bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anticholinergic Use Is a Major Risk Factor for Dysphonia
Authors: Haft Sunny , Farquhar Douglas , Carey Ryan , Mirza Natasha 
Published: May 2015

Objective: We hypothesize that many cases of dysphonia of unclear etiology are a form of sicca caused by anticholinergic medication use, and we aim to determine their association. Study Design: This was a cross-sectional study conducted over a 6-month time period. Participants were drawn from a tertiary care laryngology practice within an academic institution. Methods: One hundred forty-nine patients met inclusion criteria. Patients rated the symptom of chronic hoarseness; scores were compared with participants’ medication lists, comorbidities, age, and sex, and a multivariate logistic regression model was developed. Significance was set at P < .05. As a secondary analysis, participants rated a variety of other symptoms using the Voice Handicap Index-10, Reflux Symptom Index, and the GRBAS scale, which were likewise compared to anticholinergic use. Results: Any patient taking at least 1 anticholinergic medication had a 2.32 increased odds ( P = .03) of experiencing hoarseness. If the patient was taking 2 or more anticholinergic medications, those odds rose to 4.52 ( P = .009). Conclusion: This is the first study, to our knowledge, that implicates medication use as a major risk factor for dysphonia of unclear etiology. An awareness of this association is invaluable when attributing cause to hoarseness and when considering treatment options.
Transoral Sclerotherapy for Deep Space Cervical Lymphatic Malformations in Children With Acute Airway Compromise
Authors: Cheng Jeffrey , Yoo Mi Jin 
Published: May 2015

Introduction: Cervical lymphatic malformations in children rarely present with acute airway compromise. During an acute exacerbation or hemorrhage, lymphatic malformations involving the deep neck spaces may precipitate critical airway obstruction. These are rare clinical entities and tracheotomy is the standard procedure to bypass impending airway obstruction. Methods: We present our recent experience with 2 children presenting with acute airway compromise resulting from deep space cervical lymphatic malformations and describe our technique and success with transoral sclerotherapy. Results: Direct laryngoscopy-assisted transoral sclerotherapy with doxycycline may be considered an alternative to tracheotomy to address retropharyngeal and parapharyngeal space lymphatic malformations. Conclusions: Direct laryngoscopy-assisted transoral sclerotherapy is an excellent treatment option for children with deep space cervical lymphatic malformations with airway compromise. It is effective, provides direct access, and can be an alternative to a tracheotomy.
Making sense of DSM-5 mania with depressive features
Authors: Reinares María , del Mar Bonnín Caterina , Hidalgo-Mazzei Diego , Undurraga Juan , Mur Maria , Nieto Evaristo , Sáez Cristina , Vieta Eduard 
Published: May 2015

Objective: The assessment of the depressive component during mania has become critical for the accurate diagnosis of mixed states, which were defined very narrowly in the past classification systems before Diagnostic and Statistical Manual of Mental Disorders (5th ed.). The aim of this study was to compare socio-demographic, clinical and therapeutic characteristics, as well as clinical and functional outcomes, between manic patients with and without mixed features to validate the relevance of the Diagnostic and Statistical Manual of Mental Disorders (5th ed.) mixed specifier. Methods: This is a subanalysis of a multicentre naturalistic study MANía Aguda y COnsumo de Recursos (acute mania and health resource consumption [MANACOR]) on the burden of mania in bipolar patients from four hospitals in Catalonia (Spain). The sample consisted of 169 adult patients presenting a manic episode and systematically assessed during a 6-month period. Results: A total of 27% ( n = 46/169) of manic patients showed mixed features. Total number of episodes ( p = 0.027), particularly depressive and mixed, was greater in manic patients with mixed features, as well as depressive onset ( p = 0.018), suicide ideation ( p = 0.036), rapid cycling ( p = 0.035) and personality disorders ( p = 0.071). In contrast, a higher percentage of pure manic subjects were inpatients ( p = 0.035), started the illness with mania ( p = 0.018) and showed family history of bipolar disorder ( p = 0.037), congruent psychotic symptoms ( p = 0.001) and cannabis use ( p = 0.006). At baseline, pure manic patients received more risperidone ( p = 0.028), while mixed patients received more valproate ( p = 0.049) and antidepressants ( p = 0.005). No differences were found in syndromic recovery at the end of the study. However, depressive change was higher in the mixed group ( p = 0.010), while manic change was higher in the pure manic group ( p = 0.029). At the end of follow-up, the group with mixed features showed a significant trend towards higher psychosocial dysfunction. Conclusion: A total of 27% of manic patients showed mixed features. Groups differed regarding clinical characteristics, course of illness, psychosocial functioning, prescribed treatment and symptom progress. Depressive symptoms in mania should be routinely assessed and considered to guide treatment.
The civil war in Syria and Canada’s containment policy
Authors: Juneau Thomas 
Published: May 2015

