bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Anticoagulants for Postoperative Atrial Fibrillation After Coronary Artery Bypass Grafting: A Pilot Study
Authors: Chapin Todd W. , Leedahl David D. , Brown Andrew B. , Pasek Andrew M. , Sand Mitchell G. , Loy Maari L. , Dyke Cornelius M. 
Published: June 2020

Background: Direct-acting oral anticoagulants are indicated for the treatment of nonvalvular atrial fibrillation, but their use in patients after undergoing cardiac surgery is poorly defined despite a high prevalence of postoperative atrial fibrillation in this population. Methods: Patients diagnosed with postoperative atrial fibrillation were prospectively randomized to warfarin or apixaban. Safety, efficacy, and economic outcomes were evaluated until their 4- to 6-week postoperative appointment. Results: While this pilot study was not powered to determine a difference in safety or efficacy, adverse event rates were similar to the published literature. It was noted that a patient’s course of therapy when utilizing apixaban was significantly less costly than warfarin when including medication, bridging, and laboratory expenses. Conclusion: Apixaban and warfarin both appeared to be safe and effective for anticoagulation throughout the duration of this pilot study in treating postoperative atrial fibrillation after coronary artery bypass grafting. Apixaban was associated with significantly less expense when bridging and monitoring costs were included in addition to medication expense.
Anaphylaxis related to disinfection with chlorhexidine in a teenager treated for cancer
Authors: Devinck Astrid , Bauters Tiene , Lapeere Hilde , Willems Leen 
Published: June 2020

Introduction Literature shows upcoming allergy to chlorhexidine due to the widespread use of the disinfectant within and outside surgical settings. Only a few case reports have been published regarding the use of topical chlorhexidine disinfectant outside surgery and only a minority of these within the pediatric population. Case report We present a case-report of a teenager, treated for acute lymphoblastic leukemia who developed an anaphylactic shock after repeated chlorhexidine use for skin disinfection at the insertion of a central venous catheter during his chemotherapy treatment. Preceding minor symptoms such as local swelling and pruritus were not recognized as possible allergy to chlorhexidine. Management and outcome: He was treated with two doses of intramuscular adrenaline and transferred to the pediatric intensive care unit where he fully recovered. Specific IgE testing was positive for chlorhexidine. A total avoidance of chlorhexidine was instructed. Discussion A similar case was published regarding an anaphylaxis after use of chlorhexidine disinfectant for a dialysis catheter. Almost all other case reports of anaphylactic shock were found within surgical settings or after insertion of an impregnated central venous catheter/urine catheter. We suggest that some of the disinfectant might have been flushed in the catheter and then caused an anaphylactic reaction. The link between symptoms and chlorhexidine was not made until an anaphylactic reaction occurred. Literature data show that chlorhexidine often causes mild preceding symptoms before an anaphylaxis occurs. So let awareness arise around this ‘hidden allergen’ of which warning reactions often are being missed.
Exploring Substance Use Disorder Nursing Competency in the Italian Context
Authors: Acquaro Johnny , Scalzo Silvia , Procacci Arianna 
Published: June 2020

Background: In Italy, the majority of people treated in Addiction Treatment Service are heroin users. Nurses represent a strategic position in the multiprofessional and multidisciplinary Addiction Treatment Service team. Aims: To describe the addiction nurses’ competency in the Italian context. Method: This research uses the qualitative approach to describes the addiction nurses’ competency. The research was divided into two steps: ethnographic, to identify activities, habits, settings, critical issues and other distinctive features characterizing addiction nursing specific competencies, and a subsequent phenomenological semistructured interview to understand the lived and the meanings of the experience. Results: The meaning units identified could be organized as follows: ability to manage unexpected events, work organization, and teamwork relationships, professional responsibility. Conclusions: Many of these described competencies, if considered in general terms, relate to any area of the profession. It is possible to understand their specificity by investigating the meanings and the values attributed to the personal experience This study attempts to develop and define an Italian addiction nursing competency framework.
Unreliability of EDTA samples for measuring bioamine neurotransmitter levels in cats
Authors: Ramos Daniela , Reche-Junior Archivaldo , Brandão Juliana Dinéia Perez , Arita Danielle Yuri , Casarini Dulce Elena , Mills Daniel S 
Published: June 2020

