bluuebunny/crossref_metadata_2025_split huggingface dataset:
National Quality Assessment Evaluating Spironolactone Use During Hospitalization for Acute Myocardial Infarction (AMI) in China: China Patient‐centered Evaluation Assessment of Cardiac Events (PEACE)‐Retrospective AMI Study, 2001, 2006, and 2011
Authors: Guan Wenchi , Murugiah Karthik , Downing Nicholas , Li Jing , Wang Qing , Ross Joseph S. , Desai Nihar R. , Masoudi Frederick A. , Spertus John A. , Li Xi , Krumholz Harlan M. , Jiang Lixin ,   the China PEACE Collaborative Group
Published: June 2015

Background

Spironolactone, the only aldosterone antagonist available in China, improves outcomes in acute myocardial infarction (
AMI
) among patients with systolic dysfunction and either diabetes or heart failure (
HF
). However, national practice patterns in the use of spironolactone in China are unknown.

Methods and Results

From a nationally representative sample of
AMI
patients from in 2001, 2006, and 2011, we identified 6906 patients with either diabetes or
HF
and classified them into 1 of 4 groups according to their eligibility for spironolactone—“ideal”(left ventricular ejection fraction [
LVEF
] ≤40% and without contraindications), “contraindicated,” “not indicated” (neither ideal nor contraindicated), and “unknown indications” (
LVEF
unmeasured)—to determine how frequently patient eligibility for this drug is assessed in the hospital, how it is used in several groups, and to identify factors associated with the use in these groups. From 2001 to 2011, the proportion of patients whose eligibility for spironolactone was not assessed decreased (66.9% in 2001 to 32.8% in 2011). Spironolactone use significantly increased among ideal patients over this period (28.6% to 72.4%;
P
<0.001 for trend), but also in contraindicated patients (11.4% to 27.5%;
P
=0.002 for trend) and in other patients groups (not indicated: 27.5% to 38.3%; unknown indications: 21.3% to 35.1%; both
P
<0.01 for trend). In all 4 groups, patients presenting with
HF
on admission were more likely to receive spironolactone.

Conclusions
Although the appropriate use of spironolactone and assessment of eligibility increased in China over the past decade, there remains marked opportunities for improvement.

Clinical Trial Registration

URL
:
http://www.clinicaltrials.gov
Unique identifier:
NCT
01624883.
Age and sex variation in serum albumin concentration: an observational study
Authors: Weaving Gary , Batstone Gifford F , Jones Richard G 
Published: June 2015

Background In the UK, a common reference interval for serum albumin is widely used irrespective of age or sex. Implicit in this is that laboratories produce analytically similar results. This paper challenges the validity of this approach. Methods A three-week collection of results sent to all primary care centres in England has been analysed by age, sex and laboratory. In all, 1,079,193 serum albumin reports were included in this analysis. Results The mean population serum albumin concentration increases to peak at around age 20 years and then decreases with increasing age. Values in females decrease more rapidly but become close to male values at 60 years. The variation between laboratories was large and potentially clinically significant. Conclusions Reference intervals for serum albumin should be stratified by age and sex. Until there is greater methodological standardization, laboratories should determine their own reference intervals and not accept a single consensus reference interval.
Menstrual cycle characteristics in women with persistent schizophrenia
Authors: Gleeson Pia C , Worsley Roisin , Gavrilidis Emorfia , Nathoo Shainal , Ng Elisabeth , Lee Stuart , Kulkarni Jayashri 
Published: June 2015

