bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development of a membrane of poly (L-co-D,L lactic acid-co-trimethylene carbonate) with aloe vera: An alternative biomaterial designed to improve skin healing
Authors: Komatsu Daniel , Mistura Daniel V , Motta Adriana , Domingues Juliana A , Hausen Moema A , Duek Eliana 
Published: July 2017

The search for new therapies and drugs that act as topical agents to relieve pain and control the infectious processes in burns always attracted interest in clinical trials. As an alternative to synthetic drugs, the use of natural extracts is useful in the development of new strategies and formulations for improving the life quality. The aim of this study was to develop a wound dressing using Poly(L-co-D,L lactic acid-co-TMC) (PLDLA-co-TMC) containing aloe vera (AV). This natural plant extract is known for its modulatory effects under healing process. The membrane of PLDLA-co-TMC+aloe vera was prepared at different concentrations of AV (5, 10, 15 and 50%). The FTIR showed no change in the PLDLA-co-TMC spectrum after AV addition, while the swelling test showed changes only in PLDLA-co-TMC+AV at 50%. The wettability measurements showed decrease in the contact angle in all samples after the AV addition in the polymer, while the AV release test showed that PLDLA-co-TMC+50%AV sample has higher AV release rate than the sample with other AV concentrations. The SEM analysis showed that AV was homogeneously distributed at 5% only. Tensile tests demonstrated an increase in the Young's modulus and a reduction in the elongation till rupture of the PLDLA-co-TMC after the addition of AV. Biocompatibility in vitro evaluation with fibroblast cells seeded in the membranes of PLDLA-co-TMC+AV showed that the cells were able to adhere, proliferate and maintain mitochondrial activity in all AV concentrations tested. Due to the known skin medicinal properties attributed to AV and the results here obtained, we suggest that after in vivo trials, the PLDLA-co-TMC+AV should be a promising biomaterial for application as a device for skin curative and healing agent.
Exposure to Hardship Financing for Healthcare among Rural Poor in Chhattisgarh, India
Authors: John Denny , Kumar Vijender 
Published: July 2017

Background: This article examines the exposure of hardship financing in a cross-section of households in four blocks of Rajnandgaon district in Chhattisgarh state, India. We define hardship financing as having to borrow money with interest or to sell assets to pay out-of-pocket healthcare costs. Methods: We used survey data of 4,600 low-income rural households using a three-stage cluster sampling procedure. In first stage, blocks were selected purposively, the second stage involved selection of villages using probability proportional to size (PPS) sampling and lastly, households were randomly selected. Binary logistics regression analysis was used to identify the determinants of exposure to hardship financing related to out-of-pocket expenses for healthcare. Results: About 14.9 per cent of the total households were exposed to hardship financing. Hardship financing occurs not only for hospitalization (nearly 10 per cent) but also for outpatient care (7.91 per cent) and maternity (around 10 per cent). Our logistics regression revealed that health expenditure in the last year was positively associated with the risk for hardship financing. Other correlates of hardship financing included education-level of the head of the household, in-house toilet facility and place of residence/blocks. Conclusion: Rural households, especially the poorer households, spend higher average healthcare payments and are exposed to hardship financing on health.
Characteristics and outcomes of patients with drug overdose requiring admission to Intensive Care Unit
Authors: Athavale Vinit , Green Cameron , Lim Kai Zheong , Wong Caroline , Tiruvoipati Ravindranath 
Published: July 2017

