bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cannabis, Ischemic Stroke, and Transient Ischemic Attack
Authors: Barber Peter Alan , Pridmore Heidi M. , Krishnamurthy Venkatesh , Roberts Sally , Spriggs David A. , Carter Kristie N. , Anderson Neil E. 
Published: May 2013

Background and Purpose—
There is a temporal relationship between cannabis use and stroke in case series and population-based studies.

Methods—
Consecutive stroke patients, aged 18 to 55 years, who had urine screens for cannabis were compared with a cohort of control patients admitted to hospital without cardiovascular or neurological diagnoses.

Results—

One hundred sixty of 218 (73%) ischemic stroke/transient ischemic attack patients had urine drug screens (100 men; mean [SD] age, 44.8 [8.7] years). Twenty-five (15.6%) patients had positive cannabis drug screens. These patients were more likely to be men (84% versus 59%; χ
2
:
P
=0.016) and tobacco smokers (88% versus 28%; χ
2
:
P
<0.001). Control urine samples were obtained from 160 patients matched for age, sex, and ethnicity. Thirteen (8.1%) control participants tested positive for cannabis. In a logistic regression analysis adjusted for age, sex, and ethnicity, cannabis use was associated with increased risk of ischemic stroke/transient ischemic attack (odds ratio, 2.30; 95% confidence interval, 1.08–5.08). However after adjusting for tobacco use, an association independent of tobacco could not be confirmed (odds ratio, 1.59; 95% confidence interval, 0.71–3.70).

Conclusions—
This study provides evidence of an association between a cannabis lifestyle that includes tobacco and ischemic stroke. Further research is required to clarify whether there is an association between cannabis and stroke independent of tobacco.

Clinical Trial Registration—

URL:
http://www.anzctr.org.au
. Unique identifier: ACTRN12610000198022
Competitive Integration of Visual and Goal-related Signals on Neuronal Accumulation Rate: A Correlate of Oculomotor Capture in the Superior Colliculus
Authors: White Brian J. , Marino Robert A. , Boehnke Susan E. , Itti Laurent , Theeuwes Jan , Munoz Douglas P. 
Published: May 2013

Abstract
The mechanisms that underlie the integration of visual and goal-related signals for the production of saccades remain poorly understood. Here, we examined how spatial proximity of competing stimuli shapes goal-directed responses in the superior colliculus (SC), a midbrain structure closely associated with the control of visual attention and eye movements. Monkeys were trained to perform an oculomotor-capture task [Theeuwes, J., Kramer, A. F., Hahn, S., Irwin, D. E., & Zelinsky, G. J. Influence of attentional capture on oculomotor control. Journal of Experimental Psychology. Human Perception and Performance, 25, 1595–1608, 1999], in which a target singleton was revealed via an isoluminant color change in all but one item. On a portion of the trials, an additional salient item abruptly appeared near or far from the target. We quantified how spatial proximity between the abrupt-onset and the target shaped the goal-directed response. We found that the appearance of an abrupt-onset near the target induced a transient decrease in goal-directed discharge of SC visuomotor neurons. Although this was indicative of spatial competition, it was immediately followed by a rebound in presaccadic activation, which facilitated the saccadic response (i.e., it induced shorter saccadic RT). A similar suppression also occurred at most nontarget locations even in the absence of the abrupt-onset. This is indicative of a mechanism that enabled monkeys to quickly discount stimuli that shared the common nontarget feature. These results reveal a pattern of excitation/inhibition across the SC visuomotor map that acted to facilitate optimal behavior—the short duration suppression minimized the probability of capture by salient distractors, whereas a subsequent boost in accumulation rate ensured a fast goal-directed response. Such nonlinear dynamics should be incorporated into future biologically plausible models of saccade behavior.
Managing aggression and violence: The clinician’s role in contemporary mental health care
Authors: Allnutt Stephen H , Ogloff James R P , Adams Jonathon , O’Driscoll Colman , Daffern Michael , Carroll Andrew , Nanayakkara Vindya , Chaplow David 
Published: May 2013

