bluuebunny/crossref_metadata_2025 huggingface dataset:
Depression, hormone therapy, and the menopausal transition among women aged 45 to 64 years using Canadian Longitudinal Study on aging baseline data
Authors: Shea Alison K. , Sohel Nazmul , Gilsing Anne , Mayhew Alexandra J. , Griffith Lauren E. , Raina Parminder
Published: March 2020

Objective:

To investigate the association between menopausal status, hormone therapy (HT) use and the presence of depressive symptoms among middle-aged women in Canada.

Methods:

Cross-sectional baseline data from 13,216 women aged 45 to 64 years from the Canadian Longitudinal Study on Aging (CLSA) was used. The association between menopausal status (pre- vs postmenopausal) and self-reported symptoms of depression based on a score of 10 or more on the Center for Epidemiologic Studies Short Depression Scale-10 was assessed using logistic regression. Use and duration of use of HT, time since menopause, age at onset of menopause, and socioeconomic status and other contextual variables were explored for the association with depression.

Results:

Overall, 18.4% of middle-aged women in the CLSA data were identified as depressed using the Center for Epidemiologic Studies Short Depression Scale-10. Based on the logistic regression models, women reporting premature menopause (before the age of 40 years) and postmenopausal women currently using HT had 1.45 (1.07-1.97) and 1.21 (1.02-1.44) greater odds of having depression. Chi-square analyses showed that women with depressive symptoms were more likely to have low education, low household incomes, live alone, be nulliparous, and have low social support.

Conclusions:

Our findings highlight the association between depression and premature menopause among midlife women. Current HT use may be a proxy for more severe menopausal vasomotor symptoms, a known risk factor for depressive symptoms. Identification of risk factors, including social determinants of health, age at menopause, and menopausal symptoms can help guide clinicians when assessing mental health.

Video Summary:
http://links.lww.com/MENO/A576.
Intra-abdominal Lymph Nodes: A Privileged Donor Site for Vascularized Lymph Node Transfer
Authors: Chu Carrie K. , Schaverien Mark V. , Chang Edward I. , Hanson Summer E. , Hanasono Matthew M. , Selber Jesse C.
Published: March 2020

A variety of donor options for vascularized lymph node transfer for the surgical treatment of lymphedema have been described. Intra-abdominal harvest sites including the gastroepiploic nodes within the omental flap and the mesenteric node flap are distinguished from their extra-abdominal counterparts by the absent risk of iatrogenic donor site lymphedema and discrete scar location, as well as the ability to harvest up to 3 vascularized nodal packets from 1 donor site. However, there are also potential morbidities including hernia and intra-abdominal visceral injuries. Patient selection and flap harvest techniques are reviewed.
Craniosynostosis in an Indian Scenario: A Long-term Follow-up
Authors: Sharma Ramesh Kumar
Published: March 2020

Background:

Craniofacial surgery as a subspecialty has finally taken off in India. Young plastic surgeons in the early 1990s became fascinated by its enormous scope. The author was also among the lucky ones to be trained in this field with Dr. Ian Jackson at the Craniofacial Center at Southfield, Michigan, from 1993-1994. This facility for craniofacial surgery was established in the North Indian tertiary care hospital at the Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, in 1995.

Methods:

We have reviewed the outcomes of management of craniosynostosis patients and evaluated changes in these outcomes as the experience was gained. The study is a retrospective chart review of the 169 patients operated on for various craniosyntoses in the hospital, for the last 25 years from January 1995 to July 2019.

Results:

The whole spectrum of craniosynostoses patients have been operated on and followed up for up to 20 years. All the patients underwent open surgery involving fronto-orbital advancement and remodelling of the deformed calvarium. It was noted that all the syndromic patients required more than one operation, whereas the non-syndromic patients had a stable result after a single surgery. Craniofacial surgery has now truly arrived in India. Our experience with management of craniosynostosis at PGIMER, Chandigarh, has shown an acceptable morbidity and mortality which is at par with the global standards.
A Bilobed Pedicled Groin Flap for Reconstruction of Forearm Skin Defects following Replantation
Authors: Hayashi Kota , Hattori Yasunori , Sem Sei Haw , Sakamoto Sotetsu , Doi Kazuteru
Published: March 2020

The versatility of a pedicled groin flap can be further increased by raising it in a bilobed fashion. This allows the flap to cover both the volar and dorsal surfaces of a hand or forearm defect. A 48-year-old man sustained an avulsion amputation of his right forearm by a rolling machine in a workplace accident. Replantation of the right forearm was performed, and the postoperative course was uneventful. Unfortunately, the wound healing was complicated by circumferential marginal skin necrosis, which was confined to the distal forearm. A bilobed pedicled groin flap was performed for the wound coverage because reconstruction with a free flap would be very risky as the vessels were avulsed from the proximal part of the forearm. A good functional recovery of the hand and fingers was noted at 12 months’ follow-up. The advantages of a bilobed pedicle groin flap are that it allows coverage of both the volar and dorsal surfaces at one setting and primary closure of the donor site is possible. Furthermore, a long tube-shaped pedicle in this flap can reduce the patient discomfort and prevent finger stiffness by allowing a range of motion exercise. In conclusion, the bilobed pedicled groin flap is a useful option to cover soft tissue defects involving both the volar and dorsal surfaces over the mid- to distal forearm, especially when the free flap is contraindicated.
High-intensity Focused Ultrasound Treatment in Moderate Glaucoma Patients: Results of a 2-Year Prospective Clinical Trial
Authors: Leshno Ari , Rubinstein Yair , Singer Reut , Sher Ifat , Rotenstreich Ygal , Melamed Shlomo , Skaat Alon
Published: March 2020

