bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bilateral Central Vein Stenosis: Options for Dialysis Access and Renal Replacement Therapy when all upper Extremity Access Possibilities have been Lost
Authors: Aitken Emma , Jackson Andrew J. , Kasthuri Ram , Kingsmore David B. 
Published: July 2014

Purpose Patients with bilateral central vein stenosis present a unique challenge: treatment options are limited, largely unproven and associated with reputedly poor outcomes. Our aim was to compare patency rates of different access and renal replacement treatment (RRT) modalities in patients with bilateral central vein stenosis/occlusion. Material and methods Data on all patients presenting to a tertiary referral vascular access centre with end-stage vascular access (defined by bilateral central vein stenosis/occlusion with loss of upper limb access) over a 5-year period were included. 3, 6 and 12-month patencies of translumbar catheters (TLs), tunnelled femoral catheters (Fem), native long saphenous vein loops (SV), prosthetic mid-thigh loop grafts (ThGr), peritoneal dialysis (PD), and expedited donation after cardiac death (DCD) cadaveric renal transplants (Tx) via local allocation policies were compared using log-rank test. Kaplan–Meier survival analysis was used to estimate long-term access survival. Results One hundred forty-six vascular access modalities were attempted in 62 patients (62 Fem, 25 TL, 15 SV, 25 ThGr, 8 PD, 11 Tx). Median follow-up was 876±57 days. Three, 6 and 12-month primary-assisted patencies for each modality were as follows: Fem: 75.4%, 60% and 28%; TL: 88%, 65% and 50%; SV: 87.5%, 60% and 44.6%; ThGr: 64%, 38% and 23.5%; PD: 62.5%, 62.5% and 50%; Tx: 72.7%, 72.7% and 72.7%. SV had better secondary patency at 900 days (76.9%) than ThGr (49.2%) or Fem (35.8%) (p<0.01). No patients died as a result of loss of access. Conclusion Patients with bilateral central vein stenosis often require more than one vascular access modality to achieve a “personal access solution.” Native long saphenous vein loops provided the best long-term patency. Expedited renal transplantation with priority local allocation of DCD organs to patients with precarious vascular access provides a potential solution to this difficult problem.
A Prevalence Survey of Intravascular Catheter use in a General Hospital
Authors: Pérez-Granda María Jesús , Guembe María , Rincón Cristina , Muñoz Patricia , Bouza Emilio 
Published: July 2014

Purpose Survey of intravascular catheter management is an essential step in the control and prevention of catheter-related infection. In recent years, most surveillance studies only included catheters from intensive care units (ICUs). Data regarding the level of care and adherence to international guidelines in a whole general institution are scarce. Our objective was to evaluate the care situation of intravascular catheters in our adult units of a General Hospital. Methods We surveyed adults hospitalized in non-psychiatric/maternity wards. In a week, a nurse visited all the adult hospitalized patients. Data were registered in a protocol that included variables, such as no. of catheters, location of catheter, type of catheter, date of placement and the need of an indication of each catheter in the visit day. Results We included in the study a total of 753 adult patients. Of them, 653 (86.7%) had one or more inserted catheters at the moment of the study visit (total: 797 catheters). Of all the catheters, 144 (18.0%) were central venous catheters and 653 (81.9%) were peripheral lines. The hospitalization units where the patients were admitted were ICU, 52 (6.9%); and non-ICU, 601 (92.0%). There were 183 (22.9%) catheters with no need to remain in place in the day of the study. Overall, we found 464 (71.0%) patients with one or more opportunities for catheter care improvement. Conclusions A rapid survey of the care situation of intravascular catheters is feasible and easy to do with our methodology. The data show great opportunity for improvement, mainly in the non-ICU areas.
The use of 8-cm 22G Seldinger Catheters for Intravenous access in Children with Cystic Fibrosis
Authors: Qian Sarah Y. , Horn Matthias T. , Barnes Richard , Armstrong David 
Published: July 2014

