bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects on shoulder pain and disability of teaching patients with shoulder pain a home-based exercise program: a randomized controlled trial
Authors: Santello Giovanna , Rossi Denise Martineli , Martins Jaqueline , Libardoni Thiele de Cássia , de Oliveira Anamaria Siriani 
Published: June 2020

Objective: To investigate the effect on shoulder pain and disability of teaching patients with shoulder pain how to undertake a home-based exercise program. Design: A randomized controlled trial conducted from September 2015 to January 2016. Setting: Participants’ home. Participants: Sixty participants with shoulder pain who were waiting for physiotherapeutic treatment. Interventions: The control group ( n = 30) received minimal education about their shoulder condition and instructions to continue their activities as normal. The intervention group ( n = 30) received a two-month home exercise program with one-hour sessions delivered by a physiotherapist to begin and one month after the program for exercise instructions. Main measures: The primary outcome was change in the Shoulder Pain and Disability Index (SPADI). The secondary outcomes included change in the numeric pain rating scale and medication intake for pain relief. Results: The patients’ average age was 54.3 (13.8) years. SPADI scores at baseline were 60.9 (16.5) in the intervention and 64.7 (15.3) in the control group. After two months, the SPADI scores decreased to 18.8 (28.6) and to 61.4 (24.0), respectively, in the intervention and control groups with an estimated mean difference of 40.0, effect size: 1.61. The intervention group showed a reduced pain intensity (estimated mean difference: 3.7, effect size: 2.43) and medication intake (chi-square: 0.001). The number needed to treat was 1.2 for one patient to have a SPADI score <20. Conclusion: Teaching patients with shoulder pain how to undertake a home-based exercise program improved shoulder function and reduced pain intensity and medication intake over two months.
Large Drill Holes Are Still Present in the Long Term After Arthroscopic Bankart Repair With Absorbable Tacks: An 18-Year Randomized Prospective Study
Authors: Constantinou Christina Chrysanthou , Sernert Ninni , Rostgård-Christensen Lars , Kartus Jüri 
Published: June 2020

Background: Studies have demonstrated the development of an osseous reaction at the drill sites of anchors after arthroscopic shoulder surgery. Purpose: To investigate the drill-hole size at 18 years after arthroscopic Bankart repair using either fast polygluconate acid (PGA) or slow polylevolactic acid (PLLA) absorbable tacks and to compare the functional outcomes and development of osteoarthritis. Study design: Randomized controlled trial; Level of evidence, 2. Methods: 40 patients with unidirectional anterior shoulder instability, treated with arthroscopic Bankart repair, were randomized into the PGA group (n = 20) or the PLLA group (n = 20). Plain radiographs of both shoulders, as well as computed tomography (CT) images of the operated shoulder, were used to evaluate the drill-hole size, volume, and degenerative changes. Functional outcomes were assessed by use of the Rowe score, Constant score, and Western Ontario Shoulder Instability (WOSI) index. Results: Of the 40 patients, 32 patients returned for the follow-up (15 PGA and 17 PLLA). No significant differences were found in the population characteristics between the study groups. The mean follow-up time was 18 years for both groups. No significant differences were seen in range of motion, strength in abduction, or Constant, Rowe, and WOSI scores between the groups. Recurrence rate was 33% in the PGA group and 6% in the PLLA group during the follow-up period ( P = .07). The drill-hole appearance on plain radiographs (invisible/hardly visible/visible/cystic) was 11/2/2/0 and 6/5/5/1 for the PGA and PLLA groups, respectively ( P = .036). The mean ± SD drill-hole volume as estimated on CT images was 89 ± 94 and 184 ± 158 mm3 in the PGA and PLLA groups, respectively ( P = .051). Degenerative changes (normal/minor/moderate/severe) on plain radiographs were 7/4/4/0 and 3/8/5/1 for the PGA and PLLA groups, respectively ( P = .21), and on CT images were 5/7/3/0 and 2/6/6/3 for the PGA and PLLA groups, respectively ( P = .030). Conclusion: This long-term follow-up study demonstrated that the PLLA group had significantly more visible drill holes than the PGA group on plain radiographs. However, this difference was not evident on CT imaging, with both groups having several visible cystic drill holes and a substantial drill-hole volume defect. No significant differences were found between the study groups in terms of clinical outcomes.
Diagnostic Accuracy of Physical Examination Tests in Core Muscle Injury
Authors: Kurowicki Jennifer , Kraeutler Matthew J. , Dávila Castrodad Iciar M. , Hahn Alexander K. , Simone Erica S. , Kelly Michael A. , Talishinskiy Toghrul , Scillia Anthony J. 
Published: June 2020

