bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors with impact on magnitude of the placebo response in randomized, controlled, cross-over trials in peripheral neuropathic pain
Authors: Gillving Mimmi , Demant Dyveke , Lund Karen , Holbech Jakob V. , Otto Marit , Vase Lene , Jensen Troels S. , Bach Flemming W. , Finnerup Nanna B. , Sindrup Søren H. 
Published: June 2020

Abstract
The presence and magnitude of placebo responses is important for the outcome in clinical trials of analgesics. This explorative study aimed at identifying patients and trial-specific factors with impact on this response in randomized, controlled, cross-over trials in peripheral neuropathic pain. Data were derived from 7 trials and included observations on pinprick hyperalgesia, allodynia, and pain on repetitive stimulation. The studies were all performed by the same collaboration group in Denmark. Pain was rated daily using numeric 0 to 10 point rating scales (NRS) and placebo response was calculated as the difference in weekly average or median numeric rating scale from baseline to the last week of treatment. A clinically meaningful placebo response was defined as more than 30% reduction of pain on placebo. In 318 individual observations, the response was on average small (0.17 points, range −4.5 to 6). There was no significant impact on size of placebo response of trial-specific factors such as treatment sequence and chance of having placebo treatment in each period or of the patient-specific factors age, sensory signs, and pain symptoms. The findings were similar in patients having placebo in the first treatment period. There was no marked difference between patients with (n = 43) and without (n = 275) a clinically meaningful placebo response with respect to the patient-specific factors including frequency of sensory signs and symptoms. In conclusion, this study on cross-over trials in peripheral neuropathic pain found no robust impact of trial and patient-specific factors on the placebo response.
Evaluation of Evidence-Based Guidelines for Fever Management in Critically Ill Adult Patients With Brain Injury
Authors: Lee Jung Min , Moon Ju Ryoung , Kim Hye Jeong , Kwon Do Yeon , Shin Ja Young 
Published: June 2020

ABSTRACT

PURPOSE: The aim of this study was to evaluate the effectiveness of evidence-based guidelines for fever management of critically ill adult patients with brain injury. METHODS: We used a pretest-posttest design with 48 patients 19 years or older admitted to an intensive care unit after surgery for brain injury. We applied evidence-based guidelines only to an experimental group of 24 patients and compared with 24 control patients who did not receive evidence-based guidelines. Experimental and control groups were matched 1:1 using the Acute Physiology and Chronic Health Evaluation II score. Data included the proportion of patients with reduced fever and time to normalized temperature. RESULTS: The proportion of patients whose temperature fell to normal after fever was 4.5 times higher in the experimental group than in the control group. The time it took the patients' highest fever to fall to normal during their intensive care unit stay was 4.84 times faster in the experimental group than in the control group (hazard ratio, 4.84; 95% confidence interval, 1.79–13.11; P = .002). CONCLUSION: Evidence-based guidelines for fever management in patients with a brain injury can be used in nursing practice with rapid response, improving healthcare efficiency and contributing to better outcomes for critically ill patients.
Assessment of ejection fraction and heart perfusion using myocardial perfusion single-photon emission computed tomography in Finland and Estonia: a multicenter phantom study
Authors: Ronkainen Ari-Petteri , Eneh Chibuzor T.M. , Linder Pia H. , Hippeläinen Eero , Heikkinen Jari O. 
Published: June 2020

Objectives
Myocardial SPECT/CT imaging is frequently performed to assess myocardial perfusion and dynamic parameters of heart function, such as ejection fraction (EF). However, potential pitfalls exist in the imaging chain that can unfavorably affect diagnosis and treatment. We performed a national cardiac quality control study to investigate how much SPECT/CT protocols vary between different nuclear medicine units in Finland, and how this may affect the heart perfusion and EF values.

Methods
Altogether, 21 nuclear medicine units participated with 27 traditional SPECT/CT systems and two cardiac-centered IQ-SPECT systems. The reproducibility of EF and the uniformity of perfusion were studied using a commercial dynamic heart phantom. SPECT/CT acquisitions were performed and processed at each participating unit using their own clinical protocol and with a standardized protocol. The effects of acquisition protocols and analysis routines on EF estimates and uniformity of perfusion were studied.

