bluuebunny/crossref_metadata_2025_split huggingface dataset:
Can social support work virtually? Evaluation of rheumatoid arthritis patients’ experiences with an interactive online tool
Authors: Kostova Zlatina , Caiata-Zufferey Maria , Schulz Peter J 
Published: March 2016

BACKGROUND: There is strong empirical evidence that the support that chronic patients receive from their environment is fundamental for the way they cope with physical and psychological suffering. Nevertheless, in the case of rheumatoid arthritis (RA), providing the appropriate social support is still a challenge, and such support has often proven to be elusive and unreliable in helping patients to manage the disease.OBJECTIVES: To explore whether and how social support for RA patients can be provided online, and to assess the conditions under which such support is effective. An online support tool was designed to provide patients with both tailored information and opportunities to interact online with health professionals and fellow sufferers. The general purpose was to identify where the support provided did – or did not – help patients, and to judge whether the determinants of success lay more within patients – their engagement and willingness to participate – or within the design of the website itself.METHODS: The present study reports qualitative interviews with 19 users of the tool. A more specific purpose was to elaborate qualitatively on results from a quantitative survey of users, which indicated that any positive impact was confined to practical matters of pain management rather than extending to more fundamental psychological outcomes such as acceptance.RESULTS AND CONCLUSIONS: Overall, online learning and interaction can do much to help patients with the everyday stresses of their disease; however, its potential for more durable positive impact depends on various individual characteristics such as personality traits, existing social networks, and the severity and longevity of the disease.
Post-Transplant Lymphoproliferative Disorder in Liver Transplant Recipients: Characteristics, Management and Outcome from a Single-Centre Experience with >1000 Liver Transplantations
Authors: Mumtaz Khalid , Faisal Nabiha , Marquez Max , Healey Alicia , Lilly Leslie B , Renner Eberhard L 
Published: March 2016

BACKGROUND: The literature regarding post-transplant lymphoproliferative disorder (PTLD) in liver transplant recipients (LTRs) is limited.OBJECTIVES: To study the incidence, predictors and outcomes of PTLD after liver transplantation in a single, large-volume centre.METHODS: The charts of all LTRs (n=1372) in the authors’ centre between January 2000 and June 2012 were retrospectively reviewed and those who developed PTLD were identified. Demographic, clinical and treatment data were prospectively collected. Responses to treatment, including complete response, no response, relapse and survival, were recorded.RESULTS: The incidence of PTLD in LTRs was 32 in 1372 (2.3%). Overall, median survival was 37 months (range 0.5 to 195 months), with one-, three- and five-year survival rates of 81%, 74% and 60%, respectively. Epstein-Barr virus (EBV)-negative patients had a better mean (± SD) survival (95±79 months) than EBV-positive patients (41±42 months) (P=0.02). For stage I/II PTLD, one-, three- and five-year actuarial survival was 87%, 87% and 75%, compared with 50%, 30% and 0% for stage III/IV PTLD, respectively (P=0.001). In patients with complete response, median survival was 58 months (range 10 to 195 months); and one-, three- and five-year actuarial survival was 100%, 94% and 76%, respectively, after diagnosis of PTLD. Changing immunosuppression (IS) from calcineurin inhibitor to sirolimus at the time of diagnosis may have improved survival (seven of seven survivors) compared with only decreasing or stopping IS (14 of 25 survivors) (P=0.07).CONCLUSIONS: This series from a single large-volume centre showed excellent short and long-term survival after PTLD in adult LTRs who were EBV negative, had early disease and showed complete response. Consistent with the known in vitro antiproliferative effect of sirolimus, switching IS from calcineurin inhibitor to sirolimus may improve survival.
A Confirmed Case of Toxic Shock Syndrome Associated with the Use of a Menstrual Cup
Authors: Mitchell Michael A , Bisch Steve , Arntfield Shannon , Hosseini-Moghaddam Seyed M 
Published: March 2016

Menstrual cups have been reported to be an acceptable substitute for tampons. These flexible cups have also been reported to provide a sustainable solution to menstrual management, with modest cost savings and no significant health risk.The present article documents the first case of toxic shock syndrome associated with the use of a menstrual cup in a woman 37 years of age, using a menstrual cup for the first time. Toxic shock syndrome and the literature on menstrual cups is reviewed and a possible mechanism for the development of toxic shock syndrome in the patient is described.
Development of the Adolescent Cancer Suffering Scale
Authors: Khadra Christelle , Le May Sylvie , Tremblay Isabelle , Dupuis France , Cara Chantal , Mercier Geneviève , Vachon Marie France , Fiola Jacinthe Lachance 
Published: March 2016