Objective: Oestradiol has been implicated in the pathogenesis of schizophrenia. Women with schizophrenia often suffer with menstrual dysfunction, usually associated with low oestradiol levels, but whether menstrual dysfunction has an effect on their psychiatric symptoms is not well researched. The aim of this study is to document the menstrual characteristics of women with chronic schizophrenia with focus upon menstrual regularity, menstrual cycle length and menstrual symptoms. To determine which patient characteristics are associated with irregular menses and whether irregular menses are associated with the severity of psychotic symptoms, menstrual symptoms or depressive symptoms. Method: Cross-sectional analyses using baseline data of women enrolled in a clinical trial. Inclusion criteria include Diagnostic and Statistical Manual of Mental Disorders–Fourth Edition, Text Revision diagnosis of schizophrenia, schizoaffective or schizophreniform disorder; aged between 18 and 51 years; residual symptoms of psychosis despite treatment with a stable dose of antipsychotic medication for at least 4 weeks. Menstrual cycle characteristics including regularity, cycle length and menstrual associated symptoms were documented. Symptoms of schizophrenia were measured using Positive and Negative Syndrome Scale, cognition was measured using Repeatable Battery for the Assessment of Neuropsychological Status and depression was assessed using the Montgomery–Asberg Depression Rating Scale. Blood samples were collected at baseline for hormone assays. Results: Of the 139 women, 77 (55.4%) had regular menses, 57 (41%) had irregular menses and 5 (3.6%) women had missing data on their menstrual cycle. Use of atypical antipsychotics associated with hyperprolactinaemia was positively associated with irregular menses (odds ratio = 4.4, 95% confidence interval = [1.8, 10.9], p = 0.001), while age more than 30 years was negatively associated (odds ratio = 0.3, 95% confidence interval = [0.1, 0.6], p = 0.004). Women with irregular cycles had significantly lower oestradiol levels than women with regular cycles (213.2 ± 25.0 vs 299.0 ± 27.3, p = 0.03), but there was no difference in Positive and Negative Syndrome Scale, Montgomery–Asberg Depression Rating Scale or Repeatable Battery for the Assessment of Neuropsychological Status between those with regular and irregular cycles. The most common menstrual associated symptoms were decrease in mood with the menstrual cycle (64.8%), bloating (64.8%), cramps (59.7%), back pain (37.6%) and worsening of psychosis symptoms (32.4%). Conclusion: Regular menses are associated with higher oestradiol levels and higher rates of cyclical mood symptoms but are not associated with Positive and Negative Syndrome Scale scores. Understanding the effect the menstrual cycle can have on psychiatric illness, such as premenstrual exacerbations, is important for the holistic care of women with schizophrenia.
Is radial artery Doppler scanning mandatory for use as coronary bypass conduit?
Authors: Yadava Om Prakash , Dinda Amit Kumar , Mohanty Bikram K , Mishra Rekha , Ahlawat Vikas , Kundu Anirban 
Published: June 2015

Background Screening of the radial artery prior to harvesting as a conduit for coronary bypass may be performed clinically by the Allen test or by Doppler ultrasound. In a developing country like ours, the use of resources for Doppler studies may be questioned when Allen tests lead to a low rate of clinical sequelae. However, the rare occurrence of hand ischemia may be devastating and could justify the routine use of Doppler screening. This study aimed to address this question. Methods One hundred patients undergoing elective coronary artery bypass grafting were screened by the modified Allen test and Doppler ultrasound for suitability of use of a radial artery conduit. After harvesting, proximal and distal segments of the radial artery were subjected to histopathological examination. Results Of the 95 patients deemed suitable for radial artery grafting, 6 had mild calcification on Doppler ultrasound and 9 had calcification on histopathological examination. While Doppler showed atherosclerosis in 9 patients, only 6 had histopathological evidence of this (false-positive rate 3%). Of the 6 patients with histopathologic evidence of atherosclerosis, 2 were negative on Doppler (false-negative rate 2%). Conclusion Routine preoperative Doppler screening of the radial artery in the setting of limited resources is not justified. On the other hand, the time-tested Allen test which is easy to perform, interpret, and reproduce can be safely used as the sole screening test to harvest the radial artery.
Thirty-day outcomes after lobectomy or segmentectomy for lung cancer surgery
Authors: Ohtsuka Takashi , Kamiyama Ikuo , Asakura Keisuke , Kohno Mitsutomo 
Published: June 2015