Precis:

Ultrasound Cyclo Plasty (UCP) treatment using high-intensity focused ultrasound (HIFU) is an effective and safe therapy to reduce intraocular pressure (IOP) in moderate glaucoma patients as was measured during a 2-year follow-up period.

Purpose:

The purpose of this study was to evaluate the long-term safety and efficacy of the UCP procedure using HIFU in moderate glaucoma patients.

Patients and Methods:

A prospective interventional noncomparative study was carried out. Fifteen patients (15 eyes) with moderate open-angle glaucoma were enrolled. All eyes were treated with UCP-HIFU. A thorough ophthalmic examination and IOP measurements were performed before the UCP-HIFU procedure and at 1 day, 1 week, 4 weeks, 3 months, 6 months, 1 year, and 2 years after the procedure. The primary outcome was defined as a surgical success (IOP reduction of 20% or ≥5 mm Hg) at the last follow-up visit. The secondary outcomes were the mean IOP at each follow-up visit, number of medications used, complications profile, and reinterventions.

Results:

The mean preoperative IOP at baseline was 26.8±5.0 mm Hg. All patients had a positive response and a lower IOP after treatment, with a relatively stable 31% reduction in IOP during the follow-up period. A significant reduction in IOP was observed at all postprocedure examination points (P<0.01), with a mean 17.6±4.4 mm Hg at 2 years after the procedure (P=0.005). Surgical success was achieved in 87% of the patients at their last follow-up visit. There was a nonsignificant decrease in the mean number of glaucoma medications from 2.5±0.8 to 2.0±1.0 at 2 years (P=0.48). No major intraoperative or postoperative complications were noted.

Conclusion:

UCP-HIFU treatment is an effective, safe, and well-tolerated method to reduce IOP in patients with moderate glaucoma.
Seizure incidence of angiogram-negative subarachnoid hemorrhage: An updated meta-analysis
Authors: Jeon Jin Pyeong , Kim Sung-Eun , Chai Chung Liang , Hong Eun Pyo , Yang Jin Seo , Kang Suk Hyung , Choi Hyuk Jai , Cho Yong Jun
Published: March 2020

Background:

To provide updated information on seizure events and patterns in patients with angiogram-negative subarachnoid hemorrhage based on the initial hemorrhage patterns: perimesencephalic subarachnoid hemorrhage (PMH) vs non-PMH.

Methods:

A review of online database literature from January 1990 to November 2017 was systematically performed. In case of heterogeneity <50%, a fixed effect model was used. Publication bias was determined using Begg funnel plot and the trim-and-fill method.

Results:

A total of 9 studies with 645 patients were included for final analysis after excluding one study without any seizure within either cohort. PMH patients had lower seizure rates (odds ratio, 0.393; 95% CI, 0.158–0.978) compared with non-PMH patients. The funnel plot showed a relatively asymmetric pattern, suggesting possible publication bias. After correction of the forest plot, the adjusted odds ratio was 0.362 (95% CI, 0.148–0.886), indicating significant relationships between PMH and lower incidence of seizure.

Conclusion:

PMH is associated with lower seizure risk than non-PMH. However, possible publication bias could be a concern to the interpretation. Additional meta-analyses based on individual patient data from prospective large-scale studies are necessary.
The relationship between C-reactive protein, carbohydrate antigen 125, and hematological parameters to endometriotic nodule localization in pelvis
Authors: Topdagi Yilmaz Emsal Pinar , Topdagi Yunus Emre , Al Ragip Atakan , Kumtepe Yakup
Published: March 2020

Background:

Endometriosis is a pelvic inflammatory process, and hormonal, environmental, and genetic factors play a role in its etiopathogenesis; especially, deep pelvic endometriosis exhibits an extensive anatomical distribution. In the present study, we evaluated the contribution of routinely measured hematological parameters to the diagnosis as the number of endometriotic nodule localization increases, when evaluated with C-reactive protein (CRP) and carbohydrate antigen (CA) 125.

Methods:

The present study included patients with histopathologically confirmed diagnosis of endometriosis who underwent surgery at our hospital between January 2007 and December 2018. Their medical records were examined retrospectively.

Results:

In total, 205 patients were included in the study, of which 129 patients (62.9%) with ovarian endometrioma and 76 patients (37.1%) with deep infiltrative endometriosis were assigned to Group 1 and Group 2, respectively, and the two groups were compared. Endometriotic nodules were observed in several localizations in 71 patients (34.6%) of the 205 patients with endometriosis. Pelvic nodules were grouped as per their four different localizations: uterosacral, recto-vaginal, bladder, and ureteral. Because the anatomical localization of endometriotic nodules increased in the pelvis, the variability in the levels of CA 125 and CRP as well as hematological parameters was examined. There were significant differences in hemoglobin (p < 0.036), CA 125 (p < 0.000), and CRP (p < 0.007) levels between patients with nodules in ≤2 localizations and those with nodules in ≥3 localizations.

