bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chronic pain disorders after critical illness and ICU-acquired opioid dependence: two clinical conundra
Authors: Puntillo Kathleen Ann , Naidu Ramana 
Published: August 2016

Purpose of review
Is to describe the potential for patients to undergo an acute-to-chronic pain transition after ICU discharge as a result of pain they experienced in ICU and to explore the phenomenon of ICU-acquired opioid dependence. Both topics are timely, in that they can negatively influence patient recovery after critical illness and contribute to post-ICU syndrome.

Recent findings
Recognizing and treating pain in patients while they are in the ICU has always been important. However, new knowledge increases the importance of good pain management on patient welfare: recent basic science discoveries on mechanisms of chronic pain development; identification of myriad factors, occurring during the patient's hospital and ICU stay, that put patients at risk for development of chronic pain; the view that a multimodal analgesia treatment approach that is opioid sparing may be the optimum method for acute pain management. Furthermore, recent findings about ICU-acquired opioid dependence provide a foundation for promoting more rigorous assessment, prevention, and treatment of opioid withdrawal in ICU patients.

Summary
Providing sufficient analgesia to ICU patients while preventing opioid dependence and withdrawal is essential to promote comfort and rehabilitation. Obtaining this balance requires heightened ICU clinician attention and focused research.
Use of complementary and alternative medicine in Swedish patients with inflammatory bowel disease: a controlled study
Authors: Oxelmark Lena , Lindberg Annelie , Löfberg Robert , Sternby Berit , Eriksson Anders , Almer Sven , Befrits Ragnar , Fossum Bjöörn , Karlén Per , Broström Olle , Tysk Curt 
Published: August 2016

Background
There is an increasing interest in complementary and alternative medicine (CAM) in patients with chronic diseases, including those with inflammatory bowel disease (IBD). Patients may turn to CAM when conventional therapies are inadequate or associated with side effects for symptomatic relief or to regain control over their disease. The objectives were to explore CAM use and perceived effects in IBD patients in comparison with a control group.

Methods
A cross-sectional, multicenter, controlled study was carried out. IBD patients were invited from 12 IBD clinics in Sweden. Controls were selected randomly from a residence registry. A study-specific questionnaire was used for data collection.

Results
Overall, 48.3% of patients with IBD had used some kind of CAM during the past year compared with 53.5% in controls (P=0.025, adjusted for age, sex, geographic residence, and diet). The most frequently used CAM among IBD patients was massage (21.3%), versus controls (31.4%) (adjusted P=0.0003). The second most used CAM was natural products, 18.7% in IBD patients versus 22.3% of the controls (unadjusted P=0.018). In all, 83.1% of the patients experienced positive effects from CAM and 14.4% experienced negative effects.

Conclusion
Overall, 48.3% of Swedish IBD patients used some kind of CAM and controls used CAM significantly more. Natural products were used by one-fifth of the patients and even more by controls. This is notable from a patient safety perspective considering the possible risks of interactions with conventional medication. In all, 40% of the patients reported adverse events from conventional medicine. Patients experienced predominantly positive effects from CAM, and so did controls.
Detection of molecular bacterascites in decompensated cirrhosis defines a risk with decreased survival
Authors: Engelmann Cornelius , Krohn Sandra , Prywerek Delia , Hartmann Jan , Herber Adam , Boehlig Albrecht , Zeller Katharina , Boehm Stephan , Berg Thomas 
Published: August 2016

Background
The prognostic relevance of bacterial DNA (bactDNA) detection in ascitic fluid of patients with cirrhosis is still under debate. Using quantitative real-time PCR with broad-range primers targeting the V3 and V4 variable region of the 16S rRNA gene, we measured bactDNA concentrations in patients with and without leukocytic ascites and evaluated the impact on short-term survival.

Patients and methods
Ascites samples from 173 patients with decompensated cirrhosis were consecutively collected between February 2011 and December 2012. BactDNA-positive ascites samples were sequenced and chromatograms were identified using RipSeq. Clinical data collection and survival analyses were carried out retrospectively and correlated with ascites bactDNA levels.