BACKGROUND: While mortality due to pediatric cancer has decreased, suffering has increased due to complex and lengthy treatments. Cancer in adolescence has repercussions on personal and physical development. Although suffering can impede recovery, there is no validated scale in French or English to measure suffering in adolescents with cancer.OBJECTIVE: To develop an objective scale to measure suffering in adolescents with cancer.METHODS: A methodological design for instrument development was used. Following a MEDLINE search, semistructured interviews were conducted with adolescents 12 to 19 years of age who had undergone four to six weeks of cancer treatment, and with a multidisciplinary cohort of health care professionals. Adolescents with advanced terminal cancer or cognitive impairment were excluded. Enrollment proceeded from the hematology‐oncology department/clinic in Montreal, Quebec, from December 2011 to March 2012. Content validity was assessed by five health care professionals and four adolescents with cancer.RESULTS: Interviews with 19 adolescents and 16 health care professionals identified six realms of suffering: physical, psychological, spiritual, social, cognitive and global. Through iterative feedback, the Adolescent Cancer Suffering Scale (ACSS) was developed, comprising 41 questions on a four‐point Likert scale and one open‐ended question. Content validity was 0.98, and inter‐rater agreement among professionals was 88% for relevance and 86% for clarity. Adolescents considered the scale to be representative of their suffering.CONCLUSIONS: The ACSS is the first questionnaire to measure suffering in adolescents with cancer. In future research, the questionnaire should be validated extensively and interventions developed. Once validated, the ACSS will contribute to promote a holistic approach to health with appropriate intervention or referral.
Prevalence and Management of Back Pain in Adolescent Idiopathic Scoliosis Patients: A Retrospective Study
Authors: Théroux Jean , Le May Sylvie , Fortin Carole , Labelle Hubert 
Published: March 2016

BACKGROUND: Back pain (BP) has often been associated with adolescent idiopathic scoliosis (AIS), which is a three‐dimensional deviation of the vertebral column. In adolescents, chronic pain appears to be a predictor of health care utilization and has a negative impact on physical, psychological and family well‐being. In this population, BP tends to be persistent and may be a predictor of BP in adulthood.OBJECTIVE: To document the prevalence and management of BP in AIS patients.METHODS: A retrospective chart review of AIS patients who were referred to Sainte‐Justine University Teaching Hospital (Montreal, Quebec) from 2006 to 2011 was conducted.RESULTS: A total of 310 randomly selected charts were reviewed. Nearly one‐half of the patients (47.3%) mentioned that they experienced BP, most commonly in the lumbar (19.7%) and thoracic regions (7.7%). The type of BP was documented in only 36% (n=112) of the charts. Pain intensity was specified in only 21% (n=65) of the charts. In approximately 80% (n=248) of the charts, no pain management treatment plan was documented.CONCLUSIONS: The prevalence of BP was moderately high among the present sample of adolescents with AIS. An improved system for documenting BP assessment, type, treatment plan and treatment effectiveness would improve pain management for these patients.
Assessing Patient‐Centred Care for Chronic Pain: Validation of a New Research Paradigm
Authors: Paul-Savoie Emilie , Bourgault Patricia , Gosselin Emilie , Potvin Stéphane , Lafrenaye Sylvie 
Published: March 2016

BACKGROUND: Chronic pain is a complex phenomenon resulting from biological, psychological and social factors, and the use of patient‐centred care (PCC) appears to be a promising avenue for its treatment. Various methods have been used for measuring PCC in nurses and physicians (caregivers); however, methodological problems have been raised following the observation of real clinical encounters or standardized patient simulations. The development of new strategies is required.OBJECTIVE: To develop and validate an observation scale for the assessment of PCC in caregivers, using standardized videos of real patients with chronic pain.METHODS: An expert panel developed five videos and the Sherbrooke Observation Scale of Patient‐Centered Care (SOS‐PCC), which were tested in a sample of 21 nurses and 21 physicians working with chronic pain patients. The content validity, internal consistency and inter‐rater reliability of the SOS‐PCC were assessed.RESULTS: The expert panel was satisfied with the content validity of the SOS‐PCC. Results revealed good internal consistency (Cronbach’s alpha = 0.88) and inter‐rater reliability (intraclass coefficient = 0.93) for this scale.CONCLUSIONS: To the authors’ knowledge, the SOS‐PCC is the first instrument available in French to assess PCC behaviour of caregivers using videos of real patients with chronic pain. The psychometric qualities of these instruments are good. Future studies will need to assess this instrument with other populations of caregivers.
Hepatitis C Virus Seroconversion among Hiv‐Positive Men Who Have Sex With Men With No History of Injection Drug Use: Results from a Clinical Hiv Cohort
Authors: Burchell Ann N , Gardner Sandra L , Mazzulli Tony , Manno Michael , Raboud Janet , Allen Vanessa G , Bayoumi Ahmed M , Kaul Rupert , McGee Frank , Millson Peggy , Remis Robert S , Wobeser Wendy , Cooper Curtis , Rourke Sean B 
Published: March 2016