Conclusion:

Our study included a total of 205 patients. There was a significant difference in the CRP, CA 125, and hemoglobin levels between Group 1 and Group 2, but it was concluded that coexistence of the endometriotic nodule had no effect on the other hematological parameters. For this purpose, prospective studies with a larger number of patients are needed.
Effectiveness of a machine-assisted healthy physical fitness promotion program for community elderly
Authors: Wang Ya-Hsien , Hsu Nai-Wei , Huang Huan-Yang , Tsai Chih-Chun , Pan Po-Jung
Published: March 2020

Background:

Maintaining physical fitness is important for health of the elderly. How to implement an effective and efficient model is a practical issue. A healthy physical fitness promotion program with machine-assisted exercises was designed for elderly and executed in a community in 2015 and 2016. The program was implemented for 10 to 12 weeks with two (group 1) or three (group 2) sessions per week, and functional fitness tests were conducted before, at the end, and 3 months after the training. This study is to investigate the effectiveness of machine-assisted physical fitness promotion program for the community elderly.

Methods:

A retrospective analysis was conducted on the participants’ data, including sex, age, height, weight, waist-hip ratio, grip strength, back stretch, chair sit-and-reach, 30-second chair stand, 30-second arm curl, 2-minute step, single-leg standing, 8-ft up-and-go, and body composition. The differences in test results before, at the end, and 3 months after the training and the percentage change at different time intervals between the two groups were compared.

Results:

After training, body mass index in group 2 and the test completion time for 8-ft up-and-go in group 1 decline significantly; furthermore, significant increase was noted in the height and number of times of 2-minute step in both groups, and grip strength, number of times of their 30-second arm curl, and 30-second chair stand in group 2. The training effect sustained 3 months after the training in height and number of times of 2-minute step in both groups, and grip strength, number of times of their 30-second arm curl, and 30-second chair stand in group 2.

Conclusion:

This study discovered that 10 to 12 weeks of machine-assisted exercise training can improve the elderly community members’ body composition, muscle strength, muscle endurance, agility, dynamic balance, and cardiorespiratory endurance. Moreover, with three sessions per week, its effects were even maintained for 3 months after the training.
Poor Sleep Hygiene Is Associated With Decreased Discrimination and Inattention on Continuous Performance Task in Doctor of Physical Therapy Students: A Cross-Sectional Study
Authors: Coffyn Stacy , Siengsukon Catherine F
Published: March 2020

Introduction

Reduced sleep quality impairs learning, memory formation, attention, and executive function ability. Poor sleep quality or sleep hygiene has been shown to impair academic performance of undergraduate and medical students. The purpose of this study was to examine the association between sleep quality, sleep hygiene, and cognitive performance in Doctor of Physical Therapy (DPT) students.

Methods.

Fifty DPT students at the University of Kansas Medical Center completed the Pittsburgh Sleep Quality Index (PSQI) and the Sleep Hygiene Index (SHI). Cognitive performance was assessed using the Continuous Performance Test (CPT), which is a test of sustained attention and the Trail-Making Task to assess executive functioning. An actigraph was worn for 1 week to objectively characterize sleep outcomes. Spearman's correlations were performed to assess the association between self-report sleep quality, sleep hygiene, and outcomes on the cognitive tasks. Post hoc Mann–Whitney and Kruskal–Wallis tests were conducted to examine group differences between sleep outcomes and cognitive performance for demographic variable categories.

Results.

Twenty-three students (46%) reported poor sleep quality, and 27 participants (54%) had objectively reported poor sleep quality. There was a significant positive correlation between SHI and detectability (r
s = 0.297; P = .036) and omissions (r
s = .343; P = .015). There were group differences between sex and the number of pets on the CPT outcomes, and there was a significant group difference between the number of drinks/wk categories on the SHI.

Discussion and Conclusions.

About half of the participants were identified as having poor sleep quality. Poorer sleep hygiene was associated with poorer discrimination and inattention, which could potentially affect the students' academic and clinical performance and their health and well-being. Also, certain demographic variables may modulate the results.
Clinical Utility of Radiologic Disease Reassessment in the Management of Pediatric B-Cell Non-Hodgkin Lymphoma
Authors: Green Katherine , Pavasovic Vesna , Ghorashian Sara , Ancliff Philip , Bartram Jack , Rao Anupama , Samarasinghe Sujith , Vora Ajay , Cheng Danny , O’Connor David
Published: March 2020

Although outcomes for children with B-cell non-Hodgkin lymphoma are excellent, between 20% and 40% demonstrate residual radiologic abnormalities at disease assessment during consolidation therapy, the significance of which remains uncertain. The authors report the outcomes for all children treated for B-cell non-Hodgkin lymphoma at our center over an 11-year period. Twenty-four of 64 (38%) children had residual radiologic abnormalities at disease remission assessment. Seven (29%) underwent histologic biopsies that were normal. No children with residual radiologic abnormalities experienced disease relapse or death, suggesting that imaging at this time point creates clinical uncertainty without indicating residual disease or predicting relapse.
The Experiences of Women Living With Cervical Cancer in Africa
Authors: Maree Johanna E. , Holtslander Lorraine , Maree Johanna E.
Published: March 2020

Background

Cervical cancer is the fourth most common cancer in women worldwide. However, developing countries bear 85% of the burden, with Africa sharing the highest incidence with Melanesia.

