bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reconstruction of the Medial Patellofemoral Ligament
Authors: Lippacher Sabine , Dreyhaupt Jens , Williams Sean R.M. , Reichel Heiko , Nelitz Manfred 
Published: April 2014

Background: Recent studies have shown that medial patellofemoral ligament (MPFL) reconstruction using a standardized technique provides significant improvements in all outcome scoring systems, with low complication rates and good patient satisfaction. Although numerous studies have assessed clinical results, there is little published literature investigating return to sporting activities after reconstruction of the MPFL. Purpose: To demonstrate postoperative outcomes and the return-to-sports rate a minimum of 2 years after isolated MPFL reconstruction in a young patient cohort. Study Design: Case series; Level of evidence, 4. Methods: Between 2007 and 2010, a total of 72 isolated MPFL reconstructions (in 68 patients) were performed for recurrent patellar dislocation. Pre- and postoperative knee assessment included a thorough history of symptoms and a clinical examination consisting of crepitus, range of motion, patellofemoral pain, and patellar apprehension. Knee function was assessed using the Kujala score, International Knee Documentation Committee score, Tegner activity score, visual analog scale (VAS), and Activity Rating Scale (ARS). Results: Of patients who participated in sports preoperatively (62/68 patients), 100% returned to sports after MPFL reconstruction; 53% returned at equal or higher levels, whereas 47% returned at lower levels. Fifty-four of 68 patients (79.4%) rated themselves as very satisfied or satisfied with the results. The median Kujala score improved significantly from 66 to 87.5 and the median International Knee Documentation Committee score from 60 to 79.8. The median VAS for pain score illustrated significant preoperative to postoperative improvement, from 4 to 2. Conversely, patients’ activity levels according to the Tegner activity score dropped from 4.5 to 4, and the median Activity Rating Scale score dropped from 6 to 3. There was also a persistent instability rate of 10% as well as a slight loss of knee flexion in 24 of 72 knees. Conclusion: Reconstruction of the MPFL is a safe and effective treatment for patellofemoral instability without severe trochlear dysplasia and allows most patients to engage in regular sports activities 2 years postoperatively, at least at a recreational level. However, potential complications, such as persistent instability, pain, and loss of flexion, must be considered.
Significance of Subjective Memory Complaints in the Clinical Setting
Authors: Silva Dina , Guerreiro Manuela , Faria Catarina , Maroco João , Schmand Ben A. , Mendonça Alexandre de 
Published: April 2014

Objective: The clinical significance of subjective memory complaints in the elderly participants, particularly regarding liability of subsequent progression to dementia, has been controversial. In the present study, we tested the hypothesis that severity or type of subjective memory complaints reported by patients in a clinical setting may predict future conversion to dementia. Methods: A cohort of nondemented patients with cognitive complaints, followed up for at least 2 years or until conversion to dementia, underwent a neuropsychological evaluation and detailed assessment of memory difficulties with the Subjective Memory Complaints (SMC) Scale. Results: At baseline, patients who converted to dementia (36.8%) had less years of formal education and generally a worse performance in the neuropsychological assessment. There were no differences in the total SMC score between nonconverters (9.5 ± 4.2) and converters (8.9 ± 4.0, a nonsignificant difference), but nonconverters scored higher in several items of the scale. Conclusion: For patients with cognitive complaints observed in a memory clinic setting, the severity of subjective memory complaints is not useful to predict future conversion to dementia.
Bone marrow analysis of immune cells and apoptosis in patients with systemic lupus erythematosus
Authors: Park JW , Moon SY , Lee JH , Park JK , Lee DS , Jung KC , Song YW , Lee EB 
Published: April 2014