Results
BactDNA was detected qualitatively with a similar frequency in both nonleukocytic and leukocytic ascites [40% (57/144) and 43.5% (10/23), respectively; P=0.724]. However, the median bactDNA level was significantly higher in leukocytic ascites than in nonleukocytic ascites (1.2×104 vs. 5.7×102 copies/ml; P=0.008). Patients’ survival was associated significantly with bactDNA level. The 30-day and 180-day survival was reduced if bactDNA was above the quantification limit of 520 copies/ml (84 and 63% vs. 72 and 43%, respectively; P<0.05) and worst if bactDNA was above 5000 copies/ml. The bacterial spectrum was dominated by Gram-positive strains as shown by direct sequencing.

Conclusion
BactDNA quantification in ascitic fluid samples using culture-independent 16S rRNA gene-based methods seems to be an interesting approach to identify patients at risk of reduced survival. Our study warrants further evaluation of antibiotic treatment in patients with molecular bacterascites.
Novel B-cell subsets in atherosclerosis
Authors: Douna Hidde , Kuiper Johan 
Published: August 2016

Purpose of review
The number of deaths associated with cardiovascular disease remains high, despite great advances in treating the associated high levels of cholesterol. The main underlying pathology of cardiovascular disease is atherosclerosis, which is recognized as a chronic autoimmune-like inflammatory disease. Hence, there is a pressing need to shed light on the immune pathways associated with atherosclerosis. B cells have long been thought to have a general protective effect in atherosclerosis. However, findings in the last decade have challenged this paradigm, showing that it is crucial to differentiate between the various B-cell subsets when assessing their role/effect on atherosclerosis.

Recent findings
It has become increasingly recognized lately that B cells can have significant effects on the immune system independent of antibody production. The understanding that B cells form a major source of cytokines and can directly influence T-cell responses via surface markers, have led to the identification of novel B-cell subsets. These subsets are important modulators of autoimmune disorders but have not yet been fully investigated in atherosclerosis.

Summary
Here we review the current known roles of B-cell subsets and the putative effects of recently identified B cells on atherosclerosis.
Neuropsychological functioning and health-related quality of life in pediatric liver disease: the sum of our perspectives is greater than each alone
Authors: Sorensen Lisa G. 
Published: August 2016

Purpose of review
The review will discuss current data on neuropsychological and health-related quality of life (HRQOL) outcomes in children with liver disease. Research has trickled in over the past 30 years, mostly in small, single-center studies with observational or retrospective design. As medical treatment has advanced, survival has improved dramatically, with the majority now living into adulthood. The focus is shifting toward more systematic exploration of functional outcomes.

Recent findings
Contemporary cohorts provide evidence for increased prevalence of IQ deficits despite overall average means in children with end-stage liver disease and long after transplant. Recent studies explore specific neurocognitive domains and populations, such as pediatric acute liver failure and metabolic disorders. HRQOL is reduced in pediatric liver transplant recipients, even years later. Current research examines HRQOL in pediatric acute liver failure, infants with chronic liver disease, and specific diseases. A major psychosocial concern is the transition from pediatric to adult care, and the challenges in assessing transfer readiness.

Summary
As research in functional outcomes becomes more sophisticated (more prospective, controlled, and multisite studies), richer data are available. The most comprehensive understanding of how children with liver disease fare is achieved by integrating perspectives into one picture painted by many.
The development of moral sense and moral thinking
Authors: Carpendale Jeremy I.M. , Hammond Stuart I. 
Published: August 2016

Purpose of review
The review critically evaluates recent claims that infants have innate knowledge of morality and examines the sources of moral norms.

Recent findings
Many studies show that toddlers readily help adults with daily tasks. A more contentious set of studies suggests that young infants prefer actors who help others to those who hinder them. Some researchers have interpreted these findings as indicating that morality is innately present in humans. Others look to alternative explanations in developmental systems theory.

