bluuebunny/crossref_metadata_2025_split huggingface dataset:
The management of toxic epidermal necrolysis
Authors: Fernando Suran L 
Published: February 2012

ABSTRACTThe mortality rate of Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) is high; approximately 5% for SJS and 25% for TEN. It is therefore vital for the treating physician to recognise SJS and TEN promptly through the identification of these diseases' characteristic clinical features so that the offending drug is promptly withdrawn, supportive therapy is administered and adjunctive therapies are considered. Supportive therapy addressing the manifestations and complications of acute skin failure include monitoring the fluid – electrolyte balance and providing enteral or parenteral nutrition, wound care and treatment of sepsis. In addition, supportive care of the affected mucosal surfaces is required through the use of aggressive ocular lubrication, topical corticosteroids, hygienic mouthwashes and oral anaesthetics, together with monitoring for urinary retention. There is sufficient evidence for the use of intravenous immune globulin in the acute management of SJS/TEN provided an adequate dose of 2–3 g/kg is administered. Cyclosporine appears to also be an effective agent although randomised control studies are required to demonstrate its benefit and establish the dose, duration of therapy and safety profile. The role of corticosteroids is currently under revision. Some earlier studies have shown a lack of efficacy or increased mortality in their use but the use of high doses early in the course of disease may actually reduce morbidity and mortality. The role of plasmapheresis, anti‐tumour necrosis factor (TNF) biologics and N‐acetylcysteine is promising but further studies are required to elucidate their benefit. Preventative strategies such as pharmacogenetic screening needs to be strongly considered, with the provision of cost‐effective assays with a rapid turn‐around time.
Development of Self‐Efficacy Questionnaire for Chinese Family Caregivers
Authors: Zhang Shu‐Ying , Edwards Helen , Yates Patsy , Ruth Elder , Guo Qi Hao 
Published: February 2012

ABSTRACTThe purpose of this study was to develop a Self‐Efficacy Questionnaire for Chinese Family Caregivers. Semi‐structured interviews with 10 family caregivers of people with dementia were conducted to explore how Chinese caregivers manage caregiving and what difficulties they face. The findings of the study assisted in the development of the instrument. Five categories of caregiver behaviours were identified from the qualitative data: gathering information about treatment, symptoms, and health care; obtaining support; responding to behaviour disturbances; managing household, personal, and medical care; and managing distress associated with caregiving. The challenges of caregiving were also identified, including deterioration of care recipients, particularly their behaviour disturbances, a shortage of supportive resources, stigmatization of dementia among the general population, as well as increased distress and decreased social activities due to increased care demand. The findings were used to develop the Self‐Efficacy Questionnaire for Chinese Family Caregivers, and 35 items comprising five subscales (representing the above five categories of caregiver behaviour) were generated.
Self‐harm and attempted suicide within inpatient psychiatric services: A review of the Literature
Authors: James Karen , Stewart Duncan , Bowers Len 
Published: February 2012

ABSTRACTSelf harm is a major public health concern, yet there are considerable challenges in providing support for those who self harm within psychiatric inpatient services. This paper presents the first review of research into self harm within inpatient settings. Searches of the main electronic databases were conducted using key words for self harm and inpatient care. There was substantial variation in the rates of self‐harm and attempted suicide between studies, but rates were highest on forensic wards. There was no evidence of differences in prevalence of self‐harm between men and women; women, however, were at increased risk of attempting suicide. People were more likely to self‐harm in private areas of the ward and in the evening hours, and often self‐harmed in response to psychological distress, or elements of nursing care that restricted their freedom. Wards used a variety of strategies to prevent self‐harm; however, there is little research into their effectiveness.
Acute renal failure induced by disseminated intravascular coagulopathy in a patient with adenomyosis
Authors: Yoo Heon Jong , Chang Dong Suk , Lee Ki Hwan 
Published: February 2012

AbstractDisseminated intravascular coagulation is most frequently associated with obstetric catastrophes, metastatic malignancy, massive trauma and bacterial sepsis, but relatively rarely related to benign tumors. We report on disseminated intravascular coagulopathy in a patient with significant adenomyosis and menometrorrhagia. An extremely rare case, disseminated intravascular coagulopathy developed in this benign case and was successfully treated with a hysterectomy and blood product transfusions.
Metastatic hepatic actinomycosis masquerading as distant metastases of ovarian cancer
Authors: Kim Young Sun , Lee Bo Yon , Jung Min Hyung 
Published: February 2012

