bluuebunny/crossref_metadata_2025_split huggingface dataset:
Repair of aortic coarctation in infancy: A 10-year clinical experience
Authors: Bigdelian Hamid , Sedighi Mohsen 
Published: April 2016

Background Coarctation of the aorta is a congenital narrowing of the upper descending aorta. The approximate incidence is 4% in live-born children with congenital heart disease. This study aimed to describe the surgical outcome and survival of patients undergoing congenital aortic coarctation repair via subclavian flap aortoplasty (group 1) or resection with end-to-end anastomosis (group 2). Methods We retrospectively reviewed the clinical outcomes of 105 infants who underwent repair of aortic coarctation between 2000 and December 2012. Fifty patients (group 1) underwent subclavian flap aortoplasty and 55 (group 2) underwent resection with end-to-end anastomosis. Procedure details and early results were collected by retrospective review of hospital and clinic data. Results The mean age of patients in group 1 was 6.73 ± 1.1 vs. 6.76 ± 1.2 months in group 2, and the mean weight was 6.01 ± 1.3 vs. 5.9 ± 1.0 kg, respectively. There were no significant differences among the intra- and postoperative variables in the 2 groups. Six patients in group 1 had a peak systolic gradient >20 mm Hg. The recurrence rate in group 1 was 12% vs. 1.8% in group 2 ( p < 0.05). Overall mortality was 2.8%. Survival in group 1 was 96% vs. 98.2% in group 2. Conclusion Repair of aortic coarctation in infancy by resection with end-to-end anastomosis can be performed with a low mortality rate and a low incidence of recoarctation, and it provides the optimal prognosis for coarctation in infancy.
A side-hole catheter for catheterization of a difficult internal mammary artery
Authors: Oh Jung Suk , Choi Byung Gil , Chun Ho Jong , Lee Hae Giu 
Published: April 2016

Background The internal mammary artery (IMA) can be a source of hemoptysis in patients with chronic lung disease. Intervention via the IMA can be a challenge due to anatomic variations and lead to excessive contrast use and radiation exposure. Purpose To evaluate safety and efficiency of a new side-hole catheter for the catheterization of the IMA in patients with hemoptysis. Material and Methods From January 2011 to August 2014, a total of 96 transarterial embolization procedures required exact evaluation of the IMA due to chronic lung disease involving the anterior thorax. In 17 cases (18%) of these 96 procedures, the conventional selective IMA angiography failed and instead a novel side-hole catheter as a modification of a cobra-type curved catheter was used. The side hole allowed passage of a micro-wire and catheter. Results Failed catheterizations were due to severe vascular tortuosity, acutely angulated subclavian artery, or abnormal takeoff of the IMA. The Cobra shaped catheter with the microcatheter through the side-hole catheter yielded a technical success rate of 100%. Longer time was required to catheterize the IMA with the Cobra shaped catheter than with the side-hole catheter (17 vs. 2 min, P < 0.05). There were no procedure-related complications. Conclusion Side-hole catheter technique is useful in patients whose internal mammary artery is difficult to access. Further design revisions are needed to improve the ease and speed of IMA catheterization and angiography.
Functional interictal changes of pain processing in migraine with ictal cutaneous allodynia
Authors: Russo Antonio , Esposito Fabrizio , Conte Francesca , Fratello Michele , Caiazzo Giuseppina , Marcuccio Laura , Giordano Alfonso , Tedeschi Gioacchino , Tessitore Alessandro 
Published: April 2016

Objective A prospective clinical imaging study has been conducted to investigate pain processing functional pathways during trigeminal heat stimulation (THS) in patients with migraine without aura experiencing ictal cutaneous allodynia (CA) (MwoA CA+). Methods Using whole-brain BOLD-fMRI, functional response to THS at three different intensities (41°, 51° and 53℃) was investigated interictally in 20 adult MwoA CA+ patients compared with 20 MwoA patients without ictal CA (MwoA CA−) and 20 healthy controls (HCs). Secondary analyses evaluated associations between BOLD signal change and clinical features of migraine. Results During moderate-noxious THS (51℃), we observed a significantly greater activation in (a) the anterior cingulate cortex in MwoA CA+ patients compared to HCs and (b) the middle frontal gyrus in MwoA CA+ patients compared to both MwoA CA− patients and HCs. Furthermore, during high-noxious THS (53℃) a significantly decreased activation in the secondary somatosensory cortices was observed in (a) MwoA CA− patients compared to both MwoA CA+ patients and HCs and (b) MwoA CA+ patients compared to HCs. CA severity was positively correlated with the secondary somatosensory cortices activation. Conclusions Our findings suggest that CA may be subtended by both a dysfunctional analgesic compensatory mechanism and an abnormal internal representation of pain in migraine patients.
The Association Between Serum Biomarkers of Collagen Turnover and Subsequent Anterior Cruciate Ligament Rupture
Authors: Svoboda Steven J. , Owens Brett D. , Harvey Travis M. , Tarwater Patrick M. , Brechue William F. , Cameron Kenneth L. 
Published: April 2016