Background: Core muscle injury (CMI), often referred to as a sports hernia, is a common cause of groin pain in athletes characterized by concomitant injury to the insertion of the adductor longus and the rectus abdominis muscles. Currently, the literature on CMI is sparse with no standardized physical examination tests used in the diagnosis of this type of injury. Purpose: To determine the diagnostic accuracy of various physical examination tests in the diagnosis of CMI. Study Design: Cohort study (Diagnosis); Level of evidence, 3. Methods: A consecutive series of patients evaluated by the senior author with symptoms consistent with CMI were included. Four physical examination tests were routinely performed in these patients by the senior author and were noted in each patient’s chart as positive or negative: (1) pain with resisted cross-body sit-up in figure-of-4 position, (2) pain with straight-leg sit-up, (3) pain with resisted hip flexion in external rotation (external rotation Stinchfield test), and (4) the presence of an adductor contracture. CMI was independently diagnosed by a reference standard (magnetic resonance imaging [MRI]). All MRI scans were read by a musculoskeletal fellowship-trained radiologist. The sensitivity and specificity of each physical examination test alone and in combination were calculated based on this reference standard. Results: A total of 81 patients were included in this study. MRI was positive for a CMI in 39 patients (48%) overall. Both the cross-body sit-up test and the presence of an adductor contracture were found to have a sensitivity of 100% (specificity, 3% for both). The external rotation Stinchfield test was found to have the highest specificity of 60% (sensitivity, 15%). The sensitivity of all 4 physical examination tests in combination was found to be 100% (specificity, 0%). Conclusion: Certain physical examination maneuvers can be used to assist in the diagnosis of a CMI. The cross-body sit-up test and the presence of an adductor contracture are highly sensitive but nonspecific tests for CMI and therefore should be used in conjunction with diagnostic imaging before deciding on an appropriate treatment course.
Risk of Acute Kidney Injury in Combat-Injured Patients Associated With Concomitant Vancomycin and Extended-Spectrum β-Lactam Antibiotic Use
Authors: Yabes Joseph M. , Stewart Laveta , Shaikh Faraz , Robben Paul M. , Petfield Joseph L. , Ganesan Anuradha , Campbell Wesley R. , Tribble David R. , Blyth Dana M. 
Published: June 2020

Background: Multidrug-resistant infections complicating combat-related trauma necessitate the use of broad-spectrum antimicrobials. Recent literature posits an association between vancomycin (VANC) and piperacillin–tazobactam (VPT) combination therapy and acute kidney injury (AKI). We examined whether therapy with VPT was associated with an increased risk of AKI compared to VANC and other broad-spectrum β-lactam antibiotics (VBL) following combat-related injuries. Methods: Patients within the Trauma Infectious Disease Outcomes Study (TIDOS) who received ≥48 hours concomitant VPT or VBL started within 24 hours of each other were assessed. Exclusion criteria were receipt of renal replacement therapy and baseline creatinine >1.5 mg/dL. Acute kidney injury was defined by meeting any of the Risk, Injury, Failure, Loss, End Stage Renal Disease (RIFLE), AKIN, or VANC consensus guidelines criteria 3 to 7 days after therapy initiation. Variables significantly associated with AKI were used in inverse probability treatment weighting to perform univariate and subsequent logistic regression multivariate modeling to determine significant risk factors for AKI. Results: Sixty-one patients who received VPT and 207 who received VBL were included. Both groups had a median age of 24 years and initial median creatinine of 0.7 mg/dL. The VBL patients were more likely to have sustained blast injuries ( P = .001) and received nephrotoxic agents (amphotericin [ P = .002] and aminoglycosides [ P < .001]). In the VBL group, AKI incidence was 9.7% compared to 13.1% in the VPT group ( P = .438). Multivariate analysis identified a relative risk of 1.727 (95% CI: 1.027-2.765) for AKI associated with VPT exposure. Acute kidney injury severity generally met RIFLE Risk criteria and was 1 day in duration. Only 1 patient had persistent renal dysfunction 30 days after therapy completion. Conclusion: In this young and previously healthy, severely ill combat-injured population, VPT was associated with nearly twice the risk of AKI compared to VBL. Nevertheless, AKI was of low severity, short duration, and had high rates of renal recovery.
Violent Inclusion: Disability and the Nation in Polish 1950s and 1960s Young Adult Literature
Authors: Pamula Natalia 
Published: June 2020