AbstractActinomycosis is a chronic disease characterized by abscess, tissue fibrosis and draining sinuses. Pelvic actinomycosis in women most commonly occurs during ascending infections, which are usually associated with intrauterine devices; however, secondary hepatic actinomycosis, while rare, can also occur. We describe a patient with an unusual case of metastatic hepatic actinomycosis misdiagnosed as distant metastases of ovarian cancer.
Effects of preeclampsia on the yield of hematopoietic stem cells obtained from umbilical cord blood at delivery
Authors: Abdul Wahid Fadilah S. , Nasaruddin Mona Zaria , Mohd Idris Mohd Razif , Tusimin Maiza , Tumian Nor Rafeah , Abdullah Mahdy Zaleha 
Published: February 2012

AbstractAim:  To compare the numbers of cord blood CD34+ hematopoietic stem cells (HSC) between preeclampsia (PE) and control (non‐PE) subjects and to determine the factors that may influence this observation.Methods:  Umbilical cord blood was collected from 28 PE and 19 non‐PE subjects. Nucleated and CD34+ cell counts were derived using the Trucount tube‐based stem cell enumeration kit on BD FACSCalibur.Results:  The cord blood volume, nucleated and CD34+ cell counts were significantly reduced in PE subjects compared to non‐PE subjects. Among the PE subjects, systolic and diastolic blood pressure demonstrated a negative correlation with total nucleated and CD34+ cell counts. Gestational age at delivery influenced cord blood volume and nucleated cell counts, but not CD34+ cell counts. Birth weight and placental weight correlated strongly with cord blood volume, and nucleated and CD34+ cell counts. There were no correlations observed between cord blood parameters and maternal age, maternal white cell count, gravidity, route of delivery or neonatal gender among PE subjects.Conclusion:  Preeclampsia has a negative impact on the yield of HSC obtained from cord blood at delivery. Maternal blood pressure, neonatal birth weight and placental weight are important factors influencing the numbers of cord blood HSC. These findings should be taken into consideration when selecting cord blood units from mothers with PE for banking. Selecting the heaviest term neonate might improve the yield of cord blood HSC obtained from PE mothers.
Isolated ‘sign of the horns’: A simple, pathognomonic, prenatal sonographic marker of Crisponi syndrome
Authors: Dessì Angelica , Fanos Vassilios , Crisponi Giangiorgio , Frau Alessandro , Ottonello Giovanni 
Published: February 2012

AbstractThe case of a patient presenting with Crisponi syndrome recently hospitalized at our institution is described. During pregnancy a diagnosis of this syndrome was hypothesized following sonographic observation of the fetus with the hands showing ‘the sign of the horns’. Such a finding, if isolated, as in our case, may represent a simple, pathognomonic sonographic marker of Crisponi syndrome.
Laparoscopic and open colorectal surgery: a prospective cost analysis
Authors: Dowson H. M. , Gage H. , Jackson D. , Qiao Y. , Williams P. , Rockall T. A. 
Published: February 2012

AbstractAim  Cost has been perceived to be a factor limiting the development of laparoscopic colorectal surgery. This study aimed to compare the costs of laparoscopic and open colorectal surgery.Method  Patients undergoing laparoscopic or open elective colorectal surgery were recruited into a prospective study to evaluate the healthcare costs of each operative procedure in a district general hospital in England. All healthcare resources used (operation, hospital and community) were recorded and converted to costs in British pounds, 2006–2007. Costs of laparoscopic and open surgery were compared.Results  In all, 201 consecutive patients consented and were recruited (131 laparoscopic, 70 open). Operative costs were greater in the laparoscopic group (£2049 vs£1263, P < 0.001) due to the costs of disposable instruments, but the hospital costs were less (£1807 vs£3468, P < 0.001) due to longer lengths of stay in the open group. Community costs were similar in the two groups and had little impact on the overall costs, which were not significantly different (£3875 laparoscopic vs£4383 open, P = 0.308). In the subgroup of patients with a stoma, overall costs in the laparoscopic group are higher (not significant).Conclusion  The costs of laparoscopic and open colorectal surgery are broadly equivalent. If there is an associated improvement in patient benefit, then laparoscopic colorectal surgery may be considered to be cost effective compared with open surgery.
Low complication rate after stoma closure. Consultants attended 90% of the operations
Authors: Faunø L. , Rasmussen C. , Sloth K. K. , Sloth A. M. , Tøttrup A. 
Published: February 2012