Background: No study has attempted to associate the levels of preinjury serum biomarkers of collagen turnover with the subsequent risk of anterior cruciate ligament (ACL) injury. Hypothesis: Preinjury serum biomarkers of collagen turnover would be associated with the subsequent risk of ACL injury. Study Design: Case-control study; Level of evidence, 3. Methods: We conducted a case-control study with 45 ACL-injured cases and 45 controls matched for sex, age, height, and weight. In addition to the matching criteria, controls had no history of major joint injury. Baseline preinjury serum samples were obtained from the Department of Defense Serum Repository for all subjects. Samples were assessed for 2 serum biomarkers of collagen synthesis (CPII and CS846) and 2 markers of collagen degradation (C1,2C and C2C) through commercially available enzyme-linked immunosorbent assay (ELISA) kits. All ELISAs were performed in triplicate. Conditional logistic regression models were used to analyze the data. Results: Univariate results suggested that both biomarkers for collagen degradation (C1,2C and C2C) were significantly associated with the subsequent likelihood of ACL injury. Serum C2C and C1,2C concentration at baseline were associated with odds ratios (ORs) of 2.05 (95% CI, 1.30-3.23; P = .001) and 3.02 (95% CI, 1.60-5.71; P = .002), respectively. Baseline serum CPII concentrations were also associated with subsequent ACL injury. Serum CPII concentration at baseline was associated with an OR of 4.41 (95% CI, 1.87-10.38; P = .001). Baseline serum CS846 levels approached significance (OR = 0.77; 95% CI, 0.57-1.03; P = .080). Multivariable models suggested that preinjury CPII and C2C concentrations at baseline are important indicators of subsequent ACL injury risk. Conclusion: Preinjury differences in serum biomarker levels of collagen turnover suggest that collagen metabolism in individuals who go on to tear an ACL may be different when compared with a matched control group with no history of major joint injury. These differences may be reflective of different preinjury biochemical and/or biomechanical risk profiles or genetic factors that subsequently affect both collagen metabolism and ACL injury risk.
Outcome Trajectories among Homeless Individuals with Mental Disorders in a Multisite Randomised Controlled Trial of Housing First
Authors: Adair Carol E. , Streiner David L. , Barnhart Ryan , Kopp Brianna , Veldhuizen Scott , Patterson Michelle , Aubry Tim , Lavoie Jennifer , Sareen Jitender , LeBlanc Stefanie Renée , Goering Paula 
Published: April 2016

Purpose: Housing First (HF) has been shown to improve housing stability, on average, for formerly homeless adults with mental illness. However, little is known about patterns of change and characteristics that predict different outcome trajectories over time. This article reports on latent trajectories of housing stability among 2140 participants (84% followed 24 months) of a multisite randomised controlled trial of HF. Methods: Data were analyzed using generalised growth mixture modeling for the total cohort. Predictor variables were chosen based on the original program logic model and detailed reviews of other qualitative and quantitative findings. Treatment group assignment and level of need at baseline were included in the model. Results: In total, 73% of HF participants and 43% of treatment-as-usual (TAU) participants were in stable housing after 24 months of follow-up. Six trajectories of housing stability were identified for each of the HF and TAU groups. Variables that distinguished different trajectories included gender, age, prior month income, Aboriginal status, total time homeless, previous hospitalizations, overall health, psychiatric symptoms, and comorbidity, while others such as education, diagnosis, and substance use problems did not. Conclusion: While the observed patterns and their predictors are of interest for further research and general service planning, no set of variables is yet known that can accurately predict the likelihood of particular individuals benefiting from HF programs at the outset.
Descriptive Epidemiology of Generalized Anxiety Disorder in Canada
Authors: Watterson Rita A. , Williams Jeanne V. A. , Lavorato Dina H. , Patten Scott B. 
Published: April 2016

