bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perioperative blood product administration and thromboembolic events in patients with treated polycythemia vera: a case‐control study
Authors: Weingarten Toby N. , Hofer Ryan E. , Ahle Barrett J. , Kemp Keri M. , Nkwonta Jacinta A. , Narr Bradly J. , Pardanani Animesh , Schroeder Darrell R. , Sprung Juraj 
Published: February 2015

BACKGROUNDPatients with polycythemia vera (PV) have historically been considered to be at high risk for perioperative hemorrhagic and thromboembolic complications. However, no recent studies have compared these outcomes between treated PV patients and patients without PV undergoing similar procedures.STUDY DESIGN AND METHODSPatients with PV who underwent surgery with anesthesia from June 1, 2006, to May 31, 2011, were randomly matched (sex, age, type of surgical procedure, surgical year) at a ratio of 1:4 with control patients without PV. Conditional logistic regression analysis adjusting for surgical duration, preoperative hemoglobin, platelet count, and cardiovascular disease was used to assess the association between PV and blood product transfusions, thromboembolism, and other major cardiovascular and pulmonary complications.RESULTSFifty‐six PV patients who underwent 79 surgeries were matched with 312 controls. During hospitalization, 35 (44.3%) and 82 (25.9%) PV and control patients, respectively, were transfused with blood products. PV patients were at increased risk for transfusion intraoperatively (odds ratio [OR], 4.35; 95% confidence interval [CI], 1.79‐10.57; p = 0.001) and during hospitalization (OR, 4.35; 95% CI, 1.84‐10.31; p < 0.001). The likelihood of thromboembolic complications and/or other major complications did not differ between the two study groups (thromboembolic—OR 1.53, 95% CI 0.39‐6.02, p = 0.540; other major complications—OR 2.15, 95% CI 0.93‐4.96, p = 0.073).CONCLUSIONSMedically managed PV patients had an increased likelihood of receiving blood products perioperatively. Given the low number of observed thromboembolic events, we cannot make definitive conclusions regarding the association between PV and thromboembolism.
A randomized noninferiority crossover trial of corrected count increments and bleeding in thrombocytopenic hematology patients receiving 2‐ to 5‐ versus 6‐ or 7‐day–stored platelets
Authors: MacLennan Sheila , Harding Kay , Llewelyn Charlotte , Choo Louise , Bakrania Lekha , Massey Edwin , Stanworth Simon , Pendry Kate , Williamson Lorna M. 
Published: February 2015

BACKGROUNDBacterial screening offers the possibility of extending platelet (PLT) storage to Day 7. We conducted a noninferiority, crossover trial comparing PLTs stored for 6 or 7 days versus 2 to 5 days.STUDY DESIGN AND METHODSStable hematology patients were allocated to receive blocks of 2‐ to 5‐ and 6‐ or 7‐day PLTs in random order. The primary outcome was the proportion of successful transfusions during the first block, defined as a corrected count increment (CCI) of more than 4.5 at 8 to 24 hours posttransfusion.RESULTSOf 122 patients with an evaluable first block, 87 (71%) and 84 (69%) had successful transfusions after 2‐ to 5‐ and 6‐ or 7‐day PLTs of mean (SD) ages of 3.8 (1.0) and 6.4 (0.5) days, respectively. Six‐ or 7‐day PLTs were declared noninferior to 2‐ to 5‐day PLTs since the upper confidence interval (CI) limit was less than the predefined noninferiority margin of 10% (95% CI, −14.0% to 9.1%; p = 0.766). Logistic regression analysis gave an adjusted odds ratio of 0.86 (95% CI, 0.47‐1.58; p = 0.625). Mean (SD) 8‐ to 24‐hour CCIs were 9.4 (7.9) and 7.7 (7.1) after transfusion with 2‐ to 5‐ or 6‐ or 7‐day PLTs (95% CI, −3.31 to 0.03; p = 0.054). The proportions of days with bleeding scores of WHO Grade 2 or higher were 13% (38/297 days) and 11% (32/296 days; 95% CI, −3.2 to 7.2; p = 0.454). Median interval to next PLT transfusion (2 days) was unaffected (95% CI, −10.5 to 5.4; p = 0.531).CONCLUSIONIn hematology patients, there was no evidence that 6‐ or 7‐day PLTs were inferior to 2‐ to 5‐day PLTs, as measured by proportion of patients with successful transfusions, bleeding events, or interval to next transfusion.
Description of the Anatomy, Surgical Technique, and Outcome of Hemipelvectomy in 4 Dogs and 5 Cats
Authors: Barbur Laura A. , Coleman Kevin D. , Schmiedt Chad W. , Radlinsky MaryAnn G. 
Published: February 2015