Background Although lobectomy has been the standard operation for clinical T1aN0M0 non-small cell lung cancer, recent studies have shown that segmentectomy could be a substitute for lobectomy. However, the differences between lobectomy and segmentectomy in terms of perioperative complications have not been fully evaluated. Methods Between February 2006 and February 2013, 100 patients underwent lobectomy and 111 underwent segmentectomy for clinical T1aN0M0 non-small-cell lung cancer. We performed a retrospective comparison of perioperative morbidity, age, sex, pulmonary function, and Charlson comorbidity index in the 2 groups. Data were analyzed for all patients and for their propensity score-matched pairs. Results The incidence of postoperative complications in the segmentectomy group ( n = 21, 19%) was significantly higher than that in the lobectomy group ( n = 7, 7%; p < 0.01). The average operative time of 263 ± 64 min and estimated blood loss of 133 ± 125 mL for segmentectomy were significantly greater than those for lobectomy (201 ± 61 min and 88 ± 101 mL). In propensity score-matched analysis, the mean operative time of 270 ± 70 min for segmentectomy was longer than that for lobectomy (202 ± 67 min). Postoperative complications were more frequent in the segmentectomy group than in the lobectomy group (19.6% vs. 6.5%, p = 0.03). Conclusions Although segmentectomy offers preservation of pulmonary function, significantly more postoperative complications occurred in the segmentectomy group. Surgeons should bear in mind that complications can happen more frequently after segmentectomy than after lobectomy for T1aN0M0 non-small-cell lung cancer.
Chest injuries related to surfing
Authors: Sano Atsushi , Yotsumoto Takuma 
Published: June 2015

Background Surfing is a popular sport in coastal areas, which can be associated with chest injuries. Methods Between 2008 and 2013, 6 patients were referred to our hospital with chest injuries sustained during surfing. Clinical data were collected from their medical records and analyzed retrospectively. Results Patient age ranged from 35 to 52 years. Five of the 6 patients were male. Four patients were injured in August, and the other two were injured in September and October. Rib fractures were observed in 3 of the 6 patients. The other 3 patients were diagnosed with chest contusions only. Hemothorax occurred in one patient. No lacerations were observed in any of the 6 patients. Conclusion Chest injuries associated with surfing are usually blunt chest injuries; however, they may occasionally be life-threatening.
Surgery for huge mediastinal tumors
Authors: Motus Igor Ya , Bazhenov Alexander V , Massard Gilbert 
Published: June 2015

Background Mediastinal tumors can reach a huge size and give rise to serious surgical and oncological problems. Methods A review of 18 patients with huge mediastinal tumors was performed. Ages ranged from 16 to 61 years, and 10 were male. In 4 cases, exploratory thoracotomies had been undertaken in other hospitals; in one patient, the tumor recurred after incomplete resection. We performed a median sternotomy in 17 patients and a lateral thoracotomy in one. Radiotherapy and platinum-based chemotherapy was administered in cases found to be malignant. Results In 15 patients, the tumor was removed completely. In one patient, the operation was palliative because of vena caval and atrial invasion, and another had exploration only; biopsies revealed malignant transformation in these 2 patients. The blood loss was 425–2530 mL (average 690 mL); bleeding was fatal in one patient. Tissue diagnosis showed mature teratomas in 10 patients. Foci of malignant transformation were found in 5 cases. Chemodectoma was found in one patient, and thymoma in two. Patients with mature teratomas are free of disease. Two patients with malignant teratomas died from tumor recurrence despite irradiation and chemotherapy. Conclusions Clinical and oncological problems lie in the fact that malignant transformation of the tumor is diagnosed only after surgery. Extensive blood loss is a crucial surgical problem. Median sternotomy is the optimal operative approach. Surgical treatment of mature mediastinal tumors results in good outcomes unless malignancy is detected.
Significance of the ADC ratio in the differential diagnosis of breast lesions
Authors: Zhao Jinli , Guan Haitao , Li Minda , Gu Hongmei , Qin Jufeng , Wu Xianhua 
Published: June 2015