Objectives

The aims of this study were to explore the experiences of women living with cervical cancer in Africa and to inform others of the extent of the work done in this field of study by synthesizing the findings of qualitative research.

Methods

The work of Sandelowski and Barroso guided the study, and 6 databases were searched to identify relevant studies using the key words Africa, cervical cancer, and experiences.

Results

A total of 13 studies (n = 13) met the inclusion criteria, and their findings were synthesized. The studies originated primarily from South Africa and focused on the period from diagnosis to 1 year after completing curative treatment. One overarching core theme living a life of suffering, 2 main themes, architects of suffering and mediators of suffering, and 9 subthemes were identified.

Conclusion

Women living with cervical cancer in Africa live a life of suffering, which starts when they experience the first symptom of cervical cancer and continues well after completing treatment. The facilitators of suffering outweighed the mediators and could not be guaranteed, as it did not relieve the suffering of all.

Implications for practice

Nurses practicing in Africa should be acutely aware of cervical cancer and do their utmost within their limited resources to prevent and detect the disease in its earliest stage. Religious and support interventions could be used to lessen the suffering of these women.
Maternal Experiences of Parenting Young Children While Battling Breast Cancer in Taiwan
Authors: Chin Jui-Chih , Chang Pi-Chen , Lin Miao-Hui
Published: March 2020

Background

Western mothers with breast cancer find themselves struggling with parenting responsibilities. Because parenting is culturally shaped, literature on ill mothers' experiences of parenting young children from a collectivist culture is limited.

Objective

The aim of this study was to examine Taiwanese mothers' experiences of and cultural practices embedded in parenting young children while in treatment for breast cancer.

Methods

Sixteen mothers with at least 1 child younger than 12 years were recruited from a breast cancer organization in Taiwan. Data were collected from November 2016 to June 2017 via a semistructured individual interview and analyzed using a content analysis technique.

Results

Five themes, namely, “maternal limited disclosure, complementary with children's tacit knowledge,” “the scar is no longer a scar but a symbol for intimate bonding,” “issues of maternal absence for young children and school-aged children,” “the power of ‘We are a family’,” and “to live a simple life and to live for one's self,” elucidate how cultural beliefs and practices shape maternal parenting experiences during treatment of breast cancer.

Conclusions

The findings illustrate how Taiwanese mothers interpret their illness, contextualize illness-related messages in daily life, and maintain family ties while coping with breast cancer. The will to maintain the family's integrity, including the extended family, can empower mothers throughout the trajectory.

Implications for Practice

Ill mothers may benefit from nurses' guidance on daily routines and cultural practices that they can exploit to frame illness messages for their children. Maternal efforts to change their outlook on life, vocalize their needs, and become more assertive should be acknowledged and supported.
A Systematic Review on Oncology Nurses’ Knowledge on Palliative Care
Authors: Parajuli Jyotsana , Hupcey Judith
Published: March 2020

Background

Patients with cancer have high symptom burden and unmet needs and therefore can benefit from palliative care. Oncology nurses are consistent providers of care to patients with cancer and can provide palliative care to these patients. However, oncology nurses’ knowledge on palliative care has not been systematically evaluated.

Objective

To synthesize the current state of the science of oncology nurses’ knowledge on palliative care.

Methods

A systematic literature search was completed using PubMed, Cumulative Index of Nursing and Allied Health Literature, and PsycINFO databases using the following key words: (oncology nurs*) AND (knowledge OR attitude OR belief OR perception) and (palliative care OR supportive care OR terminal care OR end-of-life care OR hospice). The quality of identified studies was rated on a 7-point scale using Fineout-Overholt’s hierarchy of evidence.

Results

Twenty studies from 10 different countries were identified and synthesized for this review. Seventeen studies were quantitative, whereas 3 were qualitative studies. Results revealed that oncology nurses lacked knowledge on several aspects of palliative care.

Conclusions

Overall oncology nurses did not possess adequate knowledge on palliative care. Factors influencing oncology nurses’ knowledge on palliative care included nurses’ sociodemographic factors, educational status, years of experience, palliative care education/training, and clinical setting.

