bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical characteristics according to depression screening tools in patients with Alzheimer's disease: View from self, caregiver‐reported and drug‐intervention pattern
Authors: Kwak Yong Tae , Yang YoungSoon , Pyo Seon Jong , Koo Min‐Seong 
Published: October 2013

AimDepression in Alzheimer's disease (AD) has different clinical manifestations from primary depression of non‐demented patients. We designed the present study to explore the following: (i) to determine the clinical characteristics of patients with and without depression according to observational and subjective depression screening scale; and (ii) to examine the depression prevalence rate in patients with AD according to these criteria.MethodsThe Geriatric Depression Scale (GDS, observational scale) and Neuropsychiatry Inventory Depression subscale (NPI‐D; subjective scale) were administered to 257 patients with drug‐naïve probable AD. The study groups were classified into the three subgroups of “no‐depression”, GDS depression and NPI‐DS (NPI‐D significant) depression group, and the clinical characteristics of these subgroups were examined.ResultsThe NPI‐DS depression group showed lower scores on the Korean version of the Mini‐Mental State Examination compared with the no‐depression group, and higher NPI subdomain scores compared with other groups. The GDS depression group showed higher NPI motor subdomain scores compared with the no‐depression group. Depression defined by NPI‐DS was the least frequent (10.5%), and NPI‐DA (NPI‐D any) was the most frequent (56.4%). The prevalence of depression defined by GDS and anti‐depressant usage was 30.0% and 16.0% each. The level of agreement between the screening tools determined through the kappa index was from low to moderate.ConclusionsThe present study showed that different depression screening tools revealed a different prevalence and poor concordance rate among depression screening tools. Considering lower cognitive functions and higher BPSD symptoms in the NPI‐DS depression group, NPI‐DS could be associated with disease severity in AD patients. However, the clinical significance of GDS remains uncertain. Geriatr Gerontol Int 2014; 14: 660–666.
Evaluation of nail fold capillaroscopy findings in patients with primary biliary cirrhosis
Authors: Monoe Kyoko , Takahashi Atsushi , Abe Kazumichi , Kanno Yukiko , Watanabe Hiroshi , Ohira Hiromasa 
Published: October 2013

AimSome patients with primary biliary cirrhosis (PBC) experience Raynaud's phenomenon. The objective of this study was to clarify the relationships between nail fold capillaroscopy findings and clinical presentations of PBC.MethodsA total of 70 patients with PBC and 57 patients with non‐PBC liver diseases, including 44 patients with chronic viral hepatic disease, eight with autoimmune hepatitis and five with non‐alcoholic fatty liver disease, were included in this study. Nail fold capillaroscopy findings were classified as normal or abnormal and were further graded as mild, moderate or severe, and the relationships between frequency of abnormal blood vessel and their clinical presentations were examined.ResultsThe frequency of abnormal nail fold capillaroscopy findings was significantly higher in PBC patients (54.3%) than in patients with non‐PBC liver disease (13.8%) (P < 0.01). These abnormal findings observed in PBC patients were graded as mild in 15 patients, moderate in 18 patients and severe in five patients. Significantly more PBC patients with abnormal capillaroscopy findings (19/38, 50%) were positive for anticentromere antibody than were those with normal capillaroscopy findings (3/32, 9.4%) (P < 0.01).ConclusionPBC patients had significantly higher frequency of abnormal nail fold capillaroscopy findings than did patients with non‐PBC liver disease.
Enhancing health‐care workers' understanding and thinking about people living with co‐occurring mental health and substance use issues through consumer‐led training
Authors: Roussy Véronique , Thomacos Nikos , Rudd Annette , Crockett Belinda 
Published: October 2013