Purpose Long intravenous catheters are an effective and economical choice of vascular access for intravenous antibiotic therapy in children with cystic fibrosis (CF). This prospective audit assesses the use of Vygon Leaderflex 22G × 8 cm catheters in an Australian tertiary centre. Key outcomes included catheter lifespan, ability to complete antibiotic therapy and complication rates. Methods All paediatric patients admitted with infective exacerbations of CF lung disease for 18 months between 2012 and 2013 were prospectively included. Data were analysed using t-tests and Fisher exact test. Results A total of 40 successful catheter insertions for 20 patients during 32 admissions were identified. The mean duration of the catheters was 10.08 days (median 9.5, SD=5.0). Of the 32 admissions, antibiotic therapy was completed with long catheters in 78% of cases (n=25) and with a single catheter in 48% (n=19). Rates of local complications were high, but there were no serious adverse outcomes. Conclusion Although limited by a small sample size, the results from this study are promising and suggest that 8 cm long catheters are a safe, effective and economical alternative to peripherally inserted central catheters (PICCs) in treating pulmonary exacerbations in children with CF.
Synthesis and Structure of an Aluminum Bis(3-chloropentanedionate) Isopropoxide: [Al(μ-OiPr)(3-Clacac)2]2
Authors: Gupta Kiran , Mayer Peter , Pandey Ashutosh 
Published: July 2014

1A
[Al(OiPr)3]4 was reacted at ambient temperature with 3-chloropentanedione (3-ClacacH) in 1 : 1 molar ratio in toluene, to obtain the mono-substituted product. However, the bis-substituted dinuclear tetrakis(3-chloropentanedionato)-di-m-isopropoxy-dialuminum(III) [Al(μ-OiPr)(3-Clacac)2]2 () was isolated in 46% yield upon aging of the reaction mixture at −10 °C. The supernatant upon aging yielded a crop of tris-3-chloroacetylacetonate Al(3-Clacac)3·H2O (1) in 13% yield. Complexes 1A (monoclinic, space group P21/c with Z = 2) and 1(cubic, space group P43n with Z = 8) were characterized by elemental analyses, NMR and IR spectroscopy and single-crystal X-ray crystallography.
Rehabilitation Interventions for the Management of Multiple Sclerosis Relapse
Authors: Asano Miho , Raszewski Rebecca , Finlayson Marcia 
Published: July 2014

Background: This review was undertaken to identify and summarize the existing evidence regarding postrelapse rehabilitation interventions in people with multiple sclerosis (MS).
Methods: Literature searches were conducted within the following databases: CINAHL Plus with Full Text, MEDLINE via Ovid, and PsycINFO via CSA Illumina. The following terms were searched as subject headings or keywords: choice behavior, counseling, decision making, disease management, health education, health promotion, patient education, patient participation, patient satisfaction, psychotherapy, rehabilitation, self-care, self-management. Then these searches were combined with the subject headings for relapsing-remitting multiple sclerosis and subject heading or keywords for recurrence/relapse. Through the initial database search and additional citation search, 260 potentially relevant citations were identified. After screening the titles and abstracts as well as the citation search results, the reviewers agreed to keep five studies for the full-text reviews. Three rehabilitation intervention studies were included in the final review.
Results: A combined total of 145 adults who experienced a relapse within the previous 5 months received 3 to 18 days of rehabilitation. All three studies suggested the benefit of multidisciplinary rehabilitation for individuals with MS to improve impairment or disability.
Conclusions: The three multidisciplinary rehabilitation interventions included in this review appear to be effective in improving impairment or disability of people with MS who experienced a relapse. Given the limited number of studies and their methodological limitations, the results must be interpreted cautiously. Further investigation is needed to better understand the rehabilitation needs of people with MS after relapse in order to improve research and care.
Use of Nondrug, Nonoperative Interventions by Community‐Dwelling People With Hip and Knee Osteoarthritis
Authors: Hinman R. S. , Nicolson P. J. A. , Dobson F. L. , Bennell K. L. 
Published: July 2014

