bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinician perspective on parental empowerment in family‐based treatment for adolescent anorexia nervosa
Authors: Dimitropoulos Gina , Freeman Victoria E. , Lock James , Le Grange Daniel 
Published: July 2015

This qualitative study explored which core principles of family‐based treatment (FBT) for adolescents with anorexia nervosa (AN) are perceived as most necessary for FBT to be effective in clinical practice. Paediatric interdisciplinary teams were recruited to discuss the delivery of FBT in eating disorder programmes in Ontario, Canada (N = 6). Thematic analysis was used to analyze the data generated from focus groups. Three major themes emerged: (i) parental empowerment (PE) is the most salient principle of FBT; (ii) various adolescent, parental and family factors are viewed as interfering with or enhancing PE; (iii) a variety of clinical interventions are utilized by clinicians to cultivate and increase PE. PE is identified as essential for adolescents with AN to successfully recover. Greater focus on addressing barriers to empowering parents is needed throughout FBT. Future studies should include measurements of PE to ascertain effects on treatment outcomes. Training and supervision protocols focused on promoting PE are recommended.Practitioner points

PE is the most salient principle of FBT.
Strategies to enhance PE in phase 1 are imperative if there has been a long illness duration or parents experience mental health issues/burnout.
Special clinical attention to individual factors is recommended: comorbid diagnoses, affect dysregulation and enduring eating disorder symptoms.
Efforts to enhance parental involvement throughout the treatment is paramount to supporting adolescents to recover from AN.
Psychological symptoms among parents of adolescents with anorexia nervosa: a descriptive examination of their presence and role in treatment outcome
Authors: Forsberg Sarah , Darcy Alison , Bryson Susan W. , Arnow Katherine D. , Datta Nandini , Le Grange Daniel , Lock James 
Published: July 2015

Parent psychological symptoms were examined in a randomized controlled trial comparing family‐based treatment (FBT) and adolescent‐focused therapy (AFT) for anorexia nervosa, and were explored across treatments and in relation to treatment outcomes. Moderator and mediator analyses were completed with parent symptoms as predictors and weight remission and recovery status as outcome variables. Few parents had clinically significant symptoms at presentation. At the end of treatment (EOT), parents had decreased psychological symptoms in both treatment arms. Higher baseline levels of overall maternal symptomology and improvement in maternal symptomology were non‐specific predictors of adolescent weight outcome at EOT and 12‐month follow up. Mothers with few to no depressive symptoms had children with the greatest improvement in weight at EOT when assigned to family treatment. In sum, parent symptoms did not appear to negatively impact on the treatment outcome among adolescents with anorexia nervosa.Practitioner points

Parent involvement is considered best practice in the treatment of adolescent anorexia nervosa (AN).
There are limited data on psychological symptoms among parents of individuals with AN, and their impact on treatment outcome.
Among a sample of adolescents with AN, parent psychological symptoms improved across individual and family treatment.
Future studies may wish to explore the impact of maternal depression on refeeding efforts in family‐based treatment.
Poorer Drinking Outcomes with Citalopram Treatment for Alcohol Dependence: A Randomized, Double‐Blind, Placebo‐Controlled Trial
Authors: Charney Dara A. , Heath Laura M. , Zikos Eugenia , Palacios‐Boix Jorge , Gill Kathryn J. 
Published: July 2015

BackgroundPrevious research on the use of selective serotonin reuptake inhibitors (SSRIs) as a treatment for alcohol dependence has yielded mixed results. Depression has been shown to be a predictor of relapse and poor outcome following treatment, and it has been hypothesized that SSRIs would be beneficial in reducing drinking in depressed alcohol‐dependent individuals. This randomized, double‐blind, placebo‐controlled trial was designed to test the effects of citalopram on treatment outcomes among alcohol‐dependent individuals with and without depression.MethodsTwo hundred and sixty‐five patients meeting criteria for a DSM‐IV diagnosis of alcohol abuse or dependence were randomly assigned to receive placebo or citalopram 20 mg per day for the first week, followed by 40 mg per day from weeks 2 through 12. All patients received a standard course of treatment consisting of weekly individual and group psychotherapy. Participants were reassessed at 12 weeks, including dropouts from both treatment groups to determine rates of abstinence, changes in alcohol use, addiction severity, depressive symptoms, and psychiatric status.ResultsCitalopram provided no advantage over placebo in terms of treatment outcomes, and for some measures, citalopram produced poorer outcomes. Patients in the citalopram group had a higher number of heavy drinking days throughout the trial, and smaller changes in frequency and amount of alcohol consumption at 12 weeks. There was no influence of depression severity on outcomes in either medication group. Survival analyses also indicated no differences between depressed and nondepressed patients in the citalopram group for time to first slip or relapse. A diagnosis of personality disorder was associated with poorer treatment responses overall, regardless of treatment condition.ConclusionsThis trial does not support the use of citalopram in the treatment of alcohol dependence. The results suggest that the use of SSRIs among depressed and nondepressed alcohol‐dependent individuals early in recovery, prior to the onset of abstinence, may be contraindicated.
Anticraving Effect of Baclofen in Alcohol‐Dependent Patients
Authors: Imbert Bruce , Alvarez Jean‐Claude , Simon Nicolas 
Published: July 2015