Results
Considerable variation in EF estimates and in the uniformity of perfusion were observed between the units. Uniformity of perfusion was improved in some units after applying the higher count-statistic standard acquisition protocol. EF estimates varied more due to differences in analysis routines than as a result of different acquisition protocols. The results obtained with the two IQ-SPECT systems differed substantially from the traditional multipurpose cameras.

Conclusion
On average, the EF and heart perfusion were accurately estimated by SPECT/CT, but high errors could be produced if the acquisition and analysis routines were poorly optimized. Eight of the 21 participants altered their imaging protocol after this quality control tour.
Preoperative 18F-FDG PET/computed tomography predicts survival following resection for colorectal liver metastases
Authors: Grut Harald , Stern Nadide Mutlukoca , Dueland Svein , Labori Knut Jørgen , Dormagen Johann Baptist , Schulz Anselm 
Published: June 2020

Objective
The liver is the most frequent metastatic site from colorectal cancer and about 20% of these patients are treated by surgical resection. However, the 5-year disease-free survival (DFS) following resection is only about 25% and 5-year overall survival (OS) about 38%. The aim of the study was to evaluate the ability of metabolic and volumetric measurements from fluorine-18-fluorodeoxyglucose (18F-FDG) PET/computed tomography (CT) prior to resection for colorectal liver metastases (CLM) to predict survival.

Patients and methods
Preoperative 18F-FDG PET/CT examinations were assessed. Metabolic tumor volume (MTV), total lesion glycolysis (TLG), maximum, mean and peak standardized uptake values and tumor to background ratio, were obtained for all CLM. Cutoff values were determined for each of these parameters by using receiver operating characteristic analysis dividing the patients into two groups. DFS, liver recurrence-free survival (LRFS), OS and cancer-specific survival (CSS) for patients over and under the cutoff value were compared by using the Kaplan–Meier method and log-rank test.

Results
Twenty-seven patients who underwent 18F-FDG PET/CT prior to resection for CLM were included. Low values of total MTV and TLG were significantly correlated to improved 5-year LRFS (P = 0.016 and 0.006) and CSS (P = 0.034 and 0.008). Patients who developed liver recurrence had significantly higher total MTV and TLG compared to patients without liver recurrence (P = 0.042 and 0.047).

Conclusion
Low values of total MTV and TLG were significantly correlated to improved LRFS and CSS and may improve the risk stratification of patients considered for resection for CLM.
Implementing a Food is Medicine Program to Address Food Insecurity in an Academic Medical Center
Authors: Wynn Nicole , Staffileno Beth A. , Grenier Jennifer M. , Phillips Janice 
Published: June 2020

Background:
Food insecurity is a public, social, and health concern.

Local Problem:
A Food is Medicine Program was developed to address food insecurity.

Methods:
A quality improvement initiative was piloted on 3 acute care units.

Interventions:
Patients were screened for Social Determinant of Health (SDoH) needs and if identified as food insecure, linked to community resources and provided with a bag of food on discharge. Education was offered to nursing staff and a pre- and postsurvey was administered to assess SDoH knowledge and confidence.

Results:
Over a 3-month period, 2354 patients were admitted; 2063 (88%) were screened for SDoH and 220 (10%) were positive for food insecurity. Patients (n = 1525, 74%) were linked to community resources. Nearly all (97%) nurses participated in education and demonstrated increased knowledge and confidence (P < .001).

Conclusions:
These data provide preliminary outcomes from the Food is Medicine Program.
Pediatricians as Case Managers Reduce the Exposure to Computerized Tomography in Children Experiencing Minor Head Trauma
Authors: Fishman Yuri , Gross Itai , Hashavya Saar , Benifla Menachem , Tenenbaum Ariel , Rekhtman David 
Published: June 2020

Background
Head trauma is one of the most common reasons for pediatric emergency medicine department (PED) visits. Computerized tomography (CT) scan is considered the criterion standard for the diagnosis of traumatic brain injury but was shown to increases the risk of malignancies.

Methods
We retrospectively analyzed collected data of all children (ages 0–16 years) experiencing mild head trauma who were admitted to a single center, from January 1, 2010, to December 31, 2015. Comparison between patients treated by pediatricians/pediatric emergency medicine physicians (PEMP) with those treated by surgeons regarding CT rates and prognosis was done.

