Full Manuscripts Research Articles

Considerations in the modern management of stress urinary incontinence resulting from intrinsic sphincter deficiency.

Intrinsic sphincter deficiency (ISD) is a common cause of stress urinary incontinence and is associated with more severe symptoms, often being associated with failed previous surgery. Due to the impaired sphincteric function, alternative surgical approaches are often required. The purpose of this review is to appraise the contemporary literature on the diagnosis and management of ISD. A PubMed search was performed to identify articles published between 1990 and 2014 using the following terms: ISD, stress urinary incontinence and type III stress urinary incontinence. Publications were screened for relevance, and full manuscripts were retrieved. Most studies base the diagnosis of ISD upon urodynamic appearances using recognized criteria (Valsalva leak point pressure <60 cm H2O or a maximum urethral closure pressure <20 cm H2O) in addition to clinical features. A range of non-surgical and surgical treatment options are available for the patient. Pubovaginal slings are more effective than retropubic colposuspensions with outcomes comparable to those reported with midurethral slings. The artificial urinary sphincter provides long-term cure rates; however, it is associated with specific morbidity including device erosion, mechanical failure and revision. The benefits of bulking agents, however, are not sustained beyond 1 year. There are few randomized controlled trials that compare accepted treatments specifically for patients with ISD. The lack of standardization in the definition and diagnostic criteria used limits inter-study comparisons. An assessment of urethral pressure profile when combined with the clinical features may help predict outcomes of surgical intervention.

Apheresis research-more abstracts should be published as full manuscripts to provide more evidence for clinical practice guidelines.

High-quality evidence to support clinical practice is lacking in apheresis medicine compared to other therapeutic modalities. A potential source of evidence comes from the abstracts submitted to the Annual Meetings of the American Society for Apheresis (ASFA). Therefore, the goal of this study is to determine the proportion of abstracts from the 2005 to 2012 ASFA Annual Meetings that subsequently became PubMed-indexed publications. Furthermore, we sought to determine the factor(s) that were associated with the likelihood of abstracts to be published as full manuscripts. During the 8-year study period, 684 abstracts were available for analysis (median: 82/year, range: 64-118). Most abstracts (74%) were from US institutions, and 67% of first authors were affiliated with academic centers. There were more abstracts (64%) on therapeutic versus donor apheresis (20%) and cellular therapy (16%). Overall, 16% of the abstracts have been published in PubMed-indexed journals, with a median time of 17 months from the ASFA Annual Meeting (range: 1-96 months). Abstracts whose first authors were affiliated with academic institutions were 3.14 times more likely to have been published than abstracts with ones affiliated with an apheresis organization and/or a community hospital. However, neither the first author's location nor the type of apheresis procedure significantly affected the publication rate after adjusting for other covariates. In conclusion, the rate of publication is low and authors should be encouraged to follow their presentations at the meeting with peer-reviewed manuscripts. This change is essential to provide more published evidence for future apheresis practice guidelines. J. Clin. Apheresis 31:353-358, 2016. © 2015 Wiley Periodicals, Inc.

Microbial ecology associated to soil-plant interactions: exemplifying recent progress in East Asia

s for potential papers were invited from the symposium presentations and posters, from which 19 full papers were invited. The papers subsequently accepted for publication include a review and three research articles. The review paper focused on the application of stable isotope labelling of phospholipid fatty acids (SIP-PLFA) to trace C fluxes in soil-plant ecosystems (Yao et al. 2015). It concluded that the SIP-PLFA method provides an excellent tool to study the incorporation of rhizodeposited C into soil microbial biomass and understand the plant-microbe-soil interactions in the rhizosphere. The three research articles used labeling techniques to assess the flow of C photosynthetates in paddy soils and focused on molecular biological techniques to determine the microbial community Plant Soil (2015) 392:1–2 DOI 10.1007/s11104-015-2521-6 Responsible Editor: Paul Bodelier. H. Yao (*) :Y. Zhu Institute of Urban Environment, Chinese Academy of Sciences, Xiamen 361021, China e-mail: hyyao@iue.ac.cn Y. Zhu e-mail: ygzhu@iue.ac.cn H. Yao :Y. Zhu Ningbo Urban Environment Observation and Research Station, Chinese Academy of Sciences, Ningbo 315830, China changes in response to biological invasion, elevated CO2 and temperature. Ge et al. (2015) demonstrated that nitrogen fertilization can promote the incorporation of photosynthesis derived C into soil organic C pools. Overall, the amount of CO2 that was converted into SOC was proportional to the soil N concentration, indicating that N fertilization promoted rhizodeposition. However, the proportion of C in the microbial biomass C was highest at the lower fertilization rate. Higher microbial activity was found in areas invaded by Phragmites australis compared to areas dominated by native species, and plant diversity was found to be the most important regulator of microbial community structure and diversity in these areas (Song et al. 2015). Ren et al. (2015) found distinct response patterns of soil and leaf-associated bacterial communities to elevated CO2 and temperature. In this study it was observed that the dominance of Enterobacteriaceae in leaf tissue may be of great importance in rice growth. These papers highlight the current focus of understanding the interactions between crop plants and microbial communities with respect to nutrient cycling. Future research is likely to increasingly focus on problems affecting food security. Over fertilization, pesticide and industrial pollution are major concerns in many parts of East Asia, in addition to understanding the long-term consequences of climate change. We would like to thank all the authors who attended the symposium, and contributed abstracts and full manuscripts for their active responses, encouragement and cooperation. Thanks are also due to all the reviewers and to Professor Hans Lambers, the Editor-in-chief and his editorial team at Plant and Soil for handling these papers.

