bluuebunny/crossref_metadata_2025_split huggingface dataset:
Do Hip Prosthesis Related Infection Codes in Administrative Discharge Registers Correctly Classify Periprosthetic Hip Joint Infection?
Authors: Lange Jeppe , Pedersen Alma B. , Troelsen Anders , Søballe Kjeld 
Published: June 2015

Purpose Administrative discharge registers could be a valuable and easily accessible single-sources for research data on periprosthetic hip joint infection. The aim of this study was to estimate the positive predictive value of the International Classification of Disease 10th revision (ICD-10) periprosthetic hip joint infection diagnosis code in the Danish National Patient Register. Methods Patients were identified with an ICD-10 discharge diagnosis code of T84.5 (“Infection and inflammatory reaction due to internal joint prosthesis”) in association with hip-joint associated surgical procedure codes in The Danish National Patient Register. Medical records of the identified patients (n = 283) were verified for the existence of a periprosthetic hip joint infection. Positive predictive values with 95% confidence intervals (95% CI) were calculated. Results A T84.5 diagnosis code irrespective of the associated surgical procedure code had a positive predictive value of 85% (95% CI: 80-89). Stratified to T84.5 in combination with an infection-specific surgical procedure code the positive predictive value increased to 86% (95% CI: 80-91), and in combination with a noninfection-specific surgical procedure code decreased to 82% (95% CI: 72-89). Conclusions Misclassification must be expected and taken into consideration when using administrative discharge registers for epidemiological research on periprosthetic hip joint infection. We believe that the periprosthetic hip joint infection diagnosis code can be of use in future single-source register based studies, but preferably should be used in combination with alternate data sources to ensure higher validity.
A Novel Photocrosslinkable and Cytocompatible Chitosan Coating for Ti6Al4V Surfaces
Authors: Zujur Denise , Moret Josnell , Rodriguez Dubrasvka , Cruz Lauren , Lira Joaquin , Gil Linda , Dominguez Ernic , Alvarez-Barreto Jose 
Published: June 2015

Background In this work, chitosan (CH) was used to produce a novel coating for Ti6Al4V, the most widely used alloy in orthopedic implants, so as to improve the biological tissue response at the metallic surface. Methods The Ti6Al4V surface was sandblasted with alumina particles. CH was chemically modified, via carbodiimide chemistry, using lactobionic and 4-azidebenzoic acid to make it soluble at physiological pH and photocrosslinkable, respectively. The reaction was verified by FTIR, NMR and UV/vis spectroscopy. Ti6Al4V surfaces were coated with solutions of the modified CH and exposed to UV light, causing polymer crosslinking and formation of a hydrogel on the surface. The crosslinking reaction was monitored by FTIR at different exposure times. Coating morphology was observed by SEM. The coating's cytocompatibility was determined in vitro through the culture of rat bone marrow mesenchymal stem cells, using an MTT assay, with their morphology assessed by SEM. Results The developed coating behaved as a hydrogel on the Ti6Al4V and was stable on the surface. FTIR and NMR confirmed the crosslinking mechanism, based on an arile ring expansion, and subsequent reaction with the CH amine groups. Furthermore, the coating was able to support cell proliferation and osteogenic differentiation. Conclusions UV crosslinking of CH is easy to apply and has potential for future metallic implant surface modifications. Due to its nature as a hydrogel, the coating could be used for further studies in the encapsulation of bioactive molecules to improve osteogenic potential at the tissue–implant interface.
HER family Receptor Expression and Prognosis in Pancreatic Cancer
Authors: Bittoni Alessandro , Mandolesi Alessandra , Andrikou Kalliopi , Santoni Matteo , Alfonsi Simona , Lanese Andrea , Loretelli Cristian , Pellei Chiara , Piva Francesco , Scarpelli Marina , Cascinu Stefano 
Published: June 2015

