bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gaps in the Hepatitis C Continuum of Care among Sex Workers in Vancouver, British Columbia: Implications for Voluntary Hepatitis C Virus Testing, Treatment and Care
Authors: Socías M Eugenia , Shannon Kate , Montaner Julio S , Guillemi Silvia , Dobrer Sabina , Nguyen Paul , Goldenberg Shira , Deering Kathleen 
Published: March 2016

BACKGROUND: Hepatitis C virus (HCV) eradication leads to reduced morbidity, mortality and transmission. Despite the disproportionate burden of HCV among sex workers, data regarding the HCV care continuum in this population remain negligible.METHODS: Using baseline data from an ongoing cohort of women sex workers in Vancouver (An Evaluation of Sex Workers’ Health Access, January 2010 to August 2013), the authors assessed HCV prevalence and engagement in the HCV care continuum within the past year. Multivariable logistic regression analyses were used to evaluate associations with recent (ie, in the past year) HCV testing.RESULTS: Among 705 sex workers, 302 (42.8%) were HCV seropositive. Of these, 22.5% were previously unaware of their HCV status, 41.7% had accessed HCV-related care, 13.9% were offered treatment and only 1.0% received treatment. Among 552 HCV-seronegative sex workers, only one-half (52.9%) reported a recent HCV test. In multivariable analysis, women who self-identified as a sexual/gender minority (adjusted OR [aOR] 1.89 [95% CI 1.11 to 3.24]), resided in the inner city drug use epicentre (aOR 3.19 [95%CI 1.78 to 5.73]) and used injection (aOR 2.00 [95% CI 1.19 to 3.34]) or noninjection drugs (aOR 1.95 [95% CI 1.00 to 3.78]) had increased odds of undergoing a recent HCV test, while immigrant participants (aOR 0.24 [95% CI 0.12 to 0.48]) had decreased odds.CONCLUSIONS: Despite a high burden of HCV among sex workers, large gaps in the HCV care continuum remain. Particularly concerning are the low access to HCV testing, with one-fifth of women living with HCV being previously unaware of their status, and the exceptionally low prevalence of HCV treatment. There is a critical need for further research to better understand and address barriers to engage in the HCV continuum for sex workers.
Characterization of Invasive Neisseria meningitidis from Atlantic Canada, 2009 To 2013: With Special Reference to the Nonpolysaccharide Vaccine Targets (Pora, Factor H Binding Protein, Neisseria Heparin‐Binding Antigen and Neisseria Adhesin A)
Authors: Tsang Raymond SW , Law Dennis KS , Gad Rita R , Mailman Tim , German Gregory , Needle Robert 
Published: March 2016

BACKGROUND: Serogroup B Neisseria meningitidis (MenB) has always been a major cause of invasive meningococcal disease (IMD) in Canada. With the successful implementation of a meningitis C conjugate vaccine, the majority of IMD in Canada is now caused by MenB.OBJECTIVE: To investigate IMD case isolates in Atlantic Canada from 2009 to 2013. Data were analyzed to determine the potential coverage of the newly licensed MenB vaccine.METHODS: Serogroup, serotype and serosubtype antigens were determined from IMD case isolates. Clonal analysis was performed using multilocus sequence typing. The protein‐based vaccine antigen genes were sequenced and the predicted peptides were investigated.RESULTS: The majority of the IMD isolates were MenB (82.5%, 33 of 40) and, in particular, sequence type (ST)‐154 B:4:P1.4 was responsible for 47.5% (19 of 40) of all IMD case isolates in Atlantic Canada. Isolates of this clone expressed the PorA antigen P1.4 and possessed the nhba genes encoding for Neisseria heparin‐binding antigen peptide 2, which together matched exactly with two of the four components of the new four‐component meningococcal B vaccine. Nineteen MenB isolates had two antigenic matches, another five MenB and one meningitis Y isolate had one antigenic match. This provided 75.8% (25 of 33) potential coverage for MenB, or a 62.5% (25 of 40) overall potential coverage for IMD.CONCLUSION: From 2009 to 2013, IMD in Atlantic Canada was mainly caused by MenB and, in particular, the B:4:P1.4 ST‐154 clone, which accounted for 47.5% of all IMD case isolates. The new four‐component meningococcal B vaccine appeared to offer adequate coverage against MenB in Atlantic Canada.
How Can Surgeonfish Help Pediatric Surgeons? A Pilot Study Investigating the Antinociceptive Effect of Fish Aquariums in Adult Volunteers
Authors: Sanchez Matthieu , Delpont Marion , Bachy Manon , Kabbaj Reda , Annequin Daniel , Vialle Raphaël 
Published: March 2016

