bluuebunny/crossref_metadata_2025_split huggingface dataset:
The dilemma of reporting suspicions of child maltreatment in pediatric dentistry
Authors: Kvist Therese , Wickström Anette , Miglis Isabelle , Dahllöf Göran 
Published: July 2014

This study examined the factors that lead specialists in pediatric dentistry to suspect child abuse or neglect and the considerations that influence the decision to report these suspicions to social services. Focus group discussions were used to identify new aspects of child maltreatment suspicion and reporting. Such discussions illuminate the diversity of informants' experiences, opinions, and reflections. Focus groups included 19 specialists and postgraduate students in pediatric dentistry. We conducted video‐recorded focus group discussions at the informants' dental clinics. All sessions lasted approximately 1.5 h. We transcribed the discussions verbatim and studied the transcripts using thematic analysis, a method well‐suited to evaluating the experiences discussed and how the informants understand them. The analysis process elicited key concepts and identified one main theme, which we labeled ‘the dilemma of reporting child maltreatment’. We found this dilemma to pervade a variety of situations and divided it into three sub‐themes: to support or report; differentiating concern for well‐being from maltreatment; and the supportive or unhelpful consultation. Reporting a suspicion about child maltreatment seems to be a clinical and ethical dilemma arising from concerns of having contradicting professional roles, difficulties confirming suspicions of maltreatment, and perceived shortcomings in the child‐protection system.
Effects of potassium sorbate and sodium benzoate at two application rates on fermentation and aerobic stability of maize silage
Authors: Bernardes T. F. , De Oliveira I. L. , Lara M. A. S. , Casagrande D. R. , Ávila C. L. S. , Pereira O. G. 
Published: July 2014

AbstractThis study evaluated two potassium sorbate (PS) and sodium benzoate (SB) application rates in improving the aerobic stability of maize silage. Treatments included no additive, the addition of PS at 1 and 2 g kg−1 fresh matter (FM) and the addition of SB at 1 and 2 g kg−1 FM. Four replicates of each treatment were ensiled in 15‐L plastic jars. The silages were analysed for their fermentative characteristics and were subjected to an aerobic stability test with pH and yeast and mould count measurements. Considering fermentation quality and aerobic stability, both additives were effective. The PS was more active against yeasts during aerobic exposure. When the additives were applied at 2 g kg−1, the silages were more stable (256 h, on average) than those with 1 g kg−1 (119 h, on average) and control (61 h). Aerobic deterioration was more pronounced in the controls than in the treated silages. Silages treated at 2 g kg−1 had consistent effects on pH values and yeast counts over 288 h of aerobiosis. Overall, PS and SB applied at 2 g kg−1 were more effective in improving aerobic stability.
Liver stiffness measured by acoustic radiation force impulse elastography reflects the severity of liver damage and prognosis in patients with acute liver failure
Authors: Kuroda Hidekatsu , Kakisaka Keisuke , Oikawa Takayoshi , Onodera Mio , Miyamoto Yasuhiro , Sawara Kei , Endo Ryujin , Suzuki Kazuyuki , Takikawa Yasuhiro 
Published: July 2014

AimWe measured liver stiffness (LS) in patients with acute liver failure (ALF) using acoustic radiation force impulse (ARFI) elastography and investigated the usefulness of measuring LS for predicting the prognosis of ALF patients.MethodsFrom April 2010 to December 2013, we evaluated 63 patients with acute liver disease. The subjects included 41 patients with acute hepatitis (AH), 16 patients with severe AH (SAH), who had no hepatic encephalopathy despite plasma prothrombin time of 40% or less, and six patients with fulminant hepatitis (FH) diagnosed according to the criteria of the Japanese Study Group. The relationships among shear wave velocity (SWV), clinical diagnosis, liver function tests and prognosis were evaluated. Receiver–operator curve (ROC) analysis was performed to investigate whether ARFI elastography exhibits potential usefulness for the prediction of FH.ResultsThe mean SWV on admission were 1.98 ± 0.55, 2.61 ± 0.58 and 3.66 ± 0.86 m/s in the AH, SAH and FH groups, respectively. The SWV was significantly higher in the FH group than in the other groups (P < 0.001), and in the SAH group than in the AH group (P = 0.002). The area under the ROC for predicting FH was 0.924 (sensitivity, 83.3%; specificity, 93.0%). The SWV was significantly increased in non‐survivors, while remaining decreased in survivors (P = 0.002).ConclusionThe SWV measured by ARFI elastography reflects severity of liver damage, and serial changes in SWV predict the prognosis of ALF patients. The SWV is an early and precise biomarker of FH.
Skin photoprotection and consumption of coffee and polyphenols in healthy middle‐aged Japanese females
Authors: Fukushima Yoichi , Takahashi Yoshinari , Hori Yusuke , Kishimoto Yoshimi , Shiga Kaedeko , Tanaka Yuiko , Masunaga Erika , Tani Mariko , Yokoyama Mihoko , Kondo Kazuo 
Published: July 2014

AbstractBackgroundReactive oxygen species are known to mediate skin photoaging, which results in the formation of pigmented spots and wrinkles. Coffee is the largest source of polyphenols, which supplies a large number of antioxidants in one's daily life. However, little is known about how much coffee and polyphenol consumption influences skin health. In this study, a cross‐sectional survey of the diet, environmental factors, and skin conditions was conducted in healthy Japanese females to explore the influence of coffee and polyphenol consumption on skin conditions.Materials and methodsNon‐smoking, healthy female subjects with moderate sun exposure in their daily lives were recruited for this study (n = 131, age range: 30–60 years old) and recorded their food and beverage intake and life circumstances using questionnaires. The skin water content, transepidermal water loss, and elasticity were measured on the cheek of each subject using non‐invasive methods: a Corneometer, a Tewameter, and a Cutometer, respectively. Wrinkles and pigmented spots were evaluated using digital photograph images.ResultsConsumption of coffee and total polyphenols from all sources and from coffee showed a statistically significant correlation towards a decrease in pigmented spot scores (P < 0.05). Subjects with high total polyphenol consumption from coffee or chlorogenic acids (the third tertile group) showed the lowest score of ultraviolet pigmented spots (P < 0.05).ConclusionCoffee and polyphenol consumption was associated with low facial pigmented spots in Japanese middle‐aged females. We speculated that coffee helps protect human skin from photoaging, and polyphenols, including chlorogenic acids, may contribute to the decreased hyperpigmentation of pigmented spots.
A comparison of a 5% potassium hydroxide solution with a 5‐fluorouracil and salicylic acid combination in the treatment of patients with anogenital warts: a randomized, open‐label clinical trial
Authors: Işik Selda , Koca Rafet , Sarici Gülben , Altinyazar Hilmi Cevdet 
Published: July 2014

AbstractAnogenital warts are caused by human papillomavirus (HPV), over 30 types of which are infectious for the anogenital tract. Without treatment, warts may regress spontaneously, remain unchanged, or increase in number and size. This study compared the efficacy of a topical 5% potassium hydroxide (KOH) solution with that of a topical 0.5% 5‐fluorouracil (5‐FU) and 10% salicylic acid (SA) combination in the treatment of anogenital warts. Sixty patients were randomly assigned to receive topical KOH or 5‐FU + SA. Both groups demonstrated a significant decrease in numbers of lesions (P < 0.05), but this difference was not significant at week 12 (P > 0.05). The mean number of lesions decreased from baseline to week 12 from 17.03 ± 12.64 to 3.73 ± 7.30 and from 16.13 ± 12.97 to 3.10 ± 4.90 in the KOH and 5‐FU + SA groups, respectively (P < 0.001). Excellent clearance was achieved by 70.0 and 76.7% of patients in the KOH and 5‐FU + SA groups, respectively. Marked improvement was seen in 13.3 and 20.0% of patients in the KOH and 5‐FU + SA groups, respectively. At week 16, relapse was observed in two patients in the KOH group and three in the 5‐FU + SA group (P > 0.05). No serious adverse events were reported. Neither treatment was more efficacious. Safety and ease of application are important goals in treatments for anogenital warts. A 5% KOH solution is a promising alternative treatment because it is effective and inexpensive and causes minimal side effects.
Eosinophilic folliculitis occurring after stem cell transplant for acute lymphoblastic leukemia: a case report and review
Authors: Zitelli Kristine , Fernandes Neil , Adams Brian B. 
Published: July 2014