Background HER family receptors play a key role in tumor progression in several malignancies, such as colorectal, lung or breast cancer. The aims of this study were to investigate expression of HER-1, HER-2 and HER-3 in pancreatic cancer (PC) samples and evaluate the association between HER-family receptor expression and patients’ clinical outcomes. Methods Tissue samples from 91 PC patients were subjected to immunohistochemical staining to assess the expression of HER-1, HER-2 and HER-3. Semiquantitative scores of zero (no staining or staining in less than 10% of cancer cells), 1+, 2+ or 3+ were assigned to each sample based on the intensity of staining for HER receptors. Scores of 2+ or 3+ were defined as positive staining. Results HER-1 overexpression was observed in 41 out of 91 samples (45.1%), while HER-2 was not overexpressed in any of the analyzed samples. HER-3 was overexpressed in 37 samples (40.7%) and was found to be associated with advanced TNM stage. In particular, HER-3 was overexpressed in 12 out of 16 stage IV patients (75%) compared with only 33.3% of stage I-III patients (p = 0.02). Among 79 patients with available survival data, the 6 patients with strong HER-3 expression (score 3+) had a shorter survival compared with remaining patients (median overall survival 6.9 months vs. 12.3 months, respectively). Conclusions HER-1 and HER-3 were found to be expressed in a significant proportion of PC patients. Strong HER-3 expression represents an indicator of poor prognosis in PC patients, being associated with advanced stage and shorter survival.
Endometriosis as an Epiphenomenon in a Patient with Nonobstructive Primary Amenorrhea: A Case Report
Authors: Cavaco-Gomes João , Oliveira João P. , Costa Ana R. , Beires Jorge 
Published: June 2015

Introduction The pathophysiology of endometriosis is not well established. Different theories have been proposed to explain endometriosis, but none alone is able to explain all of the cases described. Case presentation We report a case of a woman with a congenital polymalformative syndrome, early puberty and primary amenorrhea, in whom an asymptomatic right adnexal nodule was detected at 14 years of age. When she was 18 years old, a laparoscopy was performed, and an ovoid lesion in the right uterine tube was identified and salpingectomy was performed. The pathological examination revealed endometriosis in the muscular layer of the tube. Conclusions Endometriosis can start early in puberty, even before menarche and in the absence of an obstructive disorder.
Effects of Preoperative and Perioperative Administration of Wobenzym Vital on Minimal-Mild Endometriosis
Authors: Giannini Andrea , Palla Giulia , Goglia Lorenzo , Genazzani Andrea R. , Genazzani Alessandro , Simoncini Tommaso 
Published: June 2015

Background Endometriosis is an estrogen-dependent chronic inflammatory disease associated with pelvic pain, inflammation and infertility. Drugs that modulate the release of chemokines and angiogenic and inflammatory molecules are under evaluation. The aim of the present randomized, double-blind, placebo-controlled study was to investigate the effects of Wobenzym Vital, an enzyme-flavonoids combination supplement with antiinflammatory activity, as supportive treatment in patients affected by minimal-moderate endometriosis selected for surgery. Methods Thirty women suspected for endometriosis stage I-II were randomly assigned to receive Wobenzym Vital or placebo for a period of 40-60 days before surgery and 60 days thereafter. Visual analog scale (VAS) scores for pain at enrollment, time of surgery and 7 and 60 days afterwards were evaluated. Blood samples were taken at the same times for the assay of several inflammatory, angiogenic and growth factors and growth factor regulators. Results Treatment with Wobenzym Vital was associated with lower VAS scores before surgery and perioperatively. Surgery further reduced VAS scores in all patients. Patients receiving placebo underwent increases in plasmatic concentrations of sCD40L, EGF, IGFBP-1, IL-6, IL-8, TGF-α and TNF-α in the perioperative period, while this was not noted in patients with active treatment. A trend for lower concentrations of several of the tested analytes in the peritoneal fluid was found in patients treated with Wobenzym Vital. Conclusions In symptomatic patients affected by minimal-mild endometriosis undergoing surgery, preoperative and postoperative treatment with Wobenzym Vital results in reduced pain and lower concentrations of inflammatory and angiogenic factors in peripheral blood and the peritoneal cavity.
Endothelial Nitric Oxide Synthase Gene Polymorphism among Endometriotic Females in Egypt
Authors: Hassan Mostafa M.M. 
Published: June 2015

