bluuebunny/crossref_metadata_2025_split huggingface dataset:
Partial Nephrogenic Diabetes Insipidus in a Burned Patient Receiving Sevoflurane Sedation With an Anesthetic Conserving Device—A Case Report
Authors: Muyldermans Marie , Jennes Serge , Morrison Stuart , Soete Olivier , François Pierre-Michel , Keersebilck Elkana , Rose Thomas , Pantet Olivier 
Published: July 2016

Objective:
To describe a case of partial nephrogenic diabetes insipidus in a burned patient after prolonged delivery of low inspired concentrations of sevoflurane via an Anesthetic Conserving Device.

Data Sources:
Clinical observation.

Study Selection:
Case report.

Data Extraction:
Relevant clinical information.

Data Synthesis:
A 34-year-old man was admitted with burns covering 52% of his total body surface area. Mechanical ventilation was provided during sedation with continuous infusions of sufentanil and midazolam. Sedation became increasingly difficult, and in order to limit administration of IV agents, sevoflurane was added to the inspiratory gas flow. This was provided using an Anesthetic Conserving Device and continued for 8 days. The patient rapidly developed polyuria and hypernatremia with an inappropriate decrease in urinary osmolality. Administration of desmopressin resulted in only a modest effect on renal concentrating ability. After cessation of sevoflurane, all variables returned to normal within 5 days. The results of further investigations (cerebral computed tomographic scan, cerebral magnetic resonance imaging, and serum arginine vasopressin concentration) were compatible with a diagnosis of partial nephrogenic diabetes insipidus. The temporal sequence of clinical findings in relation to sevoflurane administration suggests that the sevoflurane was the probable underlying cause.

Conclusions:
Clinicians should be aware of the possibility of sevoflurane-induced diabetes insipidus not only during general anesthesia but also in the intensive care setting of sedation in critically ill patients. This is especially important in patients, such as those with severe burns, in whom preserved renal concentrating ability is important to ensure compensation for extrarenal fluid losses.
Improved Anti-Treg Vaccination Targeting Foxp3 Efficiently Decreases Regulatory T Cells in Mice
Authors: Mousavi Niri Neda , Memarnejadian Arash , Pilehvar-Soltanahmadi Younes , Agha Sadeghi Mohammadreza , Mahdavi Mehdi , Kheshtchin Nasim , Arab Samaneh , Namdar Afshin , Jadidi Farhad , Zarghami Nosratollah , Hajati Jamshid 
Published: July 2016

Introduction:
The critical role of regulatory T (Treg) cells in dampening immune responses against tumor cells is apparent. Therefore, several methods have been introduced for eliminating Treg. Among them, inducing immune responses against Treg cells expressing Foxp3 transcription factor is a hopeful approach to decrease the frequency of Tregs. In current study, we used the chimeric FoxP3-Fc(IgG) fusion construct/protein to effectively stimulate the immune responses against Treg cells.

Materials and Methods:
Previously constructed FoxP3-Fc(IgG) DNA vaccine and its protein counterpart were injected into C57BL/6 mice in a prime/boost regimen. After 2 weeks, the mice were killed to measure the frequency of Tregs in their spleens, as well as analyze their specific cytokine production, T-cell proliferation, and CD8+ T-cell cytotoxicity against FoxP3 protein.

Results:
FACS analysis of FoxP3+ CD4+ cells in splenocytes revealed the efficiency of FoxP3 DNA-prime protein-boost strategy to decrease the Treg cells and further showed considerable superiority of Fc(IgG) fusion strategy. This significant reduction in Treg frequency was also concomitant with higher FoxP3-specific CTL and Th1 responses in FoxP3-Fc vaccinated animals.

Conclusions:
Prime/boost vaccination against FoxP3 in addition to enhanced antigen presentation by means of Fc fusion strategy could be successfully considered for Treg depletion studies. Validity of this approach should be experimentally tested in preclinical tumor models.
Thinking Developmentally: The Next Evolution in Models of Health
Authors: Garner Andrew S. 
Published: July 2016