AbstractBackgroundEosinophilic folliculitis (EF) comprises classic eosinophilic pustular folliculitis (EPF), human immunodeficiency virus (HIV)‐related EF, and infantile EPF subtypes. A fourth proposed subtype describes EF associated with hematologic malignancy. Recently, EF has occurred after bone marrow or stem cell transplantation (SCT).ObjectivesWe report a unique case of EF after haploidentical allogeneic SCT for acute lymphoblastic leukemia (ALL) and review the literature for similar cases.MethodsA 56‐year‐old, HIV‐negative ALL patient presented with an intensely pruritic papulopustular eruption. He had undergone haploidentical allogeneic SCT 65 days earlier, which he had tolerated well. Histopathology revealed a moderately dense perifollicular and perivascular lymphocytic infiltrate with many eosinophils extending from the superficial dermis to the subcutaneous fat. Fungal stains were negative. These findings were highly consistent with EF.ResultsTherapy with a class II topical corticosteroid ointment, oral doxepin, and emollients achieved near‐resolution of the lesions within eight weeks. Transition to topical tacrolimus 0.1% ointment applied twice daily to residual lesions yielded complete clearance by 12 weeks with mild post‐inflammatory hyperpigmentation. The patient's ALL remains in remission.ConclusionsA fourth proposed subtype of EF is associated with HIV‐negative hematologic disease. This subtype is distinguished by a predictable timeframe to presentation and a relatively rapid response to therapy. Although EF is an important consideration in all patients with hematologic malignancy, clinically heightened suspicion is warranted during the 2–3 months after transplant.
Cholestatic hepatic injury associated with vismodegib, aspirin, and naproxen use: a case study and review of vismodegib safety
Authors: Ash Mark M. , Jolly Puneet S. 
Published: July 2014

AbstractBackgroundVismodegib is a novel hedgehog pathway inhibitor approved to treat advanced and metastatic basal cell carcinoma (BCC) in the United States. Several studies have demonstrated efficacy for treatment of new and existing BCC in both basal cell nevus syndrome (BCNS) and non‐BCNS patients. However, severe and numerous adverse events are associated with vismodegib use. Therefore, we have also examined all of the currently published clinical trials and tabulated the available adverse events for review. The most frequently reported adverse events include muscle spasms (53.4%), dysgeusia/ageusia (49.3%), alopecia (38.8%), fatigue (32.0%), nausea (28.4%), weight loss (24.2%), and decreased appetite (16.5%).Case StudyWe report a case of a previously healthy 72‐year‐old male with a history of innumerable BCCs who developed severe nausea, jaundice, and cholestasis with significantly elevated BUN, creatinine, and liver enzymes one month after starting vismodegib. The patient began using over‐the‐counter nonsteroidal anti‐inflammatory drugs (NSAIDs) to treat severe, vismodegib‐induced myalgia. No other new medications were started. Our patient had no history of liver disease.ConclusionsHerein, we describe a potential serious adverse effect associated with vismodegib use. Whether the illness is directly attributable to the medication or the result of drug‐drug interactions between vismodegib and NSAIDs, practitioners should be aware of the possibility of hepatic injury in patients on vismodegib. Furthermore, patients need to be informed of the potential risks of vismodegib and should be monitored closely to ensure that life‐threatening complications of treatment are avoided.
Titanium mesh in the reconstruction of a malar defect: a case report
Authors: Massa António Fernandes , Otero‐Rivas Mercedes , Rodríguez‐Prieto Manuel Ángel 
Published: July 2014

