bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outliers affecting cardiac troponin I measurement: comparison of a new high sensitivity assay with a contemporary assay on the Abbott ARCHITECT analyser
Authors: Sawyer Nicola , Blennerhassett John , Lambert Ramon , Sheehan Paul , Vasikaran Samuel D 
Published: September 2013

Background False-positive cardiac troponin (Tn) results caused by outliers have been reported on various analytical platforms. We have compared the precision profile and outlier rate of the Abbott Diagnostics contemporary troponin I (TnI) assay with their high sensitivity (hs) TnI assay. Methods Three studies were conducted over a 10-month period using routine patients’ samples. TnI was measured in duplicate using the contemporary TnI assay in Study 1 and Study 2 ( n = 7011 and 7089) and the hs–TnI assay in Study 3 ( n = 1522). Critical outliers were defined as duplicate results whose absolute difference exceeded a critical difference (CD =  z x √2 x SDAnalytical) at a probability level of 0.0005, with one of the results on the opposite side of the decision limit to its partner. Results The TnI concentration at 10% imprecision (coefficient of variation) for the contemporary TnI assay was 0.034 µg/L (Study 1) and 0.042 µg/L (Study 2), and 0.006 µg/L (6 ng/L) for the hs–TnI assay. The critical outlier rates for the contemporary TnI assay were 0.51% (Study 1) and 0.37% (Study 2) using a cut-off of 0.04 µg/L, and 0% for the hs–TnI assay using gender-specific cut-offs. Conclusion The significant number of critical outliers detected using the contemporary TnI assay may pose a risk for misclassification of patients. By contrast, no critical outliers were detected using the hs–TnI assay. However, the total outlier rates for both assays were significantly higher than the expected variability of either assay. The cause of these outliers remains unclear.
Mood disturbance after infection
Authors: Gunaratne Pramudie , Lloyd Andrew R , Vollmer-Conna Ute 
Published: September 2013

Objective: An aetiological link between acute infection and major depression has long been hypothesized, and is increasingly gaining recognition within contemporary literature. This review aims to examine the evidence for such a link, specifically between acute, self-limiting infection and major depression, and to summarize the current understanding of pathophysiological mechanisms underlying this link. Methods: Relevant articles were sourced via an online search of published literature from Embase, MEDLINE, PsycINFO and PubMed using a variety of search terms including mood disorder, depression, infection and inflammation. Additionally, a search for articles from the bibliographies of retrieved papers was conducted. Results: Findings from retrospective studies suggest an association between infection and subsequent mood disturbance, including major depression. This association has been confirmed by studies employing prospective observational or experimental challenge designs. The available evidence supports a multifactorial basis of vulnerability towards major depression in the context of acute infection. Genetic, neuroendocrine, autonomic and psychosocial factors may interact to potentiate the likelihood of a severe and prolonged depressive response to an immunological stressor in some individuals. Conclusion: Mood disturbance is likely to have a host-protective role in the context of an acute sickness response to infection. However, this usually adaptive and reversible response may progress in some vulnerable individuals into a more sustained and severe pattern of behavioural and physiological changes of major depression. Further research is needed to delineate the factors that predispose, precipitate and perpetuate depression in the context of acute infective illness. Such insights will inform effective prevention and treatment strategies.
Does progressive resistance strength training as additional training have any measured effect on functional outcomes in older hospitalized patients? A single-blinded randomized controlled trial
Authors: Tibaek Sigrid , Andersen Christina W , Pedersen Sigrid F , Rudolf Karen S 
Published: September 2013

