bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of dynamic hyperinflation on exercise capacity and quality of life in stable COPD patients
Authors: Zhao Li , Peng Liyue , Wu Baomei , Bu Xiaoning , Wang Chen 
Published: January 2015

AbstractBackground and AimsDynamic hyperinflation (DH) is an important pathophysiological characteristic of chronic obstructive pulmonary disease (COPD). There is increasing evidence that DH has negative effects on exercise performance and quality of life. The objective of this study was to explore effects of DH on exercise capacity and quality of life in stable COPD patients.MethodsFifty‐eight COPD patients and 20 matched healthy individuals underwent pulmonary function test, 6‐min walk test and symptom‐limited cardiopulmonary exercise test (CPET). End‐expiratory lung volume/total lung capacity ratio (EELVmax/TLC) at peak exercise of CPET was evaluated, and EELVmax/TLC ≥ 75% was defined as ‘severe dynamic hyperinflation (SDH)’.ResultsOf the 58 patients studied, 29 (50.0%) presented with SDH (SDH+ group, EELVmax/TLC 79.60 ± 3.60%), having worse maximal exercise capacity reflected by lower peakload, maximal oxygen uptake (VO2max), maximal carbon dioxide output (VCO2max) and maximal minute ventilation (VEmax) than did those without SDH (SDH− group, EELVmax/TLC 67.44 ± 6.53%). The EELVmax/TLC ratio at peak exercise had no association with variables of pulmonary function and 6‐min walk distance (6MWD), but correlated inversely with peakload, VO2max, VCO2max and VEmax (r = −0.300~−0.351, P < 0.05). Although no significant differences were observed, patients with EELVmax/TLC ≥ 75% tended to have higher COPD assessment test score (15.07 ± 6.55 vs 13.28 ± 6.59, P = 0.303).ConclusionsDH develops variably during exercise and has a greater impact on maximal exercise capacity than 6MWD, even in those with the same extent of pulmonary function impairment at rest.
The role of transbronchial cryobiopsy and surgical lung biopsy in the diagnostic algorithm of interstitial lung disease
Authors: Hagmeyer Lars , Theegarten Dirk , Wohlschläger Jeremias , Treml Marcel , Matthes Sandhya , Priegnitz Christina , Randerath Winfried J. 
Published: January 2015

AbstractBackground and AimsIt is not yet known if transbronchial cryobiopsy (TCB) is a reliable and safe diagnostic tool in the investigation of interstitial lung disease (ILD). To date, there have been no studies directly comparing the value of TCB with that of surgical lung biopsy (SLB). The study was initiated to determine whether the samples taken by TCB lead to a reliable diagnosis and whether SLB can be avoided in a relevant percentage of cases.MethodsWe analyzed 32 subjects with suspected ILD who underwent a TCB. Subjects' baseline characteristics, pathological findings after TCB and SLB, and complication rates were analyzed. The pathological inter‐rater agreement was quantified statistically.ResultsThe overall inter‐rater agreement concerning TCB sample evaluation was good with a kappa value of 0.80. In 23/32 cases (72%), the findings from the TCB showed a strong congruence with all other clinical data, thereby enabling a definitive diagnosis. Eight of the remaining nine subjects gave their consent for an SLB, which led to a definitive histological diagnosis in six cases (75%). Following TCB, pneumothorax occurred in 6/32 subjects (19%) and endobronchial bleeding was moderate in 8/32 (25%) and was severe in 17/32 cases (53%).ConclusionThis is the first study to correlate histological results and complications following TCB and SLB in ILD subjects, some of whom underwent both procedures. TCB is a suitable diagnostic tool in ILD, potentially completely dispensing with the need for an SLB in some cases. In all cases, an interdisciplinary case evaluation is necessary as a final step.
The sonographic features of malignant mediastinal lymph nodes and a proposal for an algorithmic approach for sampling during endobronchial ultrasound
Authors: Alici Ibrahim Onur , Yılmaz Demirci Nilgün , Yılmaz Aydın , Karakaya Jale , Özaydın Esra 
Published: January 2015