Objective: From time to time misconceptions about violence risk assessment raise debate about the role mental health professionals play in managing aggression, with associated concerns about the utility of violence risk assessment. This paper will address some of the misconceptions about risk assessment in those with serious mental illness. Methods: The authors have expertise as clinicians and researchers in the field and based on their accumulated knowledge and discussion they have reviewed the literature to form their opinions. Results: This paper reflects the authors’ views. Conclusion: There is a modest yet statistical and clinically significant association between certain types of mental illness and violence. Debate about the appropriateness of clinician involvement in violence risk assessment is sometimes based on a misunderstanding about the central issues and the degree to which this problem can be effectively managed. The central purpose of risk assessment is the prevention rather than the prediction of violence. Violence risk assessment is a process of identifying patients who are at greater risk of violence in order to facilitate the timing and prioritisation of preventative interventions. Clinicians should base these risk assessments on empirical knowledge and consideration of case-specific factors to inform appropriate management interventions to reduce the identified risk.
Neural Monitored Revision Thyroid Cancer Surgery: Surgical Safety and Thyroglobulin Response
Authors: Phelan Eimear , Kamani Dipti , Shin Jennifer , Randolph Gregory W. 
Published: May 2013

ObjectiveTo evaluate the postoperative complications and to evaluate and stratify thyroglobulin (Tg) response associated with revision surgery for thyroid malignancy.Study DesignCase series with chart review.SettingsAcademic, tertiary care center.Subjects and MethodsAll patients with regionally recurrent thyroid carcinoma and who underwent revision thyroid surgery by the senior author (GWR) during a 5‐year period were identified. All patients had pre‐ and postoperative laryngeal examination and underwent surgery with standardized neural monitoring. Postoperative complications and thyroglobulin (Tg) response were recorded.ResultsOne hundred seventeen cases meeting the criteria for revision surgery for recurrent thyroid cancer were identified. Among this group, 30% presented for their third or higher revision procedure. Preoperative permanent vocal cord palsy was present in 14% (n = 16), and 19% (n = 22) had preoperative permanent hypocalcaemia. There were no new cases of either temporary or permanent vocal cord palsy in our study group. Approximately 5% developed temporary and 3% permanent hypocalcaemia requiring medical treatment. The mean basal Tg following revision surgery was 5.6 ng/ml (range, 0.2‐32.7), which represented a mean postoperative significant decline in Tg of approximately 90%. In nearly 40%, basal Tg was undetectable postoperatively. Tg response was stratified based on the number of revision surgeries, Tg decline was observed in 90% of all cases, 92% after first revision surgery, 85% after second, 34% after third, and 70% after fifth revision surgeries.ConclusionRevision thyroid cancer surgery can be performed with low rates of complications and significant impact on Tg levels even after multiple revision surgeries.
Family caregiver learning—how family caregivers learn to provide care at the end of life:  A qualitative secondary analysis of four datasets
Authors: Stajduhar Kelli I , Funk Laura , Outcalt Linda 
Published: May 2013

Background: Family caregivers are assuming growing responsibilities in providing care to dying family members. Supporting them is fundamental to ensure quality end-of-life care and to buffer potentially negative outcomes, although family caregivers frequently acknowledge a deficiency of information, knowledge, and skills necessary to assume the tasks involved in this care. Aim: The aim of this inquiry was to explore how family caregivers describe learning to provide care to palliative patients. Design: Secondary analysis of data from four qualitative studies ( n = 156) with family caregivers of dying people. Data sources: Data included qualitative interviews with 156 family caregivers of dying people. Results: Family caregivers learn through the following processes: trial and error, actively seeking needed information and guidance, applying knowledge and skills from previous experience, and reflecting on their current experiences. Caregivers generally preferred and appreciated a supported or guided learning process that involved being shown or told by others, usually learning reactively after a crisis. Conclusions: Findings inform areas for future research to identify effective, individualized programs and interventions to support positive learning experiences for family caregivers of dying people.
Decreased levels of cell-division cycle 42 (Cdc42) protein in peripheral lymphocytes from ischaemic stroke patients are associated with Golgi apparatus function
Authors: Mo Xiao-Ye , Li Ting , Hu Zhi-Ping 
Published: May 2013