BACKGROUND: Multiple distraction strategies have been proposed to reduce the incidence of anxiety and pain in children. Animal‐assisted therapy is acknowledged and used in children as an adjunctive treatment with cognitive, physical, psychosocial and spiritual benefits.OBJECTIVE: To determine the effect of fish aquarium animal‐assisted therapy (FA‐AAT) on pain perception in a cohort of healthy volunteers.METHODS: Sixty‐nine healthy subjects (mean age 27.3 years) were exposed to >20 different species of soft or hard corals and >25 fish in a 1000 L saltwater aquarium. Pain perception was assessed using an electrical stimulation device, the Pain Matcher (Cefar Medical AB, Sweden), after 5 min, 10 min, 20 min and 30 min of continuous aquarium viewing. The measurements were repeated 10 min after stopping aquarium viewing.RESULTS: A statistically significant pain perception threshold augmentation was observed after a 5 min aquarium viewing. This threshold augmentation was also increased after 10 min, 20 min and 30 min of FA‐AAT. A remnant effect was noted up to 10 min after exposure. This short post‐viewing time period could be useful in clinical practice to perform certain painful procedures in children, such as those involving needles, under improved conditions immediately after aquarium exposure.CONCLUSIONS: In the authors’ department, FA‐AAT is now used as a nonpharmacological antinociceptive technique in association with a protocol of inhalated oxygen/nitrous oxide mixtures for needle‐related procedures. Children and parents are invited to watch the aquarium during the 10 min to 20 min before venous punctures.
A Prospective Multicentre Study to Evaluate the Efficacy and Tolerability of Osmotic Release Oral System (Oros®) Hydromorphone in Opioid‐Naive Cancer Patients: Results of the Korean South West Oncology Group Study
Authors: Song Eun-Kee , Shim Hyunjeong , Han Hye-Suk , Sun DerSheng , Lee Soon-Il , Kang Myung Hee , Lee KyuTaek , Cho DoYeun , Cho In Sung , Park Suk Young , Kim Samyong , Yim Chang-Yeol 
Published: March 2016

BACKGROUND: Osmotic release oral system (OROS®) hydromorphone is a potent, long‐acting opioid analgesic, effective and safe for controlling cancer pain in patients who have received other strong opioids. To date, few studies have examined the efficacy of hydromorphone for pain relief in opioid‐naive cancer patients.OBJECTIVES: A prospective, open‐label, multicentre trial was conducted to determine the efficacy and tolerability of OROS hydromorphone as a single and front‐line opioid therapy for patients experiencing moderate to severe cancer pain.METHODS: OROS hydromorphone was administered to patients who had not previously received strong, long‐acting opioids. The baseline evaluation (visit 1) was followed by two evaluations (visits 2 and 3) performed two and 14 weeks later, respectively. The starting dose of OROS hydromorphone was 4 mg/day and was increased every two days when pain control was insufficient. Immediate‐release hydromorphone was the only accepted alternative strong opioid for relief of breakthrough pain. The efficacy, safety and tolerability of OROS hydromorphone, including the effects on quality of life, and patients’ and investigators’ global impressions on pain relief were evaluated. The primary end point was pain intensity difference (PID) at visit 2 relative to visit 1 (expressed as %PID).RESULTS: A total of 107 patients were enrolled in the present study. An improvement in pain intensity of >50% (≥50% PID) was observed in 51.0% of the full analysis set and 58.6% of the per‐protocol set. The mean pain score, measured using a numerical rating scale, was significantly reduced after two weeks of treatment, and most adverse events were manageable. Quality of life also improved, and >70% of patients and investigators were satisfied with the treatment.CONCLUSIONS: OROS hydromorphone provided effective pain relief and improved quality of life in opioid‐naive cancer patients. As a single and front‐line treatment, OROS hydromorphone delivered rapid pain control.
Associations among Gender, Coping Patterns and Functioning for Individuals with Chronic Pain: A Systematic Review
Authors: El-Shormilisy Nina , Strong Jenny , Meredith Pamela J 
Published: March 2016