AbstractBackgroundIncreasing rates of non‐melanoma skin cancer support the use of prosthetic materials for the closure of post‐surgical defects with cartilage or bone involvement. The use of allografts, especially titanium, is well established in maxillofacial procedures but is uncommon in dermatologic surgery.MethodsA 92‐year‐old man presented with a basal cell carcinoma measuring 2×3 cm on the right cheek. Computed tomography showed infiltration of the anterior maxillary sinus wall. The tumor was excised under general anesthesia. The final defect comprised skin, muscle, the central portion of the maxillary bone and part of the maxillary sinus mucous. The defect was closed with titanium mesh and covered with a rotation flap from the right cheek. The secondary defect created by the preauricular rotation was closed with a free skin graft from the supraclavicular area.ResultsThe use of titanium mesh enabled satisfactory esthetic and functional results to be achieved safely and quickly.ConclusionsTitanium mesh facilitates the repair of large defects and avoids the second intervention and increased risk for infection associated with bone grafting. Reconstruction with titanium mesh is considered a valuable technique in post‐trauma fractures and post‐oncologic defects but remains underused in dermatologic surgery. The present experience supports its use as a reliable option in bone replacement.
Clinical and experimental assessment of the effects of a new topical treatment with praziquantel in the management of rosacea
Authors: Bribeche Mohamed Ridha , Fedotov Valery P. , Gladichev Vitaly V. , Pukhalskaya Daria M. , Kolitcheva Natalia L. 
Published: July 2014

AbstractBackgroundRosacea is a common, chronic, and inflammatory skin disease. The burden imposed by this condition requires that new topical treatments be sought to enlarge the arsenal of drugs available in order to better manage this disease.ObjectivesThis study was conducted to carry out an in vitro/in vivo evaluation of the antimicrobial activity of 3% praziquantel (PZQ) ointment and to determine its efficacy and safety in the treatment of rosacea.MethodsPatients with rosacea (n = 65) participated in a 16‐week, randomized, single‐blind pilot study of the effects of twice‐daily monotherapy with 3% PZQ ointment vs. placebo (vehicle ointment). Efficacy was assessed clinically using the Investigator's Global Assessment Scale (IGAS) and the Clinical Erythema Assessment Scale (CEAS). Patients’ quality of life was also determined using the Dermatology Life Quality Index (DLQI). The antimicrobial potential of 3% PZQ ointment was assessed by agar diffusion assay.ResultsScores on the IGAS and CEAS showed PZQ ointment to have a statistically significant therapeutic advantage over the placebo treatment (P < 0.001). At week 16, the PZQ group demonstrated a statistically significant greater reduction in CEAS score than the placebo group (P < 0.001). Analysis of CEAS scores showed that 41.9% of patients in the PZQ group and 18.2% of those in the placebo group achieved a CEAS score equivalent to a rating of “none”. Mean scores on the DLQI at baseline and at the end of the study were, respectively, 15.8 and 4.1 in the praziquantel group. The PZQ‐treated group also experienced a statistically significant improvement in comparison with the placebo group at week 16 (P < 0.001). The inhibitory zone indicating the extent of antimicrobial activity of 3% PZQ ointment ranged from 6 mm to 17 mm. No serious treatment‐related adverse events occurred in either treatment group.ConclusionsUse of 3% PZQ ointment twice daily for 12 weeks resulted in significantly better effects than a placebo treatment in improving rosacea and the patient's quality of life.
Sun protection in a pill: the photoprotective properties of Polypodium leucotomos extract
Authors: El‐Haj Nura , Goldstein Norman 
Published: July 2014