ObjectiveTo provide (1) a comprehensive description of hemipelvectomy; and (2) report clinical application and outcome of hemipelvectomy in dogs and cats.Study DesignDescriptive report and retrospective case series.AnimalsDogs (n = 4) and 5 cats.MethodsCadaveric dissection was performed for imaging purposes using 4 mixed breed dogs euthanatized for reasons unrelated to this study. Medical records (2005–2012) were reviewed for dogs and cats that had hemipelvectomy. Data collected included signalment, body weight, body condition score, clinical presentation, diagnostic imaging findings, location and extent of tumor, definitive diagnosis, use of adjuvant therapy, ability to ambulate postoperatively, complications, and survival.ResultsThe most common indication for hemipelvectomy in cats was injection site sarcoma (ISS) and in dogs, osteosarcoma or peripheral nerve sheath tumor (PNST). Complete tumor excision was achieved in 6 (67%) cases. Incomplete excision occurred in 2 dogs with lumbosacral PNST and 1 cat having a 2nd surgery for ISS. Complications included intraoperative hemorrhage (n = 2), postoperative soft tissue infection (2), and discharge from the incision site (1). All but 1 animal were ambulatory at the time of discharge. Hospitalization ranged from 1–10 days (median, 4 days). Survival after surgery was individually assessed.ConclusionWith in‐depth anatomic familiarity, hemipelvectomy can be successful for excision of neoplastic lesions of the proximal aspect of the pelvic limb, with only minor complications.
Draft Genome Sequence of the Cellulolytic Fungus Chaetomium globosum
Authors: Cuomo Christina A. , Untereiner Wendy A. , Ma Li-Jun , Grabherr Manfred , Birren Bruce W. 
Published: February 2015

ABSTRACT

Chaetomium globosum is a filamentous fungus typically isolated from cellulosic substrates. This species also causes superficial infections of humans and, more rarely, can cause cerebral infections. Here, we report the genome sequence of C. globosum isolate CBS 148.51
,
which will facilitate the study and comparative analysis of this fungus.
Complete Genome Sequence of Enterotoxigenic Escherichia coli Siphophage Seurat
Authors: Doan Dung P. , Lessor Lauren E. , Hernandez Adriana C. , Kuty Everett Gabriel F. 
Published: February 2015

ABSTRACT

Enterotoxigenic
Escherichia coli
(ETEC) is one of the leading causes of diarrhea in developing countries. Bacteriophage therapy has the potential to aid in the prevention and treatment of ETEC-related illness. To that end, we present here the complete genome of ETEC siphophage Seurat and describe its major features.
Whole-Genome Sequences of 12 Clinical Strains of Listeria monocytogenes
Authors: Cao Guojie , Zhang Jianmin , Xu Xuebin , Jin Huiming , Yang Xiaowei , Pan Haijian , Allard Marc , Brown Eric , Meng Jianghong 
Published: February 2015

ABSTRACT

Listeria monocytogenes
is a foodborne pathogen of global concern due to the high mortality rate among immunocompromised patients. Whole-genome sequences of 12 strains of
L. monocytogenes
from humans were reported. The availability of these genomes should provide useful information on the evolutionary history and genetic diversity of
L. monocytogenes
.
Improving smoking cessation policy by assessing user demand for an inpatient smoking cessation service in adult psychiatric wards
Authors: Liu Kathy , Creamer Andrew 
Published: February 2015

