bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment resistant adolescent depression with upper airway resistance syndrome treated with rapid palatal expansion: a case report
Authors: Miller Paul , Iyer Mala , Gold Avram R 
Published: December 2012

Abstract

Introduction
To the best of our knowledge, this is the first report of a case of treatment-resistant depression in which the patient was evaluated for sleep disordered breathing as the cause and in which rapid palatal expansion to permanently treat the sleep disordered breathing produced a prolonged symptom-free period off medication.

Case presentation
An 18-year-old Caucasian man presented to our sleep disorders center with chronic severe depression that was no longer responsive to medication but that had recently responded to electroconvulsive therapy. Ancillary, persistent symptoms included mild insomnia, moderate to severe fatigue, mild sleepiness and severe anxiety treated with medication. Our patient had no history of snoring or witnessed apnea, but polysomnography was consistent with upper airway resistance syndrome. Although our patient did not have an orthodontic indication for rapid palatal expansion, rapid palatal expansion was performed as a treatment of his upper airway resistance syndrome. Following rapid palatal expansion, our patient experienced a marked improvement of his sleep quality, anxiety, fatigue and sleepiness. His improvement has been maintained off all psychotropic medication and his depression has remained in remission for approximately two years following his electroconvulsive therapy.

Conclusions
This case report introduces the possibility that unrecognized sleep disordered breathing may play a role in adolescent treatment-resistant depression. The symptoms of upper airway resistance syndrome are non-specific enough that every adolescent with depression, even those responding to medication, may have underlying sleep disordered breathing. In such patients, rapid palatal expansion, by widening the upper airway and improving airflow during sleep, may produce a prolonged improvement of symptoms and a tapering of medication. Psychiatrists treating adolescents may benefit from having another treatment option for treatment-resistant depression.
The expanded clinical profile and the efficacy of colchicine therapy in Egyptian children suffering from familial mediterranean fever: a descriptive study
Authors: Talaat Hala Salah El-Din , Mohamed Mohamed Farouk , El Rifai Nihal Mohamed Mohamed , Gomaa Mohamed Ali 
Published: December 2012

Abstract

Background
Familial Mediterranean fever (FMF) is an autosomal recessive disease characterized by self-limiting recurrent attacks of fever and serosal inflammation, leading to abdominal, thoracic or articular pain.

Objective
To detect variable clinical presentations and genotypic distribution of different groups of FMF patients and the efficacy of colchicine therapy in treatment of these groups of FMF after one year.

Methods
A cross-sectional study was conducted on 70 patients already diagnosed with FMF and following-up at the Rheumatology Clinic, Children's Hospital - Cairo University. Diagnosis of FMF was determined according to Tel Hashomer criteria for FMF. All patients were subjected to a questionnaire including detailed history with emphasis on clinical manifestations and colchicine dose to control attacks. Mutational analysis was performed for all study subjects covering 12 mutations in the MEFV gene: E148Q, P369S, F479L, M680I (G/C), M680I (G/A), I692del, M694V, M694I, K695R, V726A, A744S and R761H. Response to colchicine treatment was evaluated as complete, incomplete and unresponsive.

Results
Out of the 70 patients- 40 males and 30 females- fever was the most common presenting feature, followed by abdominal pain, and arthritis; documented in 95.7%, 94.3%, and 77.1% of cases respectively. Mutational analysis detected gene mutation on both alleles in 20 patients (homozygotes), on only 1 allele in 40 patients (heterozygotes), and on none of the alleles (uncharacterized cases). Mild to moderate disease severity score (according to Tel Hashomer key to severity score) was detected in a significant proportion of heterozygotes and the uncharacterized group than the homozygotes. All patients received colchicine therapy; 22.9% of them showed complete response, 74.3% showed incomplete response and 2.9% showed no response to therapy. The colchicine dose needed to control attacks was significantly lower in heterozygotes than the homozygotes(P=0.04). Also patients’ response to colchicine therapy was significantly better in the heterozygous group(P=0.023).

