bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incorporating assessment and prescribing for ambulatory ailments skills into practice: An environmental scan of continuing education for pharmacist prescribing in Canada
Authors: Habicht Dana , Ng Sheila , Dunford Drena , Shearer Brenna , Kuo I fan 
Published: July 2017

Objectives: Pharmacists in Canadian provinces are at different stages of applying prescribing legislation into practice. The purpose of this environmental scan was to examine differences in legislation, remuneration, professional uptake, continuing education requirements and continuing education resources relating to pharmacist prescribing for ambulatory ailments, with a focus on continuing education. Methods: Data were collected between May and December 2016 using websites and communication with provincial professional regulatory bodies, advocacy bodies, drug coverage programs and other organizations that offer continuing education for pharmacists. Results: Training requirements to prescribe for ambulatory ailments vary provincially, including no training requirements, online tutorials and a comprehensive application process. Government-funded remuneration for prescribing services is absent in most provinces. Pharmacist uptake of the training required to obtain prescribing authority ranges from 30% to 100% of pharmacists. Continuing education programs on the topic of prescribing across the country include online courses, in-person courses, webinars, panel discussions and preparation courses. Conclusion: Many aspects of pharmacist prescribing for ambulatory ailments, including the style and content of continuing education resources, vary from province to province. Further research on this topic would help to determine the effect of these differences on the success of incorporating pharmacist prescribing into practice.
Sex difference in types and distribution of risk factors in ischemic and hemorrhagic stroke
Authors: Ahangar Alijan A , Saadat Payam , Heidari Behzad , Taheri Seyedeh T , Alijanpour Shayan 
Published: July 2017

Background Stroke is the second leading cause of death worldwide and is associated with several risk factors with variable risk factor distribution by population. We report the types and frequency of the associated factors of stroke in north Iran. Methods Consecutive patients with stroke were recruited from 2014 to 2015. The two groups of ischemic and hemorrhagic stroke were compared with respect to age, sex, the prevalence, and distribution of the risk factors. Results Among 230 patients (84.3% ischemic stroke) with mean age of 61.2 years, hypertension (73%), diabetes mellitus (53%), cardiovascular disease (51%), and dyslipidemia (47%) were the most frequent risk factors. Hypertension was significantly more prevalent in males compared with females (88% vs. 60%, OR = 4.91, 95% CI: 2.48–9.71). Hypertension, smoking, and opioid consumption were associated with hemorrhagic stroke. Dyslipidemia was significantly higher in ischemic stroke (OR = 2.65, 95% CI: 1.21–5.8). Overall, 84.3% of stroke occurred in patients aged >50 years (92.8% of women vs. 74.5% of the men, OR = 4.43, 95% CI: 1.93–10.16, p = 0.001). Conclusion Stroke was more prevalent in females; hypertension was more prevalent in males. In the age group less than 50 years old, stroke is more prevalent in men.
The influence of late displacement in distal radius fractures on function, grip strength, range of motion and quality of life
Authors: Wadsten M. Å. , Sjödén G. O. , Buttazzoni G. G. , Buttazzoni C. , Englund E. , Sayed- Noor A. S. 
Published: July 2017

Late displacement of distal radius fractures, still in acceptable radiological position after 1–2 weeks, occurs in approximately one-third of cases. The aim of this study was to investigate the influence of late displacement on the functional outcome and quality of life at 1 year in non-operatively treated distal radius fractures. One hundred and seventy five unilateral conservatively treated distal radius fractures with minimal displacement after 10–14 days were finally evaluated in the study. Follow-up included radiographs at 3 months and clinical examination 1 year after the fracture. Final radiographic parameters, grip strength, range of motion, QuickDASH, EQ-5D and pain visual analogue scale were evaluated with multivariate analysis. Late displacement occurred in 28% of the cases and was associated with loss of grip strength and range of motion. No significant differences were seen in the outcome questionnaires. Level of evidence: II
Ureteric stents: The past, present and future
Authors: Williams Kevin G , Blacker Anthony JR , Kumar Priyadarshi 
Published: July 2017