Objective: The first national survey to assess the prevalence of generalized anxiety disorder (GAD) in Canada was the 2012 Canadian Community Health Survey: Mental Health and Well-Being (CCHS-MH). The World Mental Health Composite International Diagnostic Interview (WMH-CIDI), used within the representative sample of the CCHS-MH, provides the best available description of the epidemiology of this condition in Canada. This study uses the CCHS-MH data to describe the epidemiology of GAD. Method: The analysis estimated proportions and odds ratios and used logistic regression modelling. All results entailed appropriate sampling weights and bootstrap variance estimation procedures. Results: The lifetime prevalence of GAD is 8.7% (95% CI, 8.2% to 9.3%), and the 12-month prevalence is 2.6% (95% CI, 2.3% to 2.8%). GAD is significantly associated with being female (OR 1.6; 95% CI, 1.3 to 2.1); being middle-aged (age 35-54 years) (OR 1.6; 95% CI, 1.0 to 2.7); being single, widowed, or divorced (OR 1.9; 95% CI, 1.4 to 2.6); being unemployed (OR 1.9; 95% CI, 1.5 to 2.5); having a low household income (<$30 000) (OR 3.2; 95% CI, 2.3 to 4.5); and being born in Canada (OR 2.0; 95% CI, 1.4 to 2.8). Conclusions: The prevalence of GAD was slightly higher than international estimates, with similar associated demographic variables. As expected, GAD was highly comorbid with other psychiatric conditions but also with indicators of pain, stress, stigma, and health care utilization. Independent of comorbid conditions, GAD showed a significant degree of impact on both the individual and society. Our results show that GAD is a common mental disorder within Canada, and it deserves significant attention in health care planning and programs.
Posterior reversible encephalopathy syndrome and association with systemic lupus erythematosus
Authors: Ferreira TS , Reis F , Appenzeller S 
Published: April 2016

Introduction Posterior reversible encephalopathy syndrome (PRES) is a neurological complex disorder with many clinical associations and causative factors. It is important to recognize this condition because early diagnosis and treatment usually result in its complete resolution, radiological imaging becoming the key for the correct diagnosis. Methods We retrospectively reviewed charts and magnetic resonance imaging findings in the University of Campinas from January 2005 to July 2015, selecting three cases of patients with systemic lupus erythematosus syndrome who developed PRES, for whom risk factors, characteristics, magnetic resonance imaging findings and neurological resolution were analyzed. We also conducted a review of the English-language literature. Results The three cases had neurological symptoms like acute onset of headache, altered mental status, cortical blindness and seizures. Brain magnetic resonance imaging demonstrated posterior cortical and white matter alterations involving posterior brain territories, which were more conspicuous on T2-weighted and fluid-attenuated inversion recovery . Spectroscopy, diffusion-weighted imaging and susceptibility-weighted imaging were also important for neuroradiological evaluation. Immunosuppressive drugs were taken in all cases. Partial clinical and radiological recovery was observed in two cases, and complete resolution was observed in the third patient. Literature review We found 52 cases of PRES in systemic lupus erythematosus patients. Almost all patients were women 94%, ranging from 8 to 62 years old. Posterior brain territory involvements were found in 98% of patients. Hemorrhagic complications involved 26% of patients, becoming a risk factor for clinical sequels. The total percentage of patients with no complete resolution of radiological findings on follow-up images was 27.5%. Discussion In patients with autoimmune disorders, endothelial dysfunction may occur secondary to autoimmunity and the use of cytotoxic drugs, supposedly facilitating the occurrence of more severe PRES. The hypothesis that patients with autoimmune diseases have a propensity to develop non-reversible lesions has been raised.
Comparison of Removable and Irremovable Walking Boot to Total Contact Casting in Offloading the Neuropathic Diabetic Foot Ulceration
Authors: Piaggesi Alberto , Goretti Chiara , Iacopi Elisabetta , Clerici Giacomo , Romagnoli Fabio , Toscanella Fabrizia , Vermigli Cristiana 
Published: April 2016

