bluuebunny/crossref_metadata_2025_split huggingface dataset:
Telemedicine-guided forearm emergency decompressive fasciotomy for compartment syndrome
Authors: Park J Patrick , Montreuil Julien , Nooh Anas , Martineau Paul A 
Published: October 2020

Introduction We highlight the utility of telemedicine and telementoring for the management of orthopaedic emergencies using a case of forearm compartment syndrome following a penetrating trauma in a northern Inuit community in Nunavik, Quebec, Canada. Methods & Results As in many cases of compartment syndrome in rural settings, the patient was at a high risk of developing irreversible complications. A prompt diagnosis followed by an emergency decompressive fasciotomy was warranted. Using telemedicine and telementoring guidance, the diagnosis of compartment syndrome was made, and the patient’s volar compartment was successfully decompressed by a local emergency physician in a timely manner. Subsequently, the patient was able to be safely transferred to a level 1 trauma centre for further surgical management. This included a second-look operative exploration, irrigation and debridement, completion of volar fasciotomy and ulnar nerve decompression. No complications were seen. Discussion Our experience highlights two important clinical implications. First, telemedicine can be successfully implemented to facilitate clinical diagnosis of surgical emergencies in the rural setting. Second, telementoring can effectively allow surgeons to guide physicians remotely to perform emergency decompressive fasciotomy, which can help salvage the affected limb and significantly decrease the risk of debilitating complications.
Integrated telehealth-assisted home-based specialist palliative care in rural Australia: A feasibility study
Authors: Jiang Beisi , Bills Maryann , Poon Peter 
Published: October 2020

Introduction This study assessed the feasibility of integrating telehealth-assisted home-based specialist palliative care (TH-SPC) into a rural community setting. Methods This was a prospective mixed-methods pilot study conducted in rural Victoria, Australia. Newly engaged adult patients and their caregivers of a community palliative-care service received video consultations with metropolitan-located specialist palliative-care physicians, alongside standard care. Those eligible patients who failed to receive TH-SPC were treated as a control group upon analysis. Data were collected over three months and at 30 days prior to death. Feasibility outcomes included efficiency of process, user satisfaction, clinical outcome and health-care metrics. Results A total of 21 patients completed the study, with an average age of 70.4 years and an average survival of 5.8 months. Fourteen patients received TH-SPC, and seven received standard care alone. Patient–caregiver feedback for TH-SPC showed a high level of overall satisfaction. Compared to standard care, the TH-SPC group demonstrated less functional decline from baseline at two weeks (Australia-modified Karnofsky Performance Status: –1.35 vs. –12.30, p = 0.067) and three months (8.48 vs. –10.79, p = 0.04) after the intervention. At 30 days prior to death, functional status remained better in the TH-SPC group, with fewer per capita community palliative-care nursing visits (5.46 vs. 9.32, effect size = 0.7), general practitioner visits (0.13 vs. 3.88, effect size = 1.34) and hospital admissions (0.02 vs. 0.2, effect size = 0.65). Discussion TH-SPC was successfully integrated into rural community-based palliative care, with potential benefits in performance status preservation and health-care resource utilisation.
A bilingual advantage in memory capacity: Assessing the roles of proficiency, number of languages acquired and age of acquisition
Authors: Durand López Ezequiel M. 
Published: October 2020