Background Endometriosis is one of the most common benign gynecological diseases, causing pain and infertility in women of reproductive age. The etiology of the disorder is complex but probably involves the interaction of several environmental factors with different gene loci. The aim of this study was to investigate the possible association between Glu298Asp polymorphism of the endothelial nitric oxide synthase (eNOS) gene and the pathogenesis of endometriosis. Methods Fifty-eight women with an endoscopic diagnosis of endometriosis and 40 age-matched normal females were included in this study. Results The study showed an absence of statistically significant differences as regards genotype distribution of the Glu298Asp polymorphism between women with and without endometriosis. Conclusions This study showed the absence of association between Glu298Asp polymorphism of the eNOS gene and risk of endometriosis in the Egyptian population.
Relationships between Plasma Pentraxin 3 Levels and Inflammation Markers Patients with Tunneled Permanent Catheter in Hemodialysis
Authors: Yigit Irem Pembegul , Dogukan Ayhan , Taskapan Hulya , Comert Melda , Ilhan Necip , Ulu Ramazan , Aygen Bilge 
Published: June 2015

Purpose Vascular access (VA) devices may contribute to chronic inflammation in hemodialysis (HD). Pentraxin 3 (PTX3) is a recently discovered acute phase protein that responds more rapidly than other inflammatory markers. This study compared PTX3 and other markers between HD patients and healthy controls. Methods The study population included 30 patients with tunneled permanent catheter (TPC), 30 patients with arteriovenous fistula (AVF) and 30 healthy controls. Hemogram, biochemical assays, ferritin, high sensitive C-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α) and PTX3 were evaluated in all groups. Results PTX levels were highest in HD patients with TPC, intermediated in HD patients with AVF and lowest in healthy controls (5.2 + 2.4 vs. 3.1 + 1.3 vs. 1.8 + 0.7, p<0.001 for all comparisons). PTX3 levels correlated strongly to hs-CRP (r = 0.857) and moderately to TNF-α, NLR, ferritin and total neutrophil count. PTX3 and albumin levels had a negative correlation. PTX3 levels were higher in patients with 8 months of TPC than those with 7 months or less. Conclusions PTX3 levels are significantly elevated in all patients on HD, but presence and extended duration of TPC are associated with incrementally higher levels of PTX3 and other inflammatory markers. PTX3 and NLR may be useful in assessing chronic inflammatory states in HD.
Patterns of Superficial Veins of the Middle Upper Extremity in Caucasian Population
Authors: Vučinić Nikola , Erić Mirela , Macanović Milica 
Published: June 2015

Purpose Superficial veins of the middle upper extremity are frequently variable in existence and arrangement. The superficial veins are clinically important in many revascularization procedures, particularly reconstructive microsurgery and arterial bypass surgery as well as intravenous injection or therapy. The aim of this study was to assess the patterns of superficial veins of middle upper extremity in healthy volunteers. Methods We examined both arms of 169 people. A tourniquet was applied at the mid-arm and a drawing made of the pattern of veins. It took about 1-3 min for each arm. We then examined the 338 drawings looking for similar patterns. The study took place in Department of Anatomy, Faculty of Medicine in Novi Sad, Serbia. Results We found nine patterns of middle upper extremity veins. The most common was an ‘M’-shaped pattern (115/338, 34%) followed by an ‘N’-shaped pattern (97/338, 29%). Conclusions There are only nine basic patterns of middle upper extremity venous anatomy. Some are more common than others. This knowledge should help those needing venous access for medical procedures (venepuncture, transfusion, infusion, cardiac catheterization, placement of dialysis access).
Optimizing Outcomes in the Elderly with End-Stage Renal Disease—Live Long and Prosper
Authors: Masengu Agnes , Hanko Jennifer B. , Maxwell Alexander P. 
Published: June 2015