Long-term survival of critically ill patients treated with prolonged mechanical ventilation: a systematic review and meta-analysis

Prolonged dependence on mechanical ventilation after critical illness is an emerging public health challenge; however, long-term outcomes are incompletely understood. We aimed to systematically analyse long-term survival of critically ill patients treated with prolonged mechanical ventilation. We searched PubMed, CINAHL, and the Cochrane Library between 1988 and Nov 6, 2013, with no language restrictions, for studies on prolonged mechanical ventilation. We included studies of adult populations treated with mechanical ventilation for more than 14 days, who were admitted to a ventilator weaning unit, or who had a tracheostomy for acute respiratory failure. We abstracted data with a standardised collection template and assessed study quality (ie, risk of bias) using a customised Newcastle-Ottawa Scale. We did a stratified analysis based on study setting (eg, acute vs post-acute care hospitals), and used a random-effects model to calculate pooled statistics (proportions with 95% CIs) for all outcomes. We did sensitivity analyses based on study quality (ie, high-quality studies only) and country of origin (USA vs non-USA and USA vs UK). The primary outcome was mortality at 1 year. Secondary outcomes were in-hospital mortality, discharge destination among survivors, successful liberation from mechanical ventilation while in hospital, and mortality at timepoints longer than 1 year. Of 6326 studies identified, 402 underwent full manuscript review, and 124 studies from 16 countries met the inclusion criteria. 39 studies reported mortality at 1 year, which was 59% (95% CI 56-62). Among the 29 high-quality studies, the pooled mortality at 1 year was 62% (95% CI 57-67). Pooled mortality at hospital discharge was 29% (95% CI 26-32). However, only 19% (16-24) were discharged to home and only 50% (47-53) were successfully liberated from mechanical ventilation. For studies in post-acute care hospitals, outcomes were worse in the USA than internationally (mortality at 1 year was 73% [95% CI 67-78] in the USA vs 47% [29-65] in non-USA countries; in-hospital mortality was 31% [26-37] vs 18% [14-24]; and liberation from ventilation was 47% [42-51] vs 63% [59-68]; p<0·0001 for all). Although a high proportion of patients survived to hospital discharge, fewer than half of patients survived beyond 1 year. Future studies should focus on optimum patient selection for prolonged mechanical ventilation and integration of long-term outcome information into clinical decision making. Cooper University Health Care and Cooper Medical School of Rowan University.

Conversion of Society for Maternal-Fetal Medicine abstract presentations to manuscript publications