Results
During the previously mentioned period, 4232 children presented to the PED after minor head trauma, the average age was 5.4 (±4) years and 67.1% were male. Head CT was done in 7.7%, of which 30.7% had positive findings. Younger children tended to have higher percentage of positive findings on CT scan (60%, 43.8%, 26.6%, P = 0.003, for children up to 5 months, 5–24 months, and older than 24 months, respectively). Pediatricians ordered less CT scans when compared with surgeons (5.4% vs 8.5%, P < 0.001). Moreover, they had higher rates of positive findings on CT scan (52.5% vs 25.8%, P < 0.001). When all other characteristics were similar, if the case manager was a pediatrician, the patient's chances to undergo a CT scan were 4.3 times lower than if the case manager was a surgeon (odds ratio, 4.277; confidence interval, 2.274–7.104). No difference in readmissions or other complications were found between the 2 groups.

Discussion
This study highlights that when the case manager of children with minor head trauma is a pediatrician/PEMP, CT scan rates and thus exposure to radiation are diminished without a failure to detect clinically important traumatic brain injury.
In conclusion, our findings suggest that when possible, all children experiencing minor head trauma should be treated by a pediatrician/PEMP in the PED.
High Concurrent Use of Sulfonylureas and Antimicrobials With Drug Interactions Causing Hypoglycemia
Authors: Pilla Scott J. , Pitts Samantha I. , Maruthur Nisa M. 
Published: June 2020

Objectives
Sulfonylureas, the second most common oral diabetes treatment, have interactions with antimicrobials that substantially increase the risk of hypoglycemia. The objectives of this study are to quantify the concurrent use of sulfonylureas and interacting antimicrobial in U.S. ambulatory care and to examine whether interacting antimicrobials are used for an appropriate indication.

Methods
We analyzed the 2006–2016 National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey, annual probability samples of visits to U.S. office-based physicians. We determined nationally representative estimates of visits for adults with concurrent use of sulfonylureas and 7 antimicrobials with established interactions. We examined whether visit diagnoses included appropriate indications for antibiotics according to national guidelines.

Results
There were 2.5 million visits per year (95% confidence interval [CI] 2.2–2.9) in which sulfonylureas were used with systemic antimicrobials, of which 1 million (95% CI, 0.8–1.2) or 38.0% (95% CI, 32.3%–44.0%) were interacting antimicrobials. Sulfonylurea users had similar odds of interacting antimicrobial use as patients using diabetes medications without antimicrobial interactions (adjusted odds ratio, 1.07; 95% CI, 0.82–1.40). The most common interacting antimicrobials used with sulfonylureas were fluoroquinolones, accounting for 59.9% (95% CI, 50.7%–68.2%) of antimicrobials, and sulfamethoxazole-trimethoprim, accounting for 21.1% (95% CI, 14.8%–29.2%). There was no appropriate antibiotic indication in 69.7% (95% CI, 55.2%–81.1) of visits with interacting antibiotic use.

Conclusions
Sulfonylureas and antimicrobials with potentially hazardous interactions are frequently used together. To reduce resultant hypoglycemic events, there is a need for interventions to increase physician awareness and promote antibiotic stewardship.
Serum Urate Levels of Hemodialyzed Renal Patients Revisited
Authors: Arenas María-Dolores , Soriano Raquel , Andrés Mariano , Pascual Eliseo 
Published: June 2020

Objectives
The need of maintaining serum urate (SU)–lowering agents in hemodialysis (HD) patients is an understudied area that requires a review, as it is a common practice. The aims were to assess the SU reduction achieved under HD and to analyze the kinetics of SU in a week of intermittent HD.

Methods
The serum urate levels were determined before and after HD sessions in 96 consecutive patients with end-stage renal disease, and the average SU reduction was assessed. Variables related to HD were analyzed whether they were associated with SU reductions of 80% greater. In addition, a kinetics study was performed on 10 selected patients with hyperuricemia (SU before HD >6.8 mg/dL) throughout intermittent HD sessions in a 1-week period.

