bluuebunny/crossref_metadata_2025_split huