bluuebunny/crossref_metadata_2025_split huggingface dataset:
End-of-life care during and after an acute hospitalization in older patients with cancer, end-stage organ failure, or frailty: A sub-analysis of a prospective cohort study
Authors: Huijberts Sanne , Buurman Bianca M , de Rooij Sophia E 
Published: September 2015

Background: Many patients show deterioration in functioning and increased care needs in the last year of life. End-of-life care needs and health care utilization might differ between groups of acutely hospitalized older patients. Aim: To investigate differences in geriatric conditions, advance care planning, and health care utilization in patients with cancer, organ failure, or frailty, who died within 1 year after acute hospitalization. Design: Prospective cohort study conducted between 2002 and 2008, with 1-year follow-up. Setting: University teaching hospital in the Netherlands. Participants: Aged ⩾65 years, acutely hospitalized for ⩾48 h, and died within 1 year after hospitalization. At admission, all patients received a systematic comprehensive geriatric assessment. Hospital records were searched for advance care planning information and health care utilization. Differences between patient groups were calculated. Results: In total, 306 patients died within 1 year after acute admission (35%) and were included; 151 with cancer, 98 with end-stage organ failure, and 57 frail older persons. At hospital admission, 72% of the frail group had delirium and/or severe pre-existing cognitive impairment. The frail and organ failure group had many pre-existing disabilities. Three months post-discharge, 75% of the frail and organ failure group had died, 45% of these patients had an advance care plan in their hospital records. Conclusion: Patients with frailty and organ failure had highest rates of geriatric conditions at hospital admission and often had missing information on advance care planning in the hospital records. There is a need to better identify end-of-life needs for these groups.
Objective measurement of the distal resection margin by MRI of the fresh and fixed specimen after partial mesorectal excision for rectal cancer: 5 cm is not just 5 cm and depends on when measured
Authors: Bondeven Peter , Hagemann-Madsen Rikke H , Bro Lise , Moran Brendan J , Laurberg Søren , Pedersen Bodil Ginnerup 
Published: September 2015

BackgroundMost studies have directly established the optimal perioperative in situ clearance margin in surgery for rectal cancer from the histologically observed extent of distal spread, neglecting the tissue variability that occurs after resection and fixation of the rectal specimen.PurposeTo measure the length of the distal resection margin in the fresh and fixed specimen following partial mesorectal excision for rectal cancer using magnetic resonance imaging (MRI) to document tissue shrinkage after surgical removal and fixation.Material and MethodsThe length of the distal resection margin was measured by MRI of the fresh and fixed specimen and at histopathological examination of the fixed specimen in 10 patients who underwent surgery for upper rectal cancer. In addition, tissue shrinkage was estimated by measuring the total length of the fresh and fixed specimen and distance from the peritoneal reflection anteriorly to the distal cut edge of the specimen.ResultsMeasured by MRI, the distal resection margin was in the range of 0.6–10.2 cm (mean, 4.6 cm) in the fresh specimen, and 0.5–6.2 cm (mean, 3.2 cm) in the fixed specimen. The tissue shrinkage ratio was a mean of 69% (interquartile range, 61–77%). Taking all ratios from MRI and histopathological examination of tissue shrinkage into account, the collective tissue shrinkage ratio was 70% (95% confidence interval, 67–73%)ConclusionThe length of the distal resection margin was reduced by 30% after surgical removal and fixation of the specimen.
The phase value of putamen measured by susceptibility weighted images in Parkinson’s disease and in other forms of Parkinsonism: a correlation study with F18 FP-CIT PET
Authors: Kwon Gene Hyuk , Jang Jinhee , Choi Hyun Seok , Hwang Eo-Jin , Jung So-Lyung , Ahn Kook-Jin , Kim Bum-soo , Yoo Ie Ryung , Kim Sung Hoon , Haacke E Mark 
Published: September 2015

Background Iron deposition of basal ganglia in Parkinson’s disease (PD) can be measured using susceptibility weighted images (SWI) on magnetic resonance imaging (MRI). Fluoropropyl carbomethoxy-3b-4-iodophenyltropane (F18 FP-CIT) positron emission tomography (PET) has been used to differentiate Parkinsonism. Purpose To compare SWI phase values in Parkinsonian syndrome and age-matched control and to correlate them with F18 FP-CIT PET. Material and Methods Retrospectively, patients with Parkinsonian movement disorder ( n = 62) and age-matched control ( n = 16) were enrolled. Mean phase values on SWI were measured by region of interest (ROI) in putamens and caudate heads. Mean standardized uptake value (SUV) on F18 FP-CIT were measured in the same ROIs of PD ( n = 40) and other forms of Parkinsonism ( n = 22). A statistical analysis was performed to compare the phase values and SUVs and to correlate them between groups. Results The putaminal mean phase values were higher in Parkinsonism than in the control ( P ≤ 0.001). There was no difference of phase value in caudate head among the groups. Also, the mean phase value of putamen between PD and other forms of Parkinsonism was not different. Mean SUV of F18 FP-CIT in the putamen was lower in PD than other forms of Parkinsonism ( P ≤ 0.014). However, there was no significant correlation between phase values and mean SUV ( P >  0.05). Conclusion The putaminal phase value was higher than in Parkinsonian syndrome than in the age-matched controls. F18 FP-CIT PET/CT showed different tracer activity between PD and other forms of Parkinsonism. However, no correlation between phase and SUV values was discovered.
Analysis of corneal topography in patients with pure microphthalmia in Eastern China
Authors: Hu Pei-Hong , Gao Gui-Ping , Yu Yao , Pei Chong-Gang , Zhou Qiong , Huang Xin , Zhang Ying , Shao Yi 
Published: September 2015

Objectives To determine the typical corneal changes in pure microphthalmia using a corneal topography system and identify characteristics that may assist in early diagnosis. Methods Patients with pure microphthalmia and healthy control subjects underwent corneal topography analysis (Orbscan IIZ® Corneal Topography System; Bausch and Lomb, Bridgewater, NJ, USA) to determine degree of corneal astigmatism (mean A), simulation of corneal astigmatism (sim A), mean keratometry (mean K), simulated keratometry (sim K), irregularities in the 3 - and 5-mm zone, and mean thickness of nine distinct corneal regions. Results Patients with pure microphthalmia ( n = 12) had significantly higher mean K, sim K, mean A, sim A, 3.0 mm irregularity and 5.0 mm irregularity, and exhibited significantly more false keratoconus than controls ( n = 12). There was a significant between-group difference in the morphology of the anterior corneal surface and the central curvature of the cornea. Conclusions Changes in corneal morphology observed in this study could be useful in borderline situations to confirm the diagnosis of pure microphthalmia.
Efficacy of the FIFA 11+ Injury Prevention Program in the Collegiate Male Soccer Player
Authors: Silvers-Granelli Holly , Mandelbaum Bert , Adeniji Ola , Insler Stephanie , Bizzini Mario , Pohlig Ryan , Junge Astrid , Snyder-Mackler Lynn , Dvorak Jiri 
Published: September 2015

Background: The Fédération Internationale de Football Association (FIFA) 11+ program has been shown to be an effective injury prevention program in the female soccer cohort, but there is a paucity of research to demonstrate its efficacy in the male population. Hypothesis: To examine the efficacy of the FIFA 11+ program in men’s collegiate United States National Collegiate Athletic Association (NCAA) Division I and Division II soccer. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: Before the commencement of the fall 2012 season, every NCAA Division I and Division II men’s collegiate soccer team (N = 396) was solicited to participate in this research study. Human ethics review board approval was obtained through Quorum Review IRB. Sixty-five teams were randomized: 34 to the control group (CG; 850 players) and 31 to the intervention group (IG; 675 players). Four teams in the IG did not complete the study, reducing the number for analysis to 61. The FIFA 11+ injury prevention program served as the intervention and was utilized weekly. Athlete-exposures (AEs), compliance, and injury data were recorded using a secure Internet-based system. Results: In the CG, 665 injuries (mean ± SD, 19.56 ± 11.01) were reported for 34 teams, which corresponded to an incidence rate (IR) of 15.04 injuries per 1000 AEs. In the IG, 285 injuries (mean ± SD, 10.56 ± 3.64) were reported for 27 teams, which corresponded to an IR of 8.09 injuries per 1000 AEs. Total days missed because of injury were significantly higher for the CG (mean ± SD, 13.20 ± 26.6 days) than for the IG (mean ± SD, 10.08 ± 14.68 days) ( P = .007). There was no difference for time loss due to injury based on field type ( P = .341). Conclusion: The FIFA 11+ significantly reduced injury rates by 46.1% and decreased time loss to injury by 28.6% in the competitive male collegiate soccer player (rate ratio, 0.54 [95% CI, 0.49-0.59]; P < .0001) (number needed to treat = 2.64).
Significance of serum Il-9 levels in inflammatory bowel disease
Authors: Defendenti Caterina , Sarzi-Puttini Piercarlo , Saibeni Simone , Bollani Simona , Bruno Savino , Almasio Piero Luigi , Declich Paolo , Atzeni Fabiola 
Published: September 2015