ABSTRACT:
As the basic sciences that inform conceptions of human health advance, so must the models that are used to frame additional research, to teach the next generation of providers, and to inform health policy. This article briefly reviews the evolution from a biomedical model to a biopsychosocial (BPS) model and to an ecobiodevelopmental (EBD) model. Like the BPS model, the EBD model reaffirms the biological significance of psychosocial features within the patient's ecology, but it does so at the molecular and cellular levels. More importantly, the EBD model adds the dimension of time, forcing providers to “think developmentally” and to acknowledge the considerable biological and psychological consequences of previous experiences. For the health care system to move from a reactive “sick care” system to a proactive “well care” system, all providers must begin thinking developmentally by acknowledging the dynamic but cumulative dance between nature and nurture that drives development, behavior, and health, not only in childhood, but across the lifespan.
Management of Chondrodermatitis Nodularis Helicis: A Systematic Review and Treatment Algorithm
Authors: Kechichian Elio , Jabbour Samer , Haber Roger , Abdelmassih Youssef , Tomb Roland 
Published: July 2016

BACKGROUNDChondrodermatitis nodularis helicis (CNH) is an idiopathic benign inflammatory painful condition of the ear. Still, to date, no study has yet evaluated nor compared treatments regarding their safety and efficacy.OBJECTIVEThe objective of this study is to review all available treatment modalities of CNH that were described in the literature, compare their efficacy and propose a treatment algorithm.METHODS AND MATERIALSA systematic review of the literature was conducted using Embase, Medline, and Cochrane databases. Articles studying the management of CNH that reported data on the cure rates were included in this review.RESULTSA total of 29 studies were included in the review. The 3 most commonly reported treatments for CNH are surgery, pressure relief, and topical nitroglycerin. Surgery has higher cure rate (82%) compared with pressure relief treatment (37%) or nitroglycerin (51%) (p< .0001). Surgery should be considered as the first-line treatment for CNH. Second-line treatments include nonsurgical therapies, particularly nitroglycerin and pressure relief techniques, alone or in combination. Third-line treatments include newer or less studied methods.CONCLUSIONAmong the treatment modalities, surgery showed the highest cure rates. Adequately designed randomized controlled trials are warranted to compare newer therapeutic methods.
Clinical Evaluation of Hyaluronic Acid Sponge with Zinc versus Placebo for Scar Reduction after Breast Surgery
Authors: Mahedia Monali , Shah Nilay , Amirlak Bardia 
Published: July 2016

Background:
Scar formation is a major source of dissatisfaction among patients and surgeons. Individually, hyaluronan, or hyaluronic acid (HA), and zinc have been shown to reduce scarring. The authors evaluated the safety and efficacy of an HA sponge with zinc compared with placebo when applied to bilateral breast surgery scars; specifically, they evaluated whether the use of this product modulates inflammation and immediate scarring in treated patients after bilateral breast surgery.

Methods:
This double-blind, randomized, prospective study was approved by the local institutional review board. Bilateral breast surgery patients with right and left incision lines were randomly assigned to receive HA sponge with zinc or placebo within 2 to 4 days after their procedure. Participants were followed up at 6 weeks, 12 weeks, and 1 year and evaluated at 12 weeks. Three blinded evaluators reviewed photographs of the incision lines and assessed the scars using a visual analog scale, new scale, and a patient satisfaction survey.

Results:
Nineteen bilateral breast surgery patients were enrolled in the study. Statistical analysis was performed on 14 patients who completed the follow-up. The mean visual analog scale score was lower for the side receiving the HA sponge with zinc (2.6) than for the side receiving placebo (3.0), indicating a better outcome (t test; P = 0.08). The HA sponge with zinc was found to have significant positive findings on a patient satisfaction survey (P = 0.01).

Conclusions:
This is a preliminary study that shows zinc hyaluronan was associated with high patient satisfaction in achieving a better scar after bilateral breast surgery, irrespective of skin color. It seems to be safe and effective for early scars.
IMPACT OF RETINOPATHY SCREENINGS FOR PROSPECTIVE HEART TRANSPLANT CANDIDATES
Authors: Simon Shira S. , Wilcox Jane E. , Lyon Alice T. , Jampol Lee M. 
Published: July 2016

Purpose:
To determine the prevalence of retinopathy among patients undergoing heart transplantation screening and to determine the impact of this finding on eligibility for transplantation.

Methods and Patients:
A retrospective case series was collected to perform an institutional review of all inpatient consults for dilated eye examinations on potential heart transplant candidates over 5.5 years—from March 27, 2008 to October 10, 2014. Measured outcomes included the presence or absence of retinopathy and the effect of retinopathy, if present, on a patient's eligibility for cardiac transplantation.