Aims and objectives: This study examines whether different types of bilingualism modulate memory capacity differently. More specifically, the study assesses the effects of age of acquisition, number of languages acquired and proficiency in the second language (L2) on phonological short-term memory, visuospatial memory and semantic memory. Design: Memory capacity was measured by means of three tasks: the digit span task (phonological short-term memory); the Corsi block task (visuospatial memory); and the word span task (semantic memory). Participants were divided into five groups based on the number of languages acquired, age of acquisition and proficiency: monolinguals, intermediate L2 learners, advanced L2 learners, simultaneous bilinguals and multilinguals. Data and analysis: Analyses of variance were used to analyze participants’ scores for each of the memory tasks. Findings and conclusions: For the word span task, no significant differences were found among the groups, which supports the notion that semantic memory is language independent. Furthermore, intermediate and advanced L2 learners and multilinguals presented significantly higher phonological short-term memory spans compared to simultaneous bilinguals. Finally, intermediate L2 learners and multilinguals significantly outperformed monolinguals on visuospatial memory spans. Results suggest that L2 acquisition might strengthen both visuospatial and phonological short-term memory, which in turn tend to improve as L2 proficiency increases. Originality: While previous studies have provided evidence of a bilingual advantage in memory capacity, these studies have generally grouped different types of bilinguals together (e.g., L2 leaners and heritage speakers). This study takes a step forward by examining differences in memory capacity across different types of bilinguals and in comparison to their monolingual peers in order to better understand the cognitive effects of bilingualism. Significance and implications: When considering age of acquisition, number of languages acquired and proficiency as grouping factors, different effects of bilingualism on memory capacity can be observed. Future studies on this matter should include bilingual participants that are comparable with regard to the aforementioned variables.
Preoperative Planning for EndoAnchor Use During Thoracic Endovascular Aortic Repair in the Distal Aortic Arch
Authors: de Beaufort Hector W. L. , Lovato Luigi , Valdivia Andrés Reyes , Kratimenos Theodoros , Rossi Giovanni , Rousseau Hervé , Riambau Vicente , Heijmen Robin H. 
Published: October 2020

Purpose: To describe steps related to intraoperative C-arm orientations that can be taken during preoperative planning of thoracic stent-graft repair to facilitate the deployment of EndoAnchors in the distal aortic arch. Technique: Previous experience from transcatheter aortic valve implantation (TAVI) may be helpful in addressing issues with C-arm orientation. In TAVI, preoperative computed tomography (CT) images are routinely obtained to generate a patient-specific curve that represents a virtually complete rotation of the C-arm perpendicular to the annulus. The curve clearly demonstrates that each adjustment in cranial or caudal view needs parallax correction in the left or right anterior oblique direction to remain perpendicular, and vice versa. This experience can be translated to the preoperative planning of EndoAnchor use in the aortic arch. By placing markers along the circumference of the proximal landing zone of the preoperative CT scan, the required C-arm orientations can be determined for each marker. Conclusion: Determining the optimal C-arm orientation during preoperative planning will facilitate successful EndoAnchor deployment and may contribute to improved durability of endovascular repair in hostile necks in the aortic arch.
Clinical features and diagnostic imaging of cholangiolocellular carcinoma compared with other primary liver cancers: a surgical perspective
Authors: Takamura Hiroyuki , Gabata Ryousuke , Obatake Yoshinao , Nakanuma Shinichi , Hayashi Hironori , Kozaka Kazuto , Sasaki Motoko , Okazaki Mitsuyoshi , Yamaguchi Takahisa , Shimbashi Hiroyuki , Terai Shiro , Okamoto Koichi , Makino Isamu , Kinoshita Jun , Nakamura Keishi , Miyashita Tomoharu , Tajima Hidehiro , Ninomiya Itasu , Fushida Sachio , Kitao Azusa , Kitahara Masaaki , Arai Kuniaki , Yamashita Taro , Yamashita Tatsuya , Ikeda Hiroko , Satoh Yasunori , Harada Kenichi , Kaneko Syuichi , Gabata Toshihumi , Kosaka Tateo , Ohta Tetsuo 
Published: October 2020

