bluuebunny/crossref_metadata_2025_split huggingface dataset:
Concomitant Fundoplication With Gastrostomy
Authors: Fox David , Campagna Elizabeth J. , Finnell S. Maria E. , Partrick David A. , Kempe Allison 
Published: April 2016

ABSTRACTObjectives:We sought to determine whether practice differences for fundoplication exist between 2 geographically distinct states, and to determine the reflux medication use pattern associated with concomitant fundoplication.Methods:A retrospective observational cohort study of children in Colorado (CO) and North Carolina (NC) insured by Medicaid from 2006 to 2008. Children who received a surgical gastrostomy during the study period were included, and our primary outcome measure was the performance of a concomitant gastric fundoplication. Thirty‐day prescription fills for reflux medications were examined before and after gastrostomy procedure.Results:We examined 969 surgical gastrostomy admission in both states over the 3‐year study period (CO, n = 341 and NC, n = 628). Patients in each state had similar age (median age, 6 months, P = 0.97). Use of pH probe (CO: 15%, NC: 11%) and diagnosis of reflux (CO: 84%, NC: 72%) differed in each state. Concomitant fundoplication was performed in 60% of patients in CO and 43% in NC (P < 0.01). Age less than 6 months was associated with an increased adjusted odds of fundoplication in CO (OR 9.77, CI, 3.91, 24.43), but less so in NC (OR 2.73, CI, 1.48, 5.04). Among patients undergoing gastrostomy, the proportion of patients on reflux medication 4 to 6 months post‐discharge did not differ between those receiving fundoplication and those that did not in either state.Conclusions:Rates of concomitant fundoplication varied in the 2 states despite patients having similar demographic and clinical characteristics. Antireflux surgery was not associated with a reduction in reflux medications in either state.
Effect of Oral Lipid Matrix Supplement on Fat Absorption in Cystic Fibrosis
Authors: Stallings Virginia A. , Schall Joan I. , Maqbool Asim , Mascarenhas Maria R. , Alshaikh Belal N. , Dougherty Kelly A. , Hommel Kevin , Ryan Jamie , Elci Okan U. , Shaw Walter A. 
Published: April 2016

ABSTRACTPancreatic enzyme therapy does not normalize dietary fat absorption in patients with cystic fibrosis and pancreatic insufficiency. Efficacy of LYM‐X‐SORB (LXS), an easily absorbable lipid matrix that enhances fat absorption, was evaluated in a 12‐month randomized, double‐blinded, placebo‐controlled trial with plasma fatty acids (FA) and coefficient of fat absorption (CFA) outcomes. A total of 110 subjects (age 10.4 ± 3.0 years) were randomized. Total FA increased with LXS at 3 and 12 months (+1.58, +1.14 mmol/L) and not with placebo (P = 0.046). With LXS, linoleic acid (LA) increased at 3 and 12 months (+298, +175 nmol/mL, P ⩽ 0.046), with a 6% increase in CFA (P < 0.01). LA increase was significant in LXS versus placebo (445 vs 42 nmol/mL, P = 0.038). Increased FA and LA predicted increased body mass index Z scores. In summary, the LXS treatment improved dietary fat absorption compared with placebo as indicated by plasma FA and LA and was associated with better growth status.
Baseline Wall Thickness Is Lower in Mucosa‐Healed Segments 1 Year After Infliximab in Pediatric Crohn Disease Patients
Authors: Kang Ben , Choi So Yoon , Chi Sangah , Lim Yaeji , Jeon Tae Yeon , Choe Yon Ho 
Published: April 2016