Results:
A total of 155 heart transplant candidates underwent bedside ophthalmologic examination as part of their heart transplant candidacy workup. Retinopathy was found in 16 (10%) of these patients: diabetic retinopathy in 13 (8.4%) and hypertensive retinopathy in 3 (1.9%). None of these patients were excluded from the transplant candidacy based on the presence of retinopathy.

Conclusion:
On bedside ophthalmologic examination, retinopathy is an uncommon finding among cardiac transplant candidates. Retinopathy did not preclude transplantation in these patients. We question the utility of the present system of bedside ophthalmic consultation of heart transplant candidates. This may not be an optimal allocation of provider resources. Further studies are warranted to determine an appropriate protocol for ocular evaluation of these patients.
Evaluation and Management of Chemotherapy-Induced Epiphora, Punctal and Canalicular Stenosis, and Nasolacrimal Duct Obstruction
Authors: Mansur Constanza , Pfeiffer Margaret L. , Esmaeli Bita 
Published: July 2016

Purpose:
To describe the frequency, mechanisms, and treatment of epiphora caused by chemotherapeutic agents.

Methods:
Review of relevant articles published in PubMed.

Results:
The chemotherapeutic drugs best documented to cause epiphora are 5-fluorouracil and docetaxel; with both of these drugs, the main mechanism underlying epiphora is canalicular stenosis. Drugs less commonly reported to cause epiphora include S-1, capecitabine, imatinib, topical mitomycin C, and radioactive iodine for treatment of papillary thyroid carcinoma. While all the above-mentioned drugs can be associated with epiphora, some drugs and administration schedules cause only punctal and canalicular inflammation, whereas others cause significant canalicular stenosis. For example, weekly administration of docetaxel is far more likely to cause canalicular stenosis than every-3-weeks administration. The literature suggests that, in patients who receive weekly docetaxel, silicone stenting at the first sign of recurrent or progressive canalicular stenosis can prevent severe irreversible canalicular stenosis and avoid the need for a conjunctivodacryocystorhinostomy. S-1 and radioactive iodine have been reported to cause nasolacrimal duct obstruction. Early recognition of punctal and canalicular stenosis or nasolacrimal duct blockage and early intervention with topical steroids and canalicular stenting in patients at risk for permanent canalicular scarring are important to avoid the need for more invasive and complicated procedures.

Conclusion:
A variety of chemotherapeutic agents have been reported to cause epiphora, and some of these drugs have also been documented to cause obstructions of the lacrimal drainage system. Early recognition and management of epiphora is important and leads to better outcomes.
Depression Symptoms Facilitated Fibrinolytic Dysregulation and Future Coronary Artery Disease Risk in a Black Male Cohort
Authors: Malan Leoné , Mashele Nyiko , Malan Nicolaas T. , Harvey Brian H. , Potgieter Johan C. , Van Rooyen Johannes M. 
Published: July 2016

Background:Hypercoagulation is associated with coronary artery disease (CAD). Whether depression symptoms dysregulate inflammatory and hemostatic markers in an African cohort is not known; therefore, we assessed the relationship between depressive symptoms and inflammatory and hemostatic markers as potential CAD risk markers in an African sex cohort.Material and Methods:We included 181 black African urban-dwelling teachers (88 men, 93 women; aged 25–60 years) from the Sympathetic Activity and Ambulatory Blood Pressure in Africans Study. The Patient Health Questionnaire was used to assess depressive symptoms. Fasting plasma concentrations of C-reactive protein, fibrinogen, D-dimer, plasminogen activator inhibitor-1 (PAI-1) and 24-hour blood pressure measures were obtained.Results:Moderately severe depression symptom status was similar in the black sex groups. Both sex groups showed a mean hypertensive state and low-grade inflammation (C-reactive protein > 3 mg/L). Levels of PAI-1 were higher in depressed men, whereas D-dimer levels were lower in depressed women when considering concomitant confounders. In black men only, depressive symptoms were associated with levels of PAI-1 (adj.R2= 0.12;β= .22 [95% confidence interval, .0–.44];P= .04) and D-dimer (adj.R2= 0.12;β= .28 [95% confidence interval, .08–.48];P= .01), independent of confounders.Conclusion:In black men, depression symptoms accompanied by a mean hypertensive status may up-regulate inflammatory and thrombotic processes. Depression symptoms in black men facilitated hypercoagulation or fibrinolytic dysregulation and potentially increased their CAD risk. Early screening of fibrinolytic markers and for the presence of depressive symptoms is recommended.
Infantile Colic Is Associated With Low‐grade Systemic Inflammation
Authors: Pärtty Anna , Kalliomäki Marko , Salminen Seppo , Isolauri Erika 
Published: July 2016