Background and Objectives: Although cholangiolocellular carcinoma is considered a combined hepatocellular and cholangiocarcinoma, we feel that this classification is not appropriate. Therefore, we compared the diagnostic imaging findings, surgical prognosis, and pathological features of cholangiolocellular carcinoma with those of other combined hepatocellular and cholangiocarcinoma subtypes, hepatocellular carcinoma, and cholangiocarcinoma. Methods: The study patients included 7 with classical type combined hepatocellular and cholangiocarcinoma; 8 with stem cell feature, intermediate type combined hepatocellular and cholangiocarcinoma; 13 with cholangiolocellular carcinoma; 58 with cholangiocarcinoma; and 359 with hepatocellular carcinoma. All patients underwent hepatectomy or living-related donor liver transplantation from 2001 to 2014. Results: cholangiolocellular carcinoma could be distinguished from hepatocellular carcinom, other combined hepatocellular and cholangiocarcinoma subtypes, and cholangiocarcinoma by the presence of intratumoral Glisson’s pedicle, hepatic vein penetration, and tumor-staining pattern on angiography-assisted CT. Cholangiolocellular carcinoma was associated with a significantly lower SUV-max than that of cholangiocarcinoma on FDG-PET. Hepatocellular carcinoma, classical type, and cholangiolocellular carcinoma had significantly better prognoses than stem cell feature, intermediate type and cholangiocarcinoma. A cholangiocarcinoma component was detected in cholangiolocellular carcinoma that progressed to the hepatic hilum, and the cholangiocarcinoma component was found in perineural invasion and lymph node metastases. Conclusions: From the viewpoint of surgeon, cholangiolocellular carcinoma should be classified as a good-prognosis subtype of biliary tract carcinoma because of its tendency to differentiate into cholangiocarcinoma during its progression, and its distinctive imaging and few recurrence rates different from other combined hepatocellular and cholangiocarcinoma subtypes.
Autonomous Patient-Controlled Mobilization Protocol After Flexor Tendon Repair: A Case Series
Authors: Gómez Bárbara , Rodríguez María , García Luis 
Published: October 2020

Background: Despite many publications on rehabilitation after repair of flexor tendon injuries of the hand, there is no consensus as to which method is superior. It is clear that nonadherence to postoperative therapy adversely affects the outcome after flexor tendon surgery. In the context of a developing country, the most important factor associated with poor outcome is late onset of rehabilitation therapy. An autonomous rehabilitation program is proposed, with the use of a low-cost splint and based on an online illustrative video with the expectation to improve adherence and patient compliance, thus ensuring satisfactory outcome. Methods: Twenty-two consecutive digits of 14 patients after flexor tendon repair in zone II were included. Autonomous early passive mobilization physical therapy and splinting started shortly after surgery, supported by an online available video depicting prescribed exercises; follow-up was continued until postoperative week 20. Patients were evaluated regarding range of motion, grip strength, and the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) disability scale. Results: Range of motion after 20 weeks according to the scoring system of the American Society of Surgery of Hand was excellent in 4, good in 11, and fair in 4 fingers. The mean total active motion score was 86% (95% confidence interval, 78%-93%). The mean grip strength at final follow-up was 86% of the contralateral hand. The mean QuickDASH score was 12.5 (2.3-31.8). Conclusion: This protocol achieves good results in range of motion and early return of function of the hand. We propose this simple, nonexpensive method to developing countries with less than optimal availability of health care.
Intracranial and extracranial multiple arterial dissecting aneurysms in rheumatoid arthritis: A case report
Authors: Uekawa Ken , Kaku Yasuyuki , Amadatsu Toshihiro , Matsuzaki Hiroaki , Ohmori Yuki , Kawano Takayuki , Hirata Shinya , Yamaguchi Tomomi , Kosho Tomoki , Mukasa Akitake 
Published: October 2020

Objective We describe a case of intracranial and extracranial multiple arterial dissecting aneurysms in rheumatoid arthritis (RA). Case Presentation A 29-year-old man with a medical history of RA since 18 years of age was admitted to our hospital for vomiting, dysarthria, and conscious disturbance. At 23, he underwent ligation of the left internal carotid artery (ICA) with superficial temporal artery to middle cerebral artery anastomosis because of acute infarct of the left hemisphere caused by arterial dissection of the left ICA. During the current admission, computed tomography (CT) revealed subarachnoid hemorrhage, and digital subtraction angiography (DSA) demonstrated dissecting aneurysms of the left intracranial vertebral artery (VA) and right extracranial VA. We diagnosed him with a ruptured dissecting aneurysm of the left intracranial VA and performed endovascular parent artery occlusion on the left VA. For the right unruptured VA aneurysm, we performed coil embolization simultaneously. At 2 weeks after the endovascular treatment, follow-up DSA revealed that multiple de novo dissecting aneurysms developed on the origin of the left VA and left and right internal thoracic arteries. Those aneurysms were treated with coil embolization. Other remaining aneurysms on the left thyrocervical trunk, right transverse cervical artery, and both common iliac arteries were treated by conservative therapy. While continuing medical treatment for RA, the patient recovered and was discharged to a rehabilitation hospital. Conclusion Considering that RA-induced vasculitis can be a potential risk of vascular complications including multiple arterial dissections, physicians should carefully perform endovascular interventional procedures for patients with long-term RA.
Early major recurrence of cerebral aneurysms after satisfactory initial coiling
Authors: Abdalkader Mohamad , Raymond Jean , Mian Asim , Naragum Varun , Cronk Katharine , Roy Daniel , Weill Alain , Nguyen Thanh N 
Published: October 2020