Objectives To investigate levels of cell-division cycle 42 (Cdc42) protein, and their relationship with Golgi apparatus function in peripheral lymphocytes, in patients following ischaemic stroke. Methods Patients with acute cerebral ischaemic stroke (within 24–72 h of the onset of focal neurological symptoms) and healthy control subjects were enrolled in this prospective case–control study. The cellular location of Cdc42 in peripheral lymphocytes was demonstrated using immunofluorescence. Protein levels of Cdc42 and trans-golgi network protein 2 (TGN46) in peripheral lymphocytes were determined by immunocytochemical staining and Western blotting. Results A total of 38 patients with stroke and 38 control subjects were studied. The mean ± SD percentage of Cdc42-positive lymphocytes from patients with stroke was significantly lower than that in control subjects (39.53 ± 13.55% versus 66.61 ± 23.30%, respectively). Similar findings were demonstrated for TGN46. Cdc42 levels were positively correlated with TGN46 levels ( r = 0.92). Conclusions Acute ischaemic stroke was associated with reduced levels of Cdc42 protein. These findings might lead to the development of drugs that could have therapeutic benefits in patients with acute ischaemic stroke.
Clinical study of the relationship between γ-synuclein and the response of neoadjuvant chemotherapy in breast cancer
Authors: Wan Fan , Dong Li , Zhang Feng , Wang Yi , Chen Fang , Ni San , Chen Yi , Long Jing 
Published: May 2013

Objectives To investigate relationships between several protein biomarkers and clinical responses to neoadjuvant chemotherapy (NAC) in breast cancer. Methods Tumour tissue samples from female patients with locally advanced breast carcinoma (stages IIA to IIIC), treated with NAC regimens (including 5-fluorouracil, epirubicin, cyclophosphamide and docetaxel, epirubicin, cyclophosphamide) were analysed retrospectively. Immunohistochemical analysis was used to test for protein levels of oestrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor (HER)-2, protein 53 (p53) and γ-synuclein. Relationships between protein biomarkers and responses to NAC were analysed by multivariate logistic regression analysis. Results Data from 154 patients (median age, 51 years; range 27–75 years) were included. Multivariate logistic regression analysis showed that γ-synuclein was an independent predictor of NAC objective response rate, and a statistically significant relationship was observed between NAC regimen, γ-synuclein levels and pathological complete response rate. Conclusions These study findings suggest that γ-synuclein – in combination with other markers such as ER, PR and HER-2 – may serve as a biomarker for response to NAC in breast cancer and warrants further study.
Botulinum toxin-A with and without rehabilitation for the treatment of spastic cerebral palsy
Authors: Jianjun Liu , Shurong Ji , Weihong Wu , Yan Zhang , Fanyong Zeng , Nanling Li 
Published: May 2013

Objective To determine the efficacy of botulinum toxin-A (BTX-A) nerve block, with and without rehabilitation, in the treatment of spastic cerebral palsy. Methods Patients (aged 1–23 years) with spastic cerebral palsy underwent nerve block with BTX-A, followed by ≥ 2 h/day rehabilitation (experimental group) or <2 h/day rehabilitation (control group). Muscle tension and motor function were evaluated pre-block using the Modified Ashworth Scale (MAS) and gross motor function measure (GMFM), respectively. MAS was assessed weekly to determine duration of action of BTX-A; GMFM was assessed at 1 year post-block. Results There were no significant differences between the experimental group ( n = 120) and the control group ( n = 124) in age, body weight, pre-block MAS or GMFM, or BTX-A duration of action. MAS was significantly improved in both groups at 1 month post-block. At 1 year post-block, GMFM was significantly improved in both groups, with a significantly greater improvement seen in the experimental group compared with the control group. Conclusion BTX-A block improved muscle tension and motor function. Rehabilitation training, following the block, resulted in greater improvements to motor function than block alone.
Calcific Tendinitis of the Rotator Cuff
Authors: de Witte Pieter Bas , Selten Jasmijn W. , Navas Ana , Nagels Jochem , Visser Cornelis P.J. , Nelissen Rob G.H.H. , Reijnierse Monique 
Published: May 2013

