND: Hysterosalpingography (HSG) is the most commonly used method for evaluating the anatomy and patency of the uterine cavity and fallopian tubes, and is an important tool in the evaluation of infertility. The most frequent side effect is the pain associated with the procedure.OBJECTIVES: To evaluate four analgesic methods to determine the most useful method for reducing discomfort associated with HSG.METHODS: In the present prospective study, 75 patients undergoing HSG for evaluation of infertility were randomly assigned to four groups: 550 mg of a nonsteroidal anti‐inflammatory drug (NSAID) (group 1); 550 mg NSAID + paracervical block (group 2); 550 mg NSAID + paracervical analgesic cream (group 3); or 550 mg NSAID + intrauterine analgesic instillation (group 4). A visual analogue scale was used to assess the pain perception at five predefined steps.RESULTS: Instillation of the liquids used for HSG was found to be the most painful step of HSG, and this step was where the only significant difference among groups was observed. When comparing visual analogue scale scores, group 2 and group 3 reported significantly less pain than the other groups. Group 1 reported significantly higher mean ( ± SD) scores (7.2 ± 1.6) compared with groups 2 and 3 (4.7 ± 2.5 and 3.8 ± 2.4, respectively) (P<0.001). In addition, group 2 reported significantly less pain than group 4 (4.7 ± 2.5 versus 6.7 ± 1.8, respectively) (P<0.02).CONCLUSIONS: For effective pain relief during HSG, in addition to 550 mg NSAID, local application of lidocaine cream to the posterior fornix of the cervix uteri and paracervical lidocaine injection into the cervix uteri appear to be the most effective methods.
Diagnostic Disparity of Previous and Revised American Thoracic Society Guidelines for Idiopathic Pulmonary Fibrosis
Authors: Fidler Lee , Shapera Shane , Mittoo Shikha , Marras Theodore K 
Published: March 2016

BACKGROUND: A revised guideline for the diagnosis of idiopathic pulmonary fibrosis (IPF) was formulated by the American Thoracic Society (ATS) in 2011 to improve disease diagnosis and provide a simplified algorithm for clinicians. The impact of these revisions on patient classification, however, remain unclear.OBJECTIVE: To examine the concordance between diagnostic guidelines to understand how revisions impact patient classification.METHODS: A cohort of 54 patients with either suspected IPF or a working diagnosis of IPF was evaluated in a retrospective chart review, in which patient data were examined according to previous and revised ATS guidelines. Patient characteristics influencing the fulfillment of diagnostic criteria were compared using one‐way ANOVA and χ2 tests.RESULTS: Revised and previous guideline criteria for IPF were met in 78% and 83% of patients, respectively. Revised guidelines modified a classification based on previous guidelines in 28% of cases. Fifteen percent of patients meeting previous ATS guidelines failed to meet revised criteria due to a lack of honeycombing on high‐resolution computed tomography and the absence of a surgical lung biopsy. Patients failing to meet previous and revised diagnostic criteria for IPF were younger.CONCLUSION: The revised guidelines for the diagnosis of IPF classify a substantial proportion of patients differently than the previous guidelines.
Physician‐to‐Physician Telephone Consultations for Chronic Pain Patients: A Pragmatic Randomized Trial
Authors: Clark Alexander J , Taenzer Paul , Drummond Neil , Spanswick Christopher C , Montgomery Lori S , Findlay Ted , Pereira John X , Williamson Tyler , Palacios-Derflingher Luz , Braun Ted 
Published: March 2016

BACKGROUND: The impact of telephone consultations between pain specialists and primary care physicians regarding the care of patients with chronic pain is unknown.OBJECTIVES: To evaluate the impact of telephone consultations between pain specialists and primary care physicians regarding the care of patients with chronic pain.METHODS: Patients referred to an interdisciplinary chronic pain service were randomly assigned to either receive usual care by the primary care physician, or to have their case discussed in a telephone consultation between a pain specialist and the referring primary care physician. Patients completed a numerical rating scale for pain, the Pain Disability Index and the Short Form‐36 on referral, as well as three and six months later. Primary care physicians completed a brief survey to assess their impressions of the telephone consultation.RESULTS: Eighty patients were randomly assigned to either the usual care group or the standard telephone consultation group, and 67 completed the study protocol. Patients were comparable on baseline pain and demographic characteristics. No differences were found between the groups at six months after referral in regard to pain, disability or quality of life measures. Eighty percent of primary care physicians indicated that they learned new patient care strategies from the telephone consultation, and 97% reported that the consultation answered their questions and helped in the care of their patient.DISCUSSION: Most primary care physicians reported that a telephone consultation with a pain specialist answered their questions, improved their patients’ care and resulted in new learning. Differences in patient status compared with a usual care control group were not detectable at six‐month follow‐up.CONCLUSIONS: While telephone consultations are clearly an acceptable strategy for knowledge translation, additional strategies may be required to actually impact patient outcomes.