BackgroundBaclofen is a GABA‐B receptor agonist currently used in the treatment of spasticity. In recent years, baclofen has been used to reduce craving, voluntary alcohol intake and withdrawal syndrome of alcoholic patients. To date, there are no data available to estimate the relationship between baclofen exposure and the variation of craving. The first objective of this study was to investigate the variation of craving as a function of exposure, and the second was to explore the possible existence of baclofen responders and nonresponders.MethodsSixty‐seven outpatients, 43 men/24 women (weight: 73 kg [42 to 128]; age: 49 years old [29 to 68]) followed in the addictology unit, were studied during 3 months after treatment initiation. Baclofen was administered by oral route. Therapeutic drug monitoring enabled the measurement of plasma concentrations. Craving level was assessed by the Obsessive–Compulsive Drinking Scale (OCDS). A population pharmacokinetic (PK)–pharmacodynamic analysis of the OCDS variation following baclofen administration was performed. Demographic data, biological data, and tobacco consumption were tested for their influence on the parameters.ResultsData were modeled with a 1‐compartment model with first‐order absorption and elimination. PK analysis confirms the results of our previous study. An Emax model best‐described the exposure–OCDS relationship. None of the covariates tested was able to improve the fit or decrease intersubject variability. However, 2 subpopulations were defined for the exposure corresponding to half the maximal effect (BE50). The proportion of patients being classified as responders was 38% (95% confidence interval [CI] 7 to 76), the maximal decrease in OCDS (Emax) was 72% (95% CI 25 to 85), and the BE50 was 12.6 (95% CI 0.02 to 74.3) or 4,390 (95% CI 20.4 to 31,800) h mg/l for responders and nonresponders, respectively.ConclusionsWe defined the relationship between baclofen exposure and craving in patients with alcohol use disorder. Baclofen treatment decreased craving in all patients. However, we drew up the hypothesis of 2 subpopulations of patients differentiated by their speed of response. A wide interindividual variability in response was depicted, making it currently impossible to predict which group a patient will belong to.
Necrotizing fasciitis: 11‐year retrospective case review in South Auckland
Authors: Kulasegaran Suheelan , Cribb Benjamin , Vandal Alain C. , McBride Stephen , Holland David , MacCormick Andrew D. 
Published: July 2015

AbstractBackgroundThe aims of this paper were to review our experience with necrotizing fasciitis at Middlemore Hospital and to define the trends in incidence, inpatient mortality and microbiological profile.MethodsA computerized search of the electronic medical records was undertaken to identify adult patients with a diagnosis of necrotizing fasciitis between January 2000 and December 2010. A retrospective review of the clinical records was performed.ResultsOf the 138 patients with necrotizing fasciitis identified, 129 had their diagnosis confirmed at operation. The mortality at 30 days was 20.3% (95% confidence interval (CI) 13.9%–28.0%). There was a significant reduction in hospital mortality in each successive year of the study period with an odds ratio of 0.84 (95% CI 0.71–0.98, P = 0.03). A pattern of increasing incidence was noted until February 2004 (95% CI September 2002–July 2005). This was followed by a significant decrease in incidence. The empirical antibiotic regime of clindamycin, gentamicin and penicillin provides satisfactory cover against 95% of the causative pathogens.ConclusionThis represents the largest single‐centre published case series in New Zealand. Despite concerns of increasing incidence and mortality associated with necrotizing fasciitis in New Zealand, the experience in South Auckland shows a decrease in incidence of necrotizing fasciitis since 2004 and a statistically significant decreasing trend in hospital mortality.
Changes in the approach to acute diverticulitis
Authors: Jaung Rebekah , Robertson Jason , Vather Ryash , Rowbotham David , Bissett Ian P. 
Published: July 2015