Background The elderly form an expanding proportion of patients with chronic kidney disease and end-stage renal disease worldwide. The increased physiological frailty and functional morbidity associated with the aging process pose unique challenges when planning optimal management of an older patient needing renal replacement therapy (RRT). Aims This position paper discusses current evidence regarding the optimal management of end-stage renal disease in the elderly with an emphasis on hemodialysis since it is the most common modality used in older patients. Further research is needed to define relevant patient-reported outcome measures for end-stage renal disease including functional assessments and psychological impacts of various forms of RRT. For those older patients who have opted for dialysis treatment, it is important to study the strategies that encourage greater uptake of home-based dialysis therapies and optimal vascular access. Conclusions The management of advanced chronic kidney disease in the elderly can be challenging but also extremely rewarding. The key issue is adopting a patient-focused and individualized approach that seeks to achieve the best outcomes based on a comprehensive holistic assessment of what is important to the patient.
Tokio Rationale and Protocol: A Phase II Study to Evaluate the Activity and Safety of Third-line Tyrosine Kinase Inhibitor after 2 Tyrosine Kinase Inhibitors in Patients with Metastatic Renal Cell Carcinoma
Authors: Verzoni Elena , Grassi Paolo , Montone Rosanna , Galli Giulia , Necchi Andrea , Procopio Giuseppe 
Published: June 2015

Aims and Background The introduction of agents targeting vascular endothelial growth factor has radically changed the approach to metastatic renal cell carcinoma (mRCC): sunitinib and pazopanib are now the standard first-line therapy in mRCC. At sunitinib failure, second-line axitinib or everolimus or sorafenib should be considered to improve the clinical outcome. No data are available for a third-line tyrosine kinase inhibitor (TKI) after 2 previous lines of therapy with TKIs. At pazopanib failure, no prospective data are available. Study Design The TOKIO study was designed to evaluate progression-free survival, safety, and efficacy of third-line therapy with TKI in 44 patients already treated with 2 previous lines of TKIs in 10 Italian centers, and relapsed from sunitinib-axitinib (group A) or pazopanib-sorafenib (group B). Standard treatment is sorafenib in group A and sunitinib in group B, administered until disease progression or unacceptable toxicity. Secondary endpoints include the evaluation of overall survival, safety, and quality of life.
Stability of Spinal Bone Metastases and Survival Analysis in Renal Cancer after Radiotherapy
Authors: Schlampp Ingmar , Lang Helge , Förster Robert , Wolf Robert , Bostel Tilman , Bruckner Thomas , Debus Jürgen , Rief Harald 
Published: June 2015

Purpose This retrospective analysis evaluated the outcome of patients with spinal bone metastases of renal cell cancer after radiotherapy (RT) in terms of stability and survival, using a validated scoring system for spinal stability assessment. Materials and Methods The survival rates of 155 patients with bone metastases of renal cancer treated from January 2000 to January 2012 were determined. The stability of irradiated osteolytic lesions of the thoracic and lumbar spine was evaluated retrospectively using the Taneichi score and analyzed for predictive factors. The effects of therapy in terms of changes in neurological signs and tumor-related pain were recorded. Results Follow-up with regular computed tomography (CT) was available for 28 patients, 14 with unstable metastases. One hundred thiry-two patients (85%) died during follow-up. RT could not improve the stability of vertebral bodies after 3 and 6 months. Consequently, none of the examined predictive factors such as age, number of bone metastases and systemic therapy showed a significant correlation with stability 6 months after RT. The median survival of all 155 patients after diagnosis of bone metastases was 12.9 months. Improvement of pain and neurological deficits occurred in 60%, and in 24% of the respective affected in all patients. Conclusions RT was unable to improve the stability of vertebral metastases, probably due to the short overall survival, which resulted in an insufficient number of patients with evaluable follow-up. RT allowed reduction of pain and neurological deficits. A short fractionation schedule may be preferred in this situation.
The prevalence of psychological impact on caregivers of hospitalized patients: The forgotten part of the equation
Authors: Al-Zahrani Rahma , Bashihab Rahaf , Ahmed Anwar E. , Alkhodair Reem , Al-Khateeb Sultan 
Published: June 2015