Objective: To evaluate the effect of progressive resistance strength training as additional training measured on functional outcomes in older hospitalized patients. Design: A single-blinded randomized controlled trial. Setting: Department of Geriatric Rehabilitation in university hospital. Participants: A sample of 71 patients were successively included and randomized either to the treatment group (TG) ( n = 36) or the control group (CG) ( n = 35). Fifteen participants dropped out (TG n = 7; CG n = 8), leaving 56 participants with a mean age of 79 (SD 7). Intervention: Participants in the treatment group were treated in groups with progressive resistance strength training in addition to standard care. Progressive resistance strength training of the lower extremities was performed in three sets of 12–15 repetitions, intensity 60–70% of one repetition maximum, in four 50-minute sessions per week. Main measures: The effect was evaluated by timed up & go test, 30-second chair-stand test, 10-m walk test, three tasks (transfer, walking, stairs) of the Barthel Index, and use of walking aids. Results: Significant improvements in the 10-m walk test ( P < 0.01) and Barthel Index (walking) ( P = 0.01) were demonstrated within the treatment group but not in the control group. Both groups had significant improvements in timed up & go, 30-second chair-stand (modified) and Barthel Index (transfer and walking). No significant difference was found between groups except for the Barthel Index (stairs) ( P = 0.05). Analysis by the mixed-effects model showed that the treatment group improved more than the control group in all outcome variables. Conclusion: The results indicate that for older hospitalized patients progressive resistance strength training as additional training may have an effect compared to standard care, but no statistically significant effects were demonstrated when measured by functional outcomes.
α-[11C] methyl-L tryptophan-PET as a surrogate for interictal cerebral serotonin synthesis in migraine without aura
Authors: Sakai Y , Nishikawa M , Diksic M , Aubé M 
Published: September 2013

Background Alteration in central serotonin biology has been implicated in migraine, and serotonin (5-HT) agonists have been available for more than a decade in the treatment of that condition. Objectives To test this hypothesis, we studied in vivo using positron-emission tomography (PET) and α-[11C] methyl-L-tryptophan (α-[11C]MTrp) as a surrogate marker of cerebral 5-HT synthetic rate before and after administration of eletriptan in migraine and control subjects. Methods Six nonmenopausal female migraine subjects with migraine without aura (MoA) and six nonmenopausal age-matched female control subjects were scanned at baseline and after oral administration of 40 mg of eletriptan. Migraine subjects at the time of PET had to have been headache free for a minimum of three days. Images of (α-[11C]MTrp) brain trapping were colocalized with individual MRI images in three dimensions and analyzed. Results There was no difference in baseline cerebral global 5-HT synthesis between migraine and control subjects. After administration of eletriptan, there was a striking global reduction in cerebral 5-HT synthesis (K*) in the migraine group and in 22 regions of interest (ROIs). In control subjects, no significant changes were found in global cerebral 5-HT synthesis (K*) or in any of the ROIs. Conclusions These findings suggest in migraine an interictal alteration in the regulation mechanisms of cerebral 5-HT synthesis.
Anatomic and Radiographic Comparison of Arthroscopic Suprapectoral and Open Subpectoral Biceps Tenodesis Sites
Authors: Johannsen Adam M. , Macalena Jeffrey A. , Carson Eric W. , Tompkins Marc 
Published: September 2013

Background: Arthroscopic suprapectoral and open subpectoral surgical techniques are both commonly utilized approaches for proximal biceps tenodesis of the long head of the biceps brachii. A central limitation to the widespread use of an arthroscopic approach for biceps tenodesis is that the tendon may be tenodesed too proximally in the bicipital groove, leading to persistent pain and tendinopathy. Purpose/Hypothesis: The purpose of this study was to determine the in vivo tenodesis location using arthroscopic suprapectoral and open subpectoral techniques for proximal biceps tenodesis in relation to clinically pertinent anatomic and radiographic landmarks. The null hypothesis was that arthroscopic suprapectoral biceps tenodesis would not be significantly different in terms of the location from open subpectoral biceps tenodesis. Study Design: Controlled laboratory study. Methods: A total of 20 matched pairs of cadaveric shoulder specimens were randomized such that within each pair, 1 shoulder underwent a standard open subpectoral biceps tenodesis and the other underwent an arthroscopic suprapectoral tenodesis. Limited dissection and exposure of the surgical tunnel site and reference landmarks were subsequently performed, and anteroposterior and lateral radiographs were obtained. Direct measurements were performed anatomically using a digital caliper and radiographically using picture archiving and communication system (PACS) software from the proximal lip of the humeral tunnel to regional landmarks. Results: Both techniques were able to place the humeral tunnel distal to the bicipital groove in all specimens. On average, the open subpectoral approach placed the tunnel 2.2 cm distal to the arthroscopic suprapectoral approach. Conclusion: The arthroscopic suprapectoral biceps tenodesis technique used in this study consistently placed the tenodesis tunnel distal to the bicipital groove, which may allay concerns about the bicipital groove as a pain source after this procedure. Clinical Relevance: This anatomic study provides new information on tunnel placement in 2 biceps tenodesis techniques. In addition, it provides clinically relevant anatomic and radiographic guidelines using clinically pertinent landmarks. This information may be useful in preoperative planning, intraoperative technique, and postoperative assessment of both open subpectoral and arthroscopic suprapectoral biceps tenodesis.
Child–Parent Interventions for Childhood Anxiety Disorders
Authors: Brendel Kristen Esposito , Maynard Brandy R. 
Published: September 2013