Objective: Approximately 20% of patients admitted to hospital with drug overdose will require intensive care unit (ICU) admission. An understanding of the characteristics of these patients may assist with their management and identify those patients at risk of multiple hospital presentations due to drug overdose. Our aim was to examine the characteristics of patients admitted to ICU following drug overdoses and identify the predictors of multiple hospital presentations due to drug overdose. Methods: Patients admitted to a metropolitan ICU over a three-year period following drug overdoses were identified using ICU patient databases, and their medical records. Results: There were 254 admissions due to drug overdoses. The majority of overdoses were intentional (82.7%) and included multiple agents (68.1%). Two-thirds of patients had psychiatric diagnosis, and 54% had documented history of substance use disorders. In-hospital mortality was 2.8%. Over half of patients admitted had documented history of prior hospital presentation due to overdoses. Personality disorder and schizophrenia were independent predictors of multiple hospital presentations due to overdoses. Conclusion: Personality disorders or schizophrenia were independent predictors of patients with multiple overdose presentations. Preventative strategies focusing on these patients may reduce the incidence of their hospital presentations and ICU admissions.
What’s to be done when ‘foul whisp rings are abroad’? Gossip and rumour in health organisations
Authors: O’Connor Nick , Kotze Beth , Storm Victor 
Published: July 2017

Objectives: This article explores the relevance of gossip and rumour to health organisations and presents what limited empirical research is available specific to the management of gossip and rumour in health organisations. Conclusion: The concept of a sentinel function for gossip and rumour in health organisations is proposed as a topic worthy of further research.
Prevalence study on potential drug–drug interaction in cancer patients in Piacenza hospital’s Onco-Haematology department
Authors: Vecchia Stefano , Orlandi Elena , Confalonieri Corrado , Damonti Enrico , Riva Alessandra , Sartori Alessia , Cavanna Luigi 
Published: July 2017

Background Cancer patients can be a human model of potential drug interactions. Usually they receive a large number of different medications, including antineoplastic agents, drugs for comorbid illness and medication for supportive care, however information about these interactions are fragmented and poor. Objective We assessed a prospective study to evaluate the prevalence of drug interaction among patients hospitalized in the Onco-Haematology department, Hospital of Piacenza. Methods Data on drugs administered for cancer, comorbidities, or supportive care were collected from different computerized prescription software in use in the department; we compared them with a database to focus on the co-administration of drugs. A literature review was performed to identify major potential drug interaction and to classify them by level of severity and by strengths of scientific evidence. Results In this study 284 cancer patients were enrolled; patients had taken an average of seven drugs on each day of therapy plus chemotherapeutic agents, we identified 67 potential drug interactions. At least 53 patients had one potential drug interaction. Of all potential drug interactions 63 were classified as moderate severity and only four as major. In 55 cases chemotherapeutic agents were involved in possible interactions with supportive care drugs, meanwhile in 12 cases the potential drug interactions were between supportive care drugs. Conclusions In our centre, thanks to a computerized prescription software, integrated with caution alarm in case of possible interaction, we had a lower rate of potential drug interactions than the one from literature. It is possible to improve the software integrating the alarm with the potential drug interactions between chemotherapy agents and supportive care drugs.
Ibrutinib-associated tumor lysis syndrome in chronic lymphocytic leukemia/small lymphocytic lymphoma and mantle cell lymphoma: A case series and review of the literature
Authors: Titus-Rains Krystal S , Brown Jamie N , Hammond Julia M 
Published: July 2017

Background Tumor lysis syndrome results when intracellular contents are released during cell lysis. Ibrutinib, a Bruton tyrosine kinase inhibitor, is used for the treatment of chronic lymphocytic leukemia, small lymphocytic lymphoma, Waldenström’s macroglobulinemia, mantle cell lymphoma, and marginal zone lymphoma. Tumor lysis syndrome caused by ibrutinib therapy is potentially life threatening, but is rare and not often reported in clinical trials. Objective The purpose of this case series is to describe the occurrence of tumor lysis syndrome in two patients initiated on ibrutinib, and to highlight the importance of close monitoring during therapy. Discussion One patient with chronic lymphocytic leukemia/small lymphocytic lymphoma and one patient with mantle cell lymphoma developed laboratory and clinical tumor lysis syndrome following initiation of ibrutinib therapy. Assessment with the Naranjo Adverse Drug Reaction Probability Scale indicated one probable relationship and one possible relationship between ibrutinib therapy and tumor lysis syndrome. There were additional factors that may have confounded the laboratory and clinical factors observed, including baseline laboratory values and concurrent medications. Both patients were managed with supportive therapies. A literature review identified five additional reported cases of tumor lysis syndrome following ibrutinib therapy. Conclusion This case series identifies one patient with a probable relationship and one patient with a possible relationship between the development of tumor lysis syndrome and treatment with ibrutinib. Although uncommon, proper attention should be given to monitoring for this adverse drug reaction and appropriate follow-up should occur despite ibrutinib’s ease of administration.
Chorionic Histiocytic Hyperplasia is Associated With Chronic Inflammatory Lesions in the Placenta
Authors: Katzman Philip J , Metlay Leon A , McMahon Loralee A , LiQiong Li , Zhang Bin 
Published: July 2017