ABSTRACTObjectives:We aimed to quantitatively investigate the therapeutic response to combined immunosuppression treatment by magnetic resonance enterography (MRE) in active luminal Crohn disease (CD) in the pediatric population.Methods:Pediatric patients with moderate‐to‐severe luminal CD, who received scheduled infliximab and azathioprine, were included in this preliminary study. Ileocolonoscopy and MRE were performed at baseline and at 1 year, and Simple Endoscopic Score for Crohn's Disease (SES‐CD) and Magnetic Resonance Index of Activity (MaRIA) scores were calculated. The correlation between SES‐CD and MaRIA scores were investigated with analysis per person and per segment.Results:A total of 167 segments from 17 patients were evaluated by both Ileocolonoscopy and MRE. SES‐CD and MaRIA scores showed significant correlations on both per‐person analysis (ρ = 0.699, P < 0.001) and per‐segment analysis (ρ = 0.596, P < 0.001). Analysis according to ileocolonic location of each segment revealed that the correlation strength was strongest in the right colon (ρ = 0.653, P < 0.001), whereas the correlation in the rectum was statistically insignificant (ρ = 0.29, P = 0.096). A comparative analysis of MaRIA components revealed a significantly thinner bowel wall thickness at baseline in endoscopically healed segments (50/65) compared with unhealed segments (15/65) (median 4.3 vs 7.2 mm, P = 0.036).Conclusions:Therapeutic response to combined immunosuppression at 1 year assessed by MRE correlates with ileocolonoscopy in pediatric patients with CD. Bowel wall thickness of the involved segments at baseline may affect treatment response to combined immunosuppression.
CT and MRI of Rare Extraintestinal Manifestations of Inflammatory Bowel Disease in Children and Adolescents
Authors: Raymond Scott B. , Gee Michael S. , Anupindi Sudha A. , Shailam Randheer , Kaplan Jess L. , Nimkin Katherine 
Published: April 2016

ABSTRACTInflammatory bowel disease (IBD) is associated with a spectrum of extraintestinal manifestations (EIMs) affecting many organ systems. EIMs can occur in more than 40% of patients with IBD and are associated with significant morbidity. They occur at any time point in the course of disease, often during an active phase of bowel inflammation, but sometimes preceding bowel disease. Prompt recognition of EIMs enables timely and more effective therapy. Physicians who image patients with IBD should be aware of the myriad extraintestinal conditions that may be detected on imaging studies, both within and outside of the abdomen, as they may predate the diagnosis of IBD. Cross‐sectional imaging of unusual conditions associated with IBD will be presented, including pathology in the hepatobiliary, pancreatic, genitourinary, musculoskeletal, mucocutaneous, vascular, neurologic, and pulmonary systems.
Yoga Therapy for Abdominal Pain‐Related Functional Gastrointestinal Disorders in Children
Authors: Korterink Judith J. , Ockeloen Lize E. , Hilbink Mirrian , Benninga Marc A. , Deckers‐Kocken Judith M. 
Published: April 2016

ABSTRACTObjectives:The aim of the present study was to compare effects of 10 weeks of yoga therapy (YT) and standard medical care (SMC) on abdominal pain and quality of life (QoL) in children with abdominal pain–related functional gastrointestinal disorders (AP‐FGIDs).Methods:Sixty‐nine patients, ages 8 to 18 years, with AP‐FGIDs, were randomized to SMC complemented with YT or SMC alone. YT is a mixture of yoga poses, meditation, and relaxation exercises and was given once a week in group sessions. SMC consisted of education, reassurance, dietary advice, and fibers/mebeverine, if necessary. Pain intensity (pain intensity score [PIS] 0–5) and frequency (pain frequency score [PFS] 0–4) were scored in a pain diary, and QoL was measured with KIDSCREEN‐27. Follow‐up was 12 months. Treatment response was defined as ≥50% reduction of weekly pain scores.Results:At 1‐year follow‐up, treatment response was accomplished in 58% of the YT group and in 29% of the control group (P = 0.01); no significant differences for other time points were found. YT, and not SMC, resulted in a significant reduction of PIS (P < 0.01) and PFS (P < 0.01) after 12 months. During the study, however, YT was not significantly superior compared with SMC. Subanalyses for time points demonstrated a significant greater reduction of PIS at 12 months in favor of YT. No differences were found for QoL. YT was more effective in the reduction of reported monthly school absence (P = 0.03).Conclusion:At 1‐year follow‐up, YT in addition to standard care was superior compared with SMC according to treatment success, PIS, and reduction of school absence. YT, however, was not significantly more effective in improving PFS or QoL, compared with SMC.
Quality of Life in Women With Breast Cancer Treated With or Without Chemotherapy
Authors: Tiezzi Maria Fernanda Barbirato da Mata , de Andrade Jurandyr Moreira , Romão Adriana Peterson Mariano Salata , Tiezzi Daniel Guimarães , Lerri Maria Rita , Carrara Hélio Angotti Humberto , Lara Lúcia Alves Silva 
Published: April 2016

Background:
The diagnosis and treatment of breast cancer may negatively affect the quality of life (QOL) of women.

Objectives:
The aim of this study is to assess QOL in women with breast cancer who were treated with or without chemotherapy and to identify factors associated with improved or worsening QOL in these women.