Objective: This study compared the effects of direct child–parent interventions to the effects of child-focused interventions on anxiety outcomes for children with anxiety disorders. Method: Systematic review methods and meta-analytic techniques were employed. Eight randomized controlled trials examining effects of family cognitive behavior therapy compared to individual or group child-only therapy met criteria. Results: The overall mean effect of parent–child interventions was 0.26, 95% confidence interval [0.05, 0.47], p < .05, a small but positive and significant effect, favoring child–parent interventions. Results of the heterogeneity analysis were not significant ( Q = 8.08, df = 7, p > .05, I2 = 13.41). Discussion: Parent–child interventions appear to be more effective than child-focused individual and group cognitive behavioral therapy in treating childhood anxiety disorders. Implications for practice and research are discussed.
Primary Thrombophilia in México X
Authors: Velázquez-Sánchez-de-Cima Sara , Zamora-Ortiz Gabriela , Hernández-Reyes Jesús , Vargas-Espinosa Jocelyn , García-Chavez Jessica , Rosales-Padrón Jaime , Ruiz-Delgado Guillermo J. , Ruiz-Arguelles Alejandro , Ruiz-Argüelles Guillermo J. 
Published: September 2013

Introduction: The sticky platelet syndrome (SPS) is a common cause of thrombosis. There are no prospective studies concerning treatment. Objective: To analyze changes in platelet hyperaggregability of patients with SPS who were given antiplatelet drugs and to assess its association with rethrombosis. Methods: A total of 55 patients with a history of thrombosis and SPS phenotype were prospectively studied before and after treatment with aspirin and/or clopidogrel. Results: Patients were followed for 1 to 129 months, median 13. Of 55 patients, 40 received aspirin, 13 received aspirin + clopidogrel, and 2 received only clopidogrel. The platelet aggregation response to adenosine diphosphate and epinephrine significantly diminished after treatment, and only 2 patients developed rethrombosis 52 and 129 months after starting therapy, with the freedom from rethrombosis rate of the patients being 96.4% at 129 months. Conclusion: Using antiplatelet drugs, the platelet hyperreactivity of patients with the SPS phenotype was reverted; and this translated into a substantial decrease in the rethrombosis rate.
The Relationship Between Eosinophil and Cardiac Syndrome X
Authors: Demir Mehmet , Şentürk Muhammed , Kuzeytemiz Mustafa 
Published: September 2013

Aim: The pathophysiology of cardiac syndrome X (CSX) has not been clearly identified, although multiple abnormalities including microvascular spasm, endothelial dysfunction, and atherothrombosis have been reported. It is known that eosinophils play an important role in vasoconstruction and thrombosis. We aimed to compare the eosinophil counts in patients with CSX versus controls. Materials and Methods: This study included 50 patients with CSX (20 male, mean age 50.42 ± 9.6 years) and 30 control persons (10 male, mean age 49.16.11 ± 9.2 years). These participants underwent concurrent routine biochemical tests, and their eosinophil counts were obtained on whole blood count. These parameters were compared between groups. Results: Baseline characteristics of the study groups were comparable. Patients with CSX had a higher eosinophil count and mean platelet volume (MPV) value than the controls (339.4 ± 188 vs 132.7 ± 75 and 8.8 ± 0.2 vs 7.2 ± 0.1 fL; P < .001, respectively). Conclusion: As a result, our study revealed a relationship between eosinophil count and MPV in patients with CSX.
Neutrophil–Lymphocyte Ratio May Predict Left Atrial Thrombus in Patients With Nonvalvular Atrial Fibrillation
Authors: Yalcin Murat , Aparci Mustafa , Uz Omer , Isilak Zafer , Balta Sevket , Dogan Mehmet , Kardesoglu Ejder , Uzun Mehmet 
Published: September 2013