AbstractAim  To evaluate complications after stoma closure.Method  Using a retrospective review of 997 medical records, data were collected from all patients undergoing stoma closure at the Department of Surgery P, Aarhus University Hospital, Denmark, from 1996 to 2010. Patient data after Hartmann reversal and loop‐ileostomy closure were compared. Data regarding the grade of the operating surgeon and assistant were extracted.Results  Out of 997 patients, 700 (70.6%) had a loop‐ileostomy closure and 172 (17.4%) had a Hartmann reversal. Postoperative mortality was 0.5%. Seven patients required re‐operation (0.7%). Morbidity was registered in 31.9% of the patients, with 131 (13.1%) having early complications and 187 (18.8%) having late complications. Wound infection was the most frequent early complication, which occurred in 31 patients (3.1%). Only 10 patients (1%) had an anastomotic leak. Incisional hernia was the most frequent late complication, occurring in 92 patients (9.3%). A consultant attended 90% of the operations. Junior surgeons never performed stoma closure without supervision. Body mass index was significantly associated with the development of incisional hernia. Hartmann reversal was associated with higher rates of complications compared with loop‐ileostomy closure. In patients with Hartmann reversal, stapled anastomosis was associated with stricture in 12 out of 95 cases (12.6%), whereas hand‐sewn anastomosis was not associated with stricture (0 out of 64 patients; 0%; P < 0.05).Conclusion  Stoma closure is associated with low rates of leakage. A favourable case mix and high degree of consultant attendance may explain the good results.
Synchronous resection of colorectal cancer and liver metastases: comparative views of colorectal and liver surgeons
Authors: Qureshi M. S. , Goldsmith P. J. , Maslekar S. , Prasad K. R. , Botterill I. D. 
Published: February 2012

AbstractAim  The optimal management of patients presenting with colorectal cancer and synchronous liver metastases is controversial. This survey was intended to summarize the opinions of UK colorectal and liver surgeons on the specific issues pertaining to synchronous resection.Method  A validated electronic survey was sent to the consultant members of the Association of Coloproctology of Great Britain and Ireland (ACPGBI) and the Association of Upper Gastrointestinal Surgeons (AUGIS). The questions were structured to allow direct comparison between the two groups of the responses obtained.Results  Four hundred and twenty‐four specialist colorectal surgeons and 52 specialist hepatobiliary surgeons were identified from the register of their respective associations. Responses were obtained from 133 (31%) colorectal and 22 (42%) liver surgeons. A majority of both groups of surgeons felt that synchronous resection was a valid therapeutic option. A majority of both groups believed that synchronous resection was justified despite the options of laparoscopic surgery and enhanced recovery programmes for each discipline. Agreed possible advantages of synchronous resections were: a decrease in the overall length of hospital stay, cost and patient anxiety. The major concern about synchronous resections was an excessive overall physiological insult. Specific scenarios indicated that synchronous resection was favoured for major/complex major colorectal resection with minor liver resection or most colorectal resections not involving an anastomosis with either a minor or major liver resection.Conclusion  Although significant concerns relating to synchronous resection remain amongst colorectal and liver surgeons, a majority of them felt that synchronous resections could be offered to appropriately selected patients.
Risk factors for chronic pouchitis after ileal pouch–anal anastomosis: a prospective cohort study
Authors: Hashavia E. , Dotan I. , Rabau M. , Klausner J. M. , Halpern Z. , Tulchinsky H. 
Published: February 2012