AbstractIntroductionThere are several papers on the sonographic features of mediastinal lymph nodes affected by several diseases, but none gives the importance and clinical utility of the features.ObjectiveIn order to find out which lymph node should be sampled in a particular nodal station during endobronchial ultrasound, we investigated the diagnostic performances of certain sonographic features and proposed an algorithmic approach.MethodsWe retrospectively analyzed 1051 lymph nodes and randomly assigned them into a preliminary experimental and a secondary study group. The diagnostic performances of the sonographic features (gray scale, echogeneity, shape, size, margin, presence of necrosis, presence of calcification and absence of central hilar structure) were calculated, and an algorithm for lymph node sampling was obtained with decision tree analysis in the experimental group. Later, a modified algorithm was applied to the patients in the study group to give the accuracy.ResultsThe demographic characteristics of the patients were not statistically significant between the primary and the secondary groups. All of the features were discriminative between malignant and benign diseases. The modified algorithm sensitivity, specificity, and positive and negative predictive values and diagnostic accuracy for detecting metastatic lymph nodes were 100%, 51.2%, 50.6%, 100% and 67.5%, respectively.ConclusionsIn this retrospective analysis, the standardized sonographic classification system and the proposed algorithm performed well in choosing the node that should be sampled in a particular station during endobronchial ultrasound.
CCDC40 mutation as a cause of primary ciliary dyskinesia: a case report and review of literature
Authors: Sui Weiguo , Hou Xianliang , Che Wenti , Ou Minglin , Sun Guoping , Huang Shengxing , Liu Fuhua , Chen Peng , Wei Xiaolian , Dai Yong 
Published: January 2015

AbstractBackground and AimsPrimary ciliary dyskinesia (PCD) is a rare, genetically heterogeneous disorder. Genetic defects affecting motility of cilia and flagella cause chronic destructive airway disease, situs inversus and, frequently, male infertility in PCD. To date, although several genes have been implicated in PCD, the genetic bases of most cases of PCD remain elusive.MethodsBy applying a whole‐exome sequencing strategy, we reported a case of PCD carrying a novel mutant alleles in CCDC40 gene, and did literature review.ResultsA 36‐year‐old nonsmoking Chinese man suffered from chronic cough since childhood and an 8‐year history of primary infertility. Lung biopsy showed respiratory bronchiolitis. Chest images showed bronchiectasis and situs inversus. Semen analysis showed high sperm counts and poor sperm motility. Transmission electron microscopy (TEM) of cilia cross‐sections showed ultrastructural defects, including inner dynein arms (IDA) defect and axonemal disorganization. To identify gene mutations that cause PCD, we performed exome sequencing to analyze genome of this patient, and discovered a previously uncharacterized mutant alleles (NM_001243342.1:c.2609G>A; p. R870H) in CCDC40 gene. In addition, we summarize the PCD disease‐causing genes and CCDC40 mutant sites based on current literature.ConclusionsWe identified a novel mutant alleles in CCDC40 gene, which altered the protein sequence and resulted in the ultrastructural defects in the microtubule structure of cilia. Thereby, these defects lead to the patient with bronchiectasis, bronchiolitis and infertility.
Deep breathing exercises with positive expiratory pressure in patients with multiple sclerosis – a randomized controlled trial
Authors: Westerdahl Elisabeth , Wittrin Anna , Kånåhols Margareta , Gunnarsson Martin , Nilsagård Ylva 
Published: January 2015

AbstractIntroductionBreathing exercises with positive expiratory pressure are often recommended to patients with advanced neurological deficits, but the potential benefit in multiple sclerosis (MS) patients with mild and moderate symptoms has not yet been investigated in randomized controlled trials.ObjectivesTo study the effects of 2 months of home‐based breathing exercises for patients with mild to moderate MS on respiratory muscle strength, lung function, and subjective breathing and health status outcomes.MethodsForty‐eight patients with MS according to the revised McDonald criteria were enrolled in a randomized controlled trial. Patients performing breathing exercises (n = 23) were compared with a control group (n = 25) performing no breathing exercises. The breathing exercises were performed with a positive expiratory pressure device (10–15 cmH2O) and consisted of 30 slow deep breaths performed twice a day for 2 months. Respiratory muscle strength (maximal inspiratory and expiratory pressure at the mouth), spirometry, oxygenation, thoracic excursion, subjective perceptions of breathing and self‐reported health status were evaluated before and after the intervention period.ResultsFollowing the intervention, there was a significant difference between the breathing group and the control group regarding the relative change in lung function, favoring the breathing group (vital capacity: P < 0.043; forced vital capacity: P < 0.025). There were no other significant differences between the groups.ConclusionBreathing exercises may be beneficial in patients with mild to moderate stages of MS. However, the clinical significance needs to be clarified, and it remains to be seen whether a sustainable effect in delaying the development of respiratory dysfunction in MS can be obtained.
Evaluation of our self‐designed nanometer silicon membrane sandwich cup system for diagnosing tuberculosis
Authors: Peng Jun , Liu Wen‐en , Li Hong‐Ling , Liu Qing‐Xia , Liang Xiang‐Hui , Hu Ke , Jian Zi‐Juan , Li Yan‐Bing , Peng Wan‐Chan 
Published: January 2015