Objectives To examine the immune cell profile in the bone marrow of systemic lupus erythematosus (SLE) patients and to assess its clinical relevance. Methods Sixteen bone marrow samples from 14 SLE patients were compared with seven healthy control samples. The numbers of immune cells and apoptotic cells in the bone marrow were examined by immunohistochemistry. The association between immune cell subsets and clinical features was investigated. Results CD4+ T cells, macrophages and plasma cells were more common in the bone marrow of SLE patients than in healthy controls ( p = 0.001, p = 0.004 and p < 0.001, respectively). Greater numbers of CD4+ T cells and macrophages were associated with high-grade bone marrow damage. The percentage of apoptotic cells in bone marrow of SLE patients was significantly higher than that in controls ( p < 0.001) and was positively correlated with the number of plasmacytoid dendritic cells ( p = 0.013). Increased number of plasma cells along with high interleukin-6 expression was correlated with anti-double stranded DNA antibody levels and the SLE disease activity index ( p = 0.031 and 0.013, respectively). Conclusion Bone marrow from SLE patients showed a distinct immune cell profile and increased apoptosis. This, coupled with a correlation with disease activity, suggests that the bone marrow may play a critical role in the pathogenesis of SLE.
With Sincere Regret
Authors: Cummings Alysa , Ciano karin 
Published: April 2014

A teacher invests years of effort developing a G/C/T program. Years of building relationships with students and their families. Time spent developing and implementing a curriculum that meets the special needs of a select population. At this point in time, it becomes apparent that this educator will “graduate” ahead of the students in the program, moving on to another job outside the school district. Unfortunately, the school year has already begun. How do the students react to the news? How is the program affected? Is the teacher the program, or is the torch ultimately passed and continuity insured with a minimum of trauma for the students? What happens after a G/C/T teacher submits a letter that begins, “It is…
Influence of typical angina versus inducible myocardial ischemia in the contemporary management of stable coronary artery disease
Authors: De Lorenzo Andrea , Oliveira Gabriel , Naue Vania M. , Lima Ronaldo S. L. 
Published: April 2014

Objective: To investigate, in patients with known or suspected coronary artery disease (CAD) undergoing myocardial perfusion single-photon emission computed tomography (MPS),the interaction between patient symptoms and single-photon emission computed tomography (SPECT) results, and their effects on patient outcomes. Previous data have shown that medical treatment may be as beneficial as invasive treatment for most patients with stable CAD. Nonetheless, patient presentation with typical angina (TA) seems to still lead to more aggressive management, regardless of the amount of myocardial ischemia detected by noninvasive methods. Methods: Over 33 ± 20 months, 2958 patients undergoing stress/rest cardiac SPECT were followed. Summed stress, rest and difference scores (SSS, SRS and SDS, respectively) were analyzed. Abnormal SPECT was defined as a SSS>3, and ischemic SPECT as a SDS>1. During follow up, cardiac catheterization (CATH), myocardial revascularization (either percutaneous or surgical), myocardial infarction (MI) and all-cause death were evaluated. Results: TA was found in 228 patients (7.7%). Comparing patients with TA with those without it, the former more often had had abnormal (43.0% versus 34.3%, p < 0.001) and ischemic SPECT (25.9% versus 13.6%, p < 0.001). Also, higher rates of MI (2.0% versus 0.6%, p < 0.001), CATH (10.1% versus 4.7%, p < 0.001) and revascularization (7.8% versus 3.0%, p < 0.001) were observed, while death was not significantly different (1.5% versus 1.0%, p = 0.2). Even in the absence of ischemia in SPECT, patients with TA had higher CATH and revascularization rates; death, again, was not significantly increased. Conclusion: Although patients with TA more often had ischemic SPECT, all-cause death was not significantly increased. Nonetheless, TA was associated with more frequent referrals for CATH and revascularization, even with nonischemic SPECT. This may suggest that despite current evidence, the management of stable patients with known or suspected CAD is influenced by symptom type.
Skin and Adhesive Issues With Continuous Glucose Monitors
Authors: Englert Kimberly , Ruedy Katrina , Coffey Julie , Caswell Kimberly , Steffen Amy , Levandoski Lucy ,   for the Diabetes Research in Children (DirecNet) Study Group, Tsalikian Eva , Tansey Michael J. , Coffey Julie , Cabbage Joanne , Salamati Sara , Mauras Nelly , Fox Larry A. , Englert Kimberly , Permuy Joe , Sikes Kaitlin , Buckingham Bruce A. , Wilson Darrell M. , Clinton Paula , Caswell Kimberly , Weinzimer Stuart A. , Tamborlane William V. , Sherr Jennifer , Steffen Amy , Weyman Kate , Zgorski Melinda , Tichy Eileen , White Neil H. , Arbelaez Ana Maria , Levandoski Lucy , Starnes Angie , Beck Roy W. , Ruedy Katrina J. , Kollman Craig , Xing Dongyuan , Hall Callyn , Stevens Beth , Grave Gilman D. , Winer Karen K. , Leschek Ellen , Becker Dorothy M. , Cleary Patricia , Greenbaum Carla , Moran Antoinette , Steffes Michael W. , Bucksa Jean M. , Nowicki Maren L. , Makky Vicky 
Published: April 2014