Conclusion
Fever, abdominal pain and arthritis are the most common presenting features for homozygous, Heterozygous and uncharacterized patients. E148Q, V726A, and M680I were the most common mutations detected in the heterozygous group. Homozygosity were found for M680I, M694V, and M694I mutations in 13 patients (65% of homozygotes). Heterozygotes presenting with severe phenotype should be further analyzed for less common second MEFV mutation using gene sequencing. The colchicine dose required to control the attacks was significantly lower and patients’ response to colchicine therapy was significantly better in the heterozygous group than homozygous group.
Results of Annual Screening in Phase I of the United Kingdom Familial Ovarian Cancer Screening Study Highlight the Need for Strict Adherence to Screening Schedule
Authors: Rosenthal Adam N. , Fraser Lindsay , Manchanda Ranjit , Badman Philip , Philpott Susan , Mozersky Jessica , Hadwin Richard , Cafferty Fay H. , Benjamin Elizabeth , Singh Naveena , Evans D. Gareth , Eccles Diana M. , Skates Steven J. , Mackay James , Menon Usha , Jacobs Ian J. 
Published: December 2012

Purpose To establish the performance characteristics of annual transvaginal ultrasound and serum CA125 screening for women at high risk of ovarian/fallopian tube cancer (OC/FTC) and to investigate the impact of delayed screening interval and surgical intervention. Patients and Methods Between May 6, 2002, and January 5, 2008, 3,563 women at an estimated ≥ 10% lifetime risk of OC/FTC were recruited and screened by 37 centers in the United Kingdom. Participants were observed prospectively by centers, questionnaire, and national cancer registries. Results Sensitivity for detection of incident OC/FTC at 1 year after last annual screen was 81.3% (95% CI, 54.3% to 96.0%) if occult cancers were classified as false negatives and 87.5% (95% CI, 61.7% to 98.5%) if they were classified as true positives. Positive and negative predictive values of incident screening were 25.5% (95% CI, 14.3 to 40.0) and 99.9% (95% CI, 99.8 to 100) respectively. Four (30.8%) of 13 incident screen-detected OC/FTCs were stage I or II. Compared with women screened in the year before diagnosis, those not screened in the year before diagnosis were more likely to have ≥ stage IIIc disease (85.7% v 26.1%; P = .009). Screening interval was delayed by a median of 88 days before detection of incident OC/FTC. Median interval from detection screen to surgical intervention was 79 days in prevalent and incident OC/FTC. Conclusion These results in the high-risk population highlight the need for strict adherence to screening schedule. Screening more frequently than annually with prompt surgical intervention seems to offer a better chance of early-stage detection.
Impact of FOLFIRINOX Compared With Gemcitabine on Quality of Life in Patients With Metastatic Pancreatic Cancer: Results From the PRODIGE 4/ACCORD 11 Randomized Trial
Authors: Gourgou-Bourgade Sophie , Bascoul-Mollevi Caroline , Desseigne Françoise , Ychou Marc , Bouché Olivier , Guimbaud Rosine , Bécouarn Yves , Adenis Antoine , Raoul Jean-Luc , Boige Valérie , Bérille Jocelyne , Conroy Thierry 
Published: December 2012

Purpose To compare the quality of life (QoL) of patients receiving oxaliplatin, irinotecan, fluorouracil, and leucovorin (FOLFIRINOX) or gemcitabine as first-line chemotherapy and to assess whether pretreatment QoL predicts survival in patients with metastatic pancreatic cancer. Patients and Methods Three hundred forty-two patients with performance status 0 or 1 were randomly assigned to receive FOLFIRINOX (oxaliplatin, 85 mg/m2; irinotecan, 180 mg/m2; leucovorin, 400 mg/m2; and fluorouracil, 400 mg/m2 bolus followed by 2,400 mg/m2 46-hour continuous infusion, once every 2 weeks) or gemcitabine 1,000 mg/m2 weekly for 7 of 8 weeks and then weekly for 3 of 4 weeks. QoL was assessed using European Organisation for the Research and Treatment of Cancer Quality of Life Questionnaire C30 every 2 weeks. Results Improvement in global health status (GHS; P < .001) was observed in the FOLFIRINOX arm and improvement in emotional functioning (P < .001) was observed in both arms, along with a decrease in pain, insomnia, anorexia, and constipation in both arms. A significant increase in diarrhea was observed in the FOLFIRINOX arm during the first 2 months of chemotherapy. Time until definitive deterioration ≥ 20 points was significantly longer for FOLFIRINOX compared with gemcitabine for GHS, physical, role, cognitive, and social functioning, and six symptom domains (fatigue, nausea/vomiting, pain, dyspnea, anorexia, and constipation). Physical functioning, constipation, and dyspnea were independent significant prognostic factors for survival with treatment arm, age older than 65 years, and low serum albumin. Conclusion FOLFIRINOX significantly reduces QoL impairment compared with gemcitabine in patients with metastatic pancreatic cancer. Furthermore, baseline QoL scores improved estimation of survival probability when added to baseline clinical and demographic variables.
Effect of Patient Socioeconomic Status on Access to Early-Phase Cancer Trials
Authors: Mohd Noor Aisyah , Sarker Debashis , Vizor Suzanne , McLennan Blair , Hunter Sarah , Suder Aneta , Moller Henrik , Spicer James F. , Papa Sophie 
Published: December 2012