Background Magnetic resonance imaging (MRI) has high sensitivity but low specificity for breast cancer, and consequently, new techniques to improve the specificity of breast MRI in diagnosing breast cancer are under development. Purpose To assess the ability of the apparent diffusion coefficient (ADC) compared with the ADC ratio (ADCr) to differentially diagnose benign compared with malignant breast lesions. Material and Methods Forty-eight women with breast lesions (average age, 45 years) underwent MRI scanning including T1-weighted dynamic contrast-enhanced (DCE) scanning and diffusion-weighted imaging (DWI). The average ADC and ADCr values for both lesions and pectoralis major muscles (ADCrmuscle and ADCrmuscle) were measured in patients with malignant ( n = 25) and benign ( n = 23) breast lesions. The ADCr of the contralateral breast (ADCr contralateral) was also evaluated. All histology was confirmed by pathological analysis of biopsied tissue. ADC and ADCr values were analyzed using receiver-operating characteristic (ROC) curves. Results For benign lesions compared with malignant lesions, lesion-side ADC was 1.45 vs. 1.05, respectively ( P < 0.001), normal-side ADC was 1.82 vs.1.64 ( P = 0.002), ADCrmuscle was 1.35 vs. 0.9 ( P < 0.001), and ADCrcontralateral was 0.79 vs. 0.64 ( P = 0.001). ADCrmuscle showed higher sensitivity (82.61%) and specificity (96.00%) than ADCrcontralateral (60.87% and 92.00%, respectively) and ADC (69.57% and 96.00%) for discriminating malignant from benign lesions. The AUC using ADCrmuscle had higher discriminatory power (0.92, P < 0.001) for malignant versus benign breast lesions compared with either ADC (0.82, P < 0.001) or ADCrcontralateral (0.78, P = 0.001). Conclusion The ADCrmuscle value showed higher sensitivity and specificity and improved diagnostic accuracy compared with either ADC or ADCrcontralateral in differentiating benign from malignant breast lesions.
Shear-wave elastography in invasive ductal carcinoma: correlation between quantitative maximum elasticity value and detailed pathological findings
Authors: Cho Eun Yoon , Ko Eun Sook , Han Boo-Kyung , Kim Rock Bum , Cho Sooyoun , Choi Ji Soo , Hahn Soo Yeon 
Published: June 2015

Background Further information is needed regarding whether histopathological characteristics affect breast tumor elasticity. Purpose To determine whether maximum elasticity values vary according to tumor-stroma ratio, dominant stroma type, or presence of fibrosis in invasive breast cancer. Material and Methods This study included 71 patients with invasive ductal carcinoma not otherwise specified (IDC NOS) who underwent breast shear-wave elastography (SWE). Maximum elasticity (Emax) values were retrospectively correlated with pathological findings that included tumor-stroma ratio, dominant stroma type (collagen, fibroblast, lymphocyte), and fibrosis. Multiple linear regression analysis was performed to determine variables independently associated with Emax. Results High histologic grade was significantly correlated with higher Emax ( P = 0.042). Estrogen receptor and progesterone receptor expression negatively correlated with high elasticity values ( P = 0.013 and P = 0.03, respectively). Breast cancers that exhibited higher cellularity demonstrated a greater level of stiffness that was not statistically significant (ρ = 0.153; P = 0.193). While dominant stroma type and fibrosis did not affect Emax ( P = 0.197 and P = 0.598, respectively), lesion size was significantly associated with Emax (ρ  = 0.474, P < 0.001). On multivariate analysis, only lesion size was significantly associated with Emax ( P < 0.001). Conclusion The composition of tumors did not affect their Emax.
Parents’ perspectives on the appropriateness of a parent-delivered intervention for improving the social play skills of children with ADHD
Authors: Wilkes-Gillan Sarah , Bundy Anita , Cordier Reinie , Lincoln Michelle , Hancock Nicola 
Published: June 2015

Introduction This study aimed to evaluate parents’ perspectives of the appropriateness of a parent-delivered play-based intervention, The Ultimate Guide to Making Friends. The intervention was designed to improve the social play skills of children with ADHD. Method One month post-intervention, seven parents of children with ADHD participated in individual semi-structured interviews. Interviews ranged from 40–60 minutes. Parents were asked about their perceptions of the intervention: experience, benefits, logistics that supported or hindered participation and satisfaction with the intervention for themselves and their children. Data were analysed thematically using constant comparative methods, whereby two researchers worked independently to analyse emergent themes. Findings Thematic analysis revealed a single core theme of reframing: a process whereby both parents and their children were assisted to develop new perspectives regarding their social skills and interactions. The core theme comprised three sub-themes: (1) connecting with the intervention; (2) parent and child benefits resulting from a new perspective; and (3) continued everyday use of the intervention materials and strategies. Conclusion The intervention was appropriate from parents’ perspectives. The core theme of reframing and sub-themes collectively related back to the following aspects of appropriateness: (a) a positive experience; (b) relevant and important to their/their child’s needs; (c) beneficial; (d) a socially and ecologically valid approach, fitting their everyday lives; and (e) promoting change that continued over time.
A qualitative evaluation of occupational therapy-led work rehabilitation for people with inflammatory arthritis: Perspectives of therapists and their line managers
Authors: Prior Yeliz , Amanna Evangeline A , Bodell Sarah J , Hammond Alison 
Published: June 2015