ObjectiveGuidelines recommend nondrug, nonoperative treatments as the first‐line approach for hip and knee osteoarthritis (OA), yet there is limited data regarding use of these treatments in OA. This study describes the use of nondrug, nonoperative interventions in people with hip and knee OA.MethodsA convenience sample of 591 people with hip or knee OA completed a questionnaire indicating their past and/or current use of 17 nondrug, nonoperative interventions each for their hip or knee OA. Descriptive analyses, based on frequency counts and proportions, and chi‐square tests described the use of each intervention in the total cohort, and within subgroups of knee and hip OA.ResultsParticipants were currently using a mean ± SD of 0.8 ± 0.9 of the strongly recommended interventions. Making efforts to lose weight (50%, n = 294) and shoe orthoses (30%, n = 175) were the most common currently used interventions. Strengthening (26%, n = 152) and stretching exercises (23%, n = 133) were the most common interventions that participants had tried in the past but were no longer utilizing. Of note, 12% (n = 71) had never used any of the interventions. Use of 5 treatments (shoe orthoses, heat and/or cold, muscle strengthening exercises, walking aids, and transcutaneous electrical nerve stimulation) was significantly different between the hip and knee cohorts (P < 0.05).ConclusionUse of nondrug, nonoperative interventions was low among people with hip and knee OA. Our findings show evidence–practice gaps, particularly with respect to the interventions most strongly recommended in clinical guidelines for hip and knee OA (weight loss and exercise).
Are Men at Greater Risk of Lean Mass Deficits in Rheumatoid Arthritis?
Authors: Baker Joshua F. , Long Jin , Ibrahim Said , Leonard Mary B. , Katz Patricia 
Published: July 2014

ObjectiveWe aimed to determine if there were sex differences in lean body mass (LBM) in patients with rheumatoid arthritis (RA) when compared with sex‐ and race‐specific National Health and Nutrition Examination Survey (NHANES) reference data, and to investigate the impact of sex differences in risk factors for LBM deficits.MethodsDual x‐ray absorptiometry measures of whole body LBM and appendicular LBM (arms and legs, appendicular lean mass [ALM]) were obtained on a total of 190 subjects from 2 independent cohorts (141 from San Francisco [SF], 49 from Philadelphia [PA]), expressed as indices adjusted for height (LBM index and ALM index, kg/m2), and converted to sex‐ and race‐specific Z scores relative to age and based on NHANES data. Sarcopenia was defined using 4 different sex‐specific definitions. Multivariable linear and logistic regression analyses adjusted for disease activity, disease duration, physical activity, anti–cyclic citrullinated peptide seropositivity, fat mass index, and glucocorticoid use.ResultsWhile there were significant differences between the 2 cohorts, ALM index Z scores were significantly lower in men compared to women in both (SF: −1.43 versus −0.43, P < 0.0001; PA: −0.83 versus −0.06, P = 0.03). Observed sex differences were significant after adjustment in multivariable analyses within both cohorts. Odds of sarcopenia were 3 to 8 times greater in men in the SF cohort. Men in the PA cohort also had a higher, but nonsignificant, risk of sarcopenia.ConclusionRA is associated with significant LBM deficits, with greater deficits observed in men. Future study may help elucidate the mechanisms driving greater deficits among men.
Is Spinal Mobility in Patients With Spondylitis Determined By Age, Structural Damage, and Inflammation?
Authors: Calvo‐Gutierrez Jerusalem , Garrido‐Castro Juan L. , Gil‐Cabezas Jesus , Gonzalez‐Navas Cristina , Ugalde Pilar Font , Carmona Loreto , Collantes‐Estevez Eduardo 
Published: July 2014

ObjectiveTo explore the association between mobility, inflammation, and structural damage in ankylosing spondylitis (AS).MethodsPatients with AS were included in a cross‐sectional study in which spinal mobility was measured by the Bath Ankylosing Spondylitis Metrology Index (BASMI) and by the University of Córdoba Ankylosing Spondylitis Metrology Index (UCOASMI), based on an automated motion analysis. Structural damage was measured by the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS), and activity by the Ankylosing Spondylitis Disease Activity Score (ASDAS) and the Bath Ankylosing Spondylitis Disease Activity (BASDAI). We analyzed the correlations between variables, as well as interaction by multiple linear regression models to reach a predictive equation.ResultsFifty AS patients, mainly men in their mid‐40s and with moderate levels of disease activity and structural damage, were included in the study. BASMI and UCOASMI scores showed a strong correlation (r = 0.89). UCOASMI scores correlated stronger than BASMI with structural damage (r = 0.72 versus r = 0.67) and patient's age (r = 0.68 versus r = 0.56). Correlations of mobility were weaker with disease activity by the ASDAS (r = 0.38) and BASDAI (r = 0.49), and disease duration (r = 0.40). Multiple linear regression showed that factors associated to mobility by UCOASMI were age, the BASDAI, mSASSS, ASDAS (0:<2.1, 1:≥2.1), and disease duration >15 years. The largest weight in the equation corresponded to the mSASSS. The association between the ASDAS and UCOASMI is dependent on disease duration.ConclusionMobility in AS is influenced by both structural damage and activity, but definitely also by age and disease duration. Improved mobility should be a relevant target in AS, even more prominently than activity, given its closer relation to structural damage.
Factors Explaining the Discrepancy Between Physician and Patient Global Assessment of Joint and Skin Disease Activity in Psoriatic Arthritis Patients
Authors: Eder Lihi , Thavaneswaran Arane , Chandran Vinod , Cook Richard , Gladman Dafna D. 
Published: July 2014