BACKGROUND: Developing strategies for coping with chronic pain is an integral part of successfully living with this often debilitating health condition. While gender differences in pain coping strategies have long been investigated, the relationship between gender‐specific engagement in coping and associated functioning in individuals experiencing chronic pain is yet to be clearly understood.OBJECTIVE: The present systematic review focused on studies that address these relationships to critically evaluate the available evidence.METHODS: A systematic search was conducted using MEDLINE via Ovid, EMBASE, PsycINFO and CINAHL, with 7247 titles retrieved. To be included, studies had to be in English, focus on adult participants, consider chronic nonmalignant pain, use measures of coping and functioning (or disability), report on gender‐specific outcomes (for coping and functioning [or disability]), and investigate a relationship among gender, coping and functioning. One researcher screened abstracts and full‐text articles, and extracted and tabulated data, while two researchers independently assessed potential articles for eligibility and methodological quality.RESULTS: Only seven studies met the inclusion criteria – six of high quality and one of moderate quality. The presented findings suggest that women in pain are more likely to use coping strategies considered to be maladaptive, resulting in poorer functioning, while men tend to engage in coping strategies considered to be adaptive, leading to better functional outcomes.CONCLUSIONS: While there is some evidence supporting gender‐specific engagement in coping and associated functioning, future research is necessary to expand understanding of these interrelations.
Low Awareness but Positive Attitudes Toward Fecal Transplantation in Ontario Physicians
Authors: Dennis Madison , Salpeter Mary Jane , Hota Susy 
Published: March 2016

BACKGROUND: Despite mounting evidence supporting fecal transplantation (FT) as a treatment for recurrent Clostridium difficile infection (CDI), adoption into clinical practice has been slow.OBJECTIVE: To determine the health literacy and attitudes of academic physicians in Toronto and infectious disease physicians in Ontario toward FT as a treatment for recurrent CDI, and to determine whether these are significant barriers to adoption.METHODS: Surveys were distributed to 253 general internists, infectious diseases specialists, gastroenterologists and family physicians.RESULTS: The response rate was 15%. More than 60% of physicians described themselves as being ‘not at all’ or ‘somewhat’ familiar with FT. Of the 76% of physicians who had never referred a patient for FT, the most common reason (50%) was lack of awareness of where to access the treatment. The ‘ick factor’ accounted for only 13% of reasons for not referring. No respondent believed that the procedure was too risky to consider.CONCLUSION: Despite general poor health literacy on FT, most physicians sampled share similar positive attitudes toward the treatment.
Fournier’S Gangrene Caused by Listeria Monocytogenes as the Primary Organism
Authors: Asahata Sayaka , Hirai Yuji , Ainoda Yusuke , Fujita Takahiro , Okada Yumiko , Kikuchi Ken 
Published: March 2016

A 70‐year‐old man with a history of tongue cancer presented with Fournier’s gangrene caused by Listeria monocytogenes serotype 4b. Surgical debridement revealed undiagnosed rectal adenocarcinoma. The patient did not have an apparent dietary or travel history but reported daily consumption of sashimi (raw fish).Old age and immunodeficiency due to rectal adenocarcinoma may have supported the direct invasion of L monocytogenes from the tumour. The present article describes the first reported case of Fournier’s gangrene caused by L monocytogenes. The authors suggest that raw ready‐to‐eat seafood consumption be recognized as a risk factor for listeriosis, especially in cases of skin and soft tissue infection.
Use of Morphine Sulphate by South African Paramedics for Prehospital Pain Management
Authors: Vincent-Lambert Craig , de Kock Joalda Marthiné 
Published: March 2016