Objective: Neutrophil–lymphocyte ratio (NLR) has been associated with poor outcomes in patients with cardiovascular diseases. We aimed to compare NLRs among patients with nonvalvular atrial fibrillation (AF) with or without left atrial (LA) thrombus. Methods: A total of 309 (70.1 ± 9.8 years, 49% male) patients with nonvalvular AF have undergone transoesophageal echocardiography (TEE) to assess the presence of LA thrombus. Baseline NLR was measured by dividing neutrophil count to lymphocyte count. Results: Left atrial thrombus was detected in 32 (10.3%) of 309 patients. Mean NLR (2.2 ± 1.0 vs 2.7 ± 1.1, P = .026) was significantly higher among patients with LA thrombus compared to patients without LA thrombus. On multivariate analysis, NLR (odds ratio 1.59, 95% confidence interval 0.87-4.18; P < .02) was an independent risk factor for the presence of LA thrombus in patients with nonvalvular AF. Conclusion: Neutrophil–lymphocyte ratio, an emerging marker of inflammation, was independently associated with the presence of LA thrombus in patients with nonvalvular AF.
Associations of Schizophrenia Symptoms and Neurocognition With Physical Activity in Older Adults With Schizophrenia
Authors: Leutwyler Heather , Hubbard Erin M. , Jeste Dilip V. , Miller Bruce , Vinogradov Sophia 
Published: September 2013

Background: Low levels of physical activity contribute to the generally poor physical health of older adults with schizophrenia. The associations linking schizophrenia symptoms, neurocognition, and physical activity are not known. Research is needed to identify the reasons for this population’s lack of adequate physical activity before appropriate interventions can be designed and tested. Design and Methods: In this cross-sectional study, 30 adults aged ≥55 years with schizophrenia were assessed on symptoms (Positive and Negative Syndrome Scale), neurocognition (MATRICS Consensus Cognitive Battery), and physical activity (Sensewear ProArmband). Pearson’s bivariate correlations (two-tailed) and univariate linear regression models were used to test the following hypotheses: (1) more severe schizophrenia symptoms are associated with lower levels of physical activity and (2) more severe neurocognitive deficits are associated with lower levels of physical activity. Results: Higher scores on a speed-of-processing test were associated with more average daily steps ( p = .002) and more average daily minutes of moderate physical activity ( p = .009). Higher scores on a verbal working memory task were associated with more average daily minutes of moderate physical activity ( p = .05). More severe depressive symptoms were associated with more average daily minutes of sedentary activity ( p = .03). Conclusion: Physical activity interventions for this population are imperative. In order for a physical activity intervention to be successful, it must include components to enhance cognition and diminish psychiatric symptoms.
When are defunctioning stomas in rectal cancer surgery really reversed? Results from a population-based single center experience
Authors: Floodeen H. , Lindgren R. , Matthiessen P. 
Published: September 2013

Background and Aims: This study assessed the timing of reversal of defunctioning stoma following low anterior resection of the rectum for cancer and risk factors for a defunctioning stoma becoming permanent in patients who were not reversed. Material and Methods: Patients who underwent low anterior resection with defunctioning stoma during a 12-year period were assessed with regard to timing of stoma reversal. Delayed reversal was defined as >4 months after low anterior resection. Patients with a defunctioning stoma that was never reversed were assessed regarding risk factors for permanent stoma. Results: A total of 134 patients were analyzed. Of 106 stoma reversals, 19% were reversed within 4 months of low anterior resection, while 81% were reversed later than 4 months. In 58% of these patients, the delay was to due to low medical priority given to this procedure. The other main reasons for delayed stoma reversal were nonsurgical complications (20%), symptomatic anastomotic leakage following low anterior resection (12%), and postoperative adjuvant chemotherapy (10%). Of all patients, 21% (28/134) ended up with a permanent stoma. Risk factors for a defunctioning stoma becoming permanent were stage IV cancer (P < 0.001) and symptomatic anastomotic leakage following low anterior resection (P < 0.001). Conclusion: Four in five patients experienced a delayed stoma reversal, in a majority because of the low priority given to this surgical procedure.
Experience of structural onlay allografts for the treatment of bone deficiency in revision total hip arthroplasty
Authors: Mokka J. , Keemu H. , Koivisto M. , Stormi T. , Vahlberg T. , Virolainen P. , Junnila M. , Seppänen M. , Mäkelä K. T. 
Published: September 2013