AbstractAcute diverticulitis (AD) is one of the most common acute admission diagnoses for general surgery, and its prevalence is increasing, in part due to the ageing population. Currently, most patients who present to a tertiary hospital are admitted for a period of treatment and observation. Simple, safe and cost‐effective strategies for improving our current treatment of this condition will be invaluable in providing the most appropriate management for individual patients and for reducing the health resources expended on hospital admissions and parenteral antibiotics. AD can be categorized as uncomplicated or complicated, these two subtypes have a very different clinical course. The management of uncomplicated AD has become increasingly conservative, with a focus on symptomatic relief and supportive management. Recent research has brought into question the need for extended hospital admission and questioned the current use of antibiotics. Anti‐inflammatory agents that reduce local inflammation in uncomplicated AD may be a useful means of reducing damage caused by inflammation and aiding earlier resolution of the inflammatory response and associated symptoms. Mesalazine is an anti‐inflammatory agent that has been trialled in uncomplicated AD. Mesalazine has been shown to improve time to resolution of endoscopic and histological evidence of inflammation following an episode of AD and also reduce the rate of recurrence. In this literature review, we provide an overview of recent advances in AD classification, pathophysiology and management, and examine the possibility of introducing the use of anti‐inflammatory agents in the management of uncomplicated AD.
Impact of introduction of an acute surgical unit on management and outcomes of small bowel obstruction
Authors: Musiienko Anton M. , Shakerian Rose , Gorelik Alexandra , Thomson Benjamin N. J. , Skandarajah Anita R. 
Published: July 2015

AbstractBackgroundThe acute surgical unit (ASU) is a recently established model of care in Australasia and worldwide. Limited data are available regarding its effect on the management of small bowel obstruction. We compared the management of small bowel obstruction before and after introduction of ASU at a major tertiary referral centre. We hypothesized that introduction of ASU would correlate with improved patient outcomes.MethodsA retrospective review of prospectively maintained databases was performed over two separate 2‐year periods, before and after the introduction of ASU. Data collected included demographics, co‐morbidity status, use of water‐soluble contrast agent and computed tomography. Outcome measures included surgical intervention, time to surgery, hospital length of stay, complications, 30‐day readmissions, use of total parenteral nutrition, intensive care unit admissions and overall mortality.ResultsTotal emergency admissions to the ASU increased from 2640 to 4575 between the two time periods. A total of 481 cases were identified (225 prior and 256 after introduction of ASU). Mortality decreased from 5.8% to 2.0% (P = 0.03), which remained significant after controlling for confounders with multivariate analysis (odds ratio = 0.24, 95% confidence interval 0.08–0.73, P = 0.012). The proportion of surgically managed patients increased (20.9% versus 32.0%, P = 0.003) and more operations were performed within 5 days from presentation (76.6% versus 91.5%, P = 0.02). Fewer patients received water‐soluble contrast agent (27.1% versus 18.4%, P = 0.02), but more patients were investigated with a computed tomography (70.7% versus 79.7%, P = 0.02).ConclusionThe ASU model of care resulted in decreased mortality, shorter time to intervention and increased surgical management. Overall complications rate and length of stay did not change.
Feeding Solanum glaucophyllum to preparturient multiparous cows prevents postparturient hypocalcemia
Authors: Ishii Junichiro , Uramoto Akifumi , Nagao Yoshikazu , Goto Hisaya 
Published: July 2015

AbstractSolanum glaucophyllum (SG) contains 1,25‐dihydroxyvitamin D3 (1,25‐(OH)2D3) glycosides. We investigated the effect of SG on hypocalcemia in cows. Serum levels of 1,25‐(OH)2D3, total calcium and phosphorus dose‐relatedly increased after feeding with SG, while serum magnesium and chloride levels fell (P < 0.05). We also performed an ethylenediaminetetraacetic acid (EDTA) infusion to induce artificial hypocalcemia. Cows that had been fed 4.0 mg/kg body weight of SG daily for 2 weeks had a higher serum concentration of total calcium at the end of EDTA infusion than those not fed SG (P < 0.05). In a field trial, multiparous cows were assigned to one of four groups: (1) no SG, (2) 1.3 g or (3) 2.6 g of SG daily from 14 days before the estimated calving day until 3 days after calving, or (4) a single feed of 35.75 g SG at 3 days before the estimated calving day. The concentrations of serum total calcium after the calving in each treatment group were (1) 7.4, (2) 7.9, (3) 8.0 and (4) 8.9 mg/dL and higher for (4) than for (1) (P < 0.05). The data suggests that feeding a high dose of SG before the calving may maintain higher concentrations of serum calcium after the calving.
Distinctive genotypes in infants with T‐cell acute lymphoblastic leukaemia
Authors: Mansur Marcela B. , van Delft Frederik W. , Colman Susan M. , Furness Caroline L. , Gibson Jane , Emerenciano Mariana , Kempski Helena , Clappier Emmanuelle , Cave Hélène , Soulier Jean , Pombo‐de‐Oliveira Maria S. , Greaves Mel , Ford Anthony M. 
Published: July 2015