BACKGROUND: Evidence in the literature highlights the fact that acute pain in the prehospital setting remains poorly managed. Morphine remains the most commonly used analgesic agent in the South African prehospital emergency care setting. Although guidelines and protocols relating to the dosage and administration of morphine exist, little data are available describing its use by South African paramedics.OBJECTIVES: To document and describe the way in which morphine is administered by a sample of South African paramedics for the management of acute pain in the prehospital setting.METHODS: An Internet‐based survey was conducted. Sixty South African paramedics responded by completing the online questionnaire documenting and describing their use of morphine for management of acute pain.RESULTS: Results revealed that participants appeared to be overly cautious of potential adverse effects associated with administration of morphine. Although the majority of participants calculated the dose of morphine to be administered correctly according to the patient’s weight, the majority do not appear to be administering this as a bolus; rather, they administer the calculated loading dose in a titrated manner over time. This method may result in a delay and or failure to adequately achieve therapeutic serum levels.CONCLUSION: Failure to administer an appropriate bolus or ‘loading dose’ when administering morphine intravenously may result in ineffective and delayed pain management. The authors recommend more clearly defined protocols be developed to guide the use of morphine sulphate by paramedics in the local emergency medical services environment.
The Effects of Preoperative Oral Pregabalin and Perioperative Intravenous Lidocaine Infusion on Postoperative Morphine Requirement in Patients Undergoing Laparatomy
Authors: Zengin Senniye Ulgen , Saracoglu Ayten , Eti Zeynep , Umuroglu Tumay , Gogus Fevzi Yilmaz 
Published: March 2016

OBJECTIVES: To evaluate and compare the effects of preoperative oral pregabalin and perioperative intravenous lidocaine infusion on postoperative morphine requirement, adverse effects, patients’ satisfaction, mobilization, time to first defecation and time to discharge in patients undergoing laparotomy.METHODS: Eighty patients (18 to 65 years of age) undergoing elective laparotomy were randomly divided into four groups (n=20 in each group): group C, placebo capsules and normal saline infusion perioperatively (control); group L, placebo capsules and lidocaine 1 mg/kg intravenous bolus dose followed by 2 mg/kg/h infusion until skin closure; group P, 150 mg oral pregabalin and normal saline infusion perioperatively; and group PL, 150 mg oral pregabalin and lidocaine 2 mg/kg/h infusion until skin closure. Hemodynamic parameters, visual analogue scale (VAS) scores, analgesic consumption, side effects, time to mobilization, time to first defecation, time to discharge and patients’ satisfaction were recorded.RESULTS: VAS scores of group L, group P and group PL were lower than group C (P<0.05). Morphine consumption of group P and group PL was lower than group C (P<0.05). Incidence of nausea in group C was higher than group L and group PL. Time to first defecation and mobilization were shorter in group L and group PL compared with group C (P<0.05).CONCLUSION: Preoperative oral pregabalin and perioperative intravenous lidocaine infusion decreased postoperative VAS scores. Preoperative oral pregabalin decreased morphine requirement and perioperative intravenous lidocaine infusion hastened gastrointestinal motility and mobilization, and decreased the incidence of nausea in patients undergoing laparotomy. Therefore, preoperative pregabalin with or without lidocaine provides superior pain relief in patients undergoing laparatomy.
Turn‐Amplitude Analysis as a Diagnostic Test for Myofascial Syndrome in Patients with Chronic Pelvic Pain
Authors: Itza Fernando , Zarza Daniel , Salinas Jesus , Teba Fernando , Ximenez Carmen 
Published: March 2016

BACKGROUND: Myofascial pain syndrome of the pelvic floor (MPSPF) is a common disease in the context of chronic pelvic pain (CPP); however, there is currently no gold‐standard test to diagnose it.OBJECTIVE: To validate the turns‐amplitude analysis (TAA) as a diagnostic test for MPSPF in patients with CPP.METHODS: A case‐control study was performed, and patients were consecutively sampled within a specified period of time. A total of 128 patients were included: 64 patients with CPP (32 men and 32 women) and 64 control patients (32 men and 32 women). The same operator conducted all tests. Electromyography of the TAA is based on the collection of motor unit potentials that measure the number of changes in the signal and the mean amplitude of the changes. The electromyogram transfers the data to a graphical point cloud, which enables the patient’s results to be compared with the results of the healthy subjects.RESULTS: In patients and control subjects, the sensitivity and specificity of the proposed diagnostic test showed a marked clinical significance: the sensitivity was 83%, and the specificity was 100%. A positive predictive value of 1 (95% CI 1 to 1) and a negative predictive value of 0.85 (95% CI 0.77 to 0.93) were observed.CONCLUSION: TAA is a reliable diagnostic test to detect MPSPF. Further studies are needed to reproduce these results.
The Effectiveness of Ultrasound Surveillance for Hepatocellular Carcinoma in a Canadian Centre and Determinants of Its Success
Authors: Khalili Korosh , Menezes Ravi , Kim Tae Kyoung , Yazdi Leyla Kochak , Jang Hyun-Jung , Sharma Suraj , Feld Jordan , Sherman Morris 
Published: March 2016