Methods:
This cross-sectional study enrolled 112 women who were treated with chemotherapy (CTX group, with 85 [75.9%] women) or without chemotherapy (non-CTX group, with 27 [24.1%] women) for breast cancer. The Short-Form Health Survey (SF-36) assessed QOL and the Hospital Anxiety and Depression scale assessed anxiety and depression.

Results:
The overall mean SF-36 score was below 50 in all domains. Relative to CTX women, non-CTX women were significantly older (P = .001) and more likely to engage in physical exercise (P = .002). The non-CTX group had higher scores in the Physical Functioning (P = .001) and Role-Physical (P = .0009) domains of the SF-36 relative to the CTX group, and the fluoruracil + epirubicin + cyclophosphamide group had significantly lower scores in the SF-36 domains Physical Functioning (P = .009) and Role-Physical (P = .02).

Conclusion:
Chemotherapy treatment for breast cancer worsens QOL in the Physical Functioning and the Role-Physical domains of the SF-36 relative to women treated without chemotherapy.

Implications for Practice:
Nurses should assess Physical Functioning and the Role-Physical before treatment, as a woman who was not physically active before breast cancer is not likely to become physically active after treatment. Establishing support groups and providing educational sessions about the disease and its management, supportive care can improve the QOL of this population.
The Integration of Emotional, Physiologic, and Communication Responses to Medical Oncology Surveillance Appointments During Breast Cancer Survivorship
Authors: Clayton Margaret F. , Dingley Catherine , Donaldson Gary 
Published: April 2016

Background:
Breast cancer survivors regularly interact with providers during routine surveillance medical oncology visits, discussing uncertainty and anxiety about potential cancer recurrence for many years after treatment. Physiologic alteration can also occur as a stress response, triggered by an upcoming surveillance visit. Survivor-provider communication can theoretically allay emotional distress.

Objective:
The aim of this study was to evaluate associations between emotional (uncertainty, anxiety, concerns about recurrence) and physiologic responses (cytokine levels, lymphocyte counts), and survivor-provider communication (women’s plans for their visit, negotiation of decision-making roles).

Methods:
Twenty-seven community-dwelling breast cancer survivors participated. Blood specimens, and self-reported data focusing on the previous month, were collected immediately before and the morning after a regularly scheduled medical oncology visit.

Results:
Global concerns about cancer recurrence and acute anxiety and uncertainty were associated with changes in immune status before and after the visit. Postvisit natural killer cells increased in 70% of women, and uncertainty/anxiety decreased. Thirty-three percent of women reported a previous minor illness. Most women had a visit plan; 66% successfully negotiated decision-making roles with providers.

Conclusions:
Triggered by an upcoming medical oncology visit, women experience uncertainty, anxiety, and altered immunity, potentially placing them at risk of disease exacerbations.

Implications for Practice:
Not all women respond similarly to a routine surveillance visit; thus, providers must determine who may be at increased risk of emotional distress and physiologic alteration. Survivor-provider communication facilitates immediate resolution of concerns. Explanations of symptom meaning reduce anxiety and uncertainty and by extension may help resolve immune alteration. Between visits, this could be done by nurse-operated telephone-based “help lines.”
Coping With Pain Severity, Distress, and Consequences in Women With Ovarian Cancer
Authors: Gilbertson-White Stephanie , Campbell Grace , Ward Sandra , Sherwood Paula , Donovan Heidi 
Published: April 2016

Background:
Self-regulation can be useful in understanding pain management efforts in women with ovarian cancer. Self-regulation is a parallel process of problem- and emotion-focused coping; problem-focused coping involves efforts aimed at solving/reducing the problem directly, whereas emotion-focused coping is aimed at managing negative emotions.

Objectives:
The aims of this study were to describe the types of problem- and emotion-focused coping strategies used to manage pain severity, distress, and consequences and to evaluate whether there was evidence of parallel processing (ie, use of a combination of both problem- and emotion-focused strategies).

Methods:
Women (n = 162) from a cross-sectional study of cancer symptoms who reported pain as a most noticed symptom in the past week were included. Pearson correlations and t tests were used to evaluate relationships among the variables.

Results:
Mean pain severity was 5.5 (SD, 2.7) on a 0- to 10-point scale. An average of 4.6 (SD, 2.1) coping strategies were reported. Actively manage and planning were the most frequent problem-focused strategies; relaxation was the most frequent emotion-focused strategy. Higher total number of coping strategies attempted, expressing emotions, and seeking emotional support were associated with higher pain distress and consequences scores, and actively managing pain was associated with higher pain severity.