ObjectiveTo assess the extent and determinants of discordance in scoring between patient global assessment (PtGA) and physician global assessment (PhGA) in patients with psoriatic arthritis (PsA).MethodsA cross‐sectional and longitudinal analysis of data was conducted in patients attending a large PsA clinic. The difference between PtGA and PhGA (each measured on a scale of 0–10, with 0 indicating best status and 10 indicating worst status) reflected the discrepancy between the PtGA and PhGA of joint and skin activity and could take values from −10 (higher rating of disease activity by the patient) to 10 (higher rating of disease activity by the physician). Multivariate regression identified variables that contributed significantly to each of the outcomes. The proportion of variability of each outcome explained by each predictor was expressed by the partial R2.ResultsA total of 565 patients were included in the analysis. Patients tended to score their disease worse than their physicians, with greater discordance for the joints than for the skin (mean ± SD 1.68 ± 2.41 PtGA–PhGA difference for joints, and 0.77 ± 2.66 for skin). Fatigue accounted for 21% of the variation in the difference between PtGA and PhGA for joints. Pain ( = 9%) and disability by Short Form 36 health survey ( = 1.2%) were also important factors, each of which led to higher patient rating; whereas increased tender joint count ( = 16%) and swollen joint count ( = 1.4%) resulted in a higher physician rating of arthritis.ConclusionFatigue, pain, disability, and tender and swollen joint counts were the most important factors contributing to discrepancy between patient and physician assessment of joint activity.
Factors Associated With Pain Experience Outcome in Knee Osteoarthritis
Authors: Rayahin Jamie E. , Chmiel Joan S. , Hayes Karen W. , Almagor Orit , Belisle Laura , Chang Alison H. , Moisio Kirsten , Zhang Yunhui , Sharma Leena 
Published: July 2014

ObjectiveFew strategies to improve pain outcome in knee osteoarthritis (OA) exist in part because how best to evaluate pain over the long term is unclear. Our objectives were to determine the frequency of a good pain experience outcome based on previously formulated OA pain stages and test the hypothesis that less depression and pain catastrophizing and greater self‐efficacy and social support are each associated with greater likelihood of a good outcome.MethodsStudy participants, all with knee OA, reported pain stage at baseline and 2 years. Baseline assessments utilized the Geriatric Depression Scale, Pain Catastrophizing Scale, Arthritis Self‐Efficacy Scale, and Medical Outcomes Study social support survey. Using pain experience stages, good outcome was defined as persistence in or movement to no pain or stage 1 (predictable pain, known trigger) at 2 years. A multivariable logistic regression model was developed to identify independent predictors of a good outcome.ResultsOf 212 participants, 136 (64%) had a good pain outcome and 76 (36%) a poor pain outcome. In multivariable analysis, higher self‐efficacy was associated with a significantly higher likelihood of good outcome (adjusted odds ratio [OR] 1.14 [95% confidence interval (95% CI) 1.04–1.24]); higher pain catastrophizing was associated with a significantly lower likelihood of good outcome (adjusted OR 0.88 [95% CI 0.83–0.94]).ConclusionThis stage‐based measure provides a meaningful and interpretable means to assess pain outcome in knee OA. The odds of a good 2‐year outcome in knee OA were lower in persons with greater pain catastrophizing and higher in persons with greater self‐efficacy. Targeting these factors may help to improve pain outcome in knee OA.
Are Fibromyalgia Patients Cognitively Impaired? Objective and Subjective Neuropsychological Evidence
Authors: Tesio Valentina , Torta Diana M. E. , Colonna Fabrizio , Leombruni Paolo , Ghiggia Ada , Fusaro Enrico , Geminiani Giuliano C. , Torta Riccardo , Castelli Lorys 
Published: July 2014