Objectives The aim of this study was to assess the reliability of an EDTA-based method for measuring cat blood bioamines. Methods Test 1 involved collecting blood samples from seven university laboratory cats. The samples were transferred to EDTA, heparin and plain tubes to determine concentrations of four bioamines (serotonin, dopamine, epinephrine [adrenaline] and norepinephrine [noradrenaline]). Correlation of measurements performed on EDTA plasma, with those performed on heparinized plasma or serum were assessed by intraclass correlation coefficients (ICCs). In test 2, blood samples from five owned cats were collected and stored in EDTA tubes and divided between duplicate Eppendorf tubes labeled as different cats for blinding purposes and analyzed independently for the same four bioamines as in test 1. Reliability of concentration determination for these duplicates was assessed by ICCs and coefficients of variation (CVs). Results In test 1, there was no significant correlation between the EDTA plasma serotonin and serum serotonin concentrations. There was also no significant correlation between EDTA plasma and heparin plasma concentrations for either epinephrine or norepinephrine. There was a statistically significant but weak correlation between EDTA plasma and heparin plasma dopamine concentrations. In test 2, there was no correlation for repeat-analyzed serotonin and epinephrine concentrations. Although there were statistically significant correlations for dopamine and norepinephrine, CVs for each analyte were in excess of 30%. Conclusions and relevance Before any further attempt is made to measure and report on neurotransmitter concentrations in domestic cats, it is essential that the robustness of the methodology is carefully validated and the data presented.
How to carry out monthly blood flow surveillance of fistula in large-scale hemodialysis units: A cross-sectional study
Authors: Mo Ya-wen , Sun Chun-yan , Song Li , Zhou Li-fang , Zhuang Ting-ting , Zhong Mi , Zheng Shu-qian , Chen Ying-gui , Chen Yuan-han , Liu Shuang-xin , Liang Xin-ling , Fu Xia 
Published: June 2020

Background: The important effect of regular blood flow surveillance on arteriovenous fistula maintenance is emphasized. The ultrasonic dilution technique for blood flow surveillance can be performed during hemodialysis, but there are some limitations. Blood flow is traditionally measured by duplex Doppler ultrasound during the nondialysis period. However, the surveillance workload for arteriovenous fistula has increased with the rapid increase in the hemodialysis population size. Efficient methods for blood flow surveillance during hemodialysis are needed. Methods: Eighty-four hemodialysis patients with a forearm radiocephalic arteriovenous fistula were enrolled in this cross-sectional study. Each received blood flow measurements using ultrasonic dilution technique and duplex Doppler ultrasound during hemodialysis. Duplex Doppler ultrasound measurements included the blood flow of the brachial artery and radial artery. The correlations between these variables were analyzed. Results: The correlation coefficients ( r) between flow measured by ultrasonic dilution technique and brachial artery flow measured by duplex Doppler ultrasound, between flow measured by ultrasonic dilution technique and radial artery flow measured by duplex Doppler ultrasound, and between brachial artery flow and radial artery flow measured by duplex Doppler ultrasound were 0.724, 0.784, and 0.749, respectively (all p < 0.001). Conclusion: Blood flow measured by ultrasonic dilution technique was positively correlated with blood flow measured by duplex Doppler ultrasound during hemodialysis, suggesting that duplex Doppler ultrasound can be used to monitor the trends in the blood flow of the brachial artery and radial artery for timely intervention to improve patency during hemodialysis.
A cost-utility analysis of open A1 pulley release for the treatment of trigger finger
Authors: Stirling Paul H. C. , Clement Nicholas D. , Jenkins Paul J. , Duckworth Andrew D. , McEachan Jane E. 
Published: June 2020

The United Kingdom National Institute for Health and Care Excellence considers a procedure to be cost-effective if the cost per quality-adjusted life year gained falls below a threshold of £20,000–£30,000 (€22,600–33,900; US$24,600–$36,900). This study used cost per quality-adjusted life year methodology to determine the cost-utility ratio of A1 pulley release. Pre- and postoperative EuroQol 5 Dimensions 5 Likert scores were collected prospectively over 6 years from 192 patients. The median pre- and postoperative indices derived from the EuroQol 5 Dimensions 5 Likert scores were significantly different at 0.77 and 0.80. The mean life expectancy was 21 years. The mean number of quality-adjusted life years gained was 1 per patient. The mean cost-utility ratio per patient was £32,308 (€36,508; US$39,730) and £16,154 (€18,254; US$19,869) at 1 and 2 years, respectively. Provided the benefit of surgery was maintained over the remaining life expectancy, the cost-utility ratio decreased to £1537 (€1737; US$1891) per patient. A1 pulley release is cost-effective provided the benefit is maintained for 2 years. The procedure is also associated with a statistically significant improvement in quality of life. Level of evidence: III
Chronic Odontogenic Rhinosinusitis: Optimization of Surgical Treatment Indications
Authors: Simuntis Regimantas , Kubilius Ričardas , Tušas Paulius , Leketas Marijus , Vaitkus Justinas , Vaitkus Saulius 
Published: June 2020