Conclusion:
Women with a history of ovarian cancer continue to experience severe pain. Partial support for parallel processing was found.

Implications for Practice:
The relative benefits of the 2 types of coping strategies are unclear. Thorough assessment of pain and the effectiveness of coping strategies is needed to help women identify strategies that work best for them.
Hypersensitivity to Cold Stimuli in Symptomatic Contact Lens Wearers
Authors: Situ Ping , Simpson Trefford , Begley Carolyn 
Published: April 2016

ABSTRACTPurposeTo examine the cooling thresholds and the estimated sensation magnitude at stimulus detection in controls and symptomatic and asymptomatic contact lens (CL) wearers, to determine whether detection thresholds depend on the presence of symptoms of dryness and discomfort.MethodsForty-nine adapted CL wearers and 15 non–lens wearing controls had room temperature pneumatic thresholds measured using a custom Belmonte esthesiometer, during Visits 1 and 2 (Baseline CL), Visit 3 (2 weeks no CL wear), and Visit 4 (2 weeks after resuming CL wear). CL wearers were subdivided into symptomatic and asymptomatic groups based on comfortable wearing time (CWT) and CLDEQ-8 score (<8 hours CWT and ≥14 CLDEQ-8 stratified the symptom groups). Detection thresholds were estimated using an ascending method of limits and each threshold was the average of the three first-reported flow rates. The magnitude of intensity, coolness, irritation, and pain at detection of the stimulus were estimated using a 1–100 scale (1 very mild, 100 very strong).ResultsIn all measurement conditions, the symptomatic CL wearers were the most sensitive, the asymptomatic CL wearers were the least sensitive, and the control group was between the two CL wearing groups (group factor p < 0.001, post hoc asymptomatic vs. symptomatic group, all p’s < 0.015). Similar patterns were found for the estimated magnitude of intensity and irritation (group effect p = 0.027 and 0.006 for intensity and irritation, respectively) but not for cooling (p > 0.05) at detection threshold.ConclusionsSymptomatic CL wearers have higher cold detection sensitivity and report greater intensity and irritation sensation at stimulus detection than the asymptomatic wearers. Room temperature pneumatic esthesiometry may help to better understand the process of sensory adaptation to CL wear.
Modified Photodynamic Therapy Treatment of Central Serous Chorioretinopathy
Authors: Putnam Christopher M. , Vang See S. 
Published: April 2016

ABSTRACT

Purpose
Central serous chorioretinopathy (CSC) is a condition characterized by serous detachment of the neurosensory retina at the level of the retinal pigmented epithelium (RPE) as a result of leakage from the choriocapillaris. The pathophysiology of CSC is not completely understood rendering treatment and management decisions more complex. When an observational approach and topical medical therapy are unsuccessful, a surgical intervention may be necessary. Here, we examine the role of modified photodynamic therapy (PDT) in recurrent CSC with multiple points of RPE leakage.

Case Report
A 37-year-old male patient presented a case of recurrent CSC in the left eye. After an initial presentation of a large area of submacular fluid, near complete resolution was seen in 8 weeks using a topical NSAID protocol and close monitoring. Two weeks later, a second serous neurosensory detachment larger than the first occurred. The recurrent CSC was successfully treated with focal grid laser photocoagulation and modified PDT resulting in complete resolution and return of visual function 4 months after the initial presentation.

Conclusions
CSC is a multifactorial condition with the potential to severely impair daily visual function. Spectral domain optical coherence tomography retinal imaging has provided a remarkable tool in the diagnosis and monitoring of CSC. The addition of FA and ICG can create a highly precise picture of the subretinal fluid. Although most patients will spontaneously resolve, a subset of patients may benefit from medical therapy including topical nepafenac 0.1%. A smaller subset will require surgical intervention. Modified PDT with ICG-guided laser photocoagulation has a growing body of evidence as an effective treatment for recurrent CSC. Modified PDT may be the best course of action for chronic, non-resolving RPE leakage for both paramacular and foveal leaks leading to minimization of adverse visual effects.
Association Between Contact Lens Discomfort and Pre-lens Tear Film Kinetics
Authors: Guillon Michel , Dumbleton Kathryn A. , Theodoratos Panagiotis , Wong Stephanie , Patel Kishan , Banks Gaidig , Patel Trisha 
Published: April 2016