We sought to evaluate the rate of conversion of Society for Maternal-Fetal Medicine (SMFM) annual meeting abstract presentations to full manuscript publications over time. Full manuscript publications corresponding to all SMFM oral abstracts 2003 through 2010 inclusive, and SMFM poster abstracts in 2003, 2005, 2007, and 2009 were manually searched in PubMed. An abstract was considered to "match" a full publication if the abstract and publication titles as well as main methods and results were similar and the abstract first author was a publication author. In cases of uncertainty, the abstract-publication match was reviewed by a second physician researcher. Time to publication, publication rates over time, and publication rates among US vs non-US authors were examined. PubMed identification numbers were also collected to determine if >1 abstract contributed to a manuscript. Data were analyzed using Wilcoxon rank sum, analysis of variance, t test, and logistic regression. In all, 3281 abstracts presented at SMFM over the study period, including 629 orals (63 main plenary, 64 fellows plenary, 502 concurrent), were reviewed. Of 3281, 1780 (54.3%) were published, generating 1582 unique publications. Oral abstracts had a consistently higher rate of conversion to publications vs posters (77.1% vs 48.8%, P < .001). The median time to publication was 19 (interquartile range, 9-36) months, and was significantly shorter for orals vs posters (11 vs 21 months, P < .001). Over the study period, rates of publication of orals remained constant, but rates of publication of posters were lower in 2007 and 2009 compared to 2003 and 2005. Publications related to SMFM abstracts were published in 194 different journals, most commonly American Journal of Obstetrics and Gynecology (39.8%), Obstetrics and Gynecology (9.7%), and Journal of Maternal-Fetal and Neonatal Medicine (6.5%). Publication rates were higher if the abstract's first author was affiliated with a non-US institution (64.8% vs 51.1%, P < .001) and if the abstract received an award (82.7% vs 53.3%, P < .001). In regression models, oral presentation at SMFM, first author affiliation with a non-US institution, submission for American Journal of Obstetrics and Gynecology SMFM special issue, and year of abstract presentation at SMFM were associated with full manuscript publication. From 2003 through 2010, full manuscript publication rates of SMFM abstracts were high and consistent, and time to publication decreased/improved across the study period for oral presentations.

Psychological morbidity in breast cancer survivors: Prevalence-rates and determinants

dromes, and somatoform symptoms constitute the reason for a large proportion of primary care visits. Such somatoform disorders, however, appear to be difficult to recognise and are consistently underdiagnosed. Given that somatoform symptoms are associated with high impairment and low quality of life, it is critical to improve early detection. It is first necessary to identify what currently obstructs successful diagnosis. To this end, we conducted a systematic review to identify the barriers which may impede successful diagnosis of somatoform disorders. Method:Our systematic reviewMethodology followed a pre-published protocol and was registered in PROSPERO (CRD42013002540). The review included the relevant peer-reviewed qualitative and quantitative literature published in English or German in the past 10 years in: MEDLINE, EMBASE, PsycINFO and The Cochrane Database of Systematic Reviews. Additional studies were identified from the reference lists of included studies. Both title and abstract screening and data extraction from full text manuscripts was conducted by two independent reviewers. Manuscripts were excluded based on a list of exclusion criteria. Data were synthesised using a combination of textual narrative and thematic analysis approaches. Wherever possible, the PRISMA statement was used as the basis of the Method and reporting of the review and bias was assessed using the Cochrane collaboration's recommendations. Results: Data from full text publications (n = 177) was independently extracted and combined in a custom database. The level of evidence and assessment of bias for the final included studies (n = 42) was independently conducted. In total n = 379 barriers were identified comprising 77 subthemes, 16 thematic categories and five over-arching themes, i.e., patient-related, primary-carepractitioner related, doctor–patient interactional, situational, and conceptual/operational. Conclusion: Results suggest some barriers will be alleviated with the new DSM-5 criteria, others are possibly modifiable by interventions, some require widespread paradigmatic change. More direct empirical investigations are also needed. We hope that the results of this study can be used to overcome the barriers to diagnosis of somatoform type disorders by designing appropriate interventions to improve care for these patients.

Abstract ES4-3: What is the value of internal mammary chain RT and how can we deliver it safely?