AbstractBackgroundPhysical blocks (i.e. wearing appropriate clothing), exposure avoidance, and the use of sunscreens are the main methods of photoprotection currently used. However, phytochemical and natural botanical extracts such as polypodium leucotomos, a tropical fern found in Central and South America, demonstrate a strong potential as adjuncts to sunscreen protection.MethodA review of the literature was performed focusing on the photoprotective properties of PL extracts, including antioxidant, immunoregulatory, anti‐inflammatory and antitumorigenic effects in the context of sunburn, photodermatoses, chronic skin damage, photoaging, and skin cancer.ResultsPL supplementation acts at a molecular and cellular level to enhance endogenous antioxidant systems and inhibit generation of reactive oxygen species, thus decreasing UV‐mediated oxidative DNA mutations. PL has also been shown to accelerate removal of UV‐induced photoproducts, highlighting its anti‐carcinogenic role. By reducing UV‐induced inflammatory responses and inhibiting extracellular matrix remodeling, PL demonstrates some protective effects against photoaging and PUVA induced phototoxicity.ConclusionThe use of a systemic protective agent would provide significant advantages such as a more uniform coverage over the total body surface area, regardless of individual factors such as potency of the creams, amount applied, sweating, or bathing. Oral administration of PL extracts and its favorable safety profile could have significant implications in the prevention of skin cancer.
Factors associated with cognition recovery among elders with mild cognitive impairment in Korea
Authors: Kang Y. , Kim M. , Jung D. , Cha C. , Kim M. 
Published: July 2014

BackgroundOf elders with mild cognitive impairment, around half recover their cognitive function at some point in time. However, very little is known about the factors that influence their cognitive change towards recovery.AimThis study evaluated the role of depression, instrumental activity of daily living and sleep quality as they affect cognition recovery among community‐dwelling elders.MethodsThe study follows a longitudinal comparative research design using secondary data analysis. Community‐dwelling elders with mild cognitive impairment were assessed twice with a 1‐year interval to assess their levels of cognition. Adult participants were drawn from those who visited a community health centre, were aged 65 or over and who were assessed as having MCI.ResultsThose with mild cognitive impairment when compared with the normal cognition group were more likely to be younger, have more education, living with their spouses and had better cognitive function at baseline assessment than other participants. Predictors for cognitive recovery among elders with mild cognitive impairment were age, depression and cognitive function at baseline assessment.LimitationsParticipants included only those who visit a community health centre in an urban area of Korea, so the findings may not be applicable to other elders with less mobility or who live in rural areas.Implications for nursing and health policyWith the understanding that cognitive function and depression predict the recovery of mild cognitive function, nurses might be able to identify and target those older adults who are likely to achieve recovery of cognitive function. Additionally, health policy options, as suggested by the study as having the potential to improve mild cognitive impairment recovery, could include public education strategies.
Factors associated with post‐natal anxiety among primiparous mothers in Nepal
Authors: Shrestha S. , Adachi K. , Petrini M.A. , Shrestha S. 
Published: July 2014

BackgroundIn Nepal, new mothers are fatigued by childcare responsibilities because of lack of knowledge and preparation for their new role. Knowledge deficit and adherence to traditional health practices place infants at risk. Some cultural practices for the care of newborns may cause tetanus, hypothermia or other life‐threatening illnesses. Maternal education, previous experience of newborn care, economic status, relationship problems with husband or mothers‐in‐law and dissatisfaction with social relations are the variables of interest for this study.AimsTo examine the association between socio‐demographic variables and post‐natal anxiety among primiparous mothers in Nepal.DesignThe study was designed as a correlational study.SettingA major maternity hospital in Kathmandu, Nepal.ParticipantsThe sample were 216 primiparous mothers who were followed at 5–6 weeks after delivery.MethodsThree instruments were used for data collection: a demographics questionnaire, the Newborn Care Knowledge Questionnaire and the State‐Trait Anxiety Inventory for Adults.ResultsThe mothers' knowledge of newborn care, general educational level and income were inversely related to maternal anxiety, that is, mothers with a lower educational level and socio‐economic status demonstrated a higher level of post‐natal anxiety. Poor relationships with husbands or mothers‐in‐law and low social support presented potential for the development of anxiety and depression during post‐partum period.ConclusionMaternal education, socio‐economic status and knowledge of newborn care were major factors of post‐natal anxiety. On the other hand, women with low income and education, poor relationships with their husbands or mothers‐in‐law, and insufficient social support are vulnerable to the development of moderate to severe anxiety.Health policyPolicy implications from these results indicate the need for support and funding from the Ministry of Health for education for women at hospitals, which must work together to offer newborn care education during the ante‐natal and post‐natal periods.