Background The treatment of chronic odontogenic and nonodontogenic rhinosinusitis is different. It requires the elimination of odontogenic cause and optimal sinus surgical treatment. To date, there are no clear indications when sinus surgical treatment is necessary. Objective Our aim was to define clear indication(s) for sinus surgical treatment in patients with chronic odontogenic rhinosinusitis after elimination of odontogenic cause. Methods A group of 96 patients with chronic odontogenic rhinosinusitis caused by apical periodontitis completed a Sino-Nasal Outcome Test 22 (SNOT-22) questionnaire with incorporated additional symptom “malodor” before treatment. Moreover, they were distributed according to computed tomography (CT) radiological criteria such as degree of periapical pathology, anatomical ratio between maxillary lateral teeth and sinus floor, sinus mucosal thickening, and ostiomeatal complex condition. The elimination of odontogenic cause was performed by extracting causative tooth. Questionnaire was filled again 2 weeks, 3 months, and 6 months after treatment. All data were analyzed to search the clear indications for sinus surgical treatment. Results Of 96 patients, 74 (77.1%) patients had full resolution of symptoms after dental cause was eliminated. For other 22 (22.9%) patients, symptoms persisted and sinus surgical treatment was indicated. In recovered group, mean SNOT-22 score was different between all periods of measuring, while within nonrecovered group, small differences were seen only when compared to before treatment. No statistically significant correlation between radiological criteria and rhinosinusitis healing after tooth extraction was found ( P > .05). Statistically significant correlation was found between the disappearance of malodor/SNOT-22 score reduction after elimination of dental cause and healing success ( P < .005). Conclusions Our study revealed that extraction of causative tooth is an effective treatment of chronic odontogenic rhinosinusitis caused by apical periodontitis. CT criteria are not valuable indicator for sinus surgery, but persistence of malodor after 2 weeks is the strongest indication for this type of treatment.
Multilevel Risk Factors for Hospital Readmission Among Patients With Opioid Use Disorder in Selected US States: Role of Socioeconomic Characteristics of Patients and Their Community
Authors: Basu Jayasree 
Published: June 2020

Research Objective: Using a multilevel framework, the study examines the association of socioeconomic characteristics of the individual and the community with all-cause 30-day readmission risks for patients hospitalized with a principal diagnosis of opioid use disorder (OUD). Study Design: The study uses hospital discharge data of adult (18+) patients in 5 US states for 2014 from the Healthcare Cost and Utilization Project of the Agency for Healthcare Research and Quality, linked to community and hospital characteristics using data from Health Resources and Services Administration and American Hospital Association, respectively. A multilevel logistic regression model is applied on data pooled over 5 states adjusting for patient, hospital, and community characteristics. Principal Findings: Higher primary care access, as measured by density of primary care providers, is associated with reduced readmission risks among patients with OUD. Medicare is associated with the highest readmission risk (odds ratio [OR] = 2.0, P < .01) compared to private coverage, while Medicaid coverage is also associated with elevated risk (OR = 1.71, P < .01). Being self-pay or covered by other payers carried a similar risk to private coverage. Urban patients had higher readmission rates than rural patients. Conclusions: Patients’ risk of readmission following hospitalization for OUD varies according to availability of primary care providers, expected payer, and geographic location. Understanding which patients are most at risk may allow policy makers to design interventions to prevent readmissions and improve patient outcomes. Future studies may wish to focus on understanding when a decreased readmission rate represents better patient outcomes and when it represents difficulty accessing health care.
Fluorapophyllite-(NH4), NH4Ca4(Si8O20)F⋅8H2O, a new member of the apophyllite group from the Vechec quarry, eastern Slovakia
Authors: Števko Martin , Sejkora Jiří , Plášil Jakub , Dolníček Zdeněk , Škoda Radek 
Published: June 2020