This article belongs to the special cluster, “Family, Gender and (dis)Abled Bodies after 1953”, guest-edited by Maike Lehmann and Alexandra Oberländer. My article “Violent Inclusion: Disability and the Nation in Polish 1950s and 1960s Young Adult Literature” analyzes representations of physical and sensory disability in some of the most popular young adult novels published in 1950s and 1960s Poland written by Krystyna Siesicka, Jadwiga Korczakowska, Irena Krzywicka, Jadwiga Ruth-Charlewska, and Hanna Mortkowicz-Olczakowa. It argues that the recurring trope that connects the novels—the overcoming of disability—serves as a synecdoche for the Polish nation overcoming the catastrophe of World War II. Moreover, it shows that compulsory rehabilitation functions as a way of including disabled subjects into a Polish post-war society. At the same time, participation in the “rehabilitative regime” constitutes a patriotic duty for a disabled Polish child or teenager and paves a way to a socialist citizenship. Rehabilitation is always successful and culminates with a child or teenager transforming into an able-bodied socialist citizen reminding of a successful, yet sacrificial, reconstruction process of Poland. My article focuses on the sites of the overcoming of disability showing that Polish nature, whether it is a sea or woods, is crucial to the healing of a disabled subject. This way, the writers accentuate the connection between Polish nature and land and a “healthy” body, thus reconsolidating their fantasy of “Polishness.” What the novels ultimately testify to is the emergence of an embodied socialist subjectivity constructed through the corporeal rehabilitative practices and internalization of socialist values.
Investigation of DNA damage, oxidative stress, and inflammation in synthetic cannabinoid users
Authors: Guler EM , Bektay MY , Akyildiz AG , Sisman BH , Izzettin FV , Kocyigit A 
Published: June 2020

Background: The widespread use of synthetic cannabinoids (SCs) among youth has become an important public health problem. Several life-threatening side effects of SC have been reported, including cardiovascular, gastrointestinal, neurological, renal, metabolic, ophthalmologic, and pulmonary effects, besides skin toxicity and hepatotoxicity. Methods: Given that high levels of SC can lead to oxidative stress, DNA damage, and inflammation, it has been aimed in this study to investigate the effects of SC in aspects of primary DNA damage, plasma total oxidant status (TOS)/total antioxidant status (TAS), thiol–disulfide homeostasis, myeloperoxidase (MPO) level, and cytokine levels (interleukin 1 beta (IL-1β), interleukin 6 (IL-6), and tumor necrosis factor-alpha (TNF-α)) of 40 SC users (SCUs) in Turkey. Results: Mean plasma TOS levels were significantly higher in the SCUs group than in the healthy group (HG). Similarly, mononuclear leukocyte DNA damage, plasma TOS, MPO activity, disulfide, oxidative stress index levels, IL-1β, IL-6, and TNF-α levels were significantly higher in the SCU group than in the HG, whereas plasma TAS, total, and native thiol levels were significantly lower in the SCU group than in the HG. Conclusion: It is concluded that SC can cause increase in oxidative stress and in inflammatory processes in addition to its potential for DNA damage. Additional studies with larger sample sizes and longer durations should be held to understand more specific outcomes of SC use.
Mental health nurse psychotherapists are well situated to improve service shortfalls in Australia: findings from a qualitative study
Authors: Hurley John , Lakeman Richard , Cashin Andrew , Ryan Tom 
Published: June 2020