AbstractBackgroundStigma and judgemental assumptions by health workers have been identified as key barriers to accessing health care for people living with co‐occurring mental health and substance use issues (dual diagnosis).ObjectiveTo evaluate the effectiveness of consumer‐led training by people with dual diagnosis in improving the knowledge, understanding and role adequacy of community health staff to work with this consumer group.MethodsA controlled before‐and‐after study design with four waves of quantitative data collection was used. Qualitative data were collected to explore participants' views about training. Participants were staff from two community health services from Victoria, Australia. Recruitment occurred across various work areas: reception, oral health, allied health, counselling and health promotion. At baseline, all participants attended a 4‐h clinician‐led training session. The intervention consisted of a 3‐h consumer‐led training session, developed and delivered by seven individuals living with dual diagnosis. Outcome measures included understanding of dual diagnosis, participants' feelings of role adequacy and role legitimacy, personal views, and training outcomes and relevance.ResultsConsumer‐led training was associated with a significant increase in understanding. The combination of clinician‐led and consumer‐led training was associated with a positive change in role adequacy.ConclusionsConsumer‐led training is a promising approach to enhance primary health‐care workers' understanding of the issues faced by dual‐diagnosis consumers, with such positive effects persisting over time. Used alongside other organizational capacity building strategies, consumer‐led training has the potential to help address stigma and judgemental attitudes by health workers and improve access to services for this consumer group.
Decision‐making process of prenatal screening described by pregnant women and their partners
Authors: Wätterbjörk Inger , Blomberg Karin , Nilsson Kerstin , Sahlberg‐Blom Eva 
Published: October 2013

AbstractBackgroundPregnant women are often faced with having to decide about prenatal screening for Down's syndrome. However, the decision to participate in or refrain from prenatal screening can be seen as an important decision not only for the pregnant woman but also for both the partners.ObjectiveThe aim of this study was to explore the couples' processes of decision making about prenatal screening.MethodsA total of 37 semi‐structured interviews conducted at two time points were analysed using the interpretive description.SettingThe study was carried out in Maternal health‐care centres, Örebro County Council, Sweden.ParticipantsFifteen couples of different ages and with different experiences of pregnancy and childbirth were interviewed.ResultsThree different patterns of decision making were identified. For the couples in ‘The open and communicative decision‐making process’, the process was straightforward and rational, and the couples discussed the decision with each other. ‘The closed and personal decision‐making process’ showed an immediate and non‐communicative decision making where the couples decided each for themselves. The couples showing ‘The searching and communicative decision‐making process’ followed an arduous road in deciding whether to participate or not in prenatal screening and how to cope with the result.ConclusionsThe decision‐making process was for some couples a fairly straightforward decision, while for others it was a more complex process that required a great deal of consideration.
Patients’ views of teamwork in the emergency department offer insights about team performance
Authors: Henry Beverly W. , McCarthy Danielle M. , Nannicelli Anna P. , Seivert Nicholas P. , Vozenilek John A. 
Published: October 2013

AbstractBackgroundResearch into efforts to engage patients in the assessment of health‐care teams is limited.ObjectiveTo explore, through qualitative methods, patient awareness of teamwork‐related behaviours observed during an emergency department (ED) visit.DesignResearchers used semi‐structured question guides for audio‐recorded interviews and analysed their verbatim transcripts.Setting and participantsResearchers conducted individual phone interviews with 6 teamwork subject matter experts (SMEs) and held 5 face‐to‐face group interviews with patients and caregivers (n = 25) about 2 weeks after discharge from the emergency department (ED).ResultsSMEs suggested that a range of factors influence patient perspectives of teams. Many patients perceived the health‐care team within the context of their expectations of an ED visit and their treatment plan. Four themes emerged: (i) patient‐centred views highlight gaps in coordination and communication; (ii) team processes do concern patients; (iii) patients are critical observers of ways that team members present their team roles; (iv) patients’ observations of team members relate to patients’ views of team effectiveness. Analysis also indicated that patients viewed health‐care team members’ interactions with each other as proxy for how team members actually felt about patients.DiscussionResults from both sets of interviews (SME and patient) indicated that patient observations of teamwork could add to assessment of team processes/frameworks. Patients’ understanding about teamwork organization seemed helpful and witnessed interteam communication appeared to influence patient confidence in the team.ConclusionPatients perspectives are an important part of assessment in health care and suggest potential areas for improvement through team training.
Stromal expression of neutrophil gelatinase‐associated lipocalin correlates with poor differentiation and adverse prognosis in oral squamous cell carcinoma
Authors: Shinriki Satoru , Jono Hirofumi , Ueda Mitsuharu , Obayashi Konen , Nakamura Takuya , Ota Kazutoshi , Ota Tomoko , Sueyoshi Takanao , Guo Jianying , Hayashi Mitsuhiro , Hiraki Akimitsu , Nakayama Hideki , Yamashita Satoshi , Shinohara Masanori , Ando Yukio 
Published: October 2013