Results
The mean ± SD age of the patients was 66.5 ± 13.8 years, and 62 of them were male (64.6%). The mean ± SD time on HD replacement was 7.1 ± 7.2 years, and 16 (16.4%) continued with urate-lowering agents. The mean SU reduction immediately after HD was 80.2% (95% confidence interval, 78.4–82.0); 51 patients (56.7%) showed SU reduction of 80% or greater. In the SU kinetics study, SU levels significantly reduced all over the period and persisted below hyperuricemia threshold (p = 0.015). Noteworthy, 6 patients (60%) were hyperuricemic before session 1, but only 1 (10%) before session 2 and none before session 3.

Conclusions
Under HD replacement therapy, the SU levels effectively reduced and persisted below saturation point, suggesting that the SU-lowering therapy would be unnecessary for patients on HD, but necessary in selected cases. The definition of hyperuricemia under HD needs to be revised.
Ultrasonography Reliability in the Detection of Inflammatory and Structural Abnormalities
Authors: Brites Luisa , Santiago Mariana , Rovisco João , Freitas João , A.P. Silva José , Silva Inês , Teixeira Filipa , Faria Daniela S. , Silva Cândida G. , Falcão Sandra 
Published: June 2020

Background
Ultrasonography is an image technique that allows rheumatologists to visualize structural and inflammatory changes within a joint. The objective of this study was to assess the interobserver and intraobserver reliability of musculoskeletal ultrasound (US) in the detection of inflammatory and destructive joint changes in patients with polyarthritis.

Methods
A Delphi exercise was undertaken to standardize and adapt the EULAR-OMERACT elementary US definitions of inflammatory lesions (effusion, synovial hypertrophy, power Doppler, bone erosions, and synovitis) for each joint. Fifteen patients were analyzed, and video clips of 600 joints were collected. Each joint was scored for the presence of each elementary component, on 2 separate occasions, by 6 examiners. Interobserver and intraobserver agreement analysis was assessed through Fleiss κ coefficient (κ).

Results
Considering all patients and all joints, the interobserver values were highest for erosions and lowest for effusion (κ = 0.7314 and κ = 0.6044, respectively). When analyzing different regions, the highest interobserver agreement was for tibiotalar joint (κ = 0.8043) and the lowest for wrist (κ = 0.6767). Intraobserver reliability was excellent for each and all elementary components and anatomical region.

Conclusions
The present study showed either a good or excellent US interobserver and intraobserver reliability in elementary elements and anatomical region. This kind of US reliability exercises are important for standardization of exploration in everyday practice by reducing the variability associated with this imaging technique, and ensuring a greater degree of homogeneity and future comparability in the assessment of disease activity in polyarthritis patients.
A Meta-analysis and Systematic Review of Valvular Heart Disease in Systemic Lupus Erythematosus and Its Association With Antiphospholipid Antibodies
Authors: Hussain Kifah , Gauto-Mariotti Estefania , Cattoni Hugo Macchi , Arif Abdul Wahab , Richardson Carrie , Manadan Augustine , Yadav Neha 
Published: June 2020

Background
Valvular heart disease (VHD) is a known cardiac manifestation of systematic lupus erythematosus (SLE). This systematic review aims to pool data from studies to estimate the frequency of valvular lesions in SLE patients. It also aims to demonstrate the association between VHD in SLE and antiphospholipid antibodies positivity.

Methods
We included 27 studies after identifying relevant abstracts from PubMed, Scopus, and Google Scholar from the time of inception of database to 2019. Inclusion criteria consisted of English-language case-control and cohort studies. Three reviewers independently performed study selection, data extraction, and quality assessment using the Newcastle-Ottawa Scale for assessing risk for bias.

Results
For VHD in SLE patients, the most commonly involved valve was the mitral valve, with 19.7% lesions being mitral regurgitation. In terms of morphological lesions, valve thickening (11.06%) and vegetations (11.76%) were among the most prevalent. Other commonly encountered lesions were mitral valve prolapse and tricuspid regurgitation in 9.25% and 10.86% of patients, respectively. A meta-analysis of 21 studies with 2163 SLE patients, of which 23.3% had valvular lesions, showed a significant association of anticardiolipin antibodies positivity with VHD (relative risk, 1.55; confidence interval, 1.10–2.18).