Background: The purpose of this article is to describe challenges associated with successful use of continuous glucose monitoring (CGM) by young children with type 1 diabetes (T1D) and to detail the techniques and products used to improve the duration of sensor wear. Methods: The DirecNet Study Group conducted 2 studies in 169 children with T1D between the ages of 1 and 9 years who were instructed to wear a CGM device daily. Problems related to skin irritation and sensor adhesiveness in these young children presented challenges to daily use of the CGM. Study coordinators instituted a variety of techniques using commercially available products to attempt to overcome these problems. Results: Three primary factors that contributed to reduced CGM use were identified: the limited body surface area in smaller children, ambient temperature and humidity, as well as the type and duration of physical activity. Using supplemental products to minimize the impact of these factors resulted in improved adherence and reduced skin irritation. Conclusion: Achieving satisfactory adhesion of the CGM sensor and transmitter may involve finding the right supplemental product or combination of products through trial and error. Optimizing adhesion and minimizing skin irritation can significantly improve duration of use and tolerability of CGM devices by young children.
Plantar Static Pressure Distribution in Healthy Individuals
Authors: Pomarino David , Pomarino Andrea 
Published: April 2014

In literature, one finds little scientific statements regarding plantar static pressure distribution in healthy individuals. Miscellaneous studies, however, characterize pathologies of feet and associate those with abnormal static or dynamic plantar load sharing. Our study reveals that healthy individuals show significant age-dependent differences in forefoot and rear foot load measured in standing position. The forefoot and rear foot load of 238 female and 193 male individuals aged between 2 and 69 years were measured. Using a pressure distribution measurement platform, the measurements were taken barefooted in standing position. Those measurements are presented as percentage of the overall load. The measurements within the age groups A1 (2-6 years), A2 (7-10 years), and A3 (11-69 years) showed significantly different forefoot loading means of the left foot (A1, 19.9%; A2, 28.2%; A3, 39.7%) and the right foot (A1, 22.6%; A2, 29.7%; A3, 39.6%). The forefoot loadings are graphically displayed as a function of the percentiles 5, 10, 25, 50, 75, 90, and 95. Forefoot loadings are referred to as “prominent” if the measured values lie off the interquartile range; if either below the percentile 10 or above 90 the loadings are referred to as “very prominent.” Our study contains significant data regarding the extent of the static load sharing of the forefoot and rear foot of healthy individuals; the data are suited for being standard values to evaluate plantar load sharing. Levels of Evidence: Diagnostic Level IV: Case series
Assessing Patients’ Preference for Integrating Herbal Medicine Within Primary Care Services in Saudi Arabia
Authors: Allam Safaa , Moharam Maha , Alarfaj Gada 
Published: April 2014