AbstractThe new mineral fluorapophyllite-(NH4), ideally NH4Ca4(Si8O20)F⋅8H2O, was found at the Vechec andesite quarry located near Vechec village, Vranov nad Topľou Co., Prešov Region, Slovak Republic. It occurs in cavities of quartz–illite–saponite–tobelite xenolith embedded in pyroxene andesite. Fluorapophyllite-(NH4) is associated with calcite, tridymite, pyrite, chabazite-Ca and heulandite-Ca. It forms clusters, aggregates or crystalline crusts consisting of individual, well-developed crystals up to 4 mm in size, exhibiting the forms {110}, {101} and {001}. The mineral is colourless to light pink and translucent with white streak and vitreous to pearly lustre; it is non-fluorescent under ultraviolet radiation. The Mohs hardness is ~4½ to 5, tenacity is brittle, fracture is irregular, and there is perfect cleavage on {001}. The calculated density is 2.325 g cm–3. Fluorapophyllite-(NH4) is optically uniaxial (+) with ω = 1.5414(5) and ɛ = 1.5393(8) (λ = 589 nm). It is non-pleochroic. The empirical formula (based on 29 O + F apfu) is [(NH4)0.55K0.32Na0.07Ca0.06]Σ1.00(Ca4.01Mg0.02)Σ4.03Si7.97O20[F0.84(OH)0.16]Σ1.00⋅8H2O. Fluorapophyllite-(NH4) is tetragonal, space groupP4/mnc,a= 8.99336(9) Å,c= 15.7910(3) Å,V= 1277.18(3) Å3andZ= 2. The seven strongest X-ray powder diffraction lines are [dobsin Å,(I,%)(hkl)]: 7.897(32)(002), 7.812(13)(101), 4.547(14)(103), 3.946(100)(004), 2.985(39)(105), 2.4841(11)(215) and 1.5788(12)(00.10). The crystal structure of fluorapophyllite-(NH4), refined toR1= 0.0299 for 743 unique (I> 3σI) observed reflections, confirmed that the atomic arrangement is very similar to that of the other members of the apophyllite group. The new mineral is named according to the current nomenclature scheme for apophyllite-group minerals and is an NH4dominant analogue of fluorapophyllite-(K), fluorapophyllite-(Na) and fluorapophyllite-(Cs).
Granularity ofSERPINA1alleles by DNA sequencing in CanCOLD
Authors: Gupta Nisha , Gaudreault Nathalie , Thériault Sébastien , Li Pei Zhi , Henry Cyndi , Kirby Miranda , Maltais François , Tan Wan , Bourbeau Jean , Bossé Yohan ,   for the Canadian Respiratory Research Network and the CanCOLD study group
Published: June 2020

DNA sequencing of theSERPINA1gene to detect α1-antitrypsin (AAT) deficiency (AATD) may provide a better appreciation of the individual and cumulative impact of genetic variants on AAT serum levels and COPD phenotypes.AAT serum level and DNA sequencing of the coding regions ofSERPINA1were performed in 1359 participants of the Canadian Cohort Obstructive Lung Disease (CanCOLD) study. Clinical assessment for COPD included questionnaires, pulmonary function testing and computed tomography (CT) imaging. Phenotypes were tested for association withSERPINA1genotypes collated into four groups: normal (MM), mild (MS and MI), intermediate (heterozygote MZ, non-S/non-Z/non-I, compound IS, and homozygote SS) and severe (ZZ and SZ) deficiency. Smoking strata and MZ-only analyses were also performed.34 genetic variants were identified including 25 missense mutations. Overall, 8.1% of alleles in this Canadian cohort were deficient and 15.5% of 1359 individuals were carriers of at least one deficient allele. Four AATD subjects were identified and had statistically lower diffusion capacity and greater CT-based emphysema. No COPD phenotypes were associated with mild and intermediate AATD in the overall cohort or stratified by smoking status. MZ heterozygotes had similar CT-based emphysema, but lowered diffusion capacity compared with normal and mild deficiency.In this Canadian population-based cohort, comprehensive genetic testing for AATD reveals a variety of deficient alleles affecting 15.5% of subjects. COPD phenotype was demonstrated in severe deficiency and MZ heterozygotes. This study shows the feasibility of implementing a diagnostic test for AATD using DNA sequencing in a large cohort.
Catheter-induced urethral injury and tubularized urethral plate urethroplasty in such iatrogenic hypospadias
Authors: Bhat Ami Lal , Bhat M. , Khandelwal N. , Bhat A. , Singh T. 
Published: June 2020