AbstractBackground and AimsA nanometer silicon membrane sandwich cup system was self‐designed. It could concentrate the bacilli via 0.45‐μm microporous filter membrane and semi‐automate the acid‐fast bacilli (AFB) by a bacteria‐staining machine. The aim of the study was to assess the clinical value of our self‐designed system for diagnosing tuberculosis (TB).MethodsA total of 1993 sputum specimens obtained from patients with confirmed or suspected TB were subjected to direct or concentrated specimens smear at XiangYa Hospital, Central South University between May 2012 and February 2013. In addition, all the specimens were also inoculated into Lowenstein–Jensen (L‐J) media, and culture results were considered as the gold standard for calculating sensitivity and specificity.ResultsCompared with direct smear examination, an increased density of red stained bacilli was observed in the self‐designed nanometer silicon membrane sandwich cup analysis under the microscope. The positive rate of the self‐designed analysis was significantly higher than that of direct AFB smear [10.9% (217/1993) vs 6.2% (123/1993), P < 0.05]. The sensitivity of the self‐designed system increased (97.3% vs 55.2%, P < 0.05) without a loss of specificity (100% vs 100%) for identifying positive TB cases compared with the direct smear method.ConclusionThe self‐designed nanometer silicon membrane sandwich cup and semi‐automatic bacteria‐staining machine could more efficiently and rapidly detect the AFB in respiratory specimens than direct microscopy. This is a novel and safe examination, and it may replace direct smear examination for the diagnosis of patients with TB.
Tonsillar metastasis of small cell lung carcinoma
Authors: Unsal Meftun , Kutlar Gokhan , Sullu Yurdanur , Yurtlu Sirin 
Published: January 2015

AbstractMetastasis to palatine tonsils are rare, accounting from only 0.8% of all tonsillar tumors, so far only 100 cases reported in the English literature. Only a few cases have been reported for small cell and non‐small cell lung cancer as a primary site. With a diagnosis of small cell lung cancer, a 68‐year‐old male patient relapsed after six cycles of chemotherapy in tonsilla palatina and cervical lymph nodes. Patients died 26 months after being diagnosed with lung cancer and 2 months after detection of tonsil metastasis. We present the current case report because of the rarity of metastasis to tonsil in lung cancer.
Was a decision made? An assessment of patient–clinician discordance in medical oncology encounters
Authors: Leppin Aaron L. , Humeniuk Katherine M. , Fernandez Cara , Montori Victor M. , Yost Kathleen , Kumbamu Ashok , Geller Gail , Tilburt Jon C. 
Published: January 2015