Background and Aims: Loss of femoral bone stock in elective revision total hip arthroplasty poses unique and substantial challenges. Structural onlay allografts may provide mechanical stability for the cementless revision prosthesis and increase bone stock. Material and methods: At least one cortical onlay allograft was used in 40 elective total hip arthroplasty revisions (40 patients) to reconstruct femoral bone defects. The operations were performed between January 1999 and August 2010 in the Turku University Hospital, Finland. The mean follow-up time was 52 months (range: 12–125 months). Results: The allografts were incorporated into the bone tissue in 37 of 40 (92.5%) patients. Cementless revision stems healed in 36 of 40 (90.0%) patients, but these patients were not exactly the same patients whose allografts were successfully incorporated. One or more surgical complications were experienced by 14 of 40 (35.0%) patients during follow-up. In all, 4 of 40 (10.0%) patients (all women) had hip infections during follow-up. Of the 7 patients with rheumatoid arthritis, 4 (57.1%) had at least one complication. Conclusions: The use of the cortical onlay allografts provides a feasible option for restoring the integrity of the proximal femur in revision total hip arthroplasty, but the complication rate is high, particularly in female patients with rheumatoid arthritis.
Does D2 plus Para-Aortic Nodal Dissection surgery offer a better survival outcome compared to D2 surgery only for gastric cancer consistently? A definite result based on a hospital population of nearly two decades
Authors: Zhang Y. , Tian S. 
Published: September 2013

Background and Aims: Curative resection is the treatment of choice for gastric cancer. Although it has been concluded that D2 lymphadenectomy plus para-aortic nodal dissection does not improve survival rate in curable gastric cancer, it is unclear whether D2 plus para-aortic nodal dissection has a benefit in some groups of patients. We conducted a retrospective study in our hospital, in which we compared D2 with D2 plus para-aortic nodal dissection lymphadenectomy for gastric cancer in subgroups of each clinical characteristic in terms of long-term survival after surgery. Material and Methods: We selected 1792 patients who had undergone the treatment with curative intent between 1990 and 2007, 1344 in the D2 group and 448 in the D2 plus para-aortic nodal dissection group. Each procedure was verified by pathological analyses. The primary end points were 5-year overall survival. Results and Conclusions: Median follow-up periods were 50 months for patients assigned to D2 group and 54 months for patients assigned to D2 plus para-aortic nodal dissection group. Overall 5-year survival was not significantly higher in patients assigned to D2 plus para-aortic nodal dissection surgery compared to those assigned to D2 surgery (31.2% (95% confidence interval: 19.8%–42.6%) vs 26.6% (95% confidence interval: 20.3%–32.9%); log-rank p = 0.433). D2 plus para-aortic nodal dissection surgery should only be used for curable gastric cancer of T3-4 and N2 stage and should not be used for T1 disease and total gastrectomy.
Technique and short-term outcomes of single-port surgery for rectal cancer: A feasibility study of 25 patients
Authors: Bulut O. , Aslak K. K. , Rosenstock S. 
Published: September 2013

Background and Aims: Although conventional laparoscopic surgery is less traumatic than open surgery, it does cause tissue trauma and multiple scar formation. The size and number of ports determine the extent of the trauma. Single-port laparoscopic surgery is assumed to minimize and perhaps eliminate the potential adverse effects of conventional laparoscopy. The aim of this study was to examine short-term outcomes of single-port laparoscopic surgery for rectal cancer. Material and Methods: Prospectively collected data from 25 consecutive patients who underwent single-port laparoscopic surgery for rectal cancer between January 2010 and March 2012. Perioperative data, oncological resections, and short-term outcomes were assessed. Results: Male:female ratio was 10:15. Of the 25 patients, 44% had previously undergone abdominal surgery. Median body mass index was 24 kg/m2 (range: 19–32 kg/m2). In all, four patients (16%) had neoadjuvant therapy. Median operating time was 260 min (range: 136–397 min). An additional port was needed in two patients, and one case was converted to hand-assisted approach. Median postoperative stay was 7 days (range: 4–39 days), and three patients (12%) were readmitted. Median lymph node harvest was 13 (range: 3–33). The surgical margins were clear in all patients. Complications were seen in six patients. Conclusion: Single-port laparoscopic surgery for rectal cancer can be performed in selected patients with rectal cancer without compromising oncological safety and with acceptable morbidity and mortality rates.