SummaryInfant T‐cell acute lymphoblastic leukaemia (iT‐ALL) is a very rare and poorly defined entity with a poor prognosis. We assembled a unique series of 13 infants with T‐ALL, which allowed us to identify genotypic abnormalities and to investigate prenatal origins. Matched samples (diagnosis/remission) were analysed by single nucleotide polymorphism‐array to identify genomic losses and gains. In three cases, we identified a recurrent somatic deletion on chromosome 3. These losses result in the complete deletion of MLF1 and have not previously been described in T‐ALL. We observed two cases with an 11p13 deletion (LMO2‐related), one of which also harboured a deletion of RB1. Another case presented a large 11q14·1‐11q23·2 deletion that included ATM and only five patients (38%) showed deletions of CDKN2A/B. Four cases showed NOTCH1 mutations; in one case FBXW7 was the sole mutation and three cases showed alterations in PTEN. KMT2A rearrangements (KMT2A‐r) were detected in three out of 13 cases. For three patients, mutations and copy number alterations (including deletion of PTEN) could be backtracked to birth using neonatal blood spot DNA, demonstrating an in utero origin. Overall, our data indicates that iT‐ALL has a diverse but distinctive profile of genotypic abnormalities when compared to T‐ALL in older children and adults.
Gleason score 5 + 3 = 8 prostate cancer: much more like Gleason score 9?
Authors: Mahal Brandon A. , Muralidhar Vinayak , Chen Yu‐Wei , Choueiri Toni K. , Hoffman Karen E. , Hu Jim C. , Sweeney Christopher J. , Yu James B. , Feng Felix Y. , Trinh Quoc‐Dien , Nguyen Paul L. 
Published: July 2015

ObjectiveTo determine whether patients with Gleason score 5 + 3 = 8 prostate cancer have outcomes more similar to other patients with Gleason score 8 disease or to patients with Gleason score 9 disease.Patients and MethodsThe Surveillance, Epidemiology and End Results (SEER) database was used to study 40 533 men diagnosed with N0M0 Gleason score 8 or 9 prostate cancer from 2004 to 2011. Using Gleason score 4 + 4 = 8 as the referent, Fine and Gray competing risks regression analyses modelled the association between Gleason score and prostate cancer‐specific mortality (PCSM).ResultsThe 5‐year PCSM rates for patients with Gleason score 4 + 4 = 8, 3 + 5 = 8, 5 + 3 = 8, and 9 disease were 6.3%, 6.6%, 13.5%, and 13.9%, respectively (P < 0.001). Patients with Gleason score 5 + 3 = 8 or 9 disease had up to a two‐fold increased risk of PCSM (adjusted hazard ratio [AHR] 1.89, 95% confidence interval [CI] 1.50–2.38, P < 0.001; and AHR 2.17, 95% CI 1.99–2.36, P < 0.001, respectively) compared with the referent group of patients (Gleason score 4 + 4 = 8). There was no difference in PCSM between patients with Gleason score 5 + 3 = 8 vs 9 disease (P = 0.25).ConclusionsGleason score 8 disease represents a heterogeneous entity with PCSM outcomes distinguishable by the primary Gleason pattern. The PCSM of Gleason score 3 + 5 = 8 and Gleason 4 + 4 = 8 disease are similar, but patients with Gleason score 5 + 3 = 8 have a risk of PCSM that is twice as high as other patients with Gleason score 8 disease and should be considered to have a similar poor prognosis as patients with Gleason score 9 disease. Such patients should be allowed onto trials seeking the highest‐risk patients in which to test novel aggressive treatment strategies.
A New Targeted Model of Experimental Autoimmune Encephalomyelitis in the Common Marmoset
Authors: Stassart Ruth Martha , Helms Gunther , Garea‐Rodríguez Enrique , Nessler Stefan , Hayardeny Liat , Wegner Christiane , Schlumbohm Christina , Fuchs Eberhard , Brück Wolfgang 
Published: July 2015