Abstract The 2014 systematic overview of post-mastectomy radiotherapy (RT) in pN+ patients randomized ± local-regional RT reported absolute 7.9% (SE 3.1) and 9.3% (SE 2.7) reductions in 20-year breast cancer mortality in women with 1-3 and 4+ positive nodes, respectively [1]. Most patients were given RT to axilla, supraclavicular fossa (SC) and internal mammary chain (IM); hence, it is impossible to calculate what IM-RT contributes. Three randomised trials (French n=1334; MA.20 n=1832; EORTC n=4004) have specifically tested IM-RT, 2 of which included medial SC in the randomisation. All patients received axillary dissection (AD) and mastectomy/tumour excision, with an average 62% axillary node positivity. Table 1 lists the treatments delivered. Table 1TreatmentFrenchMA.20EORTCSurgeryMastectomy + ADMastectomy/Breast conservation + ADMastectomy/Breast conservation + ADRT ControlChest wall + axillary apex + medial SCChest wall or breastChest wall or breastRT Test (in addition to Control)IMIM + medial SCIM + edial SC No trial detected a statistically significant benefit in overall survival (OS), but early metanalysis of the 3 studies suggests a statistically significant improvement in OS (HR 0.88 95% CI 0.80-0.97) in patients allocated IM-RT with/without additional SC-RT [2]. Disease-free (DFS), metastasis-free (MFS) and overall survival (OS) benefits are shown in Table 2. Table 2ResultsFrenchMA.20EORTCDFSAbsolute 3.3% gain (10yr, NS)HR 0.67 (95% CI 0.52-0.87)HR 0.89 (95% CI 0.80-1.00)MFS-HR 0.64 (95% CI 0.47-0.85)HR 0.86 (95% CI 0.76-0.98)OSAbsolute 3.3% gain (10yr, NS)HR 0.76 (95% CI 0.56-1.05) Absolute 1.6% gain (5yr, NS)HR 0.87 (95% CI 0.76-1.0) Absolute 1.6% gain (10yr, NS) The sole trial (French) to report arm swelling recorded a small (3.1%) absolute excess of grade 2 arm lymphedema after IM-RT; the other 2 trials reported no excess cardiac toxicity. Only the French trial is published as a full manuscript, and until this is the case for the other 2 trials, it is impossible to say how specific and robust guidelines will be. Assuming the benefits of IM-RT rely on eradication of IM metastases, factors associated with risk of IM involvement include macroscopic involvement of multiple axillary nodes and central/medial quadrant tumours. Recommendations based on sentinel IM node biopsy, lymphoscintigraphy or positron emission tomography are likely to be may be desirable. Accurate mediastinal staging may not resolve all issues, as the current debate challenging the need to treat the axilla in women with axillary micrometastases illustrates. The 2 commonly-used techniques involve simple 3D forward planned dosimetry that is usually able to satisfy standard constraints for organs at risk. The IM is encompassed within wide tangential beams in 1 technique, and as an extension of an anterior SC beam in the other. Example of each will be presented. 1. EBCTCG. Effect of radiotherapy after mastectomy and axillary surgery on 10-year recurrence and 20-year breast cancer mortality: Meta-analysis of individual patient data for 8135 women in 22 randomised trials. Lancet, 2014. 383: p. 2127-25. 2. Budach, W., et al., Adjuvant radiotherapy of regional lymph nodes in breast cancer - a meta-analysis of randomized trials. Radiat Oncol, 2013. 8: p. 267. Citation Format: John R Yarnold. What is the value of internal mammary chain RT and how can we deliver it safely? [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr ES4-3.

Sufficient catheter length for pneumothorax needle decompression: a meta-analysis.

Needle thoracostomy is the prehospital treatment for tension pneumothorax. Sufficient catheter length is necessary for procedural success. The authors of this study determined minimum catheter length needed for procedural success on a percentile basis. A meta-analysis of existing studies was conducted. A Medline search was performed using the search terms: needle decompression, needle thoracentesis, chest decompression, pneumothorax decompression, needle thoracostomy, and tension pneumothorax. Studies were included if they published a sample size, mean chest wall thickness, and a standard deviation or confidence interval. A PubMed search was performed in a similar fashion. Sample size, mean chest wall thickness, and standard deviation were found or calculated for each study. Data were combined to create a pooled dataset. Normal distribution of data was assumed. Procedural success was defined as catheter length being equal to or greater than the chest wall thickness. The Medline and PubMed searches yielded 773 unique studies; all study abstracts were reviewed for possible inclusion. Eighteen papers were identified for full manuscript review. Thirteen studies met all inclusion criteria and were included in the analysis. Pooled sample statistics were: n=2,558; mean=4.19 cm; and SD=1.37 cm. Minimum catheter length needed for success at the 95th percentile for chest wall size was found to be 6.44 cm. A catheter of at least 6.44 cm in length would be required to ensure that 95% of the patients in this pooled sample would have penetration of the pleural space at the site of needle decompression, and therefore, a successful procedure. These findings represent Level III evidence.

Transforming a presentation to a publication: Tips for nurse practitioners.