Purpose Little is known about the influence of socioeconomic factors on patient access to cancer trials. Differences should be considered to ensure generalizability of trial results and equality of access. Methods Phase I trials unit referrals at our center over 5 years, from 2007 to 2012, were reviewed. Socioeconomic status was defined by the Index of Multiple Deprivation (IMD; 1, least deprived; 5, most deprived). Multivariate analysis was performed comparing incident cancer cases with referred patients and those ultimately enrolled onto a trial. Results Four hundred thirty patients were referred (median age, 62 years). Compared with 10,784 incident cases, referral was less likely for patients in the more-deprived quintiles compared with the least deprived (IMD 5: odds ratio [OR], 0.53; 95% CI, 0.38 to 0.74). Once reviewed in the unit, enrollment onto a trial was not affected (IMD 5: OR, 0.81; 95% CI, 0.40 to 1.63). Ethnicity analysis showed the nonwhite population was less likely to be recruited (OR, 0.48; 95% CI, 0.26 to 0.88). This relationship was lost with adjustment for age, sex, cancer type, and deprivation index. Conclusion We show for the first time to our knowledge that socioeconomic status affects early-phase cancer trial referrals. The least-deprived patients are almost twice as likely to be referred compared with the most deprived. This may be because more-deprived patients are less suitable for a trial—as a result of comorbidities, for example—or because of inequalities that could be addressed by patient or referrer education. Once reviewed at the unit, enrollment onto a trial is not affected by deprivation.
Unusual deep vein thrombosis sites: magnetic resonance venography in patients with negative compression ultrasound and symptomatic pulmonary embolism
Authors: Gary T , Steidl K , Belaj K , Hafner F , Froehlich H , Deutschmann H , Pilger E , Brodmann M 
Published: December 2012

Objectives To evaluate the clinical characteristics of patients with pulmonary embolism (PE), negative compression ultrasound (CUS) of the lower limbs and detection of unusual deep vein thrombosis (DVT) sites by means of magnetic resonance (MR) venography. Methods A retrospective data analysis of PE patients hospitalized at our institution from April 2009 to 2011. Results From April 2009 to 2011, a total of 762 PE patients were treated at our institution. In 169 of these patients CUS for DVT was negative. In these patients MR venography was performed for further evaluation. We found venous thrombosis at unusual sites in 12 of these patients. Due to free floating thrombus masses and fear of life-threatening PE progression we inserted an inferior vena cava filter in three of these 12 patients. The leading venous thromboembolism risk factor in our patients was immobilization (5 patients, 41.7%). Conclusions We conclude that especially in patients with PE and negative CUS of the lower limbs a thrombosis of the pelvic veins should be considered in case of symptoms for venous thrombosis in this area. Further diagnostic work-up with MR venography should be scheduled in these patients especially in patients with risk factor immobilization as therapeutic consequences might occur.
Disability caused by multiple sclerosis is associated with the number of extra cranial venous stenoses: possible improvement by venous angioplasty. Results of a prospective study
Authors: Denislic M , Milosevic Z , Zorc M , Ravnik I Zuran D , Mendiz O 
Published: December 2012