IL-9, which may be an inflammatory or regulatory cytokine, can be experimentally produced in a Th17 or modified Th2 context in the presence of T cell receptor (TCR) stimulation. The primary aim of this study was to measure serum IL-9 levels in patients with inflammatory bowel disease (IBD), and evaluate their relationships with the patients’ clinical characteristics. The secondary aim was to determine the levels of interferon-γ (IFN (interferon)-γ), Th2 cytokines (IL-4, IL-5 and IL-13), and IL-6 in order to clarify the context of detectable peripheral cytokines in which IL-9 is produced. Venous blood samples of 43 IBD patients (20 with Crohn’s disease [CD] and 23 with ulcerative colitis [UC]) were analysed by means of quantitative enzyme-linked immunosorbent assays using purified anti-human IL-4, IL-5, IL-13, IFN-γ, IL-9 and IL-6 antibodies, and the laboratory findings were statistically correlated with their clinical expression. None of the patients showed the peripheral presence of IL-4, IL-5 and IL-13. Forty (93%) were positive for IFN-γ, thus confirming the presence of Th1 in both UC and CD, and IFN-γ levels correlated with disease activity ( P = 0.045). Eighteen patients (41%) were positive for IL-9, which was associated with a severe prognosis ( P <0.001), and 72.2% of the IL-9-positive patients were also IL-6 positive. There was a significant correlation between disease severity and IL-9 in the CD patients ( P <0.001), but not in the UC patients ( P = 0.1). Our findings confirm the presence of common Th1 cytokines in UC and CD. However the IL-9 positivity indicates the presence of an alternative population of T cells that respond to antigen stimulation and condition the prognosis of IBD. The fact that the same serum IL-9 levels were differentially associated with clinical measures of CD and UC activity suggest that the same cytokine can be produced in different contexts.
When Breast Milk Alone Is Not Enough
Authors: Kair Laura R. , Colaizy Tarah T. 
Published: September 2015

Background: Maternal overweight and obesity are associated with decreased breastfeeding duration. Objective: This study aimed to identify barriers to breastfeeding continuation among overweight and obese mothers. Methods: A retrospective cohort study examining breastfeeding continuation barriers was conducted using results of the Centers for Disease Control and Prevention Pregnancy Risk Assessment Monitoring System survey from Illinois, Maine, and Vermont from 2004 to 2008. SAS Complex Survey version 9.3 was used for analysis. Results: Of 19 145 mothers surveyed, 3717 (19%) were obese and 4367 (23%) were overweight. Overall, 14 731 women initiated breastfeeding, and 6467 discontinued breastfeeding prior to survey completion, around 4 months postpartum. The most common reasons that mothers reported for discontinuing breastfeeding were insufficient milk supply, infant not satisfied with breast milk alone, and breastfeeding difficulty. Overweight and obese women, compared with women of normal weight, had higher odds of discontinuing breastfeeding because their babies were not satisfied by breast milk alone (overweight: odds ratio [OR] = 1.39, 95% confidence interval [CI], 1.16-1.68; obese: OR = 1.26, 95% CI, 1.03-1.54). Obese mothers, compared with normal weight mothers, had lower odds of discontinuing breastfeeding because it felt like the right time (OR = 0.64, 95% CI, 0.47-0.88) and higher odds of discontinuing due to breastfeeding difficulties (OR = 1.29, 95% CI, 1.05-1.58) and infant jaundice (OR = 1.81, 95% CI, 1.26-2.60). Conclusion: Obese and overweight mothers were significantly more likely to discontinue breastfeeding due to infant dissatisfaction with breast milk alone. Obese mothers had higher odds than normal weight mothers of discontinuing breastfeeding due to breastfeeding difficulties and infant jaundice. Breastfeeding education and support should be enhanced for this at-risk population.
Clinical Significance of Individual GAD Symptoms in Later Life
Authors: Miloyan Beyon , Pachana Nancy A. 
Published: September 2015