Objective: This paper reports the capabilities of mental health nurse (MHN) psychotherapists in Australia and their perceptions on how to best utilize their skills. Method: An MHN is a registered nurse with recognized specialist qualifications in mental health nursing. One hundred and fifty three MHNs completed an online survey; 12 were interviewed. Results: Three themes were derived from a qualitative analysis of the aggregated data: psychotherapy skills of MHN psychotherapists are under-utilized; these nurses bridge gaps between biomedical and psychosocial service provision; and equitable access to rebates in the primary care sector is an obstacle to enabling access to services. Conclusions: MHN psychotherapists are a potentially valuable resource to patients in tertiary and primary health care. They offer capacity to increase access to specialist psychotherapy services for complex and high risk groups, while being additionally capable of meeting patients’ physical and social needs. Equitable access to current funding streams including Medicare rebates can enable these outcomes.
Do Histologic Features Help Predict Colectomy in Pediatric Patients Presenting With Acute Severe Colitis?
Authors: Green Nicole , Lee Dale , Wahbeh Ghassan , Pacheco M Cristina 
Published: June 2020

Background Multiple prior studies have looked at clinical and laboratory parameters in ulcerative colitis to predict prognosis, but individual histologic features of inflammation and their prognostic significance have not been well studied. The purpose of our study was to determine whether histologic features at presentation with acute severe colitis predict colectomy in pediatric patients. Methods Patients were identified retrospectively through the gastroenterology and pathology databases. Demographic information, duration of disease, laboratory data, endoscopic appearance at scope, and histologic features of inflammation were reviewed along with medical therapies. Patients who underwent surgery within 90 days of hospitalization were compared to those who did not. Results Fifty patients with acute severe colitis, defined as Pediatric Ulcerative Colitis Activity Index ≥65, were included. Sixteen patients had colectomies performed within 90 days of presentation. No statistically significant difference was found between the surgery and no-surgery groups for patient age, albumin, hemoglobin, or C-reactive protein, though hemoglobin trended toward significance, P = .05. The endoscopic Mayo score and histologic features of inflammation (architectural changes, chronic inflammation, eosinophils, neutrophils within the lamina propria, neutrophils in epithelium, crypt destruction, and ulceration) were similar between groups. Conclusion In pediatric patients presenting for hospitalization with acute severe colitis, no histologic features of inflammation predicted colectomy within 90 days.
“What” and “How”: A New Perspective for Understanding Unawareness in Alzheimer’s Disease Through a Combination of Two Perspectives
Authors: Mayelle Amandine , El Haj Mohamad , Antoine Pascal 
Published: June 2020

Objectives: Assessments of unawareness in Alzheimer’s disease mainly focus on the objects (the “what”) of unawareness. A recent person-centered approach proposes to also assess the processes (the “how”). The present study combines 2 approaches to understand this heterogeneity in assessments of unawareness. Method: We recruited 46 participants from 8 nursing homes. They underwent a semi-structured interview and were assessed using a prediction–performance paradigm. Spearman correlations were calculated, and generalized additive models were established. Results: The 2 approaches are associated through cognitive deficits, confrontation with difficulties and identity changes. Objects (the what), mechanisms, and modes of expression (the how) explain at least 29.6% of the variance of unawareness. Conclusions: Unawareness is more than simply being unaware of something; it is a synergy between the objects and processes of arousal and expression. Moreover, unawareness extends beyond the disease to include the self. Considering the entire person seems to be necessary.
The Association Between Total Relative Value Unit and 90-Day Mortality After Noncardiac Surgery: A Hospital Data Registry Study
Authors: Oh Tak Kyu , Song In-Ae , Choi YoungRok 
Published: June 2020

Objective. The total relative value unit (TRVU) of surgery reflects surgical complexity. However, its impact on mortality after noncardiac surgery has not been identified. This study aimed to investigate the association of TRVUs for surgery with postoperative 90-day mortality in adult patients who received planned, elective noncardiac surgery. We hypothesized that higher TRVU was associated with an increase in 90-day mortality after noncardiac surgery. Method. This retrospective cohort study analyzed medical records of adult patients admitted to a single tertiary academic hospital between January 2012 and December 2018 for planned elective noncardiac surgery. The primary end point was 90-day mortality. Results. A total of 112 606 patients were included. Among them, 561 patients (.5%) exhibited mortality within 90-days. In the multivariable model, an increase of 10 000 points of TRVUs was not significantly associated with 90-day mortality (odds ratio: .98, 95% confidence interval: .93 to 1.04; P = .536). Additionally, when it was divided into 4 quartile groups (Q1, Q2, Q3, and Q4), Q2, Q3, and Q4 group of TRVUs were not associated with 90-day mortality compared to the Q1 group of TRVUs ( P = .058, .984, and .237, respectively). In receiver-operating characteristic analysis, the area under the curve of TRVUs for a 90-day mortality rate was .61. Conclusions. In conclusion , TRVUs were not associated significantly with a 90-day mortality rate after noncardiac surgery and have a low predictive ability for 90-day mortality after noncardiac surgery alone.
Modified Stapled Transanal Rectal Resection Procedure for Limited Rectal Prolapse: A Viable Alternative to the Delorme Operation
Authors: Chen Hua-Xian , Chen Zu-Qing , Huang Liang , Han Chang-Peng , Dou Ruo-Xu , Ren Dong-Lin , Lin Hong-Cheng 
Published: June 2020