AbstractBackgroundCatheter-induced urethral erosion can involve meatus, glans and any extent of penile shaft. These injuries cause a lot of psychological, social and sexual trauma to the patient. Though the use of condom drainage system can render this spinal cord injury patient effectively dry, but can lead to penile or urethral complications. Many of these patients are kept on indwelling catheter. Long duration catheterization, poor catheter care in such paraplegic patients and other morbid patients may lead to urethral erosions. We conducted a prospective study of catheter-induced urethral injury from July 2014 to February 2016 in our tertiary care centre. The demographics, past history of illness, catheter material, and duration of catheterization, securing of catheter, local examination findings and associated comorbidities were recorded. Factors leading to urethral erosion were evaluated. And patients, who were fit and were willing for surgery, underwent tubularized urethral plate urethroplasty after 4–6-week supra-pubic diversion. The objective of the study was to evaluate factors of urethral erosion, and the results tubularized urethral plate urethroplasty in iatrogenic hypospadias.ResultsWe had twelve patients of catheter associated urethral injury in the study period. Age of the patients varied from 34 to 95 years with a mean of 61.25 years. Duration of catheterization ranged from 6 to 24 months with a mean duration 10.9 months. Catheters used were silicon coated, not secured to abdomen and had comorbid condition of neurological or cardiac origin in all patients. Long duration of catheter, poor quality of catheter and poor catheter care such moribund with poor body resistance patients were the main causative factor for urethral erosion. Urethral injuries varied from erosion of distal 2 cm to entire ventral urethra till penoscrotal junction with or without penile torque. Six of these patients underwent tubularized urethral plate urethroplasty with good cosmetic and functional postoperative outcome.ConclusionPatients of spinal cord injury, patients with comorbid condition like diabetes mellitus and ischaemic heart disease, poor catheter care and long duration catheterization are likely to have severe urethral injury. Extent of injury may vary from meatal erosion to erosion of entire ventral urethra till penoscrotal junction leading to iatrogenic hypospadias. These patients either may be put on clean intermittent catheterization or supra-pubic catheterization. Results of tubularized urethral plate urethroplasty in such iatrogenic hypospadias are very good.
The propofol-sparing effect of intravenous lidocaine in elderly patients undergoing colonoscopy: a randomized, double-blinded, controlled study
Authors: Chen Mengmeng , Lu Yi , Liu Haoran , Fu Qingxia , Li Jun , Wu Junzheng , Shangguan Wangning 
Published: May 2020

Abstract
Background
Propofol provides a prominent sedation effect in colonoscopy. However, anesthesia and sedation induced with propofol in the elderly might result in cardiopulmonary complications, especially when it is combined with opoids in the regimen. This study aimed to test the hypothesis that the addition of intravenous lidocaine to propofol-based sedation could decrease the overall propofol requirement in elderly patients during colonoscopy while the procedural sedation satisfaction and the hemodynamic stability were not compromised.

Methods
Ninety-two patients undergoing colonoscopy were randomly enrolled into lidocaine+propofol (L + P) group or normal saline+propofol (NS + P) groups. Subjects received intravenous bolus of 1.5 mg/kg lidocaine followed by 4 mg kg− 1 h− 1 lidocaine continuous infusion in L + P group or equivalent volumes of normal saline for boluses and infusion in NS + P group. Anesthesia was induced with 2.5 μg sufentanil followed by injection of 1.2 mg kg− 1 propofol in all patients. A single supplemental bolus of 0.6 mg kg− 1 propofol was administered whenever MOAA/S score > 1 or had body movement during the colonoscopy. The recorded primary endpoints included: the total amount of propofol administered during entire procedure, the supplemental amount of propofol after induction, and the frequencies of boluses of supplemental propofol.

Results
A total of 79 patients were included in the final analysis. Compared with NS + P group, the total amounts of propofol (induction plus supplemental) were no significant differences in L + P group; however, the required supplemental propofol was less (69.9 ± 39.2 mg vs. 51.5 ± 38.6 mg) (P = 0.039); the average frequencies of boluses of supplemental propofol given after induction were lower (2.1 ± 1.1 vs. 1.4 ± 0.9) (P = 0.003); the calculated “unit propofol” infusion rate was lower (0.18 ± 0.05 vs. 0.14 ± 0.04 mg kg− 1 min− 1) (P = 0.002).

Conclusions
The addition of intravenous lidocaine to propofol-based sedation resulted in a remarked reduction of supplemental propofol in the elderly during colonoscopy.

Trial registration
The present clinical trial was registered at http://www.chictr.org.cn on 11th March 2019 (registration No. ChiCTR1900021818).