Introduction Occupational therapy-led work rehabilitation for employed people with inflammatory arthritis and work problems was piloted in five hospitals in the United Kingdom. This qualitative study explored the views of participating occupational therapists and their line managers about the work rehabilitation training received and conducting the intervention, with particular focus on the structured interview used, the Work Experience Survey – Rheumatic Conditions. Method Face-to-face semi-structured interviews were conducted with occupational therapists ( n = 9), followed by telephone interviews with their line managers ( n = 2). Interviews were audio-recorded, transcribed verbatim and thematically analysed by three researchers to maximize validity. Results The main themes emerging from the occupational therapists’ interviews were: varying levels of prior knowledge and experience of work rehabilitation, initial concerns about the feasibility of a lengthy work assessment in practice and increased confidence in delivering work rehabilitation as the study progressed. The line managers’ interviews generated themes around the positive impact of the work rehabilitation training the occupational therapists received, and changes in their practice. Conclusion The Work Experience Survey – Rheumatic Conditions was considered a good choice of work assessment which can be implemented in practice. Once therapists had provided the work intervention several times, their confidence and skills increased.
The Relationship Between Medial Temporal Lobe Atrophy and Cognitive Impairment in Patients With Dementia With Lewy Bodies
Authors: Tagawa Ryo , Hashimoto Hiroshi , Nakanishi Aki , Kawarada Youjirou , Muramatsu Tomohiro , Matsuda Yasunori , Kataoka Kouhei , Shimada Aiko , Uchida Kentaro , Yoshida Atsushi , Higashiyama Shigeaki , Kawabe Joji , Kai Toshihiro , Shiomi Susumu , Mori Hiroshi , Inoue Koki 
Published: June 2015

Background: The relationship between medial temporal lobe atrophy (MTA) and cognitive impairment in patients with dementia with Lewy bodies (DLB) remains unclear. We examined this relationship using voxel-based specific regional analysis system for Alzheimer disease (VSRAD) advance software, which allowed us to quantify the degree of MTA on images obtained from magnetic resonance imaging (MRI) scans. Methods: Thirty-seven patients diagnosed with DLB were recruited and scanned with a 1.5 Tesla MRI scanner. All MRI data were analyzed using VSRAD advance. The target volume of interest (VOI) included the entire region of the entorhinal cortex, hippocampus, and amygdala. The degree of MTA was obtained from the averaged positive z-score ( Z score) on the target VOI, with higher scores indicating more severe MTA. Mini-Mental State Examination (MMSE) and the Revised Hasegawa Dementia Scale (HDS-R), which strengthened the measures of memory and language more than MMSE, were used to assess the presence of cognitive impairment. Results: A negative correlation was found between the Z score and MMSE total scores or the HDS-R total scores. A stepwise multiple regression analysis performed to adjust the covariate effects of sex, age, the onset age of the disease, duration of DLB, years of education, and donepezil treatment showed that the HDS-R total scores were independently associated with the Z score, whereas MMSE total scores were not. Conclusions: These results suggest that MTA is related to cognitive impairment in patients with DLB, particularly the regions of orientation, immediate and delayed recall, and word fluency.
Clinical characteristics and mental health outcomes for women admitted to an Australian Mother–Baby Unit: a focus on borderline personality disorder and emotional dysregulation?
Authors: Yelland Chris , Girke Teresa , Tottman Charlotte , Williams Anne Sved 
Published: June 2015

Objective: To describe the clinical population of women admitted to a Mother–Baby Unit in Adelaide, South Australia and to evaluate changes during admission in both Axes I and II diagnoses of maternal mental health, and in mother–infant relationships. Method: Both clinical and self-report assessments of maternal mental health were made at admission and discharge, and self-report comparisons of the mother–infant relationship. Results: Depressive illnesses (46.2%) were found to be the most prevalent conditions leading to admission, with rates of psychosis (10.3%) and bipolar disorder (3.4%) being lower. A high incidence of borderline personality disorder (23.1%) was found clinically, with almost half the admitted women showing features of borderline personality disorder on a self-report measure at admission. Significant improvements in maternal mental health and the mother–infant relationship were found at the time of discharge. Conclusions: Admission to this Mother–Baby Unit on mothers’ self-report scales showed improvement in mothers’ mental health and the relationship that they have with their infant. Given the high prevalence of borderline personality disorder and emotional dysregulation identified within the population, treatment implications and possible consequences for the infant are discussed for this client group.