Implications for practice

This review provides evidence on gaps of oncology nurses’ knowledge on palliative care and helps inform the design of interventions targeted toward enhancing oncology nurses’ knowledge on palliative care.
Beyond Terminology Confusion
Authors: Scala Elizabeth , Alderfer Mary E. , Milburn Rowena Leong
Published: March 2020

Inquiry is the foundation of nursing practice. Inquiry projects impact safety, quality measures, and patient/staff outcomes. As the profession with closest proximity to the patient, nurses must not only participate in but also spearhead inquiry work. This article addresses the knowledge gap that continues to exist among clinical nurses regarding the three forms of nursing inquiry and provides recommendations for nursing professional development practitioners to support clinical nurses’ understanding and participation in these endeavors.
Development and Content Validity of the Clinical Assessment of Body Alignment for Children With Cerebral Palsy
Authors: George Frances K. , Benham Alex , Gabriel Lynne , Purton Judy
Published: March 2020

Purpose:

The purpose of this study is to describe the development and content validity of the clinical assessment of body alignment (CABA) to measure body alignment in children with cerebral palsy.

Methods:

Content validity and clinical utility were examined through expert opinion of 283 pediatric physical therapists. Participants reviewed items as matching or not to the domain of body alignment. Clinical utility was evaluated on a 5-point scale. Means and standard deviation were calculated for each attribute. Fleiss' kappa examined interrater reliability of expert responses.

Results:

Percentage agreement was high for 19 items and good for 1 item. Clinicians' ratings showed overall fair to good agreement. Four clinical utility attributes had a net importance score of more than 90%, although interrater reliability was low.

Conclusion:

Content validity of the CABA was supported. Construct validity, reliability, and responsiveness require further study. What this adds to the evidence: The CABA has potential to offer clinicians and researchers a clinically practical measure of postural alignment for children with cerebral palsy. Preliminary investigation of CABA shows good content validity. However, more studies to assess the assessments' psychometrics including construct validity, reliability, and responsiveness are required.
Factors Associated With Ambulation in Myelomeningocele
Authors: Davis W. Austin , Zigler Christina K. , Crytzer Theresa M. , Izzo Sara , Houtrow Amy J. , Dicianno Brad E.
Published: March 2020

Objective

Evidence is limited regarding clinical factors associated with ambulation status over the lifespan of individuals with myelomeningocele. We used longitudinal data from the National Spina Bifida Patient Registry to model population-level variation in ambulation over time and hypothesized that effects of clinical factors associated with ambulation would vary by age and motor level.

Design

A population-averaged generalized estimating equation was used to estimate the probability of independent ambulation. Model predictors included time (age), race, ethnicity, sex, insurance, and interactions between time, motor level, and the number of orthopedic, noncerebral shunt neurosurgeries, and cerebral shunt neurosurgeries.

Results

The study cohort included 5371 participants with myelomeningocele. A change from sacral to low-lumbar motor level initially reduced the odds of independent ambulation (OR = 0.24, 95% CI = 0.15–0.38) but became insignificant with increasing age. Surgery count was associated with decreased odds of independent ambulation (orthopedic: OR = 0.65, 95% CI = 0.50–0.85; noncerebral shunt neurosurgery: OR = 0.65, 95% CI = 0.51–0.84; cerebral shunt: OR = 0.90, 95% CI = 0.83–0.98), with increasing effects seen at lower motor levels.

Conclusions

Our findings suggest that effects of several commonly accepted predictors of ambulation status vary with time. As the myelomeningocele population ages, it becomes increasingly important that study design account for this time-varying nature of clinical reality.

To Claim CME Credits

Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME

CME Objectives

Upon completion of this article, the reader should be able to: (1) Describe general trends in ambulation status by age in the myelomeningocele population; (2) Recognize the nuances of cause and effect underlying the relationship between surgical intervention and ambulation status; (3) Explain why variation of clinical effect over time within myelomeningocele population matters.

Level

Advanced

Accreditation

The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
Hospital-Acquired Conditions Reduction Program, Patient Safety, and Magnet Designation in the United States
Authors: Hamadi Hanadi , Borkar Shalmali R. , Moody LaRee , Tafili Aurora , Wilkes J. Scott , Moreno Franco Pablo , McCaughey Deirdre , Spaulding Aaron
Published: March 2020

Objective

The aim of the study was to investigate the association between hospitals’ nursing excellence accreditation and patient safety performance—measured by the Hospital-Acquired Conditions Reduction Program (HACRP).

Methods

We linked data from the American Nursing Credentialing Center Magnet Recognition Program, Centers for Medicare and Medicaid Services HACRP, and the American Hospital Association annual survey from 2014 to 2016. We constrained the analysis to hospitals participating in Centers for Medicare and Medicaid Services’ HACRP and deployed propensity score matching models to calculate the coefficients for our HACRP patient safety measures. These measures consisted of (a) patient safety indicator 90, (b) hospital-associated infection measures, and (c) total HAC scores. In addition, we used propensity score matching to assess HACRP scores between hospitals achieving Magnet recognition in the past 2 versus longer and within the past 5 years versus longer.

Results

Our primary findings indicate that Magnet hospitals have an increased likelihood of experiencing lower patient safety indicator 90 scores, higher catheter-associated urinary tract infection and surgical site infection scores, and no different total HAC scores. Finally, when examining the impact of Magnet tenure, our analysis revealed that there were no differences in Magnet tenure.