Nurse practitioners (NPs) routinely make presentations at regional, national, and international conferences. However, compared to other health professionals, fewer of the presentations are followed by manuscripts in peer-reviewed journals. For more than 20 years, the Abstract to Publication rate has been a marker of conference quality and a trail of new knowledge development and dissemination. The purpose of this manuscript is to provide NPs with an approach for converting a presentation to a full manuscript. Editorials, journal articles, style guides. The overlap between a podium or poster presentation and a fully developed manuscript is quite significant; the difference is in the style of presentation. While scholarly writing may be somewhat daunting at first, resources are available to help any NP publish following a presentation. With sufficient planning, NPs can increase their Abstract to Publication rate.

The role of apheresis in hypertriglyceridemia-induced acute pancreatitis: A systematic review.

Mostly published as case reports or series, the role of apheresis in hypertriglyceridemia (HTG)-related acute pancreatitis (AP) remains unclear. We performed a systematic review of available literature on this topic with specific focus on disease severity. A search of electronic databases (PubMed, EMBASE, Cochrane) and gray literature yielded 5020 articles of which 74 met criteria for inclusion (301 unique patients). Relevant data were abstracted from full manuscripts and analyzed. Most patients were young (mean age 37.9±10.4 years) and male (71.5%). About two-thirds (69.7%) received apheresis within 48h and most required only 1 or 2 sessions (84.4%). Apheresis resulted in an average reduction of serum TG by 85.4% (p<0.001). There was high variability in reporting the presence of and criteria to define severe AP (reported 221/301, 73.4%; present 85/221, 38.5%) or organ failure (reported 104/301, 34.6%; present 52/104, 50.0%). Improvement was reported in the majority of patients (reported 144/301, 47.8%, present 136/144, 94.4%) mainly by clinical symptoms or laboratory tests. Overall mortality was 7.1% (21/294) which increased to 11.8% (10/85) with severe AP and 19.2% (10/52) with organ failure. Apheresis effectively reduces serum TG levels. However, due to uncontrolled data, reporting bias and lack of a comparison group, definitive conclusions on the efficacy of apheresis in reducing AP severity cannot be made. We propose which patients may be best suitable for apheresis, type of studies needed and outcome measures to be studied in order to provide empiric data on the role of apheresis in HTG-related AP.

Hegemann's disease and fishtail deformity: aetiopathogenesis, radiographic appearance and clinical outcome.

PurposeA systematic review regarding clinical studies on Hegemann’s disease and fishtail deformity was performed with the aims to: (1) formulate the most up-to-date theory on aetiology in order to better define these conditions, (2) summarise the most frequent radiographic descriptions on radiographs and (3) give an overview of different treatment options.MethodsA systematic review of studies to date on Hegemann’s disease and fishtail deformity was performed. Studies were eligible if: (1) the article provides a description of Hegemann’s disease or fishtail deformity, (2) original data of at least one patient was available, (3) the article was written in English, German or Dutch and (4) a full manuscript was available. Animal studies, reviews and expert opinions were not included.ResultsWe included a total of 22 articles: seven regarding Hegemann’s disease including eight patients and 15 regarding fishtail deformity including 58 patients.ConclusionsFishtail deformity and Hegemann’s disease seem to be a spectrum of vascular disorders of the distal humerus, varying from a benign mild vascular disorder to a complete avascular necrosis after fractures. Additional imaging is advised to confirm the presence of a fishtail deformity, intra-articular loose bodies and signs of osteoarthritis to decide if, and what, operative treatment is needed. As long as no clear aetiology for both diseases exist and the clinical symptoms and radiographic appearance are difficult to distinguish, both entities should preferably be named as ‘vascular disturbance of the trochlear growth plate’ to overcome confusing definitions and discussions.

Association of breast arterial calcification with stroke and angiographically proven coronary artery disease: a meta-analysis.

We conducted a meta-analysis of the current literature to deduce the strength of association between breast arterial calcification (BAC) and coronary artery disease (CAD) and/or stroke. PubMed, Google Scholar, ClinicalTrials.gov, and Ovid were searched for English-language literature up to August 2013 using the terms "breast arterial calcification," "breast vascular calcification," "coronary artery disease," "coronary heart disease," "cardiovascular disease," "abnormal coronary angiography," and "stroke." A hand search of the reference lists of key articles was performed to supplement the literature search. Our literature search revealed 75 articles for further abstract review. Limiting our search to articles that quantitatively assessed the correlation between BAC and stroke or angiographically proven CAD, we reviewed 35 full manuscripts. Of these articles, 14 were included in the final analysis. We analyzed 10 cross-sectional studies (n = 3,952) with CAD as the primary outcome (diagnosed by coronary angiography). The odds ratio (95% CI) for CAD in those with BAC versus those without BAC is 3.86 (3.25-4.59) (P < 0.0001). For stroke, six cross-sectional studies were analyzed (n = 18,888). The odds ratio (95% CI) for stroke in those with BAC versus those without BAC is 1.54 (1.25-1.90) (P < 0.0001). These results suggest that BAC is significantly associated with both CAD and stroke. Although more prospective studies are warranted to clarify whether BAC is truly a predictor of the future development of CAD and stroke, the concept that BAC is a benign finding is waning.