Ureteric stents are fundamental to modern-day urological practice. This article aims to chronicle their development over the last century and the key individuals whose efforts have made their development possible. Early stents were ureteric catheters that were exteriorised outside the body and were associated with complications including migration, infection and encrustation. The use of polyethylene stents in humans was first reported by Tulloch in 1952. Polyethylene was thought to be a promising material due to its durability and water-repellent nature. It would, however, suffer the problems that would become associated with stents over the following decades mentioned above. The first silicone ureteric stents were developed in the 1960s by Zimskind and provided prolonged, efficient drainage but were complicated with stent migration. Collars, wings, flanges and barbs were developed to help prevent migration. Finney developed a double ‘pig-tail’ stent in the 1970s which helped to prevent both proximal and distal migration and the modern-day ureteric stent was born. Modern polymers have been developed such as polyurethane or styrene ethylene-butylene (C-flex®). Metal stents have also been used over the last three decades including the Wallstent™, Resonance® and Memokath™ stents. They have shown promising results particularly when long-term relief of ureteric obstruction is needed. Various strategies are available for removal including cystoscopically, stents with a metallic end that can be removed by using a catheter with a magnet at the proximal end, tethered stents that can be removed noninvasively either by the urologist, nurse or even by the patient and dissolvable stents which are in development.
Resistance to dasatinib is associated with the activation of Akt in oral squamous cell carcinoma
Authors: Yee Pei San , Gan Chai Phei , Zainal Nur Syafinaz , Chiang Ivy KN , Dionne Kalen R , Fadlullah Muhammad ZH , Lee Bernard KB , Tiong Kai Hung , Mun Kein Seong , Abraham Mannil T , Ismail Siti M , Rahman Zainal A Abdul , Patel Vyomesh , Cheong Sok Ching 
Published: July 2017

Objectives: Overexpression and aberrant activation of Src promote the development of oral squamous cell carcinoma (OSCC), thus therapies targeting Src-related kinases may afford an improvement in patient survival. However, limited clinical activity of the Src-targeted drug, dasatinib, in cancer patients warrants further investigation to better understand the underlying basis of resistance to dasatinib in OSCC. Methods: Response to dasatinib was evaluated in a panel of oral cancer cell lines by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide, DNA synthesis, cell cycle and apoptosis analysis. The underlying mechanism of drug response was investigated using immunoblotting. Xenograft models were used to test efficacy. Results: All cell lines were sensitive to dasatinib (IC50 < 250 nM), but this was not associated with CDKN2a/p14ARF mutations. Dasatinib-induced cell cycle arrest and apoptosis, while inhibiting Src, Akt and FAK activity in all lines tested. However, dasatinib failed to inhibit tumour growth in xenograft models and treated tissues showed Akt activity despite the loss of Src activity. Conclusions: Our data revealed that reactivation of Akt (Ser473) could be a compensatory mechanism that bypasses Src inhibition by dasatinib, providing important clues that could improve treatment strategies to overcome dasatinib resistance.
Ultra-long-toss vs Straight-line Throwing for Glenohumeral Range of Motion Recovery in Collegiate Baseball Pitchers
Authors: Luo Tianyi D. , Naugher Gregory Lane , Stone Austin , Mannava Sandeep , Strahm Jeff , Freehill Michael T. 
Published: July 2017

Objectives: Repetitive throwing in baseball pitchers can lead to pathologic changes in shoulder anatomy with potential subsequent injury. There have been few studies on throwing regimens and the types of throwing most efficacious for both maintenance and recovery during the baseball season. Limited-distance straight-line throwing (SLT) mimics more normal pitching mechanics, whereas ultra-long-toss (ULT) at greater than physiological throwing distances changes shoulder kinematics, but theoretically offers the advantage of stretching the posterior capsule. Debate exists as to whether ULT or SLT is superior for glenohumeral range of motion (ROM) recovery after baseball pitching. We hypothesize that ULT, via a potential mechanism of posterior shoulder capsular stretching, will be more effective in returning a pitcher’s baseline external rotation (ER), internal rotation (IR), and total range of motion (TROM) when compared to SLT in a cohort of collegiate pitchers. Methods: Sixteen Division-I collegiate baseball pitchers were randomized to ULT (n=8, mean age 20.1 ± 1.4 years) or SLT group (n=8, mean age 20.0 ± 1.1 years). Measurements (dominant and non-dominant ER, IR, and TROM) were taken at five time-points across three days: before and immediately after a standardized bullpen (BP) session on day 1; before and immediately after a standardized ULT or SLT session on day 2; and before practice on day 3. Data were analyzed using mix design ANOVA. Post hoc analysis was used to detect differences between time-points. Results: In the ULT group (Table 1), dominant ER significantly increased from baseline to final measurements (129° to 136°, p=0.006). Significant increase in ER was observed between pre- and post-long-toss throwing (+6.2°, p=0.004). Dominant IR significantly decreased from baseline to final measurements (57° to 50°, p=0.002). TROM did not significantly change across time-points. In the SLT group, dominant ER increased from baseline to final measurements (139° to 142°), but failed to reach statistical significance. Dominant IR did not vary significantly across time-points, nor did TROM. Conclusion: Our results do not support our initial hypothesis. ULT yielded greater increases in ER and decreases in IR in comparison to SLT. Total range of motion did not change over time in either throwing group; however, the overall arc of motion changed more significantly in ULT pitchers, secondary to the greater ER and less IR. We had anticipated an increase in IR with ULT due to the theoretical advantage of posterior capsule stretching. The observed IR decrease suggests ULT may cause additive microtrauma resulting in capsular tightness rather than recovering shoulder ROM. Ultra-long-toss throwing should be further evaluated in the context of training, rehabilitation, and injury-prevention. [Table: see text]
Autologous Conditioned Plasma (ACP) versus Corticosteroid Injections for Plantar Fasciitis: A Randomized Trial
Authors: Willits Kevin , Kaniki Nicole , Bryant Dianne , O’Brecht Lyndsay , Remtulla Alliya 
Published: July 2017