AimsNeutrophil gelatinase‐associated lipocalin (NGAL) is a member of the lipocalin superfamily. Although its overexpression in various cancers has been reported, little is known about its expression and clinical significance in oral squamous cell carcinoma (OSCC). This study aimed to elucidate the clinical significance of NGAL in OSCC.Methods and resultsWe investigated NGAL expression immunohistochemically in tumour cells and stromal cells in 96 OSCC tissues. NGAL expression in tumour cells correlated significantly with histological tumour cell differentiation, as shown by its specific distribution in the horn pearl‐forming keratinized tumour cells, but not with other major clinicopathological parameters. We found NGAL+ cells in the stroma that were predominantly myeloperoxidase‐positive neutrophils. The number of such NGAL‐expressing stromal cells was associated significantly with poor differentiation and reduced overall survival in OSCC. The prognostic value of stromal NGAL expression was significant in a univariate analysis, while only a trend was found in multivariate analyses.ConclusionsThis study is the first to show the clinical significance of stromal NGAL expression, which may be an indicator of poor prognosis and more aggressive histological grade in OSCC. Our data suggest that NGAL expression in tumour cells and expression in stroma are associated in different ways with OSCC differentiation.
Expression and prognostic significance of fibronectin and matrix metalloproteases in breast cancer metastasis
Authors: Fernandez‐Garcia Belen , Eiró Noemí , Marín Laura , González‐Reyes Salomé , González Luis O , Lamelas Maria Luz , Vizoso Francisco J 
Published: October 2013

AimsFibronectin (FN) has attracted interest in cancer research, owing to its role in tumour progression. The aims of this study were to investigate the expression and clinical relevance of FN in breast cancer, and to explore its relationship with the expression of matrix metalloproteases (MMPs) and their inhibitors (TIMPs).Methods and resultsAn immunohistochemical study was performed using tumours from 110 breast cancer patients, with tissue arrays and specific antibodies against FN, MMP‐7, MMP‐9, MMP‐11, TIMP‐1, and TIMP‐2. The results indicated that FN expression was related to tumour size, histological grade, and MMP‐9 expression. Tumours with high FN expression by tumour cells were significantly associated with a higher probability of metastasis, poorer overall survival, and expression of MMP‐7, MMP‐9, MMP‐11, TIMP‐1 and TIMP‐2 by mononuclear inflammatory cells (MICs). In addition, the combination of FN expression by tumour cells and MMP‐11 by MICs was strongly associated with distant metastasis development.ConclusionsBreast carcinomas with distant metastasis frequently have tumour cells expressing intracellular FN. There is a strong association between FN expression by tumour cells and MMP or TIMP expression by stromal MICs, and this may represent crosstalk that is of prognostic relevance in breast cancer.
Decorin and biglycan immunolocalization in non‐villous structures of healthy and pathological human placentas
Authors: Borbely Alexandre U , Daher Silvia , Ishigai Marcia M , Mattar Rosiane , Sun Sue Y , Knöfler Martin , Bevilacqua Estela , Oliveira Sergio F 
Published: October 2013

AimsDecorin and biglycan are members of the small leucine‐rich proteoglycan family, and constituents of both the extracellular matrix (ECM) and the cell surface. They are recognized as important factors in the control of proliferation, migration and invasion in vivo and in vitro. In this study, the localization patterns of decorin and biglycan were determined in healthy placentas and in highly invasive placental pathologies.Methods and resultsThe study included immunolocalization of decorin and biglycan in samples of first‐trimester and term placentas, placenta accreta, invasive mole, and choriocarcinoma. Extravillous cytotrophoblast (EVT) cells were positive for both proteoglycans in all pathologies and in first‐trimester placentas, although not in term placentas. Biglycan was immunolocalized in the ECM of all healthy and pathological placentas, whereas decorin was observed only in term placenta ECM.ConclusionsThe expression of both proteoglycans was cell‐specific and gestation time‐dependent in healthy placentas, and was associated with invasive EVT cells in pathological placentas. In view of the biological properties of these molecules, it is possible that the biglycan pattern found here is intrinsically implicated in the invasive activity of EVT cells in both healthy and disordered placentas.
BRAF mutation in ‘sarcomas’: a possible method to detect de‐differentiated melanomas
Authors: Cipriani Nicole A , Letovanec Igor , Hornicek Francis J , Mullen John T , Duan Zhenfeng , Borger Darrell R , Nielsen Gunnlaugur Petur 
Published: October 2013