The prospective role of the primary health care nurse practitioner in the prevention and treatment of type 2 diabetes in youth

Background: This paper examines the literature to explore the multidimensional role of primary health care nurse practitioners (PHC NPs) in type 2 diabetes prevention and management in Canadian youth within the elements of the chronic care model (CCM). Methods: Searches were conducted in 7 electronic databases and key articles and grey literature were also reviewed. Citations were screened for the following inclusion criteria: written in English; involved children or youth 11 years of age or older; and at risk or diagnosed with type 2 diabetes. Results: One thousand and one hundred sixty nine citations were found; 1,113 were excluded through title and abstract screening. A total of 56 full text manuscripts were assessed for inclusion criteria, yielding 2 that met the key question. Both studies included assessing participants’ lifestyle choices as an outcome. The first study assessed prevalence and remission of obesity; whereas the second study measured participant body mass index (BMI). Both studies reported improvements in lifestyle choices with the involvement of a PHC NP. Conclusions: PHC NP’s greatest value and impact currently lies within the community element of the CCM. Additional research examining the PHC NP’s role within the remaining elements of the CCM will demonstrate their impact in targeting type 2 diabetes prevention and management in Canadian youth.

The acute treatment of migraine in adults: the american headache society evidence assessment of migraine pharmacotherapies.

The study aims to provide an updated assessment of the evidence for individual pharmacological therapies for acute migraine treatment. Pharmacological therapy is frequently required for acutely treating migraine attacks. The American Academy of Neurology Guidelines published in 2000 summarized the available evidence relating to the efficacy of acute migraine medications. This review, conducted by the members of the Guidelines Section of the American Headache Society, is an updated assessment of evidence for the migraine acute medications. A standardized literature search was performed to identify articles related to acute migraine treatment that were published between 1998 and 2013. The American Academy of Neurology Guidelines Development procedures were followed. Two authors reviewed each abstract resulting from the search and determined whether the full manuscript qualified for review. Two reviewers studied each qualifying full manuscript for its level of evidence. Level A evidence requires at least 2 Class I studies, and Level B evidence requires 1 Class I or 2 Class II studies. The specific medications - triptans (almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan [oral, nasal spray, injectable, transcutaneous patch], zolmitriptan [oral and nasal spray]) and dihydroergotamine (nasal spray, inhaler) are effective (Level A). Ergotamine and other forms of dihydroergotamine are probably effective (Level B). Effective nonspecific medications include acetaminophen, nonsteroidal anti-inflammatory drugs (aspirin, diclofenac, ibuprofen, and naproxen), opioids (butorphanol nasal spray), sumatriptan/naproxen, and the combination of acetaminophen/aspirin/caffeine (Level A). Ketoprofen, intravenous and intramuscular ketorolac, flurbiprofen, intravenous magnesium (in migraine with aura), and the combination of isometheptene compounds, codeine/acetaminophen and tramadol/acetaminophen are probably effective (Level B). The antiemetics prochlorperazine, droperidol, chlorpromazine, and metoclopramide are probably effective (Level B). There is inadequate evidence for butalbital and butalbital combinations, phenazone, intravenous tramadol, methadone, butorphanol or meperidine injections, intranasal lidocaine, and corticosteroids, including dexamethasone (Level C). Octreotide is probably not effective (Level B). There is inadequate evidence to refute the efficacy of ketorolac nasal spray, intravenous acetaminophen, chlorpromazine injection, and intravenous granisetron (Level C). There are many acute migraine treatments for which evidence supports efficacy. Clinicians must consider medication efficacy, potential side effects, and potential medication-related adverse events when prescribing acute medications for migraine. Although opioids, such as butorphanol, codeine/acetaminophen, and tramadol/acetaminophen, are probably effective, they are not recommended for regular use.

Histomolecular Structural Aspects of High Endothelial Vessels in Lymph Node and Its Significance in Oral Cancer and Metastasis.