Objectives: Plantar fasciitis is a chronic, degenerative breakdown of the plantar fascia that spans the bottom surface of the foot. The injury is associated with point tenderness at the medial side of the heel and pain and tightness with weight bearing. Corticosteroid (CS) injections are a fairly common treatment option after exhausting all other non-operative treatments. Autologous conditioned plasma (ACP) injections may optimize the healing environment for tissue regeneration and repair which may provide greater improvements in pain and function compared to corticosteroid injections. Thus, the purpose of this study was to compare the pain, function and quality of life in patients who have received an ACP injection versus a corticosteroid injection for the treatment of plantar fasciitis. Methods: We conducted a randomized controlled trial in patients with plantar fasciitis who were referred to our clinic from local primary care physicians. Patients were stratified by symptom duration (less than and greater than three months) and received either an ACP or CS injection. We measured outcomes at two weeks, six weeks, three months, six months, and one year. Our primary outcome was the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale; secondary outcomes included the SF-12v2 Health Survey and the Plantar Fasciitis Pain and Disability scale. We used an analysis of covariance to analyze all outcomes. We calculated the adjusted between-group mean difference with 95% confidence interval and associated probability values. Results: A total of 126 patients were included in the analysis (ACP = 64, CS = 62). For our primary outcome, at six months, the mean and standard deviation of the AOFAS Ankle-hindfoot scale was 67.1±18.3 for the ACP group and 70.8±17.6 for the CS group (mean difference -1.7, CI -7.6 to 4.2, p = 0.6). At one year, the mean and standard deviation was 72.3±19.1 for the ACP group and 75.6±17.0 for the CS group (mean difference -1.3 CI -7.3 to 4.6, p = 0.7). There was no statistically significant differences between treatment groups for any of the secondary outcome measures. Conclusion: ACP does not provide greater self-reported pain relief or function than CS injections in patients with plantar fasciitis. Given the know complications of repeated CA injections, ACP is a reasonable first line treatment option.
The Epidemiology of Lisfranc Injuries at the National Football League Combine and its Impact on an Athlete’s National Football League Career
Authors: McHale Kevin Jude , Vopat Bryan George , Sanchez George , Rossy William H. , Logan Catherine , Provencher Matthew T. 
Published: July 2017