Background Chorionic histiocytic hyperplasia (CHH) is a cellular proliferation at the base of the chorion that was identified by the authors in examining placentas for chronic chorioamnionitis (CC). This study is a retrospective review of cases diagnosed with CHH, describing its incidence alone and with associated lesions, and the immunophenotype of lesional cells. Design In this retrospective study, a laboratory information system search over a 34-month period using the key phrase “chorionic stromal” was performed. Cases identified were reviewed for presence of the following: CC, chronic villitis (CV), chronic deciduitis (CD), maternal (MIR), and fetal (FIR) acute inflammatory responses, meconium deposition; and whether CD3 immunostaining was performed. Incidences were tabulated and compared with known prevalences in our population. Select cases were stained with various immunostains to identify cell lineage and X and Y fluorescent probes to identify fetal or maternal cell origin in cases with male infants. Results Eighty cases of CHH were identified during the study period. Incidences of inflammatory lesions associated with CHH were: CV (54/80, 68%), CD (32/80, 40%), CC (25/80, 31%), MIR (39/80, 49%), and FIR (9/80, 11%). Only chronic inflammatory lesions had a significant correlation with the co-incidence of CHH. CC was identified alongside CHH in 12 of 22 cases in which a CD3 immunostain was performed. The cell population in CHH was vimentin+, CD68+, CD3−, CD45−, CD56−, hPL−, SMA−, OCT 3/4− and, in some cases, variably mixed with CD3+ lymphocytes. The cells had a male genotype by fluorescent in situ hybridization analysis. Conclusion The association of CHH with acute and chronic inflammatory conditions and its immunophenotype suggest that it may be a reactive process. CD3 immunostaining is helpful to identify concurrent CC.
Music Listening Among Postoperative Patients in the Intensive Care Unit: A Randomized Controlled Trial with Mixed-Methods Analysis
Authors: Ames Nancy , Shuford Rebecca , Yang Li , Moriyama Brad , Frey Meredith , Wilson Florencia , Sundaramurthi Thiruppavai , Gori Danelle , Mannes Andrew , Ranucci Alexandra , Koziol Deloris , Wallen Gwenyth R 
Published: July 2017

Background: Music listening may reduce the physiological, emotional, and mental effects of distress and anxiety. It is unclear whether music listening may reduce the amount of opioids used for pain management in critical care, postoperative patients or whether music may improve patient experience in the intensive care unit (ICU). Methods: A total of 41 surgical patients were randomized to either music listening or controlled non-music listening groups on ICU admission. Approximately 50-minute music listening interventions were offered 4 times per day (every 4-6 hours) during the 48 hours of patients’ ICU stays. Pain, distress, and anxiety scores were measured immediately before and after music listening or controlled resting periods. Total opioid intake was recorded every 24 hours and during each intervention. Results: There was no significant difference in pain, opioid intake, distress, or anxiety scores between the control and music listening groups during the first 4 time points of the study. However, a mixed modeling analysis examining the pre- and post-intervention scores at the first time point revealed a significant interaction in the Numeric Rating Scale (NRS) for pain between the music and the control groups ( P = .037). The Numeric Rating Score decreased in the music group but remained stable in the control group. Following discharge from the ICU, the music group’s interviews were analyzed for themes. Conclusions: Despite the limited sample size, this study identified music listening as an appropriate intervention that improved patients’ post-intervention experience, according to patients’ self-report. Future mixed methods studies are needed to examine both qualitative patient perspectives and methodology to improve music listening in critical care units.
Sleep and psychiatric symptoms in young child psychiatric outpatients
Authors: Huhdanpää Hanna , Klenberg Liisa , Westerinen Hannu , Fontell Tuija , Aronen Eeva T 
Published: July 2017