The civil war in Syria has caused the deaths of more than 230,000 civilians and combatants, has led to one of the largest refugee crises in recent memory, and has destabilized the Levant. It therefore represents an extraordinarily challenging foreign policy conundrum. A wide variety of responses—ranging from the imposition of no-fly zones to doing nothing—have been considered in Ottawa and in allied capitals since 2011. Each one, however, raises potentially significant challenges. This article explores how Canada has considered those alternatives. As is systematically the case for a non-great power, Canada’s policy options were shaped more by deliberations in allied capitals—especially Washington—and only thereafter by actual developments in Syria. After laying out Canada’s interests relative to the war in Syria, the article describes four policy alternatives that Canada has faced since 2011, as seen through the lenses of liberal pacifism, liberal interventionism, isolationism, and containment. Among this menu of deeply flawed options, containment has steadily emerged as Canada’s de facto approach. That approach has been correct: it is the least bad course of action available since it best allows Ottawa to protect and promote its interests. Nevertheless, Canada could take additional steps to implement a more comprehensive containment framework.
Does prescription of medical compression prevent development of post-thrombotic syndrome after proximal deep venous thrombosis?
Authors: Perrin Michel , Eklöf Bo 
Published: May 2015

Aim The aim of this review is to try to explain the controversy by critical analysis of previously published randomized controlled trials on the value of elastic compression stockings in the treatment of acute proximal deep vein thrombosis in prevention of post-thrombotic syndrome, which forms the scientific basis for our present management. Methods A research was made through Medline and Embase databases to identify relevant original articles, not abstracts, with the following keywords: post-thrombotic syndrome, deep venous thrombosis, venous thromboembolism, compression stockings, prevention and compliance. Results We identified five randomized controlled trials (RCTs) before the SOX trial including 798 patients with acute proximal deep vein thrombosis. Brandjes (1997): at two years’ follow-up, elastic compression stockings reduced post-thrombotic syndrome by 50%; Ginsberg (2001): no difference in post-thrombotic syndrome with or without elastic compression stockings after more than two years’ follow-up; Partsch (2004): elastic compression stockings with routine above knee and early ambulation reduced the incidence and severity of post-thrombotic syndrome after two years’ follow-up; Prandoni (2004) showed significantly less post-thrombotic syndrome after elastic compression stockings for two years with a five-year follow-up; Aschwanden (2008) showed no difference with elastic compression stockings after three years’ follow-up. Conclusion Prescription of elastic compression stockings for the prevention of post-thrombotic syndrome is now in doubt. Immediate compression after diagnosis of acute deep vein thrombosis to prevent swelling and reduce pain, permitting early ambulation in combination with adequate anticoagulation has proven benefit, although a secondary analysis of the SOX trial refutes this belief. Continued long-term compression treatment is questioned. Two major questions remain: Is the lack of positive outcome on the development of post-thrombotic syndrome after proximal deep vein thrombosis due to the fact that there were a few patients with iliofemoral extension in the quoted randomized controlled trials who may benefit from prolonged medical compression treatment? Compliance is the major issue, and the two randomized controlled trials with excellent control of compliance showed significant reduction in the rate of post-thrombotic syndrome, but we know that in daily practice the adherence is closer to Kahn’s data.
Validation of the Arabic Version of the Iowa Infant Feeding Attitude Scale among Lebanese Women
Authors: Charafeddine Lama , Tamim Hani , Soubra Marwa , de la Mora Arlene , Nabulsi Mona ,   Research and Advocacy Breastfeeding Team, Nabulsi Mona , Charafeddine Lama , Kabakian Tamar , Yehya Nadine , Tamim Hani , Sinno Durriyah , Masri Saadieh 
Published: May 2015