BACKGROUND: Internationally, there is a growing recognition that hepatitis C virus (HCV) may be sexually transmitted among HIV‐positive men who have sex with men (MSM).OBJECTIVE: To report the first Canadian estimate of HCV seroincidence in 2000 to 2010 and its risk factors among HIV‐positive MSM with no known history of injection drug use.METHODS: Data from the Ontario HIV Treatment Network Cohort Study, an ongoing cohort of individuals in HIV care in Ontario, were analyzed. Data were obtained from medical charts, interviews and record linkage with the provincial public health laboratories. The analysis was restricted to 1534 MSM who did not report injection drug use and had undergone ≥2 HCV antibody tests, of which the first was negative (median 6.1 person‐years [PY] of follow‐up; sum 9987 PY).RESULTS: In 2000 to 2010, 51 HCV seroconversions were observed, an overall incidence of 5.1 per 1000 PY (95% CI 3.9 to 6.7). Annual incidence varied from 1.6 to 8.9 per 1000 PY, with no statistical evidence of a temporal trend. Risk for seroconversion was elevated among men who had ever had syphilis (adjusted HR 2.5 [95% CI 1.1 to 5.5) and men who had acute syphilis infection in the previous 18 months (adjusted HR 2.8 [95% CI 1.0 to 7.9]). Risk was lower for men who had initiated antiretroviral treatment (adjusted HR 0.49 [95% CI 0.25 to 0.95]). There were no statistically significant effects of age, ethnicity, region, CD4 cell count or HIV viral load.CONCLUSIONS: These findings suggest that periodic HCV rescreening may be appropriate in Ontario among HIV‐positive MSM. Future research should seek evidence whether syphilis is simply a marker for high‐risk sexual behaviour or networks, or whether it potentiates sexual HCV transmission among individuals with HIV.
Edwardsiella tarda Bacteremia. A Rare but Fatal Water‐ and Foodborne Infection: Review of the Literature and Clinical Cases from a Single Centre
Authors: Hirai Yuji , Asahata-Tago Sayaka , Ainoda Yusuke , Fujita Takahiro , Kikuchi Ken 
Published: March 2016

BACKGROUND: Edwardsiella tarda bacteremia (ETB) can be a fatal disease in humans.OBJECTIVES: To determine the significant risk factors associated with death caused by ETB, and to examine the geographical, seasonal, environmental and dietary factors of the disease.METHODS: A retrospective, observational, case control study was performed. The PubMed MEDLINE and Japanese Medical Abstract Society (www.jamas.or.jp) databases were searched for ETB case reports and meeting abstracts. In additon, retrospective chart reviews of patients with ETB at the Tokyo Women’s Medical University Hospital (Tokyo, Japan) were conducted to evaluate the risk factors associated with death using multivariate analyses.RESULTS: The literature search yielded 46 publications, comprising 72 cases from the English (n=30), French (n=1), Spanish (n=1) and Japanese (n=14) literature. Five cases at the Tokyo Women’s Medical University Hospital were also included. Of the included 77 cases, the mean age was 61 years and 39% of patients were female; 77.2% of the cases occurred between June and November, and 45.5% were reported in Japan. Dietary factors (raw fish/meat exposure) were reported for 10.4% of patients and 12.9% reported environmental (ie, brackish water) exposure. The overall mortality rate was 44.6%; however, this rate increased to 61.1% for ETB patients with soft tissue infections. Liver cirrhosis was determined to be an independent risk factor associated with death (OR 12.0 [95% CI 2.46 to 58.6]; P=0.00213) using multivariate analyses.DISCUSSION: To our knowledge, the present analysis was the first and largest multi‐language review of ETB. Clinical characteristics of ETB resemble those of Aeromonas, typhoid fever and Vibrio vulnificus infections, in addition to sharing similar risk factors.CONCLUSION: ETB should be categorized as a severe food‐ and waterborne infection, which results in high mortality for patients with liver cirrhosis.
Characterization of Inflammatory Bowel Disease in Hospitalized Elderly Patients in a Large Central Canadian Health Region
Authors: Stepaniuk Peter , Bernstein Charles N , Nugent Zoann , Singh Harminder 
Published: March 2016