BACKGROUND: The effectiveness of surveillance for hepatocellular carcinoma (HCC) using ultrasound (US) in North America has been questioned due to the predominance of patients of Caucasian ethnicity and larger body habitus.OBJECTIVE: To determine the effectiveness of US surveillance for HCC in a Canadian hepatobiliary centre and to identify independent variables associated with early detection of tumour(s).METHODS: A retrospective review of patients with first HCC in a US surveillance population at the authors’ hospital yielded 201 patients (over a 10.5-year period). Patients were categorized into three groups: regular surveillance (frequency of surveillance ≤12 months [n=109]); irregular surveillance (frequency of surveillance >12 months [n=38]); or first surveillance (tumour detected on first scan [n=54]). The Milan criteria for transplantation and Barcelona Clinic Liver Cancer (BCLC) staging system were used as outcome measures. Effective surveillance was defined as tumour detection within Milan criteria or curative BCLC stages 0 and A; its association with multiple patient- and disease-related variables was tested.RESULTS: When using the Milan criteria as outcome, 84 of 109 (77%) regular surveillance patients, 23 of 38 (61%) irregular surveillance patients and 40 of 54 (74%) first surveillance patients had tumours meeting the transplantation criteria. The difference between regular and irregular surveillance was statistically significant (P=0.03). When using the BCLC staging system, 87 of 109 (80%) regular surveillance patients, 26 of 38 (68%) irregular surveillance patients and 41 of 54 (76%) first surveillance patients had their tumours detected in BCLC curative stages (0 and A; P=0.11). Regular surveillance was the only variable significantly associated with detection of tumour(s) within the Milan criteria (OR 2.76 [95% CI 1.10 to 6.88]). Tumours detected more recently were more likely to be <2 cm in size (BCLC stage 0; OR 2.38 [95% CI 1.07 to 5.31]).CONCLUSION: A high rate of HCC surveillance success was achieved using US alone when performed regularly in a specialized hepatobiliary centre.
Use of Electronic Data and Existing Screening Tools to Identify Clinically Significant Obstructive Sleep Apnea
Authors: Severson Carl A , Pendharkar Sachin R , Ronksley Paul E , Tsai Willis H 
Published: March 2016

OBJECTIVES: To assess the ability of electronic health data and existing screening tools to identify clinically significant obstructive sleep apnea (OSA), as defined by symptomatic or severe OSA.METHODS: The present retrospective cohort study of 1041 patients referred for sleep diagnostic testing was undertaken at a tertiary sleep centre in Calgary, Alberta. A diagnosis of clinically significant OSA or an alternative sleep diagnosis was assigned to each patient through blinded independent chart review by two sleep physicians. Predictive variables were identified from online questionnaire data, and diagnostic algorithms were developed. The performance of electronically derived algorithms for identifying patients with clinically significant OSA was determined. Diagnostic performance of these algorithms was compared with versions of the STOP‐Bang questionnaire and adjusted neck circumference score (ANC) derived from electronic data.RESULTS: Electronic questionnaire data were highly sensitive (>95%) at identifying clinically significant OSA, but not specific. Sleep diagnostic testing‐determined respiratory disturbance index was very specific (specificity ≥95%) for clinically relevant disease, but not sensitive (<35%). Derived algorithms had similar accuracy to the STOP‐Bang or ANC, but required fewer questions and calculations.CONCLUSIONS: These data suggest that a two‐step process using a small number of clinical variables (maximizing sensitivity) and objective diagnostic testing (maximizing specificity) is required to identify clinically significant OSA. When used in an online setting, simple algorithms can identify clinically relevant OSA with similar performance to existing decision rules such as the STOP‐Bang or ANC.