Background: There is need in the Arab world for validated instruments that can reliably assess infant feeding attitudes among women. The 17-item Iowa Infant Feeding Attitude Scale (IIFAS) has consistently shown good reliability and validity in different cultures and the ability to predict breastfeeding intention and exclusivity. Objective: This study assessed the psychometric properties of the Arabic version of the IIFAS (IIFAS-A). Methods: After translating to classical Arabic and back-translating to English, the IIFAS-A was pilot tested among 20 women for comprehension, clarity, length, and cultural appropriateness. The IIFAS-A was then validated among 170 women enrolled in a breastfeeding promotion and support clinical trial in Lebanon. Results: The IIFAS-A showed acceptable internal consistency reliability (Cronbach’s α = 0.640), with principal components analysis revealing that it is unidimensional. The 17 items had good interitem reliabilities ranging between 0.599 and 0.665. The number of breastfed children was the only predictor of the overall IIFAS-A score in a multivariate stepwise regression model (β = 1.531, P < .0001). Conclusion: The 17-item IIFAS-A is a reliable and valid instrument for measuring women’s infant feeding attitudes in the Arab context.
Here and Now Aboriginal Assessment: background, development and preliminary evaluation of a culturally appropriate screening tool
Authors: Janca Aleksandar , Lyons Zaza , Balaratnasingam Sivasankaran , Parfitt Dora , Davison Sophie , Laugharne Jonathan 
Published: May 2015

Objective: Assessment of Aboriginal social and emotional wellbeing (SEWB) is a complex and challenging task, in part due to a lack of suitable assessment tools. This paper reports the development and evaluation of a culturally appropriate screening tool called the Here and Now Aboriginal Assessment (HANAA). Method: The initial phase included development of a glossary of Aboriginal terms and concepts relating to SEWB. The glossary was used to identify 10 key HANAA domains, which included physical health, sleep, mood, suicide risk and self harm, substance use, memory, unusual experiences, functioning, life stressors and resilience. Evaluation of the HANAA included exploration of its cultural applicability, feasibility, reliability and validity. Results: The HANAA was well accepted by study participants and easily implemented by assessors. Reliability was good, with inter-rater agreements between Aboriginal and non-Aboriginal assessors measured by Kappa statistics ranging from 0.5 to 1.0. There was also a good agreement between assessors and treating clinicians in identifying the main presenting problem and recommended course of action. Conclusion: The HANAA is a culturally appropriate and useful tool for the screening of SEWB among Aboriginal adults. It can also be used for teaching and training purposes of mental health and other professionals working with Aboriginal people.
The epidemiology of amphetamine type stimulant-related admissions in Albany, Western Australia: 2008–2013
Authors: Ridley Kelly , Coleman Mathew 
Published: May 2015

Objective: To explore the epidemiology of amphetamine type stimulant (ATS)-related admissions over six years in a regional centre, and to observe changes over time and compare demographics to national trends. Method: A retrospective audit of patients admitted with an International Classification of Diseases-10 (ICD-10) code relating to ATS use from 2008 to 2013 at Albany Health Campus. Age, gender and reason for admission were compared across each year, including repeat presentations. Concomitant codes during admission were noted. Results: One hundred and fifty two ATS-related hospital episodes were identified during the study period, 55% male and 45% female, with an age range from 16 to 50. Admission numbers increased over time. Patients with multiple admissions made up 35% of episodes. The most common reasons for admission were harmful use (F15.1) and psychotic disorder (F15.5). Sixty-nine percent of admissions had a concomitant ICD-10 code for mental health, 18% another medical code and 28% another factor influencing health status. Conclusion: The number of recognised ATS-related presentations is increasing at Albany Health Campus. A broad age range and comparatively high proportion of women were hospitalised. These patients have complex needs and many had multiple ATS-related admissions.
A Nuclear Magnetic Resonance Spectroscopy as a Method for Evaluation of In Vivo Poly-l-Lactide Biodegradation Kinetics From Stent-Polymer Matrices
Authors: Orlik Bartłomiej , Buszman Piotr P. , Krauze Agata , Gąsior Paweł , Desperak Piotr , Pająk Jacek , Kasperczyk Janusz , Janas Adam , Jelonek Michał , Handzlik-Orlik Gabriela , Buszman Paweł E. , Milewski Krzysztof 
Published: May 2015