ABSTRACTObjectives:Dysbiosis, an imbalance in the taxonomic composition of the gut bacteria occurring during the critical stages of development, induces lasting shifts in the immunological and metabolic phenotype if accompanied by an inflammatory response. Because altered gut microbiota and successful treatment with probiotics have both been demonstrated in cases of colic, we hypothesized here that infants with colic might have low‐grade inflammation.Methods:In 28 infants with colic and in 12 healthy controls at the age of 1 month, we measured the following serum immunological biomarkers: cytokines interleukin 1β (IL‐1β); IL‐6; IL‐10; tumor necrosis factor α; interferon γ (IFN‐γ); chemokines IL‐8; monocyte chemotactic protein‐1 (MCP‐1); macrophage inflammatory protein 1β (MIP‐1β) and chemokine (C‐X‐C motif) ligand 16; and intestinal fatty acid–binding protein, a biomarker of enterocyte damage and zonulin, a biomarker of intestinal permeability. In addition, intestinal microbiota composition was correlated with immunological biomarkers.Results:Infants with colic had increased concentrations of IL‐8, MCP‐1, and MIP‐1β in serum as compared with healthy children. All the other immunological biomarkers were comparable between the groups. Fecal levels of Clostridium leptum correlated negatively with the proinflammatory markers MCP‐1 (r = –0.44, P = 0.02), MIP‐1β (r = –0.43, P = 0.02), and tumor necrosis factor α (r = –0.38, P = 0.04). In addition, C coccoides group levels correlated negatively with MCP‐1 (r = –0.43, P = 0.02) and Bifidobacterium breve levels positively with chemokine (C‐X‐C motif) ligand 16 (r = 0.38, P = 0.04).Conclusions:In addition to gut microbiota alterations, colic in infants is associated with low‐grade systemic inflammation. Specific bacterial species beyond conventional probiotics may have anti‐inflammatory properties that may help to modulate microbiota and alleviate colic‐related inflammation.
Antimicrobial Resistance and Neisseria gonorrhoeae Multiantigen Sequence Typing Profile of Neisseria gonorrhoeae in New Delhi, India
Authors: Mahajan Neeraj , Sood Seema , Singh Rajendra , Kapil Arti , Das Bimal Kumar , Sreenivas Vishnubhatla , Kar Hemanta Kumar , Sharma Vinod Kumar 
Published: July 2016

Abstract
Molecular epidemiology of 100 consecutive gonococcal isolates collected between April 2010 and October 2013 from New Delhi was investigated using Neisseria gonorrhoeae multiantigen sequence typing (NG-MAST) along with its association with antimicrobial resistance profiles. Neisseria gonorrhoeae isolates were assigned into 60 different sequence types and 43 (71.6%) were novel. Sole representation was seen in 76.6% sequence types. There was significant association between ST6058 and resistance to penicillin (P = 0.00) and tetracycline (P = 0.002).
Does Living Outside of a Major City Impact on the Timeliness of Chlamydia Treatment? A Multicenter Cross-Sectional Analysis
Authors: Foster Rosalind , Ali Hammad , Crowley Margaret , Dyer Roisin , Grant Kim , Lenton Joanne , Little Christine , Knight Vickie , Read Phillip , Donovan Basil , McNulty Anna , Guy Rebecca 
Published: July 2016

Background
Timely treatment of Chlamydia trachomatis infection reduces complications and onward transmission. We assessed client, process, and clinic factors associated with treatment delays at sexual health clinics in New South Wales, Australia.

Methods
A retrospective review of 450 consecutive clients with positive chlamydia results (not treated at the time of the consultation) was undertaken at 6 clinics (1 urban, 3 regional, and 2 remote) from October 2013. Mean and median times to treatment were calculated, overall and stratified by process steps and clinic location.