Objectives: Lisfranc injuries may have a detrimental effect on athletic performance and an athlete’s career. Understanding the epidemiology of these injuries in collegiate football players and their impact on future performance may assist team physicians in counseling injured athletes and determining optimal treatment. The purposes of this study are to 1) determine the epidemiology of navicular fractures in players participating in the NFL Combine, 2) define positions and demographics that might be at higher risk for sustaining this injury, and 3) evaluate the radiographic healing and eventual impact the injury and radiographic findings has on Lisfranc injuries on NFL draft position and NFL game play compared to matched controls. Methods: All players who sustained a Lisfranc injury prior to Combine evaluation between 2009 and 2015 were evaluated. The prevalence, positions affected, treatment methods, and number of missed collegiate games were recorded. Radiographic outcomes were analyzed via Combine radiograph findings, while NFL performance outcomes were assessed for all Lisfranc injuries (2009-13) compared to matched controls in first two years of play. Results: A total of 41/2162 (1.8%) Combine participants were identified with Lisfranc injuries, of which 26/41 (63.4%) were managed operatively. When compared to players managed nonoperatively, those who underwent surgery were more likely to go undrafted (38.5% vs. 13.3%, p=0.04) and featured a worse NFL draft pick position (155.6 vs. 109, p=0.03). Lisfranc-injured players were noted to have a worse NFL draft position (142 vs. 111.3, p=0.04), NFL career length ≥2 years (62.5% vs. 69.6%, p=0.23) and fewer games played (16.9 vs. 23.3, p=0.001) and started (6.8 vs. 10.5, p=0.08) within the first two years of NFL career versus controls. Radiographs demonstrated 17/41 (41.5%) athletes with residual Lisfranc joint displacement >2mm compared to the contralateral foot. Lisfranc-injured athletes with >2mm residual displacement had lower draft position (111.2 vs. 156.9, p=0.009), and fewer games played (23.3 vs. 14.4, p=0.001) and started (10.5 vs. 3,1, p=0.03) versus matched controls. Moreover, athletes with >2mm residual displacement featured worse outcomes across all assessed NFL variables versus athletes with ≤2mm residual displacement. Conclusion: Lisfranc injuries identified at the NFL Combine have an adverse effect on an NFL athlete’s draft status, draft position and overall play during initial NFL seasons. In particular, residual displacement of the Lisfranc joint has a detrimental impact on the first two seasons of NFL play and may lead to long lasting negative effects on career.
Radiographic Risk Factors and Signs of Abductor Tears in the Hip
Authors: Hartigan David Edward , Perets Itay , Walsh John P. , Chaharbakhshi Edwin , Close Mary , Domb Benjamin G. 
Published: July 2017

Objectives: There is a known increased prevalence of abductor tears in patients with increased age and female gender. This study’s purpose is to identify radiographic risk factors (RRF) and radiographic signs of abductor tendon tears. Methods: Patients with intraoperative diagnoses of abductor tear were included in this study and were matched by age ±5 years, gender, and BMI ±5 with patients who had no abductor pathology by clinical exam and MRI. An AP pelvis radiograph was performed on all patients. The radiographs were evaluated for RRF (pelvic width, body weight moment arm, abductor moment arm, abductor angle, pelvic height) and signs of abductor tendon pathology (greater trochanteric excrescence). Femoral version was measured on MRI when images were available. Results: There were 152 patients with abductor tears identified intraoperatively. All were treated with surgical repair. These patients were matched as described previously. The RRF found were an increased tear drop to tear drop distance (14.8 for abductor tears vs. 14.3 for control; p<0.001), body weight moment arm (11.1 vs. 10.9; p<0.001), abductor moment arm (7.8 vs. 7.6; p<0.001), decreased femoral anteversion (7.6 vs. 10.6; p=0.045), and excrescence presence (41% vs. 3%; p<0.001). An excrescence of the greater trochanter had a specificity of 97%, PPV of 94% and a positive likelihood ratio of 12.8 for abductor tears. Conclusion: Patients with abductor tears have a wider pelvis, longer abductor moment arm, longer body weight moment arm, less femoral anteversion, and have greater trochanteric excrescence noted on nearly half of patients with an abductor tear. Presence of an excrescence was noted to have a positive predictive value of 94%, specificity of 97%, and positive likelihood ratio of 12.75, suggesting that if noted on radiograph, the care provider should have a very high index of suspicion for abductor tendon tear.
Operative Management of Osteochondritis Dissecans: Progression to Osteoarthritis and Arthroplasty in a Population Based Cohort
Authors: Sanders Thomas L. , Pareek Ayoosh , Johnson Nick R. , Mohan Rohith , Carey James L. , Stuart Michael J. , Krych Aaron John 
Published: July 2017