Purpose. The optimal surgical approach for full-thickness rectal prolapse (FTRP) remains controversial. In China, patients with limited FTRP (<5 cm in length) are usually managed by perineal surgery. We retrospectively assessed the outcome of Delorme’s procedure and compared it with modified stapled transanal rectal resection (STARR). Methods. The study was conducted in 2 public tertiary referral centers in China with modified STARR or Delorme's procedure performed by experienced surgeons. Outcomes assessed recurrence, operative times, blood loss, complications, length of hospital stay, and continence and constipation scoring. Results. Between December 2012 and May 2019, 65 patients were assessed, including 48 with modified STARR (group 1) and 17 with Delorme’s procedure (group 2). The median follow-up was 22 months (range, 3-86 months). The mean operative time for group 1 was 37.4 ± 17.5 minutes vs 74.3 ± 30.6 minutes for group 2 ( P < .001). The blood loss for group 1 was significantly lower than that for group 2 (17.4 ± 15.9 mL vs 27.8 ± 16.7 mL, respectively; P = .028). There was no significant difference between groups in recurrence (group 1 18.8% vs group 2 23.5%; P = .944) with no effect of operation type. Both procedures showed improvement in constipation and continence scoring with a similar impact. Conclusions. Modified STARR and the Delorme operation are comparable in managing limited FTRP with superior results in operative time and blood loss for STARR.
Coronavirus disease 2019 and stroke in Iran: a case series and effects on stroke admissions
Authors: Mehrpour M , Shuaib A , Farahani M , Hatamabadi HR , Fatehi Z , Ghaffari M , Moghadam NB , Aghamiri SH , Mansouri B , Assarzadegan F , Lima BS , Hesami O 
Published: June 2020

Objective The coronavirus disease 2019 pandemic has affected healthcare systems around the globe and massively impacted patients with various non-infectious, life-threatening conditions. Stroke is a major neurological disease contributing to death and disability worldwide, and is still an ongoing issue during the pandemic. Here we investigate the impact of the coronavirus disease 2019 outbreak on stroke manifestations, treatment courses, the outcome of stroke patients, and the hospitalization rate in a referral center for stroke management in Tehran, Iran. Methods We extracted data regarding 31 stroke patients (10 patients with laboratory-confirmed coronavirus disease 2019) and compared the demographic and pathological characteristics of the patients with or without coronavirus disease 2019 infection. The association of demographic/pathological characteristics of stroke patients during the coronavirus disease 2019 pandemic and a corresponding period during the previous year (49 patients) and an earlier period during the same year as the pandemic (50 patients) was also evaluated. Results The absolute number of admissions decreased about 40% during the coronavirus disease 2019 pandemic. Except for the stroke severity (P = 0.002), there were no significant changes in the demographic and pathological characteristics of the stroke patients during the three studied periods. A significantly higher mean of age (75.60 ± 9.54 versus 60.86 ± 18.45; P = 0.007), a significant difference in the type of stroke (P = 0.046), and significantly higher stroke severity (P = 0.024) were observed in stroke patients with coronavirus disease 2019 compared with those of stroke patients without coronavirus disease 2019. Treatment approaches, duration of hospitalization, and mortality rates did not differ significantly. Conclusions This report shows that the pandemic caused the number of acute stroke admissions to plummet compared to other periods. Although the pandemic did not affect the treatment plans and care of the patients, stroke cases with coronavirus disease 2019 had higher age, more large vessel ischemic stroke, and more severe stroke. Further studies are urgently needed to realize the probable interaction of the coronavirus disease 2019 pandemic and the neurologic disease.