Results
Nearly all clients (446, 99%) were treated, with 398 (88%) treated in ≤14 days and 277 (62%) in ≤7 days. The mean time-to-treatment was 22 days at remote clinics, 13 days at regional and 8 days at the urban clinic (P < 0.001). Mean time between the laboratory receipt of specimen and reporting of result was 4.9 in the remote clinics, 4.1 in the regional, and 2.7 days in the urban clinic (P < 0.001); and the mean time between the clinician receiving the result until client treatment was15, 5, and 3 days (P < 0.01), respectively.

Conclusions
At participating clinics, treatment uptake was high, however treatment delays were greater with increasing remoteness. Strategies to reduce the time-to-treatment should be explored such as point-of-care testing, faster specimen processing, dedicated clinical time to follow up recalls, SMS results to clients, and taking treatment out to clients.
Consideration of Cost of Care in Pediatric Emergency Transfer—An Opportunity for Improvement
Authors: Gattu Rajender K. , De Fee Ann-Sophie , Lichenstein Richard , Teshome Getachew 
Published: July 2016

Background
Pediatric interhospital transfers are an economic burden to the health care, especially when deemed unnecessary. Physicians may be unaware of the cost implications of pediatric emergency transfers. A cost analysis may be relevant to reduce cost.

Objective
To characterize children transferred from outlying emergency departments (EDs) to pediatric ED (PED) with a specific focus on transfers who were discharged home in 12 hours or less after transfer without intervention in PED and analyze charges associated with them.

Methods
Charts of 352 patients (age, 0–18 years) transferred from 31 outlying EDs to PED during July 2009 to June 2010 were reviewed. Data were collected on the range, unit charge and volume of services provided in PED, length of stay, and final disposition. The average charge per patient transfer is calculated based on unit charge times total service units per 1000 patients per year and divided by 1000. Hospital charges were divided into fixed and variable.

Results
Of 352 patients transferred, 108 (30.7%) were admitted to pediatric inpatient service, 42 (11.9%) to intensive care; 36 (10.2%) went to the operating room, and 166 (47.2%) were discharged home. The average hospital charge per transfer was US $4843. Most (89%) of the charges were fixed, and 11% were variable. One hundred one (28.7%) patients were discharged home from PED in 12 hours or less without intervention. The hospital charges for these transfers were US $489,143.

Conclusions
Significant number of transfers was discharged 12 hours or less without any additional intervention in PED. Fixed charges contribute to majority of total charges. Cost saving can be achieved by preventing unnecessary transfer.
Feasibility and Effectiveness of a Peer Referral Incentive Intervention to Promote Male Circumcision Uptake in Zambia
Authors: Zanolini Arianna , Bolton Carolyn , Lyabola Lane-Lee , Phiri Gabriel , Samona Alick , Kaonga Albert , Thirumurthy Harsha 
Published: July 2016

Background:
Medical male circumcision is a promising HIV prevention tool in countries with generalized HIV epidemics, but demand creation interventions are needed to support scale-up. We piloted a peer referral intervention in which circumcision clients were offered incentives for referring their peers for circumcision.

Methods:
The intervention was implemented between June 2014 and February 2015 in 6 randomly selected health facilities in Southern Province, Zambia. For the first 5 months, circumcision clients ≥18 years of age were given referral vouchers that allowed them to refer up to 5 peers for circumcision within a 3-month period. An incentive of US$2 was offered for each referral. The primary outcome was the number of circumcisions performed per month in each facility. To assess the effect of the intervention, a difference-in-difference analysis was performed using longitudinal data from the intervention facilities and 22 nonintervention facilities. A questionnaire was also implemented to understand men's perceptions of the intervention.

Results:
During the 8-month intervention period, 1222 men over 18 years of age were circumcised in intervention facilities. In the first 5 months, 699 circumcision clients were enrolled and 385 clients brought a referral voucher given to them by an enrolled client. Difference-in-difference analyses did not show a significant increase in circumcisions performed in intervention facilities. However, circumcision clients reported that the referral incentive motivated them to encourage their friends to seek male circumcision. Peer referrals were also reported to be an important factor in men's decisions because 78% of clients who were referred reported that talking with a circumcised friend was important for their decision to get circumcised.

Conclusions:
The peer referral incentive intervention for male circumcision was feasible and acceptable. However, the intervention did not have a significant effect on demand for male circumcision. Barriers to circumcision and features of the intervention may have limited the effect of the intervention. Further efforts regarding encouraging male-to-male communication and evaluations with larger sample sizes are needed.