Molecular cancer research studies focus on identifying diagnostic, screening, and metastatic indicators, and monitoring therapeutic responses. Migration of tumor cells and lymphocytes are important aspects in metastasis. High endothelial vessels are specialized histological structures identified in the blood vessels in lymphoid organs, which allow the migration of lymphocytes. In the recent decades, the role of high endothelial vessels is being addressed in cancer metastatic research. This review article is to highlight the histological and molecular structural aspects of high endothelial venules (HEVs) in the lymph node, and to demonstrate the role of HEVs in oral cancer metastasis, specifically oral and pharyngeal squamous cell carcinoma. The literature for the present paper were searched from the data sources such as Medline/PubMed, CINAHL plus, and gray literature sources from inception to May 2015. Searches were conducted using both free texts and medical subject headings related to the title of the present paper. Only the full text manuscripts of the search results that support the objective(s) of the paper and papers written in English were included. HEVs are unique structures that are identified in the lymphocytes and primarily assist in the lymphocytic migration from the blood stream into the lymph node. Understanding the histomolecular characteristics of HEV will allow researchers to develop novel therapeutic approaches in cancer tissues.

Symptoms of cardiovascular diseases in the course of mental disorders

Background: Psychosomatic disorders are extremely common in patients in non-psychiatric departments. It is widely known that in these cases comorbid psychiatric disorders are highly prevalent and that the importance of psychosocial factors is relevant. However, it is still a challenge for both internal medicine and mental health professionals to diagnose and treat them effectively. The need of evidence-based treatment guidelines for clinicians is obvious. As far as it is concerned, DSM-5 has redefined the criteria of somatoform disorders, underlying the importance of incorrect thoughts about symptoms whether organic ethiology. Methods/Design: The aim was to provide an insight into the barriers of diagnosing psychosomatic disorders in cardiology referring to possible psychiatric comorbidity. Over 150 actual abstracts and full text manuscripts were checked. The literature published in English and Polish, mostly in PubMED/MEDLINE, PsycINFO, EMBASE, Cochrane Database of Systematic Reviews of past 10 years was studied and compared to the literature of psychoanalytic theory. Disscussion: It is worth to remember, that for high proportion of patients with mental disorders somatic syndrome is the only symptom they report to physicians. Emotion regulation theory, alexithymia theory and desomatization and resomatization theory find it as the effect of unsolved problems with emotions. Moreover, functional neuroimaging studies seem to reveal coherent findings. Based on it, the neurophysilogical model of emotion regulation and the mechanism of cognitive-emotional executive control were described. Accordingly, literature shows that in heart disease patients the incorporation of psychological interventions in healing process significantly reduces mortality and relapse.

A Systematic Review and Meta-Analysis of Open vs. Laparoscopic Resection of Gastric Gastrointestinal Stromal Tumors.

Gastric gastrointestinal stromal tumors (GISTs) are the most common sarcoma of the gastrointestinal tract, and surgical resection is the primary treatment of early disease. Limited data exist concerning laparoscopic resections of these neoplasms. This systematic review was designed to evaluate the literature comparing laparoscopic and open surgical resection of gastric GISTs and to assess the effectiveness and safety of this minimally invasive technique. We performed a systematic search of MEDLINE, the Cochrane Library, PubMed, Embase, Scopus, Web of Science, Google Scholar, the clinical trials database and ProQuest Dissertations and Theses as well as the past 3 years of conference abstracts from the Society of American Gastrointestinal and Endoscopic Surgeons Annual Meetings. Studies comparing the open and the laparoscopic approaches to the resection of gastric GISTs were included in this systematic review. Two reviewers independently performed the screen of titles and abstracts, the full manuscript review, the data extraction and the risk of bias assessment. A quantitative analysis was performed. Of the 189 studies identified, seven studies were included. The laparoscopic approach was associated with a significantly lower length of hospital stay (3.82 days (2.14 - 5.49)). There was no observed difference in operative time, adverse events, estimated blood loss, overall survival and recurrence rates. This study supports that laparoscopic resection is safe and effective for gastric GISTs and is associated with a significantly lower length of hospital stay. Further trials are needed for cost analysis and to rigorously assess oncologic outcomes.