AbstractAim  The association between various demographic, clinical and pathological parameters and the evolution of chronic pouchitis was evaluated.Method  All ulcerative colitis patients who underwent ileal pouch anal anastomosis (1981–2009) were followed prospectively in a comprehensive pouch clinic. We examined risk factors including the presence of appendiceal inflammation and backwash ileitis in the colonic specimen, gender, ethnicity, age at disease onset, disease duration, extent of colitis, presence of extraintestinal manifestations (e.g. primary sclerosing cholangitis), family history of inflammatory bowel disease, indication for surgery, medical treatment, age at operation, staged procedure, diverting ileostomy and length of follow‐up. Univariate analysis was performed on all risk factors followed by logistic regression analysis.Results  The 201 enrolled patients (106 women, age at surgery 35 ± 15 years) were followed for a mean of 108 months. One hundred and thirty‐eight (69%) had either a normal pouch or episodes of acute pouchitis and 63 (31%) developed chronic pouchitis. On univariate analysis the presence of an ileostomy (P = 0.017), pancolitis (P = 0.008), shorter disease duration (P = 0.04) and longer follow‐up (P = 0.01) were identified as risk factors for chronic pouchitis. Multivariate analysis showed that patients with pancolitis (OR 3.26, 95% CI 1.20–8.85) and longer follow‐up (OR 1.09, 95% CI 1.01–1.18) were more likely to develop chronic pouchitis. There was also an association to disease duration but this did not reach a level of significance.Conclusions  Pancolitis and longer follow‐up are directly related to the development of chronic pouchitis.
Effects of intravitreal injection of KH902, a vascular endothelial growth factor receptor decoy, on the retinas of streptozotocin‐induced diabetic rats
Authors: Huang J. , Li X. , Li M. , Li S. , Xiao W. , Chen X. , Cai M. , Wu Q. , Luo D. , Tang S. , Luo Y. 
Published: February 2012

Aims: KH902 is a fusion protein that can bind vascular endothelial growth factor (VEGF) and placental growth factor (PlGF) through its binding ligand taken from the domains of VEGF receptor 1 and VEGF receptor 2 (VEGFR2). This study was to investigate the effects of intravitreal injection of KH902 on the retinas of streptozotocin‐induced diabetic rats.Methods: Two weeks after induction of diabetes, the left eyes of diabetic rats in each group received an intravitreal injection of phosphate‐buffered saline (PBS), Avastin or KH902 solution, respectively. Four weeks after intravitreal injection, retinal electrophysiological function and the integrity of inner blood retinal barrier (iBRB) were measured by electroretinogram and Evans blue perfusion. The protein levels of VEGF signal pathway were assayed by western blot. The expression and distribution of claudin‐5 and occludin were analysed by double immunofluorescent staining under confocal microscope. The expression of VEGFR2 and PlGF was measured by immunohistochemistry.Results: Four weeks after intravitreal injection, KH902‐treated rats had better retinal electrophysiological function, less retinal vessel leakage and lower levels of VEGFR2, PI3K, AKT, p‐AKT, p‐ERK and p‐SRC than PBS or Avastin‐treated rats. The distribution of claudin‐5 and occludin in the retinal vessels of diabetic rats treated by KH902 was smoother and more uniform than those of diabetic rats treated by PBS or Avastin. The expression of PlGF and VEGFR2 in KH902‐treated rats was decreased compared with those in PBS or Avastin‐treated rats.Conclusions: KH902 could improve retinal electrophysiological function and inhibit the breakdown of iBRB by inhibiting the expression of VEGFR2, PlGF and PI3K, and the activation of SRC, AKT and ERK.
The effect of linagliptin on glycaemic control and tolerability in patients with type 2 diabetes mellitus: a systematic review and meta‐analysis
Authors: Singh‐Franco D. , McLaughlin‐Middlekauff J. , Elrod S. , Harrington C. 
Published: February 2012

Aim: Linagliptin is a new dipeptidyl peptidase‐4 inhibitor recently approved for use in the USA. The objective of this systematic review and meta‐analysis was to assess effect of linagliptin on glycaemic control, biomarkers and incidence of adverse events (AEs) in patients with type 2 diabetes mellitus.Methods: Five published and four unpublished randomized, clinical trials were identified from multiple databases. Qualitative assessments and quantitative analyses were performed.Results: Nine studies included 4246 participants with 53% men, 59.4% Caucasians, 38.7% Asians, and age range 45–69 years. Linagliptin was given as monotherapy (vs. placebo) or combined with metformin (vs. metformin + placebo), sulphonylurea (vs. sulphonylurea + placebo) or pioglitazone (vs. pioglitazone + placebo). Linagliptin 5 mg/day for 12–24 weeks, significantly reduced haemoglobin A1c (HbA1c) (−0.63%, p < 0.00001), fasting plasma glucose (FPG) (−1.01 mmol/l, p < 0.00001) and improved disposition index (DI, product of insulin sensitivity and acute insulin secretion) (p = 0.0001). Linagliptin monotherapy was not more effective than metformin at reducing HbA1c or FPG. Similar proportion of patients in linagliptin and placebo groups reported AEs including upper respiratory tract infections, headaches, nausea, hypertension and back pain.Conclusions: Linagliptin was associated with modest but significant reduction in HbA1c and FPG and improved DI after 12–24 weeks. Patients who would probably benefit most are those with HbA1c <9%, already on an active agent, compliant with weight reduction strategies, and can recognize and manage hypoglycaemia, fluid retention and upper respiratory tract infections. Long‐term studies are needed to determine durability of response, incidence of microvascular and macrovacular complications, cost‐effectiveness and safety.
Effects of JNJ‐38431055, a novel GPR119 receptor agonist, in randomized, double‐blind, placebo‐controlled studies in subjects with type 2 diabetes
Authors: Katz L. B. , Gambale J. J. , Rothenberg P. L. , Vanapalli S. R. , Vaccaro N. , Xi L. , Sarich T. C. , Stein P. P. 
Published: February 2012