Background: Sleep may underlie psychiatric symptoms in young children. However, not many studies have reported on sleep and its associations with symptoms in young child psychiatric patients. Objectives: To assess the amount and quality of sleep and how sleep associates with psychiatric symptoms in young child psychiatric patients. Furthermore, we evaluated how sleep and daytime somnolence differed in patients and their age- and gender-matched controls. Method: The sample consisted of 139 3- to 7-year-old child psychiatric outpatients and 139 age- and gender-matched controls from community. We evaluated sleep and daytime somnolence with the Sleep Disturbance Scale for Children in all children and psychiatric symptoms with Child Behaviour Checklist (CBCL) in the patient group. Family background information was collected from the patients. Results: Of the patients, 31.6% had a significant sleep problem and 14.4% slept too little. The most typical sleep problems were restless sleep (31.7%), morning tiredness (21.6%) and difficulties getting to sleep at night (18.7%). All types of sleep problems were associated with CBCL total, internalising and externalising problems (all p-values < .01). We observed a strong association between all types of sleep problems and emotionally reactive subscale ( p-value < .001). Furthermore, parent-reported sleep problems increased significantly the risk of having high scores on total (odds ratio (OR) = 5.3, 95% confidence interval (CI) = [2.2, 12.6], p < .001), external (OR = 3.7, 95%, CI = [1.6, 8.5], p < .01) and internal (OR = 2.5, 95% CI = [1.1, 5.5], p < .05) scores after controlling for age, gender, family structure and parent’s educational level. Even mild sleep disturbance increased the intensity of psychiatric symptoms. Compared to controls, patients slept less ( p < .001) and had significantly more frequent restless sleep, nightmares and morning and daytime somnolence. Conclusion: Sleep problems and too little sleep are prevalent in young child psychiatric patients, and they relate strongly to the intensity of psychiatric symptoms. Identification and treatment of sleep problems should be a routine part of the treatment plan for young child psychiatric patients. The results emphasise the need for assessing sleep in young child psychiatric patients, as treating the sleep problem may reduce psychiatric symptoms.
Oral and written language abilities in young Spanish/English bilinguals
Authors: Ardila Alfredo , Rosselli Mónica , Ortega Alexandra , Lang Merike , Torres Valeria L 
Published: July 2017

Purpose: The purpose of this study was to compare oral and written language abilities in English and Spanish of young bilinguals residing in the USA. Methodology: Sixty-two participants (mean age = 23.7; SD = 3.50), consisting of 42 bilinguals (born of Spanish-speaking parents) and 20 English monolinguals, were administered a battery of 15 language tasks. Analysis: Bilinguals were divided into two groups: (a) US-born (simultaneous bilinguals who had been exposed to English and Spanish since birth and educated primarily in English) and (b) Latin American-born (early sequential bilinguals who were educated in Spanish and English, although exposed to Spanish at birth and to English before the age of 10). Findings: Higher lexical ability was demonstrated in English compared to Spanish in bilinguals. Performance in grammar tests of the two languages was inconsistent. Reading/writing ability in English was similar for participants born in the USA and in Latin America; however, participants who were born in Latin America had significantly higher scores for Spanish reading/writing tasks. When comparing performance in English tests, it was found that scores for bilingual participants were similar to those of English monolinguals. Originality: The current study directly compares oral and written language abilities in two subgroups of young Spanish/English bilinguals. Three language dimensions are studied: lexicon/grammar; oral/written language; and language knowledge/language use. Implications: Our results suggest that bilingualism does not interfere with normal linguistic ability in English. Limitations: The current study was carried out in a specific bilingual context. Generalization of these results should be done with caution.
Cognitive Fluctuations and Cognitive Test Performance Among Institutionalized Persons With Dementia
Authors: Mainland Brian J. , Herrmann Nathan , Mallya Sasha , Fiocco Alexandra J. , Sin Gwen-Li , Shulman Kenneth I. , Ornstein Tisha J. 
Published: July 2017