AimsBRAF is mutated in 50–60% of melanomas, but BRAF mutation in sarcomas has not been systematically evaluated. Some melanomas are spindled and may show no immunohistochemical evidence of melanocytic differentiation. Similarly, many sarcomas are undifferentiated, i.e. undifferentiated pleomorphic sarcomas (UPS). Diagnosing melanoma versus sarcoma in an undifferentiated spindle cell malignancy can be challenging. Our aim was to evaluate the prevalence of BRAF mutation in sarcomas and the use of BRAF mutational status in the diagnosis of spindle cell malignancies.Methods and resultsBRAF mutational analysis was performed on tissue from 104 patients: 90 with sarcoma only (50 UPS) and 14 with sarcoma and melanoma (seven UPS). In the sarcoma‐only group, BRAF mutation was absent. In the sarcoma–melanoma group, three sarcomas showed BRAF mutation; all were UPS, occurred after the melanomas and did not stain for melanocytic markers. One melanoma–sarcoma pair showed identical BRAF V600E mutations.ConclusionsThe presence of BRAF mutation in these tumours raises the possibility that poorly differentiated spindle cell malignancies with BRAF mutation may represent melanomas, and BRAF mutational analysis should be considered in a patient with a spindle cell malignancy and a history of melanoma, as a positive result may indicate de‐differentiated melanoma.
Venous invasion in oesophageal adenocarcinoma: enhanced detection using elastic stain and association with adverse histological features and clinical outcomes
Authors: Castonguay Mathieu C , Li‐Chang Hector H , Driman David K 
Published: October 2013

AimsIn oesophageal adenocarcinoma, detection rates of venous invasion using haematoxylin and eosin (H&E) and elastic stains have not been compared. The aims of this study were to investigate whether or not elastic stains facilitate the detection of venous invasion, and to determine the prognostic significance of venous invasion following review with elastic stains.Methods and resultsOne hundred and three resection specimens containing oesophageal adenocarcinoma, all reported originally as negative for venous invasion, were examined for the presence of venous invasion using H&E and subsequently Movat pentachrome stains. Venous invasion was detected in eight cases with H&E and an additional 66 cases using Movat pentachrome; overall, 72% of cases contained venous invasion. Venous invasion was associated with advanced stage, tumour size, lymphatic and perineural invasion and subsequent distant metastases. Venous invasion, stage, size, grade, lymphatic invasion and perineural invasion were prognostically significant on univariate analysis. Only tumour stage was independently prognostic. Two of eight patients with venous invasion but no other indication for adjuvant treatment died of recurrent disease.ConclusionsElastic stains improve detection of venous invasion significantly in oesophageal adenocarcinoma. Venous invasion is associated with multiple adverse clinicopathological features. Its identification may facilitate the stratification of patients at risk for visceral metastases and disease‐related death.
Reciprocal relationship of Tn/NF‐κB and sTn as an indicator of the prognosis of oral squamous cell carcinoma
Authors: Lin Chi‐Yu , Ho Jar‐Yi , Hsieh Meng‐Ti , Chiang Hsiao‐Ling , Chuang Jei‐Min , Whang‐Peng Jacqueline , Chang Yun‐Ching , Tseng Yi‐Han , Chen Su‐Feng , Nieh Shin , Hwang Jaulang 
Published: October 2013

AimsIn order to determine whether the expression of tumour‐associated carbohydrate antigens (Tn/sTn) and a representative inflammation marker, nuclear factor‐κB (NF‐κB), is associated with the invasiveness of oral squamous cell carcinoma (OSCC), this study has attempted to investigate the correlation of the aforementioned markers with the well‐established invasive pattern grading score (IPGS) and clinicopathological parameters.Methods and resultsSpecimens from 143 OSCC patients with classified clinicopathological parameters and IPGS were stained immunohistochemically using anti‐Tn, sTn and NF‐κB antibodies. Our results showed that the expression of both Tn and NF‐κB was correlated positively with staging (P = 0.036; P = 0.015), recurrence (P < 0.001; P < 0.001) and distant metastasis (P = 0.005; P = 0.009), as well as with IPGS, while the expression of sTn was correlated inversely. In addition, poor survival was associated with overexpression of Tn and NF‐κB but not with expression of sTn.ConclusionsOur results indicate that a reciprocal relationship between Tn and sTn expression may serve as a reliable indicator for OSCC prognostic evaluation. In addition, expression of Tn rather than sTn may play an important role in deeply invasive OSCC via regulation of NF‐κB signalling.
Impact of GB virus C viraemia on clinical outcome in HIV‐1‐infected patients: a 20‐year follow‐up study
Authors: Ernst D , Greer M , Akmatova R , Pischke S , Wedemeyer H , Heiken H , Tillmann HL , Schmidt RE , Stoll M 
Published: October 2013