Background: Despite its efficacy in healing neuropathic diabetic foot ulcers (DFUs), total contact cast (TCC) is often underused because of technical limitations and poor patient acceptance. We compared TCC to irremovable and removable commercially available walking boots for DFU offloading. Methods: We prospectively studied 60 patients with DFUs, randomly assigned to 3 different offloading modalities: TCC (group A), walking boot rendered irremovable (i-RWD; group B), and removable walking boot (RWD; group C). Patients were followed up weekly for 90 days or up to complete re-epithelization; ulcer survival, healing time, and ulcer size reduction (USR) were considered for efficacy, whereas number of adverse events was considered for safety. Patients’ acceptance and costs were also evaluated. Results: Mean healing time in the 3 groups did not differ ( P = .5579), and survival analysis showed no difference between the groups (logrank test P = .8270). USR from baseline to the end of follow-up was significant ( P < .01) in all groups without differences between the groups. Seven patients in group A (35%), 2 in group B (10%), and 1 in group C (5%) (Fisher exact test P = .0436 group A vs group C) reported nonsevere adverse events. Patients’ acceptance and costs were significantly better in group C ( P < .05). Conclusions: Our results suggest that a walking boot was as effective and safe as TCC in offloading the neuropathic DFUs, irrespective of removability. The better acceptability and lesser costs of a removable device may actually extend the possibilities of providing adequate offloading. Level of Evidence: Level II, prospective comparative study.
Cortistatin Improves Cardiac Function After Acute Myocardial Infarction in Rats by Suppressing Myocardial Apoptosis and Endoplasmic Reticulum Stress
Authors: Shi Zhi-Yu , Liu Yue , Dong Li , Zhang Bo , Zhao Meng , Liu Wen-Xiu , Zhang Xin , Yin Xin-Hua 
Published: April 2016

Objectives: The endoplasmic reticulum (ER) stress-induced apoptotic pathway is associated with the development of acute myocardial infarction (AMI). Cortistatin (CST) is a novel bioactive peptide that inhibits apoptosis-related injury. Therefore, we investigated the cardioprotective effects and potential mechanisms of CST in a rat model of AMI. Methods: Male Wistar rats were randomly divided into sham, AMI, and AMI + CST groups. Cardiac function and the degree of infarction were evaluated by echocardiography, cardiac troponin I activity, and 2,3,5-triphenyl-2H-tetrazolium chloride staining after 7 days. The expression of CST, ER stress markers, and apoptotic markers was examined using immunohistochemistry and Western blotting. Results: Compared to the AMI group, the AMI + CST group exhibited markedly better cardiac function and a lower degree of infarction. Electron microscopy and terminal deoxynucleotidyl transferase dUTP nick end labeling confirmed that myocardial apoptosis occurred after AMI. Cortistatin treatment reduced the expression of caspase 3, cleaved caspase 3, and Bax (proapoptotic proteins) and promoted the expression of Bcl-2 (antiapoptotic protein). In addition, the reduced expression of glucose-regulated protein 94 (GRP94), glucose-regulated protein 78 (GRP78), CCAAT/enhancer-binding proteins homologous protein, and caspase 12 indicated that ER stress and the apoptotic pathway associated with ER stress were suppressed. Conclusions: Exogenous CST has a notable cardioprotective effect after AMI in a rat model in that it improves cardiac function by suppressing ER stress and myocardial apoptosis.
Pilot study of biological monitoring of four antineoplastic drugs among Canadian healthcare workers
Authors: Poupeau Céline , Tanguay Cynthia , Plante Caroline , Gagné Sébastien , Caron Nicolas , Bussières Jean-François 
Published: April 2016