Summary
Explaining the emergence of morality as innate, or wholly socialized, is problematic; instead morality could emerge in a developmental system in which children's early capacities are shaped by interpersonal engagement. Children's improving ability to coordinate with others at a practical level is later transformed through language and reflective thought, as children gain the ability to talk about what was previously implicit in interaction. Throughout, parents and caregivers have many opportunities to foster children's moral development in daily interactions.
Lack of Utility of Anti‐tTG IgG to Diagnose Celiac Disease When Anti‐tTG IgA Is Negative
Authors: Absah Imad , Rishi Abdul R. , Gebrail Rami , Snyder Melissa R. , Murray Joseph A. 
Published: August 2016

ABSTRACTObjectives:Guidelines for diagnosing celiac disease (CD) recommend initial testing with a highly sensitive serologic test for anti–tissue transglutaminase immunoglobulin A antibodies (tTG IgA). When the probability of CD is high, IgA deficiency should be considered. The 2 approaches to address this include measuring “both tTG IgA and tTG IgG” or measuring “total IgA.” We aim to assess the utility of an isolated positive tTG IgG result in diagnosing CD.Methods:We conducted a retrospective review of patients undergoing serologic testing for CD from January 1997 to June 2014. Patients with positive tTG IgG and negative tTG IgA were included. Moreover, all patients who had any other positive CD‐specific serologic findings were excluded. Demographics, clinical presentation, tests, and biopsy results were recorded.Results:The indication for checking celiac serology was gastrointestinal symptoms in 172 of 233 patients, iron deficiency anemia in 12, and high‐risk screening in 48. Small bowel biopsy was performed in 178 patients (77%); 160 had normal results and 18 had histologic changes suggestive of enteropathy. Nine patients had increased intraepithelial lymphocytes, and 9 had partial villous atrophy. Only 6 cases of CD were, however, confirmed. The utility of isolated tTG IgG in diagnosis of CD was low at 3% (6/178).Conclusion:In this cohort of patients, the utility of isolated tTG IgG in diagnosing CD was low at 3%.
Comparison of Patients’ and Doctors’ Reports on Health‐related Quality of Life in Celiac Disease
Authors: Vriezinga Sabine L. , Farih Nora , van der Meulen‐de Jong Andrea E. , Putter Hein , Rings Edmond H.H.M. , Schaart Maaike W. , Schweizer Joachim J. , Wessels Margreet M.S. , Mearin M. Luisa 
Published: August 2016

ABSTRACTObjective:To investigate whether implementation of a celiac disease (CD)–specific health‐related quality of life (HRQOL) questionnaire would add value to CD follow‐up visits; we compared patients’ self‐reported CD‐specific HRQOL with the physician's report provided during a regular CD follow‐up visit in children and young adults.Methods:A cross‐sectional study in the control group of a study on self‐management in CD (CoelKids). Eligible patients had CD for ≥1 year and were 25 years or younger. They completed a CD‐specific HRQOL questionnaire (CDDUX) after their regular follow‐up visit. Their physicians were unaware of the present study's objectives or self‐reported HRQOL. Primary outcome: agreement between physician‐reported and self‐reported HRQOL. Secondary outcomes: patient variables predicting a discrepancy between reports, or a lower HRQOL.Results:Physician‐reported HRQOL was available in 70 of 78 enrolled patients. The self‐reported and physician‐reported HRQOL were concordant in 30 of 70 (K = 0.093), 6 of them had a poor self‐reported HRQOL. Reports were discrepant in 40 of 70; all 40 self‐reported a poor HRQOL. Discrepancies occurred more frequently in patients with a disease duration <9 years (32/40 with discrepant reports were diagnosed <9 years ago vs 17/30 with no discrepancy, P<0.001) and in females (35/40 with discrepant reports were girls versus 16 of 30 with no discrepancy, P = 0.001). Both factors were predictors of a poorer HRQOL.Conclusions:During regular CD follow‐up visits, physicians did not report a poor HRQOL in 40 of 46 children and young adults with a poor self‐reported HRQOL. This is consistent with previous studies examining other chronic diseases and supports the implementation of self‐reported CD‐specific HRQOL measurements in CD follow‐up visits.
Psychiatric Disorders and Predictors Hereof Among Refugee Children in Early Adulthood
Authors: Barghadouch Amina , Carlsson Jessica , Norredam Marie 
Published: August 2016