Conclusions

Results indicate that the processes, procedures, and educational aspects associated with Magnet recognition seem to provide important improvements associated with care that is controlled by nursing practice. However, because these improvements do not differ when comparing total HAC scores nor Magnet hospitals with different tenure, there are likely opportunities for Magnet hospitals to continue process improvements focused on HACRP scores.
Imaging of Neuronal and Mixed Glioneuronal Tumors
Authors: Abdel Razek Ahmed Abdel Khalek , Elsebaie Nermeen A. , Zamora Carlos , Castillo Mauricio
Published: March 2020

Neuronal and mixed glioneuronal tumors represent a group of neoplasms with varying degrees of neural and glial elements. Their age of presentation varies, but they are most commonly seen in children and young adults. With the exception of anaplastic ganglioglioma and other atypical variants, most lesions are low grade; however, they can have significant morbidity because of seizures, mass effect, or difficult to treat hydrocephalus. Although many tumors show overlapping clinical and imaging features, some have relatively distinctive imaging characteristics that may aid in narrowing the differential diagnosis. In this review, we discuss relevant clinical and pathologic characteristics of these tumors and provide an overview of conventional and advanced imaging features that provide clues as to the diagnosis.
Evaluation of the Patient-Practitioner Consultation on Surgical Treatment Options for Patients With Craniosynostosis
Authors: Pfeifauf Kristin D. , Said Abdullah M. , Naidoo Sybill D. , Skolnick Gary B. , Kestle John R. W. , Lee Amy , Birgfeld Craig , Anderson Richard C. E. , Gociman Barbu , Siddiqi Faizi A. , Pollack Ian F. , Goldstein Jesse A. , Tamber Mandeep , Imahiyerobo Thomas , Smyth Matthew D. , Patel Kamlesh B.
Published: March 2020

Introduction:

Endoscope-assisted craniectomy and spring-assisted cranioplasty with post-surgical helmet molding are minimally invasive alternatives to the traditional craniosynostosis treatment of open cranial vault remodeling. Families are often faced with deciding between techniques. This study aimed to understand providers’ practice patterns in consulting families about surgical options.

Methods:

An online survey was developed and distributed to 31 providers. The response rate was 84% (26/31).

Results:

Twenty-six (100%) respondents offer a minimally invasive surgical option for sagittal craniosynostosis, 21 (81%) for coronal, 20 (77%) for metopic, 18 (69%) for lambdoid, and 12 (46%) for multi-suture. Social issues considered in determining whether to offer a minimally invasive option include anticipated likelihood of compliance (23 = 88%), distance traveled for care (16 = 62%) and financial considerations (6 = 23%). Common tools to explain options include verbal discussion (25 = 96%), 3D reconstructed CT scans (17 = 65%), handouts (13 = 50%), 3D models (12 = 46%), hand drawings (11 = 42%) and slides (10 = 38%). Some respondents strongly (7 = 27%) or somewhat (3 = 12%) encourage a minimally invasive option over open repair. Others indicate they remain neutral (7 = 27%) or tailor their approach to meet perceived needs (8 = 31%). One (4%) somewhat encourages open repair. Despite this variation, all completely (17 = 65%), strongly (5 = 19%) or somewhat agree (4 = 15%) they use shared decision making in presenting surgical options.

Conclusion:

This survey highlights the range of practice patterns in presenting surgical options to families and reveals possible discrepancies in the extent providers believe they use shared decision making and the extent it is actually used.
Fasciocutaneous Flap Side-to-Side V-Y: Fish Flap
Authors: Guerrissi Jorge Orlando
Published: March 2020

The use of fasciocutaneous flaps remain as first election of reconstructive method after remotion of tumors, benign lesions and sequel of traumas.

A new designed fasciocutaneous flap according to mechanism V-Y like island flap is described. It has 2 different portions: 1. Superior and 2. Inferior or triangular.

Resected area is reconstructed by means of the active or superior part, recruiting perilesional unaffected tissues; safe vascular supply is maintained by means of random pedicle from its inferior or triangular portion.

Between 2012 and 2015 were operated in the Division Plastic Surgery at Argerich Hospital of Buenos Aires, 180 patients with benign and maligns lesions and trauma sequels in different body areas; reconstructive surgery was carried out using the flap described in this article.

All flaps survived, except 2 which developed partial flap necrosis finally treated by advancement flap coverage. All donor sites were closed primarily with no secondary skin grafting; in the early postoperative period, any flaps showed signs of excessive tension of its margins and failures of arterial vascularization. All flaps achieve adequate reconstruction with excellent aesthetic results; all patients were satisfied with the surgical outcome. All the flaps reached objectives purposed obtaining an acceptable functional and aesthetic restoration.