AbstractSmoking rates are higher among people with mental health conditions compared to the general population. Smoking reduces physical, mental and financial well-being, and interacts with psychotropic drugs. An inpatient admission provides an opportunity to engage and support smokers in smoking cessation. Compliance with Trust/NICE smoking cessation guidelines was assessed in two inpatient wards, and a questionnaire evaluated user demand for an inpatient smoking cessation service. A need for improved documentation of smoking status to identify and treat smokers routinely was revealed.A new electronic health form was designed and introduced, and a clear pathway for onward referrals was developed. This intervention preceded the introduction of the Trust-wide smoke free policy from October 2014. The intervention doubled rates of documentation of smoking status, cessation advice and offer of NRT/referral. There were large differences between the two wards, highlighting the need for a tailored approach.
THE POTENTIAL FOR NURSE INDEPENDENT PRESCRIBING BY THE CLINICAL NURSE SPECIALIST IN PALLIATIVE CARE IN THE COMMUNITY; ATTITUDES AND EXPERIENCES OF GENERAL PRACTITIONERS
Authors: McGleish Elaine , Sivell Stephanie , Nelson Annmarie 
Published: February 2015

IntroductionNurse Independent Prescribing (NIP) has the potential to enhance patient care and the practice of palliative care in the community. Medical prescribing in the community is the key responsibility of the General Practitioner (GP); however, many GPs see palliative care patients infrequently. Conversely, community Clinical Nurse Specialists (CNSs) are key workers in the delivery of specialist palliative care, often working autonomously and are arguably better positioned to respond quickly to patients' needs. In practice there is some resistance to NIP and little research into the views of GPs towards NIP in palliative care in the community.AimTo explore GPs' attitudes and experiences towards NIP in palliative care in order to identify the barriers, benefits and support available, and thus inform future practice.MethodsSemi-structured interviews were undertaken with ten GPs in one local health board in Wales. Interviews were audio recorded and transcribed verbatim. Data were analysed using thematic analysis.ResultsFour major themes were generated from the data: (i) impact of nurse prescribing; (ii) prescribing practices; (iii) communication; (iv) education. Overall attitudes towards NIP were positive with eight of the GPs having experience of NIP. Identified benefits included: time-saving for CNSs and patients; greater autonomy for CNSs; improved working relationships between GPs and CNSs.ConclusionsNIP is an evolving area of clinical practice enhancing the nursing role. This study demonstrates evidence of support from GPs; effective collaborative working between GPs and CNSs will be fundamental to successful implementation of NIP in palliative care.
TEACHING PALLIATIVE CARE (PC) TO MEDICAL STUDENTS; ARE WE DEVELOPING SAFE PRACTITIONERS?
Authors: Walker Steven , Gishen Faye , Lodge Philip , Wee Bee 
Published: February 2015

IntroductionAppropriate training is essential to ensure PC is safely practised1. A proportion of newly qualified doctors report that undergraduate teaching has not adequately prepared them to manage PC patients.2Little is known about how PC training is delivered across UK medical schools3. Addressing this requires key data; one group likely to have an overview are the responsible PC educational leads.Aim(s) and method(s)To undertake a comprehensive review of PC teaching across UK medical schools by means of an anonymised, multifactorial questionnaire of educational leads.A 40-point questionnaire was developed using SurveyMonkey® and sent to PC educational leads at all 30 UK medical schools. This study received ethical approval.ResultsThe response was 100%. PC teaching occurred in all institutions. In 20 (67%), there was a formal PC component. Teaching around last days of life, death and bereavement was mandatory. Training in other areas (e.g. emergencies) was sometimes optional. Teaching was generally ‘integrated’ (15 respondents) and/or ‘formed a module’ within a larger course (17 respondents) and generally occurred in the final 2 years. A student selected component was offered by 27 (90%).Most respondents were positive about their courses which, in general, were well supported locally, personally satisfying and highly rated by students.Concerns included:Limited student placements (20, 66%).Restricted opportunity to visit a hospice and observe MDT care (10, 33%)Insufficient teachers (22, 73%)Insufficient funding (10, 33%)Variability in teaching (15, 50%)Whether courses prepared doctors to care for PC patients (9, 30%) delivered quality training (5, 17%) and fulfilled GMC requirements (2, 7%).ConclusionsPC training for medical students in the UK continues to evolve with greater integration into the curriculum and the wider use of learning assessment. There is, however, variability, which has the potential to affect patient safety, with a minority of medical schools offering limited teaching and patient contact.
WHAT DO INFORMAL CARERS WANT TO LEARN ABOUT BREATHLESSNESS IN ADVANCED DISEASE AND HOW DO THEY WANT TO LEARN IT?
Authors: Penfold C , Ewing G , Gilligan D , Mahadeva R , Booth S , Benson J , Burkin J , Howson S , Lovick R , Todd C , Farquhar M 
Published: February 2015