Objective: Chronic cerebrospinal venous insufficiency (CCSVI) was recently described in patients with multiple sclerosis (MS). The hypothesis of the vascular aetiology provides a new approach in the investigation and treatment of MS. Methods: Our open-label study included 94 MS patients who fulfilled ultrasound sonographic criteria required for CCSVI. The internal jugular and/or azygous veins by a catheter venography were dilated. Results: In 34.8% of the patients unilateral, in 65.2% bilateral venous abnormalities and in 2.1% no luminal obstructions were demonstrated. The patient group with the higher disability score had a significantly higher number of venous lesions ( P < 0.005). Significant improvement of clinical disability in relapsing-remitting patients was ( P < 0.001) achieved. In our study no stents were used. Re-stenosis occurred in 21.7% of the patients. Conclusion: The number of venous narrowings is higher in more disabled patients. A significant improvement in clinical disability in the relapsing-remitting group was observed.
Reducing of the Sound Pressure Level in Industrial Areas by Screening Noise Sources
Authors: Claudia Tomozei , Valentin Nedeff , Gabriel Lazar , Elena Ciobanu 
Published: December 2012

This paper presents several ways in which the propagation of acoustic waves produced by an industrial noise source can be attenuated by identifying the optimal location of an acoustic screen near the noise source. Six types of acoustic screens were used, made of six types of materials (of the category used in the field of construction), with or without sound absorbing qualities. The noise source was placed in four different positions in front of the acoustic screen. The microphone was placed in 16 recording positions, at four distances and four heights. The experimentally obtained values indicate that the efficiency of the acoustic screen is optimal when the screen is placed at a reduced distance from the noise source, in a centered position. To obtain a high degree of sound pressure level attenuation, one can choose among variants with at least two screening walls positioned in a “V” form.
Influence of Tobacco Displays and Ads on Youth: A Virtual Store Experiment
Authors: Kim Annice E. , Nonnemaker James M. , Loomis Brett R. , Baig Asma , Hill Edward , Holloway John W. , Farrelly Matthew C. , Shafer Paul R. 
Published: December 2012

OBJECTIVE:
To examine the potential impact of banning tobacco displays and ads at the point of sale (POS) on youth outcomes.

METHODS:
An interactive virtual convenience store was created with scenarios in which the tobacco product display at the POS was either openly visible (status quo) or enclosed behind a cabinet (display ban), and tobacco ads in the store were either present or absent. A national convenience sample of 1216 youth aged 13 to 17 who were either smokers or nonsmokers susceptible to smoking participated in the study. Youth were randomized to 1 of 6 virtual store conditions and given a shopping task to complete in the virtual store. During the shopping task, we tracked youth’s attempts to purchase tobacco products. Subsequently, youth completed a survey that assessed their perceptions about the virtual store and perceptions about the ease of buying cigarettes from the virtual store.

RESULTS:
Compared with youth in the status quo condition, youth in the display ban condition were less aware that tobacco products were for sale (32.0% vs 85.2%) and significantly less likely to try purchasing tobacco products in the virtual store (odds ratio = 0.30, 95% confidence interval = 0.13−0.67, P &lt; .001). Banning ads had minimal impact on youth’s purchase attempts.

CONCLUSIONS:
Policies that ban tobacco product displays at the POS may help reduce youth smoking by deterring youth from purchasing tobacco products at retail stores.
Nonsteroidal Antiinflammatory Drugs in Late Pregnancy and Persistent Pulmonary Hypertension of the Newborn
Authors: Van Marter Linda J. , Hernandez-Diaz Sonia , Werler Martha M. , Louik Carol , Mitchell Allen A. 
Published: December 2012

OBJECTIVE:Persistent pulmonary hypertension of the newborn (PPHN) is a clinical syndrome of late-preterm and full-term infants associated with failure of the normal fetal-to-neonatal circulatory transition. This study was designed to test the hypothesis that risk for PPHN is increased after antenatal exposure to nonsteroidal antiinflammatory drugs (NSAIDs), with particular emphasis on late gestational exposures.METHODS:Between 1998 and 2003, we interviewed 377 women whose infants had PPHN and 836 control mothers of infants matched to cases by hospital and birth date. Interviews captured information on prescription and over-the-counter medication use in pregnancy as well as a variety of potential confounding factors. Crude and adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for third-trimester maternal NSAID use were estimated by using multivariate conditional logistic regression.RESULTS:During the third trimester of gestation, 33 infants (8.8%) with PPHN were exposed to any NSAID compared with 80 (9.6%) controls (OR 0.8; 95% CI 0.5–1.3). We observed an elevated OR for PPHN risk among infants whose mothers consumed aspirin during the third-trimester; however, the lower 95% CI included the null. Neither nonaspirin NSAIDs at any time during pregnancy nor ibuprofen use during the third trimester was associated with an elevated risk of PPHN. Similarly, no association was observed between a mother’s third-trimester acetaminophen use and the occurrence of PPHN in her newborn.CONCLUSIONS:This large multicenter epidemiologic study of PPHN risk revealed no evidence to support the hypothesis that maternal consumption during pregnancy of NSAIDs overall or ibuprofen in particular is associated with PPHN risk.
Readability, Suitability, and Characteristics of Asthma Action Plans: Examination of Factors That May Impair Understanding
Authors: Yin H. Shonna , Gupta Ruchi S. , Tomopoulos Suzy , Wolf Michael S. , Mendelsohn Alan L. , Antler Lauren , Sanchez Dayana C. , Lau Claudia Hillam , Dreyer Benard P. 
Published: December 2012