Background: There are age-related differences in the manifestation of generalized anxiety disorder (GAD) symptoms and their associated impact on psychosocial and functional status. However, it remains unclear whether specific symptoms (or symptom patterns) are of comparable clinical significance across different functional domains. Methods: A sample of 865 self-reported worriers (aged 60 years and older) who endorsed GAD screening questions in the Alcohol Use Disorder and Associated Disabilities Interview Schedule, Diagnostic and Statistical Manual of Mental Disorders, fourth edition, were derived from Wave 1 of the National Epidemiological Survey of Alcohol and Related Conditions. Results: Being easily fatigued was significantly associated with occupational disability and a functional disability variable (restricting usual activity in any way). Irritability was significantly associated with social friction (arguments with friends, family, or colleagues) and a functional disability variable (found was unable to do something wanted to do), and poor self-perceived health was also associated with the same functional disability variable. Excessive worry, despite being among the least reported symptoms, was significantly associated with distress. Conclusions: These findings suggest that individual GAD symptoms are differentially associated with aspects of clinical significance relevant to daily life, such as social, occupational, and functional ability. The differential impact of individual symptoms on functional status may be diluted when using symptom sum scores. A nuanced approach to assessing the clinical significance of individual GAD symptoms in older adults may be fruitful for efforts aimed at early detection and treatment.
Ureaplasma parvum and Mycoplasma genitalium are found to be significantly associated with microscopy-confirmed urethritis in a routine genitourinary medicine setting
Authors: Cox Ciara , McKenna James P , Watt Alison P , Coyle Peter V 
Published: September 2015

Summary Inflammation of the urethra defined by an excess of polymorphonuclear leukocytes in the absence of sexually transmitted Chlamydia trachomatis and Neisseria gonorrhoeae is called non-chlamydial non-gonococcal urethritis (NCNGU). Although Mycoplasma genitalium is now recognised as causing a sexually transmitted infection, the clinical significance of the other Mollicute species is less clear. This study used specific real-time quantitative polymerase chain reaction assays to detect and quantify four Mollicute species, M. genitalium, M. hominis, Ureaplasma urealyticum and U. parvum, in urine specimens from men with and without NCNGU. A total of 165 urine specimens from male patients attending a genitourinary medicine clinic were eligible for the study, with microscopy-confirmed (≥5 polymorphonuclear leukocytes in urethral swab) NCNGU in 75 (45.5%) and non-confirmed NCNGU in 90 (54.5%). Chi-squared statistical analysis indicated a significantly higher prevalence of U. parvum (17.3% vs. 5.6%; p = 0.03) and M. genitalium (12% vs. 0%; p < 0.001) in NCNGU. In a subset analysis, M. genitalium was also significantly ( p = 0.03) higher in men who have sex with men (MSM; 13.5%) compared to non-MSM (3.1%). No significant associations were reported for U. urealyticum and M. hominis. In conclusion, this study supports a clinically significant role in NGNCU for both U. parvum and M. genitalium.
Administration of tenofovir disoproxil fumarate-based antiretroviral therapy in an HIV-infected patient following unilateral nephrectomy
Authors: Biagi Mark , Badowski Melissa , Chiampas Thomas , Young Jeremy , Vaughn Pyrai , Shicker Louis , Patel Mahesh 
Published: September 2015