Objective: To examine the nature and frequency of cognitive fluctuations (CFs) among institutionalized persons with dementia. Method: A clinical interview and a medical chart review were conducted, and 55 patients were assigned a specific dementia diagnosis. The Severe Impairment Battery (SIB) was administered to assess cognitive function, and the Dementia Cognitive Fluctuation Scale (DCFS) was administered to each patient’s primary nurse to determine the presence and severity of CFs. Results: A simple linear regression model was conducted with DCFS as the predictor variable and SIB total score as the dependent variable. The overall model was significant, suggesting that score on the DCFS significantly predicted SIB total score. Additionally, greater severity of CFs predicted poorer performance in the areas of orientation, language, and praxis. Conclusions: Results suggest that CFs exert a clinically significant influence over patients’ cognitive abilities and should be considered as a source of excess disability.
Endoscopic screening for gastric cancer: A cost‐utility analysis for countries with an intermediate gastric cancer risk
Authors: Areia Miguel , Spaander Manon CW , Kuipers Ernst J , Dinis‐Ribeiro Mário 
Published: July 2017

BackgroundEndoscopic screening for gastric cancer is debatable in countries with an intermediate risk.ObjectiveThe objective of this article is to determine the cost‐utility of screening strategies for gastric cancer in a European country.MethodsWe conducted a cost‐utility analysis using a Markov model comparing three screening strategies versus no screening: stand‐alone upper endoscopy, endoscopy combined with a colorectal cancer screening colonoscopy after a positive faecal occult blood test or pepsinogens serologic screening. Clinical data were collected from systematic reviews, costs from published national data and utilities as quality‐adjusted life years (QALY). The primary outcome was the incremental cost‐effectiveness ratio (ICER). Deterministic and probabilistic sensitivity analyses were performed. The threshold was set at €37,000 (2016 prices).ResultsUpper endoscopy combined with screening colonoscopy (every 10 or 5 years) had an ICER of 15,407/QALY and €30,908/QALY respectively, stand‐alone endoscopic screening (every five years) an ICER of €70,693/QALY and pepsinogens screening an ICER of €143,344/QALY. Sensitivity analyses revealed that only endoscopic costs <€75, a provision of only three endoscopies per patient or a gastric cancer risk >25/100,000 would make stand‐alone endoscopic screening cost‐effective.ConclusionEndoscopic gastric cancer screening in Europe can be cost‐effective if combined with a screening colonoscopy in countries with a gastric cancer risk ≥10 per 100,000.
An Exploratory Study of Autonomic Function Investigations in Hemophiliacs on Homoeopathy Medications Using Impedance Plethysmography
Authors: Kundu Tapas K. , Barde Pradip B. , Jindal Ghanshyam D. , Motiwala Farooq F. 
Published: July 2017

Background. Status of autonomic homoeostasis in hemostasic disturbances due to hemophilia needs to be studied. Objectives. To compare autonomic nervous system markers measured by heart rate variability (HRV) and blood flow variability (BFV) in hemophiliacs and healthy age-matched control population using medical analyzer system. Design. Cross-sectional study. Settings. Motiwala Homoeopathy Medical College, and Hemophilia Clinics, Nashik. Subjects. Eighty subjects. Interventions. Nil. Outcome Measures. Autonomic function markers for HRV and BFV. Results. Among 80 subjects, BFV time domain measure, root mean square of successive NN (normal-to-normal) interval differences (RMSSD), was significantly higher among hemophiliacs than nonhemophiliacs. Frequency domain analysis parameter, low frequency for both HRV and BFV was significantly higher among hemophiliacs as compared with nonhemophiliacs. Conclusions. Hemophiliacs were shown to have higher autonomic activity as compared with healthy controls. Homoeopathic medicines used as an adjunct was associated with decrease in parasympathetic modulations.