Background: Family physician advice and follow-up may be important to reduce the negative aspects of locally marketed herbal remedies and improve the patient outcome. There is a lack of studies assessing the preference of Saudi patients for the integration of herbal medicine into primary care services. Objectives: To examine the knowledge, attitudes, and practice of Saudi patients toward herbal medicine and its integration into primary care services. Methods: A cross-sectional study was conducted between February and March 2013 among adult patients attending the family medicine clinics at a primary care center in Riyadh, Saudi Arabia. A self-administered questionnaire (27 items) was developed and administered to all patients. Results: A total of 240 patients were included in the current analysis. The average age was 33.5 ± 9.9 years, and 61% of the patients were women. Approximately 60% of the patients were aware of herbal medicine use and its possible side effects. More than 85% of the patients believed that herbal containers should be labeled with safety information. Approximately 71% of the patients had a favorable attitude toward integrated services. Approximately 65% of the patients used herbal remedies for themselves, and 42% used them for their children. Preference for integrated services was significantly associated with female sex, better knowledge, positive attitudes toward safety and regulations, and higher level of practice. Conclusions: A good knowledge and a very favorable attitude toward integrating herbal medicine into primary care services were found among a group of patients attending a primary care center in Saudi Arabia.
Requirement for CDK6 in MLL-rearranged acute myeloid leukemia
Authors: Placke Theresa , Faber Katrin , Nonami Atsushi , Putwain Sarah L. , Salih Helmut R. , Heidel Florian H. , Krämer Alwin , Root David E. , Barbie David A. , Krivtsov Andrei V. , Armstrong Scott A. , Hahn William C. , Huntly Brian J. , Sykes Stephen M. , Milsom Michael D. , Scholl Claudia , Fröhling Stefan 
Published: April 2014

Key Points
CDK6 is a critical effector of MLL fusions in myeloid leukemogenesis. Genetic and pharmacologic inhibition of CDK6 overcome the differentiation block associated with MLL-rearranged AML.
Efficacy of a multifactorial intervention on therapeutic adherence in patients with chronic obstructive pulmonary disease (COPD): a randomized controlled trial
Authors: Leiva-Fernández José , Leiva-Fernández Francisca , García-Ruiz Antonio , Prados-Torres Daniel , Barnestein-Fonseca Pilar 
Published: April 2014

Abstract

Background
Therapeutic adherence of patients with chronic obstructive pulmonary disease (COPD) is poor. This study evaluated the effectiveness of a multifactorial intervention on improving the therapeutic adherence in chronic obstructive pulmonary disease (COPD) patients with scheduled inhalation therapy.

Methods
The study design consisted of a randomised controlled trial in a primary care setting. 146 patients diagnosed with COPD were randomly allocated into two groups using the block randomisation technique. One-year follow-ups with three visits were performed. The intervention consisted of motivational aspects related to adherence (beliefs and behaviour) in the form of group and individual interviews, cognitive aspects in the form of information about the illness and skills in the form of training in inhalation techniques. Cognitive-emotional aspects and training in inhalation techniques were reinforced during all visits of the intervention group. The main outcome measure was adherence to the medication regimen. Therapeutic adherence was determined by the percentage of patients classified as good adherent as evaluated by dose or pill count.

Results
Of the 146 participants (mean age 69.8 years, 91.8% males), 41.1% reported adherence (41.9% of the control group and 40.3% of the intervention group). When multifactorial intervention was applied, the reported adherence was 32.4% for the control group and 48.6% for the intervention group, which showed a statistically significant difference (p = 0.046). Number needed to treat is 6.37. In the intervention group, cognitive aspects increased by 23.7% and skilled performance of inhalation techniques increased by 66.4%. The factors related to adherence when multifactorial intervention was applied were the number of exacerbations (OR = 0.66), visits to health centre (OR = 0.93) and devices (OR = 2.4); illness severity (OR = 0.67), beta-2-adrenergic (OR = 0.16) and xantine (OR = 0.19) treatment; activity (OR = 1.03) and impact (OR = 1.03) scales of the Saint George Respiratory Questionnaire.

Conclusion
Application of the multifactorial intervention designed for this study (COPD information, dose reminders, audio-visual material, motivational aspects and training in inhalation techniques) resulted in an improvement in therapeutic adherence in COPD patients with scheduled inhalation therapy.