Objectives: We aimed to comprehensively evaluate poly-lactide polymer degradation and sirolimus release kinetics from a drug-eluting stent matrix in the in vivo setting using a nuclear magnetic resonance (NMR) method. Methods: In 22 domestic swine, 18 biodegradable polymer-only coated stents (BPSs) and 36 biodegradable polymer-coated sirolimus-eluting stents (BP-SES) were implanted in coronary arteries with 115% overstretch. The animals were sacrificed at 1, 3, 7, 14, 28, and 56 days following baseline procedures. Vessel segments with BPS were harvested to evaluate polymer degradation with a NMR method, whereas BP-SES to analyze sirolimus tissue uptake and retention. Additionally, 8 BP-SES were implanted for histological analysis for 90 days of follow-up. Results: The NMR showed a gradual absorption of the polymer over the 6 consecutive time points, from 5.48 µg of the polymer on the stent at 1-day follow-up, through 4.33 µg at 3 days, 3.16 µg at 7 days, 2.42 µg at 14 days, 1.92 µg at 28 days to 1.24 µg in the last day of the study. The curve of polymer degradation corresponds well with the pharmacokinetic profile of sirolimus eluted from its surface and measured at identical time points. In histopathology, at 90 days, complete healing and biocompatibility were reported. Conclusions: The utilization of NMR method for BP absorption kinetics evaluation is a useful tool, which may be widely adopted to test other biodegradable implants. Further, it may substantially improve their safety and efficacy by facilitating programmed polymer and drugs elution.
Use of a new soft and long coil reduces the number of coils to embolize a small aneurysm
Authors: Sadato Akiyo , Hayakawa Motoharu , Adachi Kazuhide , Kato Yoko , Hirose Yuichi 
Published: May 2015

Background In embolizing a cerebral aneurysm, achievement of a high-volume embolization ratio (VER: volume of inserted coils / aneurysm volume) is important because it may prevent coil compaction and recanalization. The goal of the study is to examine whether use of softer and longer coils gives an adequate VER with fewer coils, particularly for small aneurysms. Methods Aneurysm volumes, VERs, and numbers of inserted coils were investigated in 23 cases of small aneurysms embolized using Infini coils, a long soft coil with a primary diameter of 0.010 inches (Infini group). An aneurysm volume- and VER-matched control (non-Infini) group of 59 cases was selected from patients treated at our facility. Data were also compared between subgroups of patients ( n = 18 and n = 34 in the Infini and non-Infini groups, respectively) who were not treated with thicker coils with primary diameters of 0.0135–0.015 inches (18-type coils), since these coils affect the number of coils by increasing VER rapidly. Results Average aneurysm volumes and VERs did not differ significantly between the Infini and non-Infini groups. Significantly fewer coils were used per 0.1 ml aneurysm volume in the Infini group (4.08 coils in average) compared with the non-Infini group (5.67) ( p < 0.001). In the non-18-type subgroups, the number of coils used remained significantly smaller in the Infini group (4.49) compared with the non-Infini group (6.72), ( p < 0.001). Conclusion To achieve VER ≥20%, use of Infini coils significantly decreased the number of coils required per unit volume of a small aneurysm.
Adherence to therapy for Barrett’s esophagus‐associated neoplasia
Authors: Cassani Lisa , Slaughter James C , Yachimski Patrick 
Published: May 2015

ObjectivesMultiple endoscopic sessions may be necessary for treatment and surveillance of Barrett’s esophagus (BE)‐associated neoplasia. Adherence to an endoscopic therapeutic regimen is important for longitudinal management of BE. The objective of this study was to identify the factors associated with adherence to therapy for BE‐associated neoplasia.MethodsWe retrospectively identified patients with BE whom were referred to a tertiary center for endoscopic mucosal resection (EMR) or radiofrequency ablation (RFA) between 2009 and 2012. Demographic and clinical data were extracted from the medical record.ResultsWe had 69 subjects meet our inclusion criteria. Referral diagnosis was low‐grade dysplasia in 9 (13%) subjects, high‐grade dysplasia in 33 (48%) subjects and adenocarcinoma in 26 (38%) subjects. The majority (55%) lived more than 100 miles from the treatment center. The primary third‐party payer was US Medicare for 54% of the subjects and private insurance for 36% of them; 45% of the subjects were seen in the clinic by the treating endoscopist, prior to endoscopic therapy and 71% underwent EMR as the initial treatment, while 29% underwent RFA without prior EMR. We found that 72% of subjects were adherent to therapy, including: 23 (33%) completing endoscopic therapy with documented post‐treatment surveillance, 18 (26%) with ongoing endoscopic therapy, and 9 (13%) whom underwent esophagectomy. Subjects seen in gastroenterology clinical consultation were significantly more likely to demonstrate adherence than those referred for open access endoscopy (Lasso OR 2.31).ConclusionsPatients seen in a clinical consultation prior to endoscopic therapy for BE‐associated neoplasia were more likely to demonstrate treatment adherence, compared to patients referred for open‐access endoscopy. A clinic visit prior to therapy may define expectations regarding treatment course and increase the likelihood of patient adherence.
Knee Extension Range of Motion at 4 Weeks Is Related to Knee Extension Loss at 12 Weeks After Anterior Cruciate Ligament Reconstruction
Authors: Noll Sarah , Garrison J. Craig , Bothwell James , Conway John E. 
Published: May 2015