Objectives: Osteochondritis dissecans (OCD) is a disorder of subchondral bone that causes adverse effects on the overlying cartilage and commonly affects the knee. The purpose of this study is to (1) evaluate the rate of arthritis and knee arthroplasty in a population-based cohort of patients with OCD lesions treated operatively and (2) evaluate factors that may predispose patients to knee osteoarthritis and arthroplasty. Methods: 221 patients (mean age 26.1 ± 13.6 years) with OCD lesions treated operatively were identified between 1976 and 2014 and followed for a mean of 16.3 (±11.4) years from diagnosis. Information related to the diagnosis, laterality of lesion, details of treatment, and progression to arthritis was obtained from the medical record. Surgical treatment was classified as palliative (fragment excision) or restorative (lesion drilling, fragment fixation, osteochondral allograft or autograft). Factors predictive of arthritis and arthroplasty were examined. Results: In the palliative group, the cumulative incidence of arthritis was 12.0% at 5 years, 17.0% at 10 years, 26.0% at 15 years, 39.0% at 20 years, and 70% at 30 years. The cumulative incidence of arthroplasty was 2.0% at 5 years, 4.0% at 10 years, 4.0% at 15 years, 10.0% at 20 years, and 32.0% at 30 years. In the restorative group, the cumulative incidence of arthritis was 3.0% at 5 years, 7.0% at 10 years, 16.0% at 15 years, 25.0% at 20 years, and 51% at 30 years. The cumulative incidence of arthroplasty was 0.0% at 5 years, 0.0% at 10 years, 3.0% at 15 years, 6.0% at 20 years, and 11.0% at 30 years. BMI greater than 25 kg/m2 (HR 3.3, 95% CI: 1.6, 7.0), older age at diagnosis (HR 4.9, 95% CI: 1.8, 17.3) and fragment excision (HR 2.3, 95% CI: 1.2, 4.6) were predictive of arthritis. Conclusion: OCD patients treated with fragment excision have a high rate of arthritis and knee arthroplasty at long-term follow-up. In contrast, patients treated with fragment repair or osteochondral restoration have lower rates of arthritis and arthroplasty. BMI greater than 25 kg/m2, older age at diagnosis, and fragment excision were predictive of arthritis.
OCA Transplantation Outcomes for Replacing Large Bipolar Defects in the Knee using Novel Techniques
Authors: Cook James L. , Stannard James P. , Kfuri Mauricio , Crist Brett D. , Smith Matthew Jared 
Published: July 2017

Objectives: Osteochondral allograft (OCA) transplantation can functionally restore large articular cartilage defects in the knee, shoulder, hip and ankle. Studies have reported 10-year survivorship between 71% and 85% and up to 74% survivorship at 15 years. Outcomes after OCA treatment have been good to excellent, even in the athletic population in which 88% of patients returned to sport, including 79% returning to preinjury level of sport. However, OCA transplantations for bipolar defects in the knee have traditionally had less favorable results. With the advent of improved allograft preservation methods and refined surgical techniques, OCA transplantations for bipolar defects in the knee have shown a trend toward better outcomes. Therefore, the objective of this study was to report early functional outcomes associated with OCA transplantations to replace large (>4 cm2) bipolar articular cartilage defects in the knee using novel techniques for graft preservation, enhancing bone ingrowth, and implantation. Methods: With IRB approval, patients were enrolled in a dedicated registry for prospective assessment of outcomes after OCA surgery. Demographic and operative data were collected. Outcomes assessments including VAS pain, VAS level of function, IKDC, SANE and PROMIS Mobility are prospectively collected at 6 months and yearly after surgery. All complications and re-operations are recorded. OCA survival is determined based on maintenance of acceptable levels of pain and function and/or need for revision surgery. Data are compared to pre-operative and/or pre-injury levels using repeated measures analyses with significance set at p<0.05. Results: Large bipolar OCA transplantations were performed in 23 knees: femorotibial (n=19), patellofemoral (n=4). Mean age of patients was 34.6 years. Mean pre-operative pain, function, IKDC, SANE and PROMIS Mobility scores were 4.7, 4.1, 40.8, 40.1 and 42.1, respectively. At 6 months postop (n=17), mean scores improved to 1.3, 6, 56.2, 71.8 and 46.1, respectively. At 1 year (n=11), mean scores further improved to 0.4, 8.4, 76.7, 80.6 and 58.4, respectively (Table). Two (8.7%) meniscotibial grafts failed in the first 6 months after surgery and were successfully revised by a second OCA transplantation, making initial survival 91.3%. Five (21.7%) other patients required minor reoperations for lysis of adhesions to restore range of motion and/or screw removal. All subjects are enrolled in the registry and outcomes assessments are ongoing and will be updated for presentation. Conclusion: Bipolar osteochondral allograft transplantation surgeries for treatment of large (>4 cm2) femorotibial or patellofemoral articular cartilage defects in the knee using novel techniques are associated with significant improvements in levels of pain and function at 1 year after surgery. [Table: see text]