Introduction:Despite the large number of caregivers suffering from various psychiatric disorders, research on psychological symptoms among caregivers of hospitalized patients is lacking in Saudi populations.Objectives:The objective of this study is to determine the prevalence of depression, anxiety and stress among caregivers of hospitalized Saudi patients.Methods:A cross-sectional study of depression, anxiety and stress among caregivers of hospitalized patients was conducted. Arabic speaking caregivers (n = 353) between the ages of 14 and 80 years were included in the study. The Depression Anxiety Stress Scales (DASS-21) test (Arabic version) was used to measure the three psychological symptoms.Results:The study has shown high rates of depression, anxiety and stress among caregivers (72.8%, 76.5%, and 61.5%, respectively). Depression was found to be associated with long-term hospital stay (81.4% vs. 69.3%; p-value = 0.021) and family caregivers (75.4% vs. 46.9%, p-value = 0.001). Anxiety was found to be associated with family caregivers (78.8% vs. 53.1%; p-value = 0.001). The three psychological symptoms were higher among those with an age above 20 years old (p-value < 0.05). Multivariate logistic models show the risk of the psychological symptoms increased with low-income, higher education, immediate relation to the patient, and older caregivers.Conclusions:The findings suggest that the prevalence of depression, anxiety and stress symptoms were very common among caregivers. The results showed that approximately 8 out of 10 caregivers suffer from at least one psychiatric disorder. Older, low socioeconomic status, and well-educated caregivers were identified as being at higher risk of developing psychiatric symptoms.
Unnecessary Overtreatment Index: a useful tool in family practice
Authors: Pezeshki Mohammad Zakaria , Pezeshki Sina 
Published: June 2015

One of the most important aspects of quaternary prevention is avoiding the exposure of the patients to unnecessary overtreatment. In this commentary we explain how a valid and reliable double blinded randomized controlled clinical trial (RCT) with a good external validity may help a physician to estimate the magnitude of unnecessary overtreatment.
Osteopathic Manipulative Therapy in Women With Postpartum Low Back Pain and Disability: A Pragmatic Randomized Controlled Trial
Authors: Schwerla Florian , Rother Katrin , Rother Denis , Ruetz Michaela , Resch Karl-Ludwig 
Published: June 2015

Abstract

Context: Persistent low back pain (LBP) is a common complaint among women during and after pregnancy, and its effects on quality of life can be disabling.

Objective: To evaluate the effectiveness of osteopathic manipulative therapy (OMTh; manipulative care provided by foreign-trained osteopaths) in women with persistent LBP and functional disability after childbirth.

Methods: A pragmatic randomized controlled trial was conducted among a sample of women with a history of pregnancy-related LBP for at least 3 months after delivery. Participants were identified from the general population in Germany. By means of external randomization, women were allocated to an OMTh group and a waitlist control group. Osteopathic manipulative therapy was provided 4 times at intervals of 2 weeks, with a follow-up after 12 weeks. The OMTh was tailored to each participant and based on osteopathic principles. The participants allocated to the control group did not receive OMTh during the 8-week study; rather, they were put on a waiting list to receive OMTh on completion of the study. Further, they were not allowed to receive any additional treatment (ie, medication, physical therapy, or other sources of pain relief) during the study period. The main outcome measures were pain intensity as measured by a visual analog scale and the effect of LBP on daily activities as assessed by the Oswestry Disability Index (ODI).

Results: A total of 80 women aged between 23 and 42 years (mean [SD], 33.6 [4.5] years) were included in the study, with 40 in the OMTh group and 40 in the control group. Pain intensity decreased in the OMTh group from 7.3 to 2.0 (95% CI, 4.8-5.9; P<.001) and in the control group from 7.0 to 6.5 (95% CI, -0.2 to -0.9; P=.005). The between-group comparison of changes revealed a statistically significant improvement in pain intensity in the OMTh group (between-group difference of means, 4.8; 95% CI, 4.1-5.4; P<.001) and level of disability (between-group difference of means, 10.6; 95% CI, 9.9-13.2; P<.005). The follow-up assessment in the OMTh group (n=38) showed further improvement.

Conclusion: During 8 weeks, OMTh applied 4 times led to clinically relevant positive changes in pain intensity and functional disability in women with postpartum LBP. Further studies that include prolonged follow-up periods are warranted. (German Clinical Trials Register: DRKS00006280.)