ObjectivesThe impact of coexisting GB virus C (GBV‐C) infection on the clinical course of HIV infection remains controversial. Early data from HIV‐1 infected patients attending the Hannover Medical School in 2001 suggested prognostic benefit in GBV‐C viraemic patients. The aim of this study was to evaluate patterns in long‐term mortality and morbidity outcomes in this cohort. The impact of the introduction of antiretroviral therapy (ART) on the perceived benefits of GBV‐C viraemia was subsequently investigated.MethodsA retrospective follow‐up analysis of data in this cohort was performed. GBV‐C status (GBV‐C RNA positive, antibodies against GBV‐C envelope protein E2 or no evidence of GBV‐C exposure) had been determined at enrolment, with several markers of HIV disease progression (such as viral load and CD4 cell count) being collated from 1993/1994, 2000 and 2012. These eras were chosen to reflect variations in treatment strategies within the cohort. In addition, mortality and HIV‐related morbidity data were collated for all patients.ResultsComplete data were available for 156 of 197 patients (79%). In highly active antiretroviral therapy (HAART)‐naïve patients, GBV‐C RNA positivity conferred significant improvements in the course of HIV infection and mortality as well as lower rates of HIV‐related diseases. E2 positivity alone conferred no significant advantage. With the advent of HAART, however, the benefits GBV‐C RNA positivity disappeared.ConclusionsAlthough GBV‐C coinfection appears to inherently improve morbidity and mortality in HIV‐infected patients, modern HAART has eradicated these advantages. Evidence of synergy between GBV‐C status and HAART response exists, with further studies examining the role of GBV‐C in existing treatment de‐escalation strategies being required.
A comparison of estimated glomerular filtration rates using Cockcroft−Gault and the Chronic Kidney Disease Epidemiology Collaboration estimating equations in HIV infection
Authors: Mocroft A , Ryom L , Reiss P , Furrer H , D'Arminio Monforte A , Gatell J , de Wit S , Beniowski M , Lundgren JD , Kirk O ,   for EuroSIDA in EuroCOORD
Published: October 2013

ObjectivesThe aim of this study was to determine whether the Chronic Kidney Disease Epidemiology Collaboration (CKD‐EPI)‐ or Cockcroft−Gault (CG)‐based estimated glomerular filtration rates (eGFRs) performs better in the cohort setting for predicting moderate/advanced chronic kidney disease (CKD) or end‐stage renal disease (ESRD).MethodsA total of 9521 persons in the EuroSIDA study contributed 133 873 eGFRs. Poisson regression was used to model the incidence of moderate and advanced CKD (confirmed eGFR < 60 and < 30 mL/min/1.73 m2, respectively) or ESRD (fatal/nonfatal) using CG and CKD‐EPI eGFRs.ResultsOf 133 873 eGFR values, the ratio of CG to CKD‐EPI was ≥ 1.1 in 22 092 (16.5%) and the difference between them (CG minus CKD‐EPI) was ≥ 10 mL/min/1.73 m2 in 20 867 (15.6%). Differences between CKD‐EPI and CG were much greater when CG was not standardized for body surface area (BSA). A total of 403 persons developed moderate CKD using CG [incidence 8.9/1000 person‐years of follow‐up (PYFU); 95% confidence interval (CI) 8.0–9.8] and 364 using CKD‐EPI (incidence 7.3/1000 PYFU; 95% CI 6.5–8.0). CG‐derived eGFRs were equal to CKD‐EPI‐derived eGFRs at predicting ESRD (n = 36) and death (n = 565), as measured by the Akaike information criterion. CG‐based moderate and advanced CKDs were associated with ESRD [adjusted incidence rate ratio (aIRR) 7.17; 95% CI 2.65–19.36 and aIRR 23.46; 95% CI 8.54–64.48, respectively], as were CKD‐EPI‐based moderate and advanced CKDs (aIRR 12.41; 95% CI 4.74–32.51 and aIRR 12.44; 95% CI 4.83–32.03, respectively).ConclusionsDifferences between eGFRs using CG adjusted for BSA or CKD‐EPI were modest. In the absence of a gold standard, the two formulae predicted clinical outcomes with equal precision and can be used to estimate GFR in HIV‐positive persons.