AbstractBackgroundShared decision making is promoted to improve cancer care quality. Patients and clinicians may have different ideas about what constitutes a cancer care decision, which may limit the validity of self‐reported measures of shared decision making. We sought to estimate the extent to which patients and clinicians agree on whether a cancer care decision was made during an outpatient encounter.MethodsWe surveyed patients and clinicians immediately after an oncology encounter at a large, tertiary medical centre and calculated agreement in response to the single‐item question, ‘Was a specific decision about cancer care made during the appointment today?’ Answer options were ‘yes’ and ‘no’. Participants were 315 oncology patients, with any solid tumour malignancy and at any stage of management, and their clinicians (22 staff oncologists, nine senior fellows and five nurse practitioners).ResultsPatients and clinicians reported having made a cancer care decision in 184 (58%) and 174 (55%) of encounters, respectively. They agreed on whether a cancer care decision was made in 213 (68%) of encounters (chance‐adjusted agreement was 0.34); in 56 of the 102 discordant encounters, the patient reported making a decision while the clinician did not. We found no significant correlates with discordance.ConclusionsPatients and clinicians do not always agree on whether a cancer care decision was made. As such, measures that ask patients and/or clinicians to evaluate a decision‐making process or outcome may be methodologically insufficient when they do not explicitly orient respondents towards the thing they are being asked to assess.
Combined verbal and numerical expressions increase perceived risk of medicine side‐effects: a randomized controlled trial of EMA recommendations
Authors: Knapp Peter , Gardner Peter H , Woolf Elizabeth 
Published: January 2015

AbstractBackgroundThe study evaluated European Medicines Agency (EMA) recommendations on communicating frequency information on side‐effect risk.MethodsThe study used a 2 × 2 factorial trial, with random allocation of information about 10 side‐effects of paclitaxel (Taxol) expressed using one of four formats. Recruitment was via the CancerHelpUK website. Information was conveyed using numerical frequency bands (e.g. ‘may affect up to 1 in 10 people’) or combined verbal terms and numerical bands (e.g. ‘common: may affect up to 1 in 10 people’); in addition, the risk qualifier verb was manipulated, with risks expressed either as ‘will affect…’ or ‘may affect…’. Participants then made six side‐effect frequency estimates indicated their satisfaction with the information and evaluated the side‐effects: how bad; how likely; how risky to health; and their influence on taking paclitaxel.ResultsThe sample comprised 339 people, of whom 37.5% had cancer. The combined verbal and numerical risk expressions resulted in higher estimates of side‐effects, four of which reached statistical significance (P < 0.05), and participants also said that side‐effects would be more likely. Use of ‘may affect’ or ‘will affect’ did not result in differences in any estimates.ConclusionsThis is the first evaluation of the full range of combined verbal and numerical risk expressions recommended in EMA guidance; it demonstrates that they can lead to significant risk overestimations when compared to numerical frequency bands alone. The EMA should consider revising its guidance. Government agencies and professional bodies should be cautious about recommendations for risk communication in the absence of empirical evidence.
Self‐management support from the perspective of patients with a chronic condition: a thematic synthesis of qualitative studies
Authors: Dwarswaard Jolanda , Bakker Ellen J.M. , van Staa AnneLoes , Boeije Hennie R. 
Published: January 2015

AbstractBackgroundReceiving adequate support seems to be crucial to the success of self‐management. Although different empirical studies separately examined patients' preferences for self‐management support (SMS), an overview is lacking.ObjectiveThe aim of this qualitative review was to identify patients' needs with respect to SMS and to explore by whom this support is preferably provided.Search strategyQualitative studies were identified from Embase, MEDLINE OvidSP, Web of science, PubMed publisher, Cochrane central, the Cumulative Index to Nursing and Allied Health Literature (CINAHL) and PsycINFO.Inclusion criteriaArticles needed to meet all of the following criteria: (i) focuses on self‐management, (ii) concerns adult patients with rheumatic diseases (rheumatoid arthritis and fibromyalgia), a variant of cancer or chronic kidney disease, (iii) explores support needs from the patients' perspective, (iv) uses qualitative methods and (v) published in English.Data extraction and synthesisA thematic synthesis, developed by Thomas and Harden, was conducted of the 37 included studies.Main resultsChronic patients need instrumental support, psychosocial support and relational support from health‐care professionals, family/friends and fellow patients to manage the chronic condition. Relational support is at the centre of the support needs and fuels all other types of support.Discussion and conclusionsPatients do not self‐manage on their own. Patients expect health‐care professionals to fulfil a comprehensive role. Support needs can be knitted together only when patients and professionals work together on the basis of collaborative partnership. Dynamics in support needs make it important to regularly assess patient needs.
Bilirubin provides perforator flap protection from ischaemia‐reperfusion injury in a rat model: a preliminary result
Authors: Kim Sung Young , Rah Dong Kyun , Chong Yosep , Lee Song Hyun , Park Tae Hwan 
Published: January 2015