Summary We report the use of efavirenz 600 mg/emtricitabine 200 mg/tenofovir disoproxil fumarate 300 mg, once daily in a 47-year-old black man with a solitary kidney and human immunodeficiency virus (HIV). In 1990, he underwent radiation, chemotherapy, and ultimately, a unilateral nephrectomy for Wilms' tumor. Because of previous reports of tenofovir disoproxil fumarate-induced nephrotoxicity, our objective was to evaluate and monitor our patient's renal function over the course of 19 months based on serum creatinine, estimated creatinine clearance using the Cockroft-Gault equation, estimated glomerular filtration rate using the modification of diet in renal disease formula and urinalyses. After experiencing gastrointestinal side effects from other antiretroviral agents, our patient was switched to efavirenz/emtricitabine/tenofovir disoproxil fumarate in June 2013. At baseline, his serum creatinine was 1.35 mg/dL, estimated creatinine clearance 68.7 mL/min (based on actual body weight of 71.8 kg), estimated glomerular filtration rate 72.9 mL/min/1.73 m2, with a CD4 cell count of 119 cells/mm3 (5%) and an undetectable HIV viral load. In March 2015, his weight was 73.2 kg, serum creatinine 1.42 mg/dL, estimated creatinine clearance 65.2 mL/min, estimated glomerular filtration rate 68.1 mL/min/1.73 m2, with a CD4 cell count of 120 cells/mm3 (10%) and an undetectable HIV viral load. Other authors have reported tenofovir-induced nephrotoxicity in patients with a solitary kidney. Our patient had no evidence of nephrotoxicity over the course of 19 months on tenofovir disoproxil fumarate-based antiretroviral therapy (ART). He maintained adequate renal function, comparable to his baseline renal function. Our case report suggests that a tenofovir disoproxil fumurate-based ART may be a viable option for some patients with a solitary kidney. Additional studies and data are needed considering this is a small and relatively unstudied population.
Effect of Obesity on Total Ankle Arthroplasty Outcomes
Authors: Schipper Oliver N. , Denduluri Sahitya K. , Zhou Ying , Haddad Steven L. 
Published: September 2015

Background: The purpose of this study was to evaluate the effect of obesity on intermediate- to long-term implant failure rates and survivorship after total ankle arthroplasty. Methods: A chart review was performed for all patients who underwent primary total ankle arthroplasty between 2004 and 2009 with a minimum 5-year follow-up. Patients were separated into a reference group with a body mass index less than 30 kg/m2 and an obese group with an index greater than or equal to 30 kg/m2. Minimum 5-year follow-up outcomes were available for 49 patients in the obese group and 48 patients in the nonobese group. Mean follow-up was 8.2 ± 2.0 years (range, 5.1-11.5 years) in the reference group and 7.7 ± 2.0 years (range, 5.0-11.9 years) in the obese group ( P = .26). Results: Based on multivariable logistic regression, obese patients had a significantly greater probability of implant failure by final follow-up (adjusted odds ratio, 2.8 [95% CI, 1.04-7.53]; P = .04). Cox regression analysis of 5-year implant survivorship showed no significant difference between the 2 groups (adjusted hazard ratio, 1.89 [95% CI, 0.77-4.65]; P = .17). When compared with obese patients with inflammatory or posttraumatic arthritis, obese patients with osteoarthritis demonstrated a significantly decreased 5-year survivorship (adjusted hazard ratio, 3.73 [95% CI, 1.05-10.43]; P = .04). Conclusion: This study demonstrated an increased long-term risk of implant failure among obese patients that was not seen in the intermediate term. Furthermore, obese patients with primary osteoarthritis were found to have a significantly decreased 5-year implant survivorship after ankle arthroplasty as compared with obese patients with inflammatory or posttraumatic arthritis and therefore should be counseled appropriately when deciding between arthroplasty and arthrodesis. Level of Evidence: Level III, retrospective comparative series.
Combined effect of ultrasound and essential oils to reduce Listeria monocytogenes on fresh produce
Authors: Özcan Gülçin , Demirel Zorba Nükhet Nilüfer 
Published: September 2015

Salads prepared from contaminated fresh produce have a high risk of causing food-borne illnesses. Essential oils obtained from plants have antimicrobial activity and may provide a natural approach to reduce the pathogens on fresh produce. Additionally, ultrasound treatments have been shown to reduce the microbial counts on different foods. The objective of this study was to investigate the antimicrobial activities of cinnamon and lemon essential oils in vitro and in food applications. Mixtures of lettuce, parsley and dill were inoculated with Listeria monocytogenes and then dip-treated for 5 min in one of the following treatments: sterile tap water, chlorinated water, 1% lemon essential oil, 2% cinnamon essential oil or 2% cinnamon essential oil + ultrasound. The samples were stored at 4 ℃ and collected at d 0, 1, 3, 5, 7 and 9 post inoculation. The 1% lemon (4 log) and 2% cinnamon (2 log) essential oil washes provided partial inhibition against L. monocytogenes by d 1. The combined application of 2% cinnamon oil and ultrasound resulted in only 0.85 log inhibition by d 1; however, the number of L. monocytogenes increased during storage and became nearly equal to the control at d 9. Therefore, different combinations of essential oils with other antimicrobials or novel technologies are required.