AbstractMultiple sclerosis (MS) is the most common cause for sustained disability in young adults, yet treatment options remain very limited. Although numerous therapeutic approaches have been effective in rodent models of experimental autoimmune encephalomyelitis (EAE), only few proved to be beneficial in patients with MS. Hence, there is a strong need for more predictive animal models. Within the past decade, EAE in the common marmoset evolved as a potent, alternative model for MS, with immunological and pathological features resembling more closely the human disease. However, an often very rapid and severe disease course hampers its implementation for systematic testing of new treatment strategies. We here developed a new focal model of EAE in the common marmoset, induced by myelin oligodendrocyte glycoprotein (MOG) immunization and stereotactic injections of proinflammatory cytokines. At the injection site of cytokines, confluent inflammatory demyelinating lesions developed that strongly resembled human MS lesions. In a proof‐of‐principle treatment study with the immunomodulatory compound laquinimod, we demonstrate that targeted EAE in marmosets provides a promising and valid tool for preclinical experimental treatment trials in MS research.
Incidence of adrenal crisis in patients with adrenal insufficiency
Authors: Smans Lisanne C.C.J. , Van der Valk Eline S. , Hermus Ad R.M.M. , Zelissen Pierre M.J. 
Published: July 2015

SummaryBackgroundAn adrenal crisis (AC) is a potential life‐threatening event in patients with adrenal insufficiency (AI). This study aims to determine the incidence, causes, and risk factors of AC in AI.MethodsPatients with AI diagnosed and treated at the University Medical Center Utrecht for the past 30 years were identified, and all medical records were assessed by two independent investigators. The observed frequency of AC was determined as incidence rate, calculated as the number of AC divided by person‐years (PY). In addition, precipitating factors and risk factors were assessed.ResultsWe observed an incidence rate of 5·2 AC (95% CI 4·3–6·3) per 100 PY in primary adrenal insufficiency (PAI, a total of 111 patients), and 3·6 AC (95% CI 3·1–4·1) per 100 PY in secondary adrenal insufficiency (SAI a total of 319 patients). Patients with an established diagnosis of tertiary (glucocorticoid‐induced) adrenal insufficiency (a total of 28 patients) had 15·1 AC (95% CI 11·0–19·9) per 100 PY. The most important risk factor was the existence of comorbidity. Gastro‐enteritis and other infections were the most common precipitating factors for AC.ConclusionAC still occurs relatively frequent in patients with AI, mostly precipitated by infections and particularly in patients with high comorbidity. This should be taken into account in the education and follow‐up of patients with AI.
Effects of wind‐energy facilities on breeding grassland bird distributions
Authors: Shaffer Jill A. , Buhl Deborah A. 
Published: July 2015

AbstractThe contribution of renewable energy to meet worldwide demand continues to grow. Wind energy is one of the fastest growing renewable sectors, but new wind facilities are often placed in prime wildlife habitat. Long‐term studies that incorporate a rigorous statistical design to evaluate the effects of wind facilities on wildlife are rare. We conducted a before‐after‐control‐impact (BACI) assessment to determine if wind facilities placed in native mixed‐grass prairies displaced breeding grassland birds. During 2003–2012, we monitored changes in bird density in 3 study areas in North Dakota and South Dakota (U.S.A.). We examined whether displacement or attraction occurred 1 year after construction (immediate effect) and the average displacement or attraction 2–5 years after construction (delayed effect). We tested for these effects overall and within distance bands of 100, 200, 300, and >300 m from turbines. We observed displacement for 7 of 9 species. One species was unaffected by wind facilities and one species exhibited attraction. Displacement and attraction generally occurred within 100 m and often extended up to 300 m. In a few instances, displacement extended beyond 300 m. Displacement and attraction occurred 1 year after construction and persisted at least 5 years. Our research provides a framework for applying a BACI design to displacement studies and highlights the erroneous conclusions that can be made without the benefit of adopting such a design. More broadly, species‐specific behaviors can be used to inform management decisions about turbine placement and the potential impact to individual species. Additionally, the avoidance distance metrics we estimated can facilitate future development of models evaluating impacts of wind facilities under differing land‐use scenarios.