Background and purpose Early major recurrence (EMR) of cerebral aneurysms treated by coiling has not been investigated. The purpose of this study is to characterize the frequency and risk factors of this phenomenon. Materials and methods A retrospective review was performed of consecutive patients who presented with ruptured and unruptured cerebral aneurysms and underwent coiling from July 2009 to June 2019 at a university hospital. We defined EMR as recurrence of the aneurysm greater than its initial size within the first 6 months of an initial satisfactory coil embolization. Patient demographics, clinical information, aneurysm characteristics, angiographic and technical details were reviewed. Results From July 2009 to June 2019, 338 aneurysms (190 unruptured aneurysms and 148 ruptured cerebral aneurysms) underwent coiling and satisfied our study criteria. Among these patients, 23 patients (19 ruptured and 4 unruptured aneurysms) were found to have recurrent aneurysm. Of those, 4 were found to have early major aneurysm regrowth occurring within 6 months after coiling (1.2%). The detection of the EMR was as early as 4 weeks and as late as 20 weeks after the initial coil embolization. The average detection time was 10 ± 7.2 weeks (mean ± SD, range:4-20 weeks). In each case, the recurrent aneurysm cavity was more than twice the initial size of presentation. All aneurysms with major recurrence were ruptured with low aspect ratios (dome height to neck ratio) and involved a communicating segment. All patients underwent successful retreatment of the recurrent aneurysm with good outcome. Conclusions Early major recurrence of treated aneurysms is a rare but important complication that harbors an impending risk of re-rupture. Early control angiography after endovascular coiling may be warranted for small ruptured aneurysms, even in cases in which the initial result seems technically satisfactory.
Adult malnutrition, nutritional interventions and outcomes in Singapore: a scoping review of local studies for the past 20 years
Authors: Wong Alvin , Huang Yingxiao , Sowa Przemyslaw M , Banks Merrilyn D , Bauer Judith D 
Published: October 2020

Background: There is currently no review published on the prevalence and incidence of malnutrition in Singapore across various populations, or what interventions or policies are in place for preventing/treating malnutrition. Objectives: This review aims to determine the: (a) incidence and prevalence of malnutrition in the community, and in acute, intermediate and long-term care facilities; (b) interventions implemented for screening, assessing and treating/preventing malnutrition; (c) specific clinical populations investigated for malnutrition or nutritional therapy; and (d) implications of malnutrition and effectiveness of treating malnutrition or using nutritional therapy in Singapore. Methods: A structured search strategy was applied to available electronic databases (MEDLINE/PubMed, EMBASE, CINAHL, the Cochrane Library and Google Scholar) using selected search terms, with additional reports and grey literature identified using iterative searches. Results: Forty-two articles were found, with the majority of research performed in the community and acute care settings. Malnutrition screening and assessment is the most common nutritional research performed in Singapore. Approximately 14.7% to 65.0% of acute care and 2.8% to 31.5% of community populations are found to be malnourished. Limited interventional and economic-related studies are available. Conclusion: Malnutrition rates in Singapore appear to be similar to other developed countries. Future studies will need to focus on nutritional intervention, cost-effectiveness analyses and specific populations such as the underprivileged, chronically ill and those dependent on nutritional support.
Subarachnoid diverticulum associated with feline infectious peritonitis in a Siberian cat
Authors: Hoey Christopher , Nye George , Fadda Angela , Bradshaw Janet , Barker Emi N 
Published: October 2020