OBJECTIVE:
Recognition of the complexity of asthma management has led to the development of asthma treatment guidelines that include the recommendation that all pediatric asthma patients receive a written asthma action plan. We assessed the readability, suitability, and characteristics of asthma action plans, elements that contribute to the effectiveness of action plan use, particularly for those with limited literacy.

METHODS:
This was a descriptive study of 30 asthma action plans (27 state Department of Health (DOH)–endorsed, 3 national action plans endorsed by 6 states). Outcome measures: (1) readability (as assessed by Flesch Reading Ease, Flesch-Kincaid, Gunning Fog, Simple Measure of Gobbledygook, Forcast), (2) suitability (Suitability Assessment of Materials [SAM], adequate: ≥0.4; unsuitable: &lt;0.4), (3) action plan characteristics (peak flow vs symptom-based, symptoms, recommended actions).

RESULTS:
Mean (SD) overall readability grade level was 7.2 (1.1) (range = 5.7–9.8); 70.0% were above a sixth-grade level. Mean (SD) suitability score was 0.74 (0.14). Overall, all action plans were found to be adequate, although 40.0% had an unsuitable score in at least 1 factor. The highest percent of unsuitable scores were found in the categories of layout/typography (30.0%), learning stimulation/motivation (26.7%), and graphics (13.3%). There were no statistically significant differences between the average grade level or SAM score of state DOH developed action plans and those from or adapted from national organizations. Plans varied with respect to terms used, symptoms included, and recommended actions.

CONCLUSIONS:
Specific improvements in asthma action plans could maximize patient and parent understanding of appropriate asthma management and could particularly benefit individuals with limited literacy skills.
Trends in Adverse Reactions to Trimethoprim-Sulfamethoxazole
Authors: Goldman Jennifer L. , Jackson Mary Anne , Herigon Joshua C. , Hersh Adam L. , Shapiro Daniel J. , Leeder J. Steven 
Published: December 2012

OBJECTIVE:To examine temporal trends of adverse drug reactions (ADRs) associated with trimethoprim-sulfamethoxazole (TMP-SMX) use in children.METHODS:We performed a retrospective observational study to characterize TMP-SMX ADRs in children between 2000 and 2009. We completed a chart review at our institution by identifying children diagnosed with TMP-SMX ADRs. To compare local trends to comparable institutions, we estimated the frequency of hospitalizations for TMP-SMX ADRs at 25 tertiary pediatric hospitals utilizing the Pediatric Health Information System database. To determine whether changes in outpatient prescribing rates occurred, we used the National Ambulatory Medical Care Survey/National Hospital Ambulatory Medical Care Survey.RESULTS:At our institution, 109 children were diagnosed with a TMP-SMX ADR (5 cases from 2000 to 2004 as compared with 104 cases from 2005 to 2009). Fifty-eight percent had been treated for a skin and soft tissue infection (SSTI). A similar trend was observed nationally, where the incidence of TMP-SMX ADRs more than doubled from 2004 to 2009 at comparable pediatric hospitals (P &lt; .001). Although national outpatient data revealed no change in overall TMP-SMX prescribing, the percentage of children prescribed TMP-SMX for SSTI sharply increased during the study period (0%–2% [2000-2004]; 9%–17% [2005–2009]).CONCLUSIONS:The majority of TMP-SMX ADRs at our institution occurred in conjunction with SSTI treatment. TMP-SMX ADRs have occurred more frequently coincident with increased prescribing for SSTI. Increased usage alone may explain the increasing trend of TMP-SMX ADRs in children; however drug–disease interaction may play a role and requires further investigation.