Background: The anterior cruciate ligament (ACL) is commonly torn, and surgical reconstruction is often required to allow a patient to return to their prior level of activity. Avoiding range of motion (ROM) loss is a common goal, but little research has been done to identify when ROM loss becomes detrimental to a patient’s future function. Purpose: To determine whether there is a relationship between early knee side-to-side extension difference after ACL reconstruction and knee side-to-side extension difference at 12 weeks. The hypothesis was that early (within the first 8 weeks) knee side-to-side extension difference will be predictive of knee side-to-side extension difference seen at 12 weeks. Study Design: Cohort study; Level of evidence, 3. Methods: Knee side-to-side extension difference measures were taken on 74 patients undergoing ACL reconstruction rehabilitation at the initial visit and 4, 8, and 12 weeks postoperatively. Visual analog scores (VAS) and International Knee Documentation Committee (IKDC) scores were also recorded at these time frames. Results: There was a strong relationship between knee extension ROM at 4 and 12 weeks ( r = 0.639, P < .001) and 8 and 12 weeks ( r = 0.742, P < .001). When the variables of knee extension ROM at initial visit and 4 and 8 weeks were entered into a regression analysis, the predictor variable explained 61% ( R2 = 0.611) of variance for knee extension ROM at 12 weeks, with 4 weeks ( R2 = 0.259) explaining the majority of this variance. Conclusion: This study found that a patient’s knee extension at 4 weeks was strongly correlated with knee extension at 12 weeks. Clinical Relevance: This information may be useful for clinicians treating athletic patients who are anxious for return to sport by providing them an initial goal to work toward in hopes of ensuring successful rehabilitation of their knee.
Concepts of pathogenesis in psoriatic arthritis: genotype determines clinical phenotype
Authors: FitzGerald Oliver , Haroon Muhammad , Giles Jon T , Winchester Robert 
Published: May 2015

AbstractThis review focuses on the genetic features of psoriatic arthritis (PsA) and their relationship to phenotypic heterogeneity in the disease, and addresses three questions: what do the recent studies on human leukocyte antigen (HLA) tell us about the genetic relationship between cutaneous psoriasis (PsO) and PsA – that is, is PsO a unitary phenotype; is PsA a genetically heterogeneous or homogeneous entity; and do the genetic factors implicated in determining susceptibility to PsA predict clinical phenotype? We first discuss the results from comparing the HLA typing of two PsO cohorts: one cohort providing the dermatologic perspective, consisting of patients with PsO without evidence of arthritic disease; and the second cohort providing the rheumatologic perspective, consisting of patients with PsA. We show that these two cohorts differ considerably in their predominant HLA alleles, indicating the heterogeneity of the overall PsO phenotype. Moreover, the genotype of patients in the PsA cohort was shown to be heterogeneous with significant elevations in the frequency of haplotypes containing HLA-B*08, HLA-C*06:02, HLA-B*27, HLA-B*38 and HLA-B*39. Because different genetic susceptibility genes imply different disease mechanisms, and possibly different clinical courses and therapeutic responses, we then review the evidence for a phenotypic difference among patients with PsA who have inherited different HLA alleles. We provide evidence that different alleles and, more importantly, different haplotypes implicated in determining PsA susceptibility are associated with different phenotypic characteristics that appear to be subphenotypes. The implication of these findings for the overall pathophysiologic mechanisms involved in PsA is discussed with specific reference to their bearing on the discussion of whether PsA is conceptualised as an autoimmune process or one that is based on entheseal responses.