399: Conversion of society for maternal fetal medicine (SMFM) abstract presentations to manuscript publications

To evaluate the rate of conversion of SMFM Annual Meeting abstract presentations (’abstracts’) to full manuscript publication (‘pub’) over time. Full manuscript publications corresponding to all SMFM oral abstracts 2003-2009 inclusive, and SMFM poster abstracts in 2003, 2005, and 2007 (random sample years selected) were manually searched in PubMed. An abstract was considered to ‘match’ a full pub if the abstract and pub titles as well as main methods and results were similar and the abstract 1st author was a pub author. In cases of uncertainty, the abstract-pub match was reviewed by a 2nd physician researcher. Time to pub, pub rates over time, and pub rates among US vs. non-US authors were examined. PMID numbers were also collected to determine if >1 abstract contributed to a manuscript. Data were analyzed using Wilcoxon rank-sum, ANOVA, and chi-square. 2455 abstracts presented at SMFM over the study period, including 544 orals (56 main plenary, 56 fellows plenary, 432 concurrent), were reviewed. 1406/2455 (57%) were published, generating 1228 unique pubs. Oral abstracts had a consistently higher rate of conversion to pubs vs. posters (78% vs. 51%, p<0.001). The median time to pub was 19 (IQR 9-39) months, and was significantly shorter for orals vs. posters (12.5 vs. 22 months, p<0.001). Pubs related to SMFM abstracts were published in 175 different journals, most commonly AJOG (602/1406, 43%), Obstet Gynecol (139/1406, 10%), and J Matern Fetal Neonatal Med (92/1406, 7%). The proportion of abstracts resulting in pub varied significantly over the study period (p<0.001, figure). Pub rates were higher if the abstract’s 1st author was affiliated with a non-US institution (66% vs. 55%, p<0.001). Non-US authors were less likely to combine multiple abstracts into one publication (8% vs. 14%, p=0.003). Most SMFM abstract presentations are converted to full manuscript publications. Abstracts presented as orals and by non-US primary authors had higher rates of publication.

Examination of the Relationship between Students’ Attitudes towards Computer and Self-Directed Learning with Technology

A lot of studies conducted in the past examined the construct of Self-Directed Learning (SDL) and attitude towards computer; however, there are not sufficient number of studies examining these constructs in terms of children and together with concept of technology. Therefore, those two constructs and the relationship between them were examined in terms of children and in the context of concept of technology using structural equation modeling (SEM). In this study, the scales of students’ attitudes towards computer (SATC) and self-directed learning with technology for young students (SDLTYS) adapted into Turkish respectively by Demir and Yurdugul (2014) and Demir and Yurdugul (2013) were administered as measurement tools. 2219 students enrolled in either a public middle or secondary school located in Bursa and Ankara constituted the sampling of the study. As a result of this study, it was found that there is a positive high level correlation (r=.74) between aforementioned two constructs. In the full manuscript of the study, discussion regarding the findings of the study is included in detail.

Indomethacin for control of ICP.

Our goal was to perform a systematic review of the literature on the use of indomethacin and its effects on intracranial pressure (ICP) in patients with neurological illness. All articles from MEDLINE, BIOSIS, EMBASE, Global Health, Scopus, Cochrane Library, the International Clinical Trials Registry Platform (inception to July 2014), reference lists of relevant articles, and gray literature were searched. Two reviewers independently identified all manuscripts utilizing the following inclusion and exclusion criteria. Humans, prospective studies (five or more patients), documented ICP response to indomethacin, and English. non-English, retrospective studies, no documentation of ICP response to indomethacin, and animal studies. A two-tier filter of references was conducted. First, we screened manuscripts by title and abstract. Second, those references passing the first filter were pulled, and the full manuscript was checked to see if it matched the criteria for inclusion. Two reviewers independently extracted data including population characteristics and treatment characteristics. The strength of evidence was adjudicated using both the Oxford and GRADE methodology. Our search strategy produced a total of 208 citations. Twelve original articles, 10 manuscripts, and 2 meeting proceeding, were considered for the review with all utilizing indomethacin, while documenting ICP in neurological patients. All studies were prospective. Across all studies, there were a total of 177 patients studied, with 152 receiving indomethacin and 25 serving as controls in a variety of heterogeneous studies. All but one study documented a decrease in ICP with indomethacin administration, with both bolus and continuous infusions. No significant complications were described. There currently exists Oxford level 2b, GRADE C evidence to support that indomethacin reduces ICP in the severe TBI population. Similar conclusions in other populations cannot be made at this time. Comments on its impact, on patient outcome, and side effects cannot be made given the available data. At this time, indomethacin for ICP control remains experimental and further prospective study is warranted.