IntroductionBreathlessness is a distressing, disabling symptom of advanced disease with considerable impact on informal carers. We know that carers experience anxiety, isolation, restriction of activity, lack of support and powerlessness. Despite this knowledge the evidence-base for educational interventions to support informal carers and enhance their caregiving capacity is limited.Aim(s) and method(s)To identify informal carer preferences for learning content and delivery modes of an educational intervention for carers on breathlessness in advanced disease. In-depth interviews with a purposive sample of 24 patient-carer dyads from two disease groups (cancer and COPD) to facilitate exploration of similarities and differences in education needs and preferences for differing disease trajectories. Analysed using a Framework approach.ResultsThere was a notable degree of overlap in content and delivery-mode preferences among informal carers across the two disease trajectories. Five areas of learning were salient for carers: understanding breathlessness (causes and experience); managing anxiety and panic; helpful and safe levels of activity; maintaining quality of life; and, knowing what to expect in the future. Intervention delivery-mode preferences included face-to-face group learning incorporating clinical-practitioner expertise and a supportive element through sharing experiences, ‘work-arounds’ and useful tips with peers. Carers generally wanted to learn with their patient so short sessions, not too early in the day, in venues accessible for breathless patients were important practical considerations.ConclusionsAn evidence-based educational intervention needs to be broad in scope, incorporating both clinical-practitioner expertise and peer experience. It should also be flexible to accommodate a variety of delivery-mode preferences and personalised content.
ADAPTATION, FACE AND CONTENT VALIDATION OF A PALLIATIVE CARE NEEDS ASSESSMENT TOOL FOR PEOPLE WITH INTERSTITIAL LUNG DISEASE
Authors: Reigada C , Bajwah S , Ross J , Boland J , Wells A , Yorke J , Grande G , Hart S , Currow D , Papadopoulos T , Macleod U , Johnson M 
Published: February 2015

IntroductionInterstitial lung disease (ILD) is a non-malignant progressive disease which causes breathlessness, cough, fatigue, psycho-social, financial and spiritual distress; difficult for patients and their family carers. The Needs Assessment Tool: Progressive Disease (NAT:PD-C) was developed as an “aide-memoire” to help clinicians identify a range of palliative care needs in people with cancer, and their carers, in daily practice. We have adapted this tool for people with ILD.Aim(s) and method(s)Our aim was to adapt, and then test face and content validity of the adapted version.The NAT:PD-C was adapted for people with ILD using data from a systematic review of the literature and previously completed qualitative interviews. Focus groups were held (patients [N=7], carers [N=3], clinicians [N=8] followed by an Expert Consensus Group to discuss face and content validity of the NAT:PD-ILD. The Expert Group also discussed issues regarding implementation in practice. The discussion was audio and video-recorded, and cognitive mapping was used. Data was analysed following the principles of inductive theory building. Further validation and reliability testing is ongoing. We present the preliminary results of the face/content validation.ResultsAll sections (“red flags” for high risk patients; priority referral; patient wellbeing; ability of carer to provide care; carer wellbeing) of the tool were felt to be important. Some symptoms (voice, mucous and mobility) were added by patients. Clinicians identified training needs about “Spiritual or existential concerns”. Carers highlighted the need for support for themselves.Conclusion(s)The NAT:PD-ILD appears to have face and content validity and the content and structure reflected the experience of all groups.*This research was funding by Marie Curie Care Cancer Research UK.
PILOTING A NEW APPROACH TO IDENTIFYING, ASSESSING AND SUPPORTING CARERS OF PEOPLE WITH PALLIATIVE CARE NEEDS IN PRIMARY CARE
Authors: Carduff E , Highet G , Finucane A , Kendall M , Jarvis A , Harrison N , Greenacre J , Murray SA 
Published: February 2015