ObjectivePatients with fibromyalgia (FM) syndrome often report a cluster of cognitive disorders that strongly interferes with their work and daily life, but the relationship between impaired cognitive function and self‐reported dysfunction remains unclear. We aimed to investigate the presence of cognitive impairments in patients with FM and to analyze the relationship between the impairments and their evaluation by the patients through a comparison with a group of healthy controls.MethodsIn total, 30 FM patients and 30 healthy controls performed a neuropsychological and clinical evaluation of short‐term, long‐term, and working memory; executive function; and self‐evaluation of cognitive impairment and depressive and anxiety symptoms. To thoroughly investigate executive function, we adopted the Miyake model that identifies 4 domains: shifting, inhibition, updating, and access.ResultsOur results confirmed the presence of impairments of attention, long‐term memory, working memory, and shifting and updating executive functions in FM patients compared with healthy controls. These impairments are reflected in patient reports independently of depressive symptoms.ConclusionThe use of a self‐reported questionnaire in clinical practice would provide a first and easy screen for the presence of cognitive impairment in FM patients and, in most cases, obviate the need for a time‐consuming full neuropsychological test battery.
Design and Effects of Supportive Followup Interventions in Clinical Care of Patients With Rheumatic Diseases: A Systematic Review With Meta‐Analysis
Authors: Berdal Gunnhild , Smedslund Geir , Dagfinrud Hanne , Hagen Kåre Birger , Kjeken Ingvild 
Published: July 2014

ObjectiveTo describe the design and determine the clinical effects of supportive followup interventions delivered after or alongside nonsurgical treatment or rehabilitation of patients with rheumatic diseases.MethodsWe performed a systematic review of randomized controlled trials searching the Ovid Medline, Embase, Cinahl, AMED, PsychINFO, and Cochrane Library databases. Trials evaluating the effects of interventions designed to enhance and/or prolong the effects of rheumatic treatment or rehabilitation were included. Data on pain, depression, and physical function were pooled in separate meta‐analyses, including analyses made to calculate short‐term (0–2 months) and long‐term (5–6 months after followup intervention) effects. Risk of bias was assessed by 2 independent reviewers.ResultsThe searches generated 3,231 citations, of which 11 original trials were included. The results demonstrated a great variety in the design of followup interventions. We found moderate quality evidence for small effects on self‐reported physical function, with standardized mean differences of −0.15 (95% confidence interval [95% CI] −0.30, 0.00; P = 0.05) at short term, and −0.18 (95% CI −0.37, 0.00; P = 0.05) at long‐term followup. Moderate quality evidence showed no effect of supportive followup interventions on short‐term depression. Low quality evidence showed no significant effects on short‐term pain, and very low quality evidence showed no significant effects on long‐term pain and depression.ConclusionCurrently there is no clear evidence concerning what constitutes an optimal design of supportive followup interventions. There is evidence that supportive followup can improve physical function in patients with rheumatic diseases, whereas no significant effects were found for pain and depression.
Visits to Rheumatologists for Arthritis: The Role of Access to Primary Care Physicians, Geographic Availability of Rheumatologists, and Socioeconomic Status
Authors: Badley Elizabeth M. , Canizares Mayilee , Gunz Anna C. , Davis Aileen M. 
Published: July 2014

ObjectiveThis multilevel study examines access to rheumatologists for all arthritis and inflammatory arthritis, taking into account geographic availability of rheumatologists, access to primary care physicians (PCPs), and population characteristics (e.g., socioeconomic status [SES]).MethodsWe analyzed data from the population (age ≥18 years) living in the 105 health planning areas in Ontario, Canada on visits to physicians for arthritis and musculoskeletal disorders. Using data from a survey of rheumatologists and Geographic Information System analysis, an index of geographic availability for rheumatologists was calculated, incorporating distance between the population and rheumatologist locations and the number of hours per week of rheumatologist care. Multilevel Poisson regression was used to examine factors associated with the rates of rheumatology visits for inflammatory arthritis and all arthritis.ResultsControlling for age and sex, the rheumatologist availability index was associated with visit rates for all arthritis, but not inflammatory arthritis. Patients living in areas with low access to PCPs or low SES were less likely to have office visits to rheumatologists for all arthritis and inflammatory arthritis.ConclusionBesides potential deficiencies in rheumatology provision, there may be access barriers to rheumatology services, particularly for populations with low access to PCPs or low SES. This is of special concern for patients with inflammatory arthritis for whom rheumatologist care is necessary. In developing models of care for arthritis, this study points to the need to pay attention to areas with low PCP resources and areas of low SES, as well as the location and amount of rheumatology services available.