Fasciocutaneous flaps have become popular in modern reconstructive surgery because of low donor-site morbidity and good preservation of muscles and close skin. The advantages of “fish” flap included shorter operative time, lesser pedicle trauma, similar color-match and same texture, ample recruitment of both skin and soft tissues around of principal flap and finally it allowed an adequate closure of donor and reconstructed areas.
Rich Fat Hemangioma of the Parotid Gland in the Adult
Authors: Liu Jie , Cheng Liang Jing , Zhang Yong , Song Tao Hong , Wang Jian Wei
Published: March 2020

Hemangiomas are relatively rare tumors representing approximately 0.4% of all the salivary gland tumors and occur predominantly in the parotid. Most of the hemangiomas appear during the first year of life; however, are uncommon in adults. Moreover, the rich fat hemangiomas in the parotid are extremely rare. Magnetic resonance imaging is the most important radiologic methods for the diagnosis of the disease as its high resolution of soft tissue which helps to show the relationship with the adjacent structures.
Assessment of Interpupillary Distance in the Azerbaijan Society
Authors: Sahbaz Ibrahim
Published: March 2020

Introduction:

To determine the normal distribution of interpupillary distance (IPD) in adult males and females of the Azerbaijani society and create a specific IPD database.

Materials and Methods:

Subjects (641 males, 491 females) aged 18 to 85 years were investigated for anatomical IPD in this study. Eye examinations and measurements were performed. The subjects were divided into 2 main groups: male and female, and further divided into 4 groups according to the age range. Auto refractometer was used for IPD measurements (Topcon Auto Kerato-Refracto Tonometer TRK-2P, Tokyo, Japan).

Results:

The mean age in the 18 to 85 age range was 39.1 ± 15.2 years. The mean IPD was 63.7 ± 3.5 mm (range 51–82). IPD values were higher in males (P < 0.001), and IPD values were found to be statistically significant (P < 0.001).

Discussion:

Age, sex and ethnicity are all significant factors that influence IPD. IPD measurements are essential in surgical management, optical frames and lenses, forensic science and anthropological investigations.
Comparison of Early and Long-Term Effects of Piezosurgery With Conventional Techniques for Osteotomies in Rhinoplasty
Authors: Aydoğdu Imran , Bayram Ali Alper
Published: March 2020

Objective:

Osteotomy is a critical step of rhinoplasty. Various osteotomy techniques have been developed to reduce postoperative edema and ecchymosis and achieve optimal aesthetic results. In this study, we aimed to compare the early and long-term effects of piezoelectric surgery with conventional osteotomy.

Methods:

In this prospective study, 72 rhinoplasty patients were randomly divided into 2 groups according to osteotomy technique used, either conventional osteotomy or piezosurgery. These 2 groups were compared for postoperative edema, ecchymosis, and pain on the first and seventh postoperative days. The sinonasal outcome test-22 (SNOT-22), peak nasal flowmetry, and Connecticut Chemosensory Clinical Research Center test were applied to all patients before and 8 weeks after surgery.

Results:

The study consisted of 72 patients, 42 of whom were female and 30 were male. The mean age was 28.1 ± 6.5 (range 18–49 years). On the first postoperative day, edema and ecchymosis were significantly less in the piezosurgery group (P < 0.001). VAS results showed that only the piezosurgery group experienced less pain on the first postoperative day (P < 0.001). Nasal airflow of the patients was evaluated preoperatively and postoperatively, nasal airflow decreased postoperatively in both groups, but this decrease was not statistically significant, and no significant difference was found between the groups. The preoperative and postoperative comparison of odor functions was similar in both groups after the operation, and there was no significant difference between the groups.

Conclusion:

Piezosurgery in the early period after rhinoplasty has been shown to decrease eyelid edema, periorbital ecchymosis, and pain compared to conventional osteotomy techniques. However, the superiority of piezosurgery in terms of nasal airflow, olfactory functions and quality of life were not found in the long term.
Hyoid Bone Position and Head Posture in Patients With Richieri-Costa Pereira Syndrome (EIF4A3 Mutations)
Authors: Pinto Rayane de Oliveira , Peixoto Adriano Porto , Pinto Ary dos Santos , Richieri-Costa Antonio , Raveli Dirceu Barnabé , Tonello Cristiano , Dalben Gisele da Silva
Published: March 2020

Robin sequence with cleft mandible and limb anomalies, known as Richieri-Costa-Pereira syndrome (RCPS), is an autosomal recessive acrofacial dysostosis characterized by mandibular cleft and other craniofacial anomalies and respiratory complications. The aim of this cross-sectional study was to describe the hyoid and head posture of 9 individuals with RCPS using cephalometric measurements and provide a discussion about its implications in obstructive sleep apnea syndrome (OSAS). The study was conducted on lateral cephalograms of patients with RCPS and 9 selected age-matched controls in tertiary cleft center in Brazil. The cephalograms were digitized and analyzed on a software to obtain the vertical and horizontal hyoid position, its relationship with the mandible and the relation of the cranial base and postvertebral line. The t test was used for analysis of means and Levene's test for equality of variances.

Cephalometric measurements H-S (vertical distance between hyoid bone and sella) (Supplemental Digital Content, Figure 1, http://links.lww.com/SCS/B247) and H-C4lp (horizontal position of the hyoid in relation to the post-pharyngeal space) showed statistically significant difference compared to controls (P < 0.05). Therefore, the hyoid bone was more inferiorly and posteriorly positioned in the study group compared with the control group. The vertebrae measurements did not present differences compared to controls. The described position of hyoid bone could be involved in the severe OSAS of RCPS patients.
Shrapnel Injuries on Regions of Head and Neck in Syrian War
Authors: Ucak Murat
Published: March 2020

Background:

Perforating and cutting injuries to the head and neck due to shrapnels are largely life-threatening and require immediate medical attention. In the present article, the surgical conditions in the war-related head and neck injuries were presented in terms of war surgery with mortality rates.