AbstractThe use of bilirubin, a well‐known and powerful antioxidant, has gained popularity in recent years because of its role in the prevention of ischaemic heart disease in patients with Gilbert's syndrome. We investigate the effects of bilirubin on ischaemia‐reperfusion (I/R) injury using a rat perforator flap model.Forty‐eight rats were randomly divided into two groups: experimental (bilirubin) group (n = 24) and control group (n = 24). In each group, elevated bilateral deep inferior epigastric perforator (DIEP) flaps were created. The right (no ischaemia side) and left (ischaemia side) DIEP flaps were separated according to the presence of ischaemia induction. Ischaemia was induced in anaesthetised rats by perforator clamping for 15 or 30 minutes. After surgery, the flap survival was assessed daily on postoperative days 0 to 5, and overall histological changes of DIEP flaps above the perforator were analysed at postoperative day 5.The flap survival rate in the bilirubin group was significantly higher than that in the control group at the ischaemia side following perforator clamping for 15 or 30 minutes (93·42 ± 4·48% versus 89·63 ± 3·98%, P = 0·002; and 83·96 ± 4·23% versus 36·46 ± 6·38%, P < 0·001, respectively). The difference in flap survival between the two groups was the most prominent on the ischaemic side following 30 minutes of perforator clamping.From a morphologic perspective, pre‐treatment with bilirubin was found to alleviate perforator flap necrosis caused by I/R injury in this experimental rat model.
Prevalence of methylchloroisothiazolinone and methylisothiazolinone contact allergy in facial dermatitis: a single centre Irish study
Authors: Murad A. , Marren P. 
Published: January 2015

AbstractBackgroundThere has been an increase in methylchloroisothiazolinone (MCI) and especially methylisothiazolinone (MI) contact allergy in recent years.ObjectivesWe examined the prevalence and demography of MCI/MI and MI contact allergy in patients presenting with facial dermatitis.MethodsEighty patients with facial dermatitis were patch tested to the British Society for Cutaneous Allergy standard series, preservatives and own products between January 2012 and March 2014.ResultsA total of 14 (17.5%) patients had positive reactions to this preservative. Five (6.3%) patients tested positive to MCI/MI (0.02%), four (5%) patients tested positive to MI (0.2%) and five (6.3%) patients tested positive to both preparations. Six (7.5%) of these patients were atopic. All patients were female and the mean age was 53.8 years. Sources of allergen were in cosmetics and skin care products.ConclusionsContact allergies to MCI/MI and MI are commoner than what was reported before and is an emerging cause of facial dermatitis. The detection rate of this allergen was increased by 5% in our cohort since the inclusion of MI (0.2%) in the standard series.
Identification of macrolide‐resistant Mycoplasma genitalium using real‐time PCR
Authors: Wold C. , Sorthe J. , Hartgill U. , Olsen A.O. , Moghaddam A. , Reinton N. 
Published: January 2015

AbstractObjectivesMycoplasma genitalium is a common cause of non‐gonococcal urethritis (NGU) in Western Europe, but is not routinely tested for in all clinics. A high prevalence of macrolide‐resistant M. genitalium has been reported. An easy to use test that can predict likely macrolide treatment failure is potentially very valuable. We report the development of a rapid and reliable real‐time PCR‐assay which detects all relevant resistance loci in the M. genitalium 23S rRNA gene.MethodsMycoplasma genitalium‐positive clinical samples were collected between December 2012 and May 2013, from samples sent routinely to the laboratory for diagnostic testing for M. genitalium. The real‐time PCR assay was designed using forward amplification primers complementary to all relevant commonly identified 23s rRNA gene mutations, a common reverse amplification primer and a common TaqMan Probe.ResultWe report a Taqman assay for detection of common 23S rRNA genotypes at position 2058 and 2059 (Escherichia coli numbering) associated with macrolide resistance, directly from clinical samples. We validated the assay by comparison with DNA sequence determination.ConclusionOur TaqMan assay detects common genotypes associated with macrolide‐resistant M. genitalium, namely, A2058G, A2059G and A2058C. We show association between the presence of resistant M. genitalium and treatment failure, thereby confirming the validity of testing for these mutants to prevent further spread of antimicrobial resistance and to allow informed choice of antibiotics for treatment.