OBJECTIVE: To determine differences in phenotype and treatment among hospitalized elderly and young patients with inflammatory bowel disease (IBD), and the utility ofInternational Classification of Diseases, 10th Revision(ICD)-10 codes in hospital discharge abstracts in diagnosing IBD in elderly patients.METHODS: A large Canadian health region hospitalization discharge database was used to identify elderly (>65 years of age) and young (19 to 50 years of age) patients with IBD admitted between April 1, 2007 and March 31, 2012, and a random sample of elderly patients with other colonic conditions. Medical records were reviewed to confirm IBD diagnosis and extract clinical information. The characteristics of elderly versus young hospitalized IBD patients and accuracy of ICD-10 IBD discharge codes in the elderly were assessed.RESULTS: One hundred forty-three elderly and 82 young patients with an IBD discharge diagnosis, and 135 elderly patients with other gastrointestinal discharge diagnoses were included. Elderly IBD patients were less likely to have ileocolonic Crohn disease (21.4% versus 50.9%; P=0.001), more likely to be prescribed 5-aminosalicylates (61% versus 43%; P=0.04), and less likely to be prescribed biologics (6% versus 21%; P=0.016) or immunomodulators (21% versus 42%; P=0.01). The sensitivity, specificity and positive predictive value of a single ICD code for CD were 98%, 96% and 94%, respectively, and for ulcerative colitis (UC) were 98%, 92% and 70%, respectively.CONCLUSIONS: Treatment approaches in elderly patients were different than in younger IBD patients despite having disease sufficiently severe to require hospitalization. While less accurate in UC, a single ICD-10 IBD code was sufficient to identify elderly CD and UC hospitalized patients.
A Case Series of Third‐Trimester Raltegravir Initiation: Impact on Maternal HIV‐1 Viral Load and Obstetrical Outcomes
Authors: Boucoiran I , Tulloch K , Pick N , Kakkar F , van Schalkwyk J , Money D , Boucher M 
Published: March 2016

OBJECTIVE: To describe the impact of initiating raltegravir (RAL)‐containing combination antiretroviral therapy (cART) regimens on HIV viral load (VL) in pregnant women who have high or suboptimal VL suppression late in pregnancy.METHODS: HIV‐infected pregnant women who started RAL‐containing cART after 28 weeks’ gestation from 2007 to 2013 were identified in two university hospital centres.RESULTS AND DISCUSSION: Eleven HIV‐infected women started RAL at a median gestational age of 35.7 weeks (range 31.1 to 38.0 weeks). Indications for RAL initiation were late presentation in pregnancy (n=4) and suboptimal VL suppression secondary to poor adherence or viral resistance (n=7). Mean VL at the time of RAL initiation was 73,959 copies/mL (range <40 to 523,975 copies/mL). Patients received RAL for a median of 20 days (range one to 71 days). The mean decline in VL from the time of RAL initiation to delivery was 1.93 log, excluding one patient who received only one RAL dose and one patient with undetectable VL at the time of RAL initiation. After eight days on RAL, 50% of the women achieved a VL <1000 copies/mL (the threshold for recommended Caesarean section to reduce the risk for perinatal transmission). There were no cases of perinatal HIV transmission.CONCLUSION: The present study provides preliminary data to support the use of RAL‐containing cART to expedite HIV‐1 VL reduction in women who have a high VL or suboptimal VL suppression late in pregnancy, and to decrease the risk of HIV perinatal transmission while avoiding Caesarean section. Further assessment of RAL safety during pregnancy is warranted.
Pain in Canadian Veterans: Analysis of Data from the Survey on Transition to Civilian Life
Authors: VanDenKerkhof Elizabeth G , VanTil Linda , Thompson James M , Sweet Jill , Hopman Wilma M , Carley Meg E , Sudom Kerry 
Published: March 2016