Abstract
Studies show a high level of mental health problems among refugee children and adults. This study aimed to examine psychiatric disorders among refugee children in early adulthood. A total of 15,264 young adult refugees, who obtained residence permission January 1, 1993 to December 31, 2010, were matched 1:6 on age and sex with 99,313 Danish-born children. Rate ratios (RR) of having a first-time in- or outpatient hospital diagnosis with an affective (F30–39), psychotic (F29–30), neurotic (F40–48), or any psychiatric disorder (F00–99) according to ICD-10 were computed. Refugees had higher RRs of psychotic (RR: 1.81, 95%CI: 1.41–2.32) and nervous (RR: 1.28, 95% CI: 1.14–1.43) disorders compared with Danish-born children. The RRs of having an affective disorder among refugees was 0.74 (95% CI: 0.60–0.90) compared with Danish-born children. Sex, geographical origin, migrant status, household income, age at residence permission, and accompanied/unaccompanied arrival predicted psychiatric contacts among refugees. A focus on both prevention and treatment in vulnerable groups is needed.
The Null Effect of Chewing Gum During Hemodialysis on Dry Mouth
Authors: Duruk Nazike , Eşer Ismet 
Published: August 2016

Aims and Objectives:
The study was conducted to determine the effect of chewing gum during hemodialysis on dry mouth and its symptoms.

Background:
The imposition of fluid restriction and the use of medications that reduce saliva production may lead to dry mouth.

Design:
This study is a randomized, controlled, single-blind, crossover experimental study.

Methods:
The subjects consisted of 61 hemodialysis patients recruited from 4 dialysis centers in southern Turkey. The data were collected using a Patient Identification Form, a Form for Assessing the Symptoms of Dry Mouth, and a Patient Follow-up Form. Saliva samples were obtained for analysis of flow rates.

Results:
The salivary flow rates of the patients increased during the first hour on the day when gum was chewed, and this increase was statistically significant. However, no significant difference was found between the salivary flow rates at the 0- and 4-hour time points on the day when gum was chewed (P > .05). In addition, the salivary pH values were in the normal range on both days, although the pH values tended to be more acidic on the day when gum was not chewed.

Conclusions:
Overall, it was found that chewing gum for 15 minutes each hour during a hemodialysis session did not increase the saliva amount, maintain the pH value of the saliva within a normal range, or control dry mouth symptoms.
Brain Injury Vision Symptom Survey (BIVSS) Questionnaire
Authors: Laukkanen Hannu , Scheiman Mitchell , Hayes John R. 
Published: August 2016

ABSTRACT

Purpose
Validation of the Brain Injury Vision Symptom Survey (BIVSS), a self-administered survey for vision symptoms related to traumatic brain injury (TBI).

Methods
A 28-item vision symptom questionnaire was completed by 107 adult subjects (mean age 42.1, 16.2 SD, range 18–75) who self-reported as having sustained mild-to-moderate TBI and two groups of reference adult subjects (first-year optometry students: mean age 23.2, 2.8 SD, range 20–39; and 71 third-year optometry students: mean age 26.0, 2.9 SD, range 22–42) without TBI. Both a Likert-style method of analysis with factor analysis and a Rasch analysis were used. Logistic regression was used to determine sensitivity and specificity.

Results
At least 27 of 28 questions were completed by 93.5% of TBI subjects, and all 28 items were completed by all of the 157 reference subjects. BIVSS sensitivity was 82.2% for correctly predicting TBI and 90.4% for correctly predicting the optometry students. Factor analysis identified eight latent variables; six factors were positive in their risk for TBI. Other than dry eye and double vision, the TBI patients were significantly more symptomatic than either cohort of optometry students by at least one standard deviation (p < 0.001). Twenty-five of 28 questions were within limits for creating a single-dimension Rasch scale.

Conclusions
Nearly all of the adult TBI subjects were able to self-complete the BIVSS, and there was significant mean score separation between TBI and non-TBI groups. The Rasch analysis revealed a single dimension associated with TBI. Using the Likert method with the BIVSS, it may be possible to identify different vision symptom profiles with TBI patients. The BIVSS seems to be a promising tool for better understanding the complex and diverse nature of vision symptoms that are associated with brain injury.
Tear Lipid Layer Thickness Change and Topical Anti-Glaucoma Medication Use
Authors: Lee Sang Yeop , Lee Hun , Bae Hyoung Won , Kim Tae-im , Kim Chan Yun 
Published: August 2016

ABSTRACT

Purpose
To investigate the effects of topical anti-glaucoma medications on tear lipid layer thickness (LLT) and the ocular surface.