IntroductionUK general practices are incentivised to “have a protocol for the identification of carers and a mechanism for referral for social services assessment”. This is rarely done systematically and very few carers of patients with palliative care needs are identified. Thus they fail to receive support.Aim(s) and method(s)To model and pilot a systematic approach to identifying, assessing and supporting carers of people with palliative care needs in primary care.Four general practices which varied in size were recruited to pilot a theoretically modelled intervention for 12 months. Each practice nominated a carer liaison to lead on carer identification and support.ResultsThe practices varied in size from 5840 to 10832 patients. 83 carers were identified across the 4 practices via registers; illness (12), palliative care (12), carer (11); advanced care plans (12) or opportunistically (28) at GP appointments or at home. 7 carers self-identified. There were 55 female and 28 male carers. Overall, 81 carers received the intervention and 25 returned the Carer Support Needs Assessment Tool (CSNAT). On average carers each identified 4/14 areas of need. 11 carers received a follow up call from the practice to discuss support. 12 carers were also referred for support.Conclusion(s)The findings suggest that the new approach to identifying and supporting carers was feasible, but had to be embraced by the whole practice. Carers did not tend to self-identify, nor ask for help. Practices need to be motivated and equipped with information about local carer support and take measures to empower carers to self-identify.
RELATIVES' PREFERRED PLACE OF CARE AT THE END-OF-LIFE: IMPLICATIONS FOR PALLIATIVE CARE IN THE FUTURE
Authors: Woodman C , Baillie J , Sivell S 
Published: February 2015

IntroductionGovernment policy stresses the need to include patients and relatives in decisions surrounding place of end-of-life care. Relatives play an important role in providing care at the end-of-life, therefore understanding their preferences is essential. While systematic reviews have explored patients' perspectives and demonstrated preference for home care, no such review considers relatives' preferences alone.Aim(s) and method(s)The aim of this study was to systematically review and synthesise the qualitative literature exploring relatives' perspectives on preferred place of care for their relatives at the end-of-life. Ten databases were searched up until January 2014 and relevant studies were appraised for quality. The included studies (n=18) were thematically synthesised.ResultsRelatives reported involvement in decisions surrounding place of end-of-life care, but described experiencing expectations from patients and healthcare professionals to provide care at home. Home was relatives' preferred place of care: other locations of care were infrequently considered. Care at home was facilitated by resilience, positive family relationships and appreciation of the caregiving role. Caring for relatives impacted positively on families as they were able to demonstrate their love, but also led to feelings of loneliness. Relatives felt they had failed if the patient did not die at home.Conclusion(s)Appropriate support mechanisms for patients and relatives are needed if end-of-life care at home is to be achieved. To improve patients' and relatives' experiences of end-of-life care, equitable support and real options for place of care are needed. Patients' and relatives' preferences need to be considered when forming future practice guidelines and policies.
USE OF APREPITANT AS AN ANTIEMETIC IN CYSTIC FIBROSIS PATIENTS
Authors: Jamali A , Harrison M , Bilton D , Simmonds N , Ross J 
Published: February 2015

IntroductionAprepitant is a NK1 receptor antagonist licensed for treatment of nausea and vomiting (n&v) associated with emetogenic chemotherapy. There are case reports of use for n&v post-operatively or secondary to diabetic gastroparesis. There is no published evidence in patients with cystic fibrosis (CF).Tigecycline is used in treatment of Non-Tuberulosis Mycobacteria in CF. However uncontrolled n&v can result in dose reduction, interruption or discontinuation, and treatment failure.AimsTo evaluate the efficiacy and side-effects of aprepitant (added to domperidone and ondansetron) in CF patients requiring tigecycline treatment.MethodsRetrospective and prospective audits (studies) were conducted with case note review of consecutive CF patients receiving IV tigecycline, using a standardised proforma. Consecutive admissions for IV tigecycline therapy were consented and commenced on aprepitant 80mg OD for the first five days of tigecycline therapy. They completed daily n&v and side-effect diaries.Results16 case notes were evaluated retrospectively and 10 patients prospectively audited.Aprepitant was likely to have contributed to reduction in n&v in 17/26 (65%) cases. 9/10 (90%) patients in prospective audit completed the full course/dose of tigecycline.8/26 (31%) cases reported mild side-effects (headache (3), hiccups, dyspepsia (2), abdominal pain, atrial tachycardia); all resolved on continuing aprepitant or persisted despite stopping aprepitant.Conclusion(s)Aprepitant was well tolerated and appeared to be effective for a number of CF patients. Ongoing work will further evaluate the benefit of aprepitant in this population and inform clinical guidelines for management of n&v in CF patients.