ABSTRACTPurposeThe relationship between contact lens wettability and comfort has been extensively evaluated; however, a direct correlation between the characteristics of the pre-lens tear film and the symptoms associated with contact lens discomfort has yet to be established. In addition, there is relatively limited knowledge relating to the entire tear film kinetics during the inter-blink period in contact lens wearers. The purpose of this analysis was to identify the characteristics of the pre-lens tear film kinetics that may be associated with the symptoms of contact lens discomfort.MethodsThe study population comprised 202 soft (hydrogel and silicone hydrogel) contact lens wearers attending pre-screening visits at the OTG-i research clinic. All participants completed the Ocular Surface Disease Index (OSDI) questionnaire and the tear film was quantified via post hoc, masked analysis of high definition digital Tearscope videos recorded at the visit. The tear film kinetics of the least symptomatic wearers (OSDI lowest quintile scores, n = 45) were compared to the tear film kinetics of the most symptomatic wearers (OSDI highest quintile scores, n = 43). The hypothesis tested was that the tear film kinetics of asymptomatic wearers were better than tear film kinetics of symptomatic wearers.ResultsThe distribution of lens types worn was as follows: Daily Disposable 46.5%, 1-Month Replacement 39.6%, and 2-Week Replacement 13.6%. 48.2% of lenses were silicone hydrogel and 51.8% hydrogel. Symptomatic wearers had a shorter break-up time (4.7 s vs. 6.0 s; p = 0.003), lesser surface coverage by the tear film during the interblink period (95.1% vs. 98.5%; p < 0.001) and greater surface exposure at the time of the blink (9.4% vs. 3.9%; p = 0.001).ConclusionsThe current study demonstrated that the tear film kinetics of asymptomatic and symptomatic contact lens wearers were different, the findings supporting the hypothesis of poorer tear film kinetics for symptomatic than asymptomatic wearers in a general contact lens wearing population.
Investigating Various Thresholds as Immunohistochemistry Cutoffs for Observer Agreement
Authors: Ali Asif , Bell Sarah , Bilsland Alan , Slavin Jill , Lynch Victoria , Elgoweini Maha , Derakhshan Mohammad H. , Jamieson Nigel B. , Chang David , Brown Victoria , Denley Simon , Orange Clare , McKay Colin , Carter Ross , Oien Karin A. , Duthie Fraser R. 
Published: April 2016

Background:
Clinical translation of immunohistochemistry (IHC) biomarkers requires reliable and reproducible cutoffs or thresholds for interpretation of immunostaining. Most IHC biomarker research focuses on the clinical relevance (diagnostic, prognostic, or predictive utility) of cutoffs, with less emphasis on observer agreement using these cutoffs. From the literature, we identified 3 commonly used cutoffs of 10% positive epithelial cells, 20% positive epithelial cells, and moderate to strong staining intensity (+2/+3 hereafter) to use for investigating observer agreement.

Materials and Methods:
A series of 36 images of microarray cores stained for 4 different IHC biomarkers, with variable staining intensity and percentage of positive cells, was used for investigating interobserver and intraobserver agreement. Seven pathologists scored the immunostaining in each image using the 3 cutoffs for positive and negative staining. Kappa (κ) statistic was used to assess the strength of agreement for each cutoff.

Results:
The interobserver agreement between all 7 pathologists using the 3 cutoffs was reasonably good, with mean κ scores of 0.64, 0.59, and 0.62, respectively, for 10%, 20%, and +2/+3 cutoffs. A good agreement was observed for experienced pathologists using the 10% cutoff, and their agreement was statistically higher than for junior pathologists (P=0.02). In addition, the mean intraobserver agreement for all 7 pathologists using the 3 cutoffs was reasonably good, with mean κ scores of 0.71, 0.60, and 0.73, respectively, for 10%, 20%, and +2/+3 cutoffs. For all 3 cutoffs, a positive correlation was observed with perceived ease of interpretation (P<0.003). Finally, cytoplasmic-only staining achieved higher agreement using all 3 cutoffs than mixed staining patterns.

Conclusions:
All 3 cutoffs investigated achieve reasonable strength of agreement, modestly decreasing interobserver and intraobserver variability in IHC interpretation. These cutoffs have previously been used in cancer pathology, and this study provides evidence that these cutoffs can be reproducible between practicing pathologists.