Materials and Methods:

The study was designed as a retrospective clinical case-control study including primarily 179 head and neck injuries that occurred due to shrapnels in the Syrian Civil War. The records of 2015–2019 years were analyzed according to demographics, injury types, injury location, plastic surgery approaches and postoperative outcomes.

Results:

Injury mechanism of all wounds was penetrating type, which was commonly secondary to an explosive device, collapse due to shrapnels of the explosion, gunshot or grenade. While 43(24%) of the wounded were soldiers, 136 (76%) were civilians. Considering the reason for the shrapnel injury, 83% was due to the explosion and 17% was due to gunshot injuries. The 32% showed facial fractures. As the most common fractures of the face were around the maxilla-zygoma (28.4%), orbita (22%), and teeths (18.5%). Considering neck injury zones, region-2 was mostly affected by the region. The third zone had the lowest rate of injury with 10%. In 89 (49%) patients, the authors preferred primary, while 15 gained secondary reconstruction (8%). The authors used Limberg flap for 24 (32%) patients, rotation flap for 39 (52%) patients, and bilobe flap for 12 (16%) patients.

Conclusion:

The most important cause of mortality was not the destruction, tissue loss caused by shrapnel injury, or experience of the surgeon, but the severe states of sepsis or multiple different trauma when brought for treatment from long range from the war zone.
Isolated Frontosphenoidal Suture Craniosynostosis: Treatment Approaches and Literature Review for a Unique Condition
Authors: Puente-Espel Jordi , Kozusko Steven D. , Konofaos Petros , Boop Frederick A. , Wallace Robert D.
Published: March 2020

Background:

Craniosynostosis isolated to the frontosphenoidal suture is an extremely rare entity, distinct from other types of synostotic anterior plagiocephaly, from the embryologic, phenotypic and endocranial morphology viewpoints. Embryologically, the sphenoid bone has two origins, which morphogenetically represent 2 distinct subunits. Depending on the region involved, unique craniofacial features involving the forehead, temporal region and orbit will be demonstrated. A case of frontosphenoidal suture synostosis depicting these features is presented. In addition, a literature review was performed and a treatment algorithm is proposed.
Effectiveness of Interprofessional Manikin-Based Simulation Training on Teamwork Among Real Teams During Trauma Resuscitation in Adult Emergency Departments
Authors: Lapierre Alexandra , Bouferguene Sabrina , Gauvin-Lepage Jérôme , Lavoie Patrick , Arbour Caroline
Published: March 2020

Summary Statement

This systematic review synthesizes the relevant evidence about the effectiveness of interprofessional manikin-based simulation training on teamwork among real teams during trauma resuscitation in adult civilian emergency departments. A systematic literature search was conducted in MEDLINE, CINAHL, EMBASE, EBM reviews, PsycINFO, and Web of Science with no time limit. Only experimental and quasi-experimental studies were included. Effects of the simulation intervention on teamwork were categorized according to a modified version of the Kirkpatrick's model. From the 1120 studies found, 11 studies were included for synthesis. All studies showed immediate improvement in teamwork after training, but divergent results were found regarding skills retention. Although this review focused on interprofessional manikin-based simulations in real trauma teams, the results are similar to previous systematic reviews including different types of simulation. This raises significant questions regarding the importance of simulation design characteristics to improve teamwork in trauma care.
Reasons Behind Preferences for Community-Based Continence Promotion
Authors: Brown Heidi W. , Wise Meg E. , LeCaire Tamara J. , Braun Emilie J. , Drewry Anna M. , Buttigieg Emily M. , Macco Maria , Barnet Jodi H. , Bersch Andrew , Peppard Paul E. , Malecki Kristen M.C. , Nieto F. Javier , Mahoney Jane E.
Published: March 2020

Objectives

This study aimed to understand the potential reach of continence promotion intervention formats among incontinent women.

Methods

The Survey of the Health of Wisconsin conducts household interviews on a population-based sample. In 2016, 399 adult women were asked about incontinence and likelihood of participation in continence promotion via 3 formats: single lecture, interactive 3-session workshop, or online. Descriptive analyses compared women likely versus unlikely to participate in continence promotion. To understand format preferences, modified grounded theory was used to conduct and analyze telephone interviews.

Results

One hundred eighty-seven (76%) of 246 incontinent women reported being likely to attend continence promotion: 111 (45%) for a single lecture, 43 (17%) for an interactive 3-session workshop, and 156 (64%) for an online program. Obesity, older age, nonwhite race, prior health program participation, and Internet use for health information were associated with reported continence promotion participation. Cited advantages of a single lecture included convenience and ability to ask questions. A workshop offered accountability, hands-on learning, and opportunity to learn from others; online format offered privacy, convenience, and self-directed learning.

Conclusions

Most incontinent women are willing to participate in continence promotion, especially online.