Conclusions
Systemic lupus erythematosus is associated with VHD, and it should be considered a clinical manifestation of SLE in the absence of other valvular pathologies. There is a clear association between VHD in SLE and immunoglobulin G anticardiolipin antibodies positivity. This association suggests that this subgroup of SLE patients might benefit from a screening echocardiogram.
Prevalence and Financial Impact of Claustrophobia, Anxiety, Patient Motion, and Other Patient Events in Magnetic Resonance Imaging
Authors: Nguyen Xuan V. , Tahir Sana , Bresnahan Brian W. , Andre Jalal B. , Lang Elvira V. , Mossa-Basha Mahmud , Mayr Nina A. , Bourekas Eric C. 
Published: June 2020

Abstract
Claustrophobia, other anxiety reactions, excessive motion, and other unanticipated patient events in magnetic resonance imaging (MRI) not only delay or preclude diagnostic-quality imaging but can also negatively affect the patient experience. In addition, by impeding MRI workflow, they may affect the finances of an imaging practice. This review article offers an overview of the various types of patient-related unanticipated events that occur in MRI, along with estimates of their frequency of occurrence as documented in the available literature. In addition, the financial implications of these events are discussed from a microeconomic perspective, primarily from the point of view of a radiology practice or hospital, although associated limitations and other economic viewpoints are also included. Efforts to minimize these unanticipated patient events can potentially improve not only patient satisfaction and comfort but also an imaging practice's operational efficiency and diagnostic capabilities.
Complementary and Alternative Medicine in Radiotherapy
Authors: Borm Kai J. , Schiller Kilian , Asadpour Rebecca , Combs Stephanie E. 
Published: June 2020

Abstract
Complementary and alternative medicine (CAM) approaches are widely used by patients throughout a broad range of medical fields and diseases, and often self-administered by patients without the involvement of physicians or other members of the health care team. CAM use is well documented in cancer and chronic illnesses, and emerging data in radiation oncology show CAM usage of 26% to 97% in radiation therapy patients. No information is, however, available on CAM usage in radiology and in the imaging procedure fields. This article reviews the fundamental principles and the experience with the wide spectrum of CAM in radiation oncology—a field that shares many parallels with radiology, such as prevalence of imaging, procedural requirements, and cooperation demanded from patients.
CAM is defined as “approaches and practices that are typically not part of conventional medical care,” and includes the use of mind- and body-based practices (eg, meditation, massage, acupuncture), natural products (eg, herbs, vitamins, minerals), and other interventions. Supplements are used frequently to alleviate side effects of therapy and promote overall well-being. Specifically, the mindfulness/meditation approaches of CAM are known to reduce anxiety and enhance physical and emotional wellbeing in patients with chronic diseases, such as cancer or neurologic diseases, through physiological, psychological, and perhaps placebo mechanisms. Such patients often require repetitive and invasive imaging examinations or procedures, such as for cancer treatment, cancer surveillance/follow-up, or monitoring of chronic diseases, for example, surveillance MRI in multiple sclerosis. Such parallels suggest that the vastly understudied area of CAMs deserve further investigation in both the radiation oncology and the imaging fields. Further research on CAM is needed to develop refined recommendations and national/and international guidelines on its use.
Adenoid Cystic Carcinoma of Lacrimal Gland with Bone Remodeling
Authors: Parlak Safak , Bulut Elif Gunay 
Published: June 2020

Abstract
Adenoid cystic carcinoma is the most common type of malignancy seen in the lacrimal glands and is generally characterized by invasive malignant appearance with irregular margins and associated bone erosion or destruction. The authors report an unusual patient with a large expansile, well-circumscribed lacrimal adenoid cystic carcinoma with adjacent bone remodeling, radiologically mimicking a benign lesion.
Prognosis of Patient With Resorbable Plates and Screws Under the Incision Site
Authors: Shin Jin Yong , Roh Si-Gyun , Chang Suk Choo , Lee Nae-Ho 
Published: June 2020

Abstract
Various resorbable plates and screws were used for facial bone fractures because of several strengths. However, there are few studies on their clinical course and long-term follow-up concerning their degradation and resorption time. The authors present rare case of long term follow-up of resorbable plates and screws under the incision site.