Aim: G‐protein coupled receptor agonists are currently under investigation for their potential utility in patients with type 2 diabetes mellitus (T2DM). The objective was to determine the pharmacokinetics, pharmacodynamics, safety and tolerability of GPR119 agonist, JNJ‐38431055 in T2DM subjects.Methods: This was a randomized, double‐blind, placebo‐ and positive‐controled, single‐dose cross‐over study and a randomized, double‐blind, placebo‐controled multiple‐dose parallel design study. The study was conducted at 4 US research centres. Two different experiments involving 25 and 32 different subjects were performed in male and female subjects, aged 25–60 years, mean body mass index between 22 and 39.9 kg/m2 who had T2DM diagnosed 6 months to 10 years before screening. JNJ‐38431055 (100 and 500 mg) or sitagliptin (100 mg) as a single‐dose or JNJ‐38431055 (500 mg) once daily for 14 consecutive days were tested. Effects on stimulated plasma glucose, insulin, C‐peptide and incretin concentrations were pre‐specified outcomes.Results: JNJ‐38431055 was well tolerated and not associated with hypoglycaemia. Plasma systemic exposure of JNJ‐38431055 increased as the dose increased, was approximately two‐fold greater after multiple‐dose administration, and attained steady‐state after approximately 8 days. Compared with placebo, single‐dose administration of oral JNJ‐38431055 decreased glucose excursion during an oral glucose tolerance test, but multiple‐dose administration did not alter 24‐h weighted mean glucose. Multiple dosing of JNJ‐38431055 increased post‐meal total glucagon‐like peptide 1 and gastric insulinotropic peptide concentrations compared to baseline.Conclusions: These studies provide evidence of limited glucose lowering and incretin activity for JNJ‐38431055 in subjects with T2DM.
Congenital keratoconjunctivitis sicca and ichthyosiform dermatosis in Cavalier King Charles spaniel dogs–part II: candidate gene study
Authors: Hartley Claudia , Barnett Keith C. , Pettitt Louise , Forman Oliver P. , Blott Sarah , Mellersh Cathryn S. 
Published: February 2012

AbstractPurpose  To identify causative mutation(s) for congenital keratoconjunctivitis sicca and ichthyosiform dermatosis (CKCSID) in Cavalier King Charles spaniel (CKCS) dogs using a candidate gene approach.Methods  DNA samples from 21 cases/parents were collected. Canine candidate genes (CCGs) for similar inherited human diseases were chosen. Twenty‐eight candidate genes were identified by searching the Pubmed OMIM database (http://www.ncbi.nlm.nih.gov/omim). Canine orthologues of human candidate genes were identified using the Ensembl orthologue prediction facility (http://www.ensembl.org/index.html). Two microsatellites flanking each candidate gene were selected, and primers to amplify each microsatellite were designed using the Whitehead Institute primer design website (http://frodo.wi.mit.edu/primer3/). The microsatellites associated with all 28 CCGs were genotyped on a panel of 21 DNA samples from CKCS dogs (13 affected and eight carriers). Genotyping data was analyzed to identify markers homozygous in affected dogs and heterozygous in carriers (homozygosity mapping).Results  None of the microsatellites associated with 25 of the CCGs displayed an association with CKCSID in the 21 DNA samples tested. Three CCGs associated microsatellites were monomorphic across all samples tested.Conclusions  Twenty‐five CCGs were excluded as cause of CKCSID. Three CCGs could not be excluded from involvement in the inheritance of CKCSID.Support  Kennel Club Charitable Trust grant.