Methods
This retrospective study examined ocular surface disease (OSD) subjects who had (n = 34) and who did not have (n = 51) open-angle glaucoma (OAG). OSD was evaluated with lipid layer thickness (using LipiView interferometer), tear breakup time (TBUT), total corneal and conjunctival staining (Oxford grading scale), and Ocular Surface Disease Index (OSDI). Four variables (total duration of anti-glaucoma medication use, duration of current anti-glaucoma medication use, total number of daily anti-glaucoma medication drops applied, and total number of anti-glaucoma medications [bottles]) related to anti-glaucoma medication were used to verify associations with LLT.

Results
Among the parameters, only LLT showed significantly lower values in the OAG group. In both groups, total staining showed a significant negative correlation between LLT and TBUT. Only in the OAG group, the OSDI showed significant correlations with number of medications (r = 0.389, p = 0.012) and daily number of drops (r = 0.354, p = 0.02); LLT showed significant correlations with TBUT (r = 0.381, p = 0.026) and total medication duration (r = −0.387, p = 0.013). In multivariate analyses, TBUT and total medication duration showed significant correlations with LLT (p = 0.032 and p = 0.015, respectively) in the OAG group.

Conclusions
Topically medicated OAG subjects with OSD had a lower tear LLT than those with OSD who did not have OAG. Therefore, our results indicate that one should evaluate ocular surface disease status in patients who take anti-glaucoma medications.
Parafibromin, APC, and MIB-1 Are Useful Markers for Distinguishing Parathyroid Carcinomas From Adenomas
Authors: Hosny Mohammed Kareem , Siddiqui Momin T. , Willis Brian C. , Zaharieva Tsvetkova Dobromira , Mohamed Amr , Patel Snehal , Sharma Jyotirmay , Weber Collin , Cohen Cynthia 
Published: August 2016

Background:
Differentiation of parathyroid carcinoma (PC) from parathyroid adenoma (PA) relies solely on the pathologic determination of invasion of surrounding structures and/or distant metastasis. Parathyroid lesions with atypical histologic features with no demonstration of invasion or metastasis present a diagnostic dilemma. Different authors report a parafibromin and adenomatous polyposis coli (APC) loss or reduction in PC cases. High proliferative activity of MIB-1 and increased galectin 3 expression are reported in PC. There is no clear cutoff for the sensitivity, specificity, or predictive value for all these markers.

Methods:
The immunohistochemical expression of parafibromin, APC, MIB-1, and galectin 3 was studied in 73 adenomas, 21 PCs, and 3 atypical adenomas. The presence or absence of each marker was identified through the use of a comprehensive scoring system based on multiplying the percentage of tumor cells stained (0 to 100) and the staining intensity (0 to 3) on each biopsy. The highest score that any slide could reach was 300. A cutoff of >100 was used to consider the specimen positive for parafibromin, APC, or galectin 3 staining. MIB-1 proliferation indices were calculated using image cytometry; proliferation indices >5% were considered positive.

Results:
We identified parafibromin loss in 7/21 (33%) carcinomas and 1/73 (1%) adenomas. Loss of APC was seen in 20/21 (95%) carcinomas and 38/73 (52%) adenomas. MIB-1 indices were elevated in 18/21 (86%) carcinomas. MIB-1 indices were <5% in all (100%) adenomas. MIB-1 indices were elevated in 2/3 (67%) atypical adenomas.

Conclusions:
Our study presents a clear cutoff to determine the practicality of using parafibromin, APC, and MIB-1 as immunohistochemical markers to differentiate between PCs and PAs. Loss of parafibromin and a high MIB-1 index are both independently sensitive and specific markers for the diagnosis of PC. Loss of APC was only specific for PC. This panel of markers provides a novel, useful approach in the diagnosis and differentiation of PCs from PAs.