Trial registration
Current Controlled Trials ISRCTN18841601.
Glucose-regulated protein 78 and heparanase expression in oral squamous cell carcinoma: correlations and prognostic significance
Authors: Xia Fei , Xu Jin Cheng , Zhang Pei , Zhang Yuan Yuan , Zhang Qian Wen , Chao Zhen Hua , Wang Fang 
Published: April 2014

Abstract

Background
The aim of the present study was to investigate the expression of glucose-related protein 78 (GRP78) and heparanase (HPA) in oral squamous cell carcinoma (OSCC) and their relationship with clinicopathological parameters and potential implications for survival.

Methods
A total of 46 patients with OSCC and 10 normal individuals were recruited for the study. GRP78 and HPA expression were determined in the lesion tissues using immunohistochemical analysis. The correlation between GRP78 and HPA was assessed using the Spearman correlation analysis. The associations of GRP78 and HPA with clinicopathological characteristics and survival were examined using the x2-test, Kaplan–Meier, or Cox regression.

Results
Patients with OSCC showed a statistically significant higher prevalence of GRP78 and HPA expression than normal oral tissues. GRP78 and HPA expression was positively correlated with size, TNM stage, histological grade, lymphatic metastasis, and distant metastasis in OSCC patients. GRP78 expression was also positively correlated with HPA expression. Positive GRP78 and HPA expression was inversely correlated with survival in OSCC patients.

Conclusions
HPA expression was found to be positively correlated with GRP78 expression. GRP78 and HPA are biomarkers that may have the potential to guide the treatment of oral cancer patients.
Serum C-X-C motif chemokine 13 is elevated in early and established rheumatoid arthritis and correlates with rheumatoid factor levels
Authors: Jones Jonathan D , Hamilton B JoNell , Challener Gregory J , de Brum-Fernandes Artur J , Cossette Pierre , Liang Patrick , Masetto Ariel , Ménard Henri A , Carrier Nathalie , Boyle David L , Rosengren Sanna , Boire Gilles , Rigby William F C 
Published: April 2014

Abstract
Introduction
We hypothesized that serum levels of C-X-C motif chemokine 13 (CXCL13), a B-cell chemokine, would delineate a subset of rheumatoid arthritis (RA) patients characterized by increased humoral immunity.

Methods
Serum from patients with established RA (the Dartmouth RA Cohort) was analyzed for CXCL13, rheumatoid factor (RF) levels, anticitrullinated peptide/protein antibody (ACPA) and total immunoglobulin G (IgG); other parameters were obtained by chart review. A confirmatory analysis was performed using samples from the Sherbrooke Early Undifferentiated PolyArthritis (EUPA) Cohort. The Wilcoxon rank-sum test, a t-test and Spearman’s correlation analysis were utilized to determine relationships between variables.

Results
In both the Dartmouth and Sherbrooke cohorts, CXCL13 levels were selectively increased in seropositive relative to seronegative RA patients (P = 0.0002 and P < 0.0001 for the respective cohorts), with a strong correlation to both immunoglobulin M (IgM) and IgA RF levels (P < 0.0001). There was a weaker relationship to ACPA titers (P = 0.03 and P = 0.006, respectively) and total IgG (P = 0.02 and P = 0.14, respectively). No relationship was seen with regard to age, sex, shared epitope status or inclusion high-sensitivity C-reactive protein (hsCRP) in either cohort or regarding the presence of baseline erosions in the Sherbrooke Cohort, whereas a modest relationship with Disease Activity Score in 28 joints CRP (DAS28-CRP) was seen in the Dartmouth cohort but not the Sherbrooke cohort.

Conclusion
Using both established and early RA cohorts, marked elevations of serum CXCL13 levels resided nearly completely within the seropositive population. CXCL13 levels exhibited a strong relationship with RF, whereas the association with clinical parameters (age, sex, DAS28-CRP and erosions) or other serologic markers (ACPA and IgG) was either much weaker or absent. Elevated serum CXCL13 levels may identify a subset of seropositive RA patients whose disease is shaped by or responsive to RF production.