Background: Calcific tendinitis of the rotator cuff (RCCT) is frequently diagnosed in patients with shoulder pain, but there is no consensus on its treatment. Purpose: To compare 2 regularly applied RCCT treatments: ultrasound (US)–guided needling and lavage (barbotage) combined with a US-guided corticosteroid injection in the subacromial bursa (subacromial bursa injection [SAI]) (group 1) versus an isolated SAI (group 2). Study Design: Randomized controlled trial; Level of evidence, 1. Methods: Patients were randomly assigned to the 2 groups. Shoulder function was assessed before treatment and at regular follow-up intervals (6 weeks and 3, 6, and 12 months) using the Constant shoulder score (CS, primary outcome), the Western Ontario Rotator Cuff Index (WORC), and the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH). Additionally, calcification location, size, and Gärtner classification were assessed on radiographs. Results were analyzed using the t test, linear regression, and a mixed model for repeated measures. Results: This study included 48 patients (25 female, 52.1%; mean age, 52.0 ± 7.3 years; 23 patients in group 1) with a mean baseline CS of 68.7 ± 11.9. No patients were lost to follow-up. Four patients in group 1 and 11 in group 2 ( P = .06) had an additional barbotage procedure or surgery during the follow-up period because of persisting symptoms and no resorption. At 1-year follow-up, the mean CS in group 1 was 86.0 (95% CI, 80.3-91.6) versus 73.9 (95% CI, 67.7-80.1) in group 2 ( P = .005). The mean calcification size decreased by 11.6 ± 6.4 mm in group 1 and 5.1 ± 5.7 mm in group 2 ( P = .001). There was total resorption in 13 patients in group 1 and 6 patients in group 2 ( P = .07). With regression analyses, correcting for baseline CS and Gärtner type, the mean treatment effect was 20.5 points ( P = .05) in favor of barbotage. Follow-up scores were significantly influenced by baseline scores. Results for the DASH and WORC were similar. Conclusion: On average, there was improvement at 1-year follow-up in both treatment groups, but clinical and radiographic results were significantly better in the barbotage group.
Elevation of Plasma Milrinone Concentrations in Stage D Heart Failure Associated With Renal Dysfunction
Authors: Cox Zachary L. , Calcutt Marion W. , Morrison Thomas B. , Akers Wendell S. , Davis Mary Beth , Lenihan Daniel J. 
Published: May 2013

Purpose: To determine steady state milrinone concentrations in patients with stage D heart failure (HF) with and without renal dysfunction Methods: We retrospectively identified patients with stage D HF at a single medical center on continuous milrinone infusion at the time of plasma collection for entry into a research registry database. Milrinone was prescribed and titrated to improve hemodynamic and clinical status by a cardiologist. Plasma samples were obtained at steady state milrinone concentrations. Patients were stratified by creatinine clearance (CrCl) into 4 groups: group 1 (CrCl >60 mL/min), group 2 (CrCl 60-30 mL/min), group 3 (CrCl <30 mL/min), and group 4 (intermittent hemodialysis). Retrospective chart review was performed to quantify the postmilrinone hemodynamic changes by cardiac catheterization and electrophysiologic changes by implantable cardiac defibrillator (ICD) interrogation. Results: A total of 29 patients were identified: group 1 (n = 14), group 2 (n = 10), group 3 (n = 3), and group 4 (n = 2). The mean infusion rate (0.391 ± 0.08 µg/kg/min) did not differ between groups ( P = 0.14). The mean milrinone concentration was 451± 243 ng/mL in group 1, 591 ± 293 ng/mL in group 2, 1575 ± 962 ng/mL in group 3, and 6252 ± 4409 ng/mL in group 4 ( P<0.05 compared to groups 1). There was no difference in postmilrinone hemodynamic improvements between the groups ( P=0.41). The ICD interrogation revealed limited comparisons, but 6 of the 8 postmilrinone ventricular tachycardia episodes requiring defibrillation occurred in group 4 patients. Conclusion: Patients with stage D HF having severe renal dysfunction have elevated milrinone concentrations. Future studies of milrinone concentrations are warranted to investigate the potential risk of life-threatening arrhythmias and potential dosing regimens in renal dysfunction.
Comparison of 2 Diagnostic Criteria for the Behavioral Variant of Frontotemporal Dementia
Authors: Costa Sónia , Suárez-Calvet Marc , Antón Sofia , Dols-Icardo Oriol , Clarimón Jordi , Alcolea Daniel , Fortea Juan , Carmona María , Sala Isabel , Sánchez-Saudinós M. Belén , Blesa Rafael , Lleó Alberto 
Published: May 2013