BACKGROUND: Little is known about the prevalence of chronic pain among Veterans outside the United States.OBJECTIVE: To describe the prevalence of chronic pain and associated sociodemographic, health behaviour, employment/income, disability, and physical and mental health factors in Canadian Veterans.METHODS: The 2010 Survey on Transition to Civilian Life included a nationally representative sample of 3154 Canadian Armed Forces Regular Force Veterans released from service between 1998 and 2007. Data from a telephone survey of Veterans were linked with Department of National Defence and Veterans Affairs Canada administrative databases. Pain was defined as constant/reoccurring pain (chronic pain) and as moderate/severe pain interference with activities.RESULTS: Forty‐one percent of the population experienced constant chronic pain and 23% experienced intermittent chronic pain. Twenty‐five percent reported pain interference. Needing help with tasks of daily living, back problems, arthritis, gastrointestinal conditions and age ≥30 years were independently associated with chronic pain. Needing help with tasks of daily living, back problems, arthritis, mental health conditions, age ≥30 years, gastrointestinal conditions, low social support and noncommissioned member rank were associated with pain interference.CONCLUSIONS: These findings provide evidence for agencies and those supporting the well‐being of Veterans, and inform longitudinal studies to better understand the determinants and life course effects of chronic pain in military Veterans.
Adenoma Detection Rates Decline with Increasing Procedural Hours in an Endoscopist’s Workload
Authors: Almadi Majid A , Sewitch Maida , Barkun Alan N , Martel Myriam , Joseph Lawrence 
Published: March 2016

BACKGROUND: Operator fatigue may negatively influence adenoma detection (AD) during screening colonoscopy.OBJECTIVE: To better characterize factors affecting AD, including the number of hours worked, and the number and type of procedures performed before an index screening colonoscopy.METHODS: A retrospective cohort study was conducted involving individuals undergoing a screening colonoscopy at a major tertiary care hospital in Montreal, Quebec. Individuals were identified using an endoscopic reporting database; AD was identified by an electronic chart review. A hierarchical logistic regression analysis was performed to determine the association between patient- and endoscopist-related variables and AD.RESULTS: A total of 430 consecutive colonoscopies performed by 10 gastroenterologists and two surgeons were included. Patient mean (± SD) age was 63.4±10.9 years, 56.3% were males, 27.7% had undergone a previous colonoscopy and the cecal intubation rate was 95.7%. The overall AD rate was 25.7%. Age was associated with AD (OR 1.06 [95% CI 1.03 to 1.08]), while female sex (OR 0.44 [95% CI 0.25 to 0.75]), an indication for average-risk screening (OR 0.47 [95% CI 0.27 to 0.80]) and an increase in the number of hours during which endoscopies were performed before the index colonoscopy (OR 0.87 [95% CI 0.76 to 0.99]) were associated with lower AD rates. On exploratory univariable analysis, a threshold of 3 h of endoscopy time performed before the index colonoscopy was associated with decreased AD.CONCLUSION: The number of hours devoted to endoscopies before the index colonoscopy was inversely associated with AD rate, with decreased performance possibly as early as within 3 h. This metric should be confirmed in future studies and considered when optimizing scheduling practices.
Urinary Tract Infection Diagnosis and Response to Therapy in Long‐Term Care: A Prospective Observational Study
Authors: Daley Peter , Penney Carla , Wakeham Susan , Compton Glenda , McKim Aaron , O’Keefe Judy , Barrett Brendan , Nicolle Lindsay 
Published: March 2016

BACKGROUND: The prevalence of asymptomatic bacteriuria among residents of long‐term care (LTC) facilities is high, and is a source of inappropriate antibiotic prescription.OBJECTIVE: To establish symptoms and signs associated with a positive urine culture, and to determine whether antibiotic therapy is associated with functional improvement.METHODS: A total of 101 LTC patients were prospectively observed after submission of urine for culture.RESULTS: The culture positivity rate was consistent with the expected asymptomatic bacteriuria rate. Change in mental status and male sex were associated with culture positivity. Treatment decisions were not consistent with culture results. Treatment did not lead to improvement in activities of daily living scores at two days or seven days.DISCUSSION: Significant growth cannot be well predicted based on clinical variables; thus, the decision to submit urine is somewhat arbitrary. Because urine culture testing and treatment does not lead to functional improvement, restricting access to the test may be reasonable.CONCLUSION: Urine culture testing in LTC facilities does not lead to functional improvement.