Case summary A 7-month-old Siberian cat was presented for investigation of acute onset multifocal neurological deficits. Neurological examination documented dull mental status and an ambulatory left hemiparesis. Serum biochemistry documented marked hyperglobulinaemia. MRI of the brain identified marked leptomeningeal contrast enhancement extending along the brainstem caudally to involve the cranial cervical spinal cord. MRI of the cervical spine further identified a subarachnoid diverticulum that extended from the level of the obex to the C2–C3 vertebrae. Cerebrospinal fluid quantitative RT-PCR was positive for the presence of feline coronavirus. Histopathology revealed pyogranulomatous meningitis and choroid plexitis, uveitis and nephritis. Relevance and novel information This article describes the first reported case of a subarachnoid diverticulum associated with feline infectious peritonitis.
Intimate Partner Violence Experienced by Physicians
Authors: Reibling Ellen T. , Distelberg Brian , Guptill Mindi , Hernandez Barbara Couden 
Published: October 2020

Purpose: World Health Organization (WHO) defines intimate partner violence (IPV) as physical, sexual or psychological harm caused by an intimate partner or ex-partner. There are few studies describing interpersonal violence (IPV) among physicians. Our study describes IPV experienced by U.S. physicians. Methods: This was a multicenter survey administered to 4 physician groups in 2015 to 2016. In total 400 respondents returned survey results. Measures included current IPV, childhood abuse, mental health, professional role, and demographics. Results: IPV was reported by 24% of respondents. The most frequent abuses reported were: verbal (15%), physical (8%) followed by sexual abuse (4%) and stalking (4%). Logistic regression model found that IPV was more likely to be reported by older participants (aged 66–89), those who experienced childhood abuse, working less than full time, and had been diagnosed with a personality disorder. Women and Asian Americans reported slightly higher IPV rates. Conclusions: Our study has implications for both medical education and intervention development. Universal screening and education that addresses clinical implications when treating peers who experience IPV are needed. Workplace interventions that consider unique physician characteristics and experiences are needed, as well as programs that support sustained recovery. This is the first survey to our knowledge that confirms that physicians experience IPV at a rate consistent or higher than the national level. We developed a standardized instrument to assess IPV in male and female physicians at various career stages. We also identified significant predictors that should be included in IPV screening of potential physician victims.
Effect of Albumin Addition to Cardiopulmonary Bypass Prime on Outcomes in Children Undergoing Open-Heart Surgery (EACPO Study)—A Randomized Controlled Trial
Authors: Rauf Abdul , Joshi Reena K. , Aggarwal Neeraj , Agarwal Mridul , Kumar Manendra , Dinand Veronique , Joshi Raja 
Published: October 2020

Background: There is a paucity of literature regarding the association of high oncotic priming solutions for pediatric cardiopulmonary bypass (CPB) and outcomes, and no consensus exists regarding the composition of optimal CPB priming solution. This study aimed to examine the impact of high oncotic pressure priming by the addition of 20% human albumin on outcomes. Methods: Double-blinded, randomized controlled study was done in the pediatric cardiac intensive care unit of a tertiary care hospital. Consecutive children with congenital heart diseases admitted for open-heart surgery were randomized into two groups, where the study group received an additional 20% albumin to conventional blood prime before CPB initiation. Results: We enrolled 39 children in the high oncotic prime (added albumin) group and 37 children in the conventional prime group. In the first 24-hour postoperative period, children in the albumin group had significantly lower occurrence of hypotension (28.2% vs 54%, P = .02), requirement of fluid boluses (25.6% vs 54%, P = .006), and lactate clearance time (6 vs 9 hours, P < .001). Albumin group also had significantly higher platelet count (×103/µL) at 24 hours (112 vs 91, P = .02). There was no significant difference in intra-CPB hemodynamic parameters and incidence of acute kidney injury. In subgroup analysis based on risk category, significantly decreased intensive care unit stay (4 vs 5 days, P = .04) and hospital stay (5 vs 7 days, P = .002) were found in the albumin group in low-risk category. Conclusion: High oncotic pressure CPB prime using albumin addition might be beneficial over conventional blood prime, and our study does provide a rationale for further studies.