Objectives The aim of this study was to compare the applicability of the 1998 consensus diagnostic criteria for the behavioral variant of frontotemporal dementia (bvFTD) with the recently proposed diagnostic criteria of the International bvFTD Criteria Consortium (FTDC). Methods We reviewed each individual item in the 1998 and FTDC criteria in 30 patients with bvFTD followed in a memory clinic (including 2 with the C9orf72 gene repeat expansion). Results All patients fulfilled the FTDC criteria (40% possible, 60% probable bvFTD) but only 66.7% fulfilled the 1998 criteria. One of the C9orf72 expansion carriers did not fulfill the 1998 criteria. This discordance was always due to the presence of exclusion features in the 1998 criteria, the most common being spatial disorientation and early severe amnesia. Conclusion The new FTDC criteria are less restrictive and hence more sensitive for the diagnosis of bvFTD.
Current attitudes on self-use and prescription of hormone therapy among New York City gynaecologists
Authors: Devi Gayatri , Sugiguchi Fumitaka , Pedersen Anette Tønnes , Abrassart Dana , Glodowski Michele , Nachtigall Lila 
Published: May 2013

Objective The results of the Women’s Health Initiative studies dramatically altered hormone therapy use around the world. In countries outside the United States, self-use in physicians remained unaltered while prescription use declined, implying that physicians may not concur with the findings. We wished to explore prevailing attitudes among American physicians by examining New York City obstetrician-gynaecologists’ self-use and prescription use of hormone therapy. Study design All board-certified obstetrician-gynaecologists in New York City were invited to complete and return a detailed, previously validated questionnaire concerning hormone therapy use. Results Two hundred and nine questionnaires were returned, for a response rate of 12% (209/1797). Gynaecologists agreed with the findings from the Women’s Health Initiative studies regarding indications and contraindications to hormone therapy use. Even so, three-quarters of female gynaecologists and female partners of male gynaecologists (74%; 67/91) use or have previously used hormone therapy. However, only 27.3% (21/77) of male gynaecologists and 12.3% (14/114) of female gynaecologists recommend hormone therapy to all menopausal women regardless of contraindications. Gynaecologists remain divided in their attitude toward hormone therapy; 30% of gynaecologists felt that hormone therapy use generally prolonged women’s lives, 36% felt it was not useful in prolonging women’s lives, and 33% were unsure. Conclusion Since the publication of the Women’s Health Initiative findings, New York City gynaecologists prescribe hormone therapy to fewer patients. However, they continue to self-use hormone therapy at much higher rates, even as they seem to concur with Women’s Health Initiative recommendations, contributing to the ongoing controversy surrounding the validity of the Women’s Health Initiative findings.
Disparities in Mental Health Care among HIV-Infected Youth
Authors: Whiteley Laura B. , Brown Larry K. , Swenson Rebecca , Kapogiannis Bill G. , Harper Gary W. 
Published: May 2013

Objective: Untreated psychiatric illness is detrimental to the health and well-being of HIV-infected youth. This study examines the relationships between social and demographic variables and the rates of psychiatric treatment among HIV-infected youth. Methods: Analyses are from a cross-sectional survey of 1706 HIV-infected youth (13-26 years) in care at treatment sites or affiliates of the Adolescent Medicine Trials Network for HIV/AIDS Interventions from 2010 to 2011. Among the youth who reported recent significant mental health symptoms, comparisons on demographic variables (including race, ethnicity, language spoken, level of education, sexual orientation, and household income) were made. Results: Psychiatrically symptomatic black youth were significantly less likely than symptomatic nonblack peers to receive mental health care (37.4% versus 48.6%) and psychiatric medications (19.3% versus 26.9%). Conclusion: Care providers should be alerted to the potential disparities in mental health care treatment that exist for black youth living with HIV.
Complement activation by heme as a secondary hit for atypical hemolytic uremic syndrome
Authors: Frimat Marie , Tabarin Fanny , Dimitrov Jordan D. , Poitou Caroline , Halbwachs-Mecarelli Lise , Fremeaux-Bacchi Veronique , Roumenina Lubka T. 
Published: May 2013

Key PointsHeme activates complement alternative pathway in serum and on endothelial cell surfaces. Heme-induced complement activation in the presence of complement mutations contributes as a secondary hit to the development of aHUS.