Purpose There are health risks to workers occupationally exposed to antineoplastic drugs. We hypothesized that implementing a biological monitoring program would be feasible. The goal was to present the results of our pilot cross-sectional study of biological monitoring of four antineoplastic drugs. Methods We recruited workers from the hematology–oncology department and control workers in a mother–child university health center. This study was preceded by an information period during which we aimed at enhancing the workers’ awareness and knowledge of the risks of occupational exposure. Participants filled out a journal containing activities performed and personal protective equipment worn. One urine sample was collected at the end of their shift. Samples were analyzed by UPLC/MS-MS for the presence of cyclophosphamide, ifosfamide, methotrexate, and alpha-fluoro-beta-alanine (5-fluorouracile’s main urinary metabolite). Results The participation rate was 85.7% (102/119). No urine sample had detectable concentrations of any of the four drugs evaluated (0/101; 0/74 nurses, 0/11 pharmacists, 0/9 pharmacy technicians, and 0/7 doctors). In the 5 days before sampling, 67/92 (72.8%) hematology–oncology participants performed at least one activity with antineoplastic drugs. Nurses wore all of the recommended protection for technical activities (86.2%), but rarely for non-technical activities (14.9%). Pharmacists and pharmacy technicians wore all of the recommended protection for all activities (100.0%). Conclusions This pilot study had a good participation rate. The absence of positive samples was a good indication that the measures in place ensured workers’ safety, even though we found areas where the worker protection can be enhanced.
Single 4.5 mg fixed-dose of rasburicase for hyperuricemia associated with tumor lysis syndrome
Authors: Patel Kajal S , Lau Jessica E , Zembillas Anthony S , Gallagher Erika M 
Published: April 2016

Rasburicase is a recombinant urate oxidase enzyme administered for treatment of hyperuricemia associated with tumor lysis syndrome. Studies demonstrate effectiveness of single fixed-dose rasburicase as compared to the FDA-approved dose of 0.2 mg/kg intravenously daily for up to five days. Doses in these studies range from 1.5 mg to 7.5 mg. Our study evaluated outcomes in patients who received single 4.5 mg fixed-dose rasburicase. This retrospective, IRB-approved chart review evaluated adult oncology subjects who received fixed-dose rasburicase between January 2007 and April 2014. The primary outcome was percentage of patients with normalization of uric acid (level <8 mg/dL within 24 h) after a single 4.5 mg fixed-dose of rasburicase. Secondary objectives were incidence of initial failure of fixed-dose rasburicase and normalization of uric acid in overweight (body mass index ≥25 kg/m2) versus non-overweight patients. Initial failure was defined as need for additional doses or progression to dialysis within one week of the initial fixed-dose. In the 128 patients included, the mean baseline uric acid level was 14.84 mg/dL. Of the 112 patients with a follow-up uric acid level, 68% achieved normalization within 24 h of rasburicase administration. Thirty-eight patients received additional treatment: 10 received additional dose(s) and 28 underwent dialysis. Normalization of uric acid in overweight versus non-overweight patients was 66% and 73%, respectively. Overall, a single 4.5 mg fixed-dose of rasburicase effectively normalized uric acid in 68% of patients within 24 h. Further studies are needed to determine the optimal single fixed-dose necessary for treatment response across all patients.
Stratification of telehealthcare for patients with chronic obstructive pulmonary disease using a predictive algorithm as decision support: A pilot study
Authors: Stausholm Mads N , Egmose Andreas , Dahl Simon C , Lilholt Pernille H , Cichosz Simon L , Hejlesen Ole K 
Published: April 2016

Introduction The number of patients needing care who suffer from chronic obstructive pulmonary disease (COPD) is expected to increase in the future. The consequences thereof will increase the socio-economic burden for both patients and society. Telehealthcare technologies have shown potential in reducing hospitalisation-related costs and in improving health-related quality of life (HRQOL) for some COPD patients, but not all. The aim of this study was to investigate the potential of predictive algorithms for helping the general practitioner to stratify telehealthcare for COPD patients in a way that maximises HRQOL and minimises COPD-related costs. Methods Data from 553 COPD patients based in the North Denmark Region were analysed and used as predictors for four multiple linear regression models. The models were trained and evaluated for their abilities to predict individual patient’s future health- and cost-related developments, with and without telehealthcare. Results The average root-mean-square error (RMSE) of the health and cost models was 5.265 HRQOL scores and US dollars (US$)5430.49, respectively. The accuracy regarding the polarity of the predicted changes ranged from 61–65% for the health models and 74–75% for the cost models. While differences in the magnitude of predictions with and without telehealthcare were statistically significant ( p < 0.01), the polarity of predictions was similar across models in 82.05% of all cases. Discussion Our results indicate that it may be possible to predict the magnitude and polarity of a COPD patient’s future health- and cost-related developments with and without telehealthcare. Predictive algorithms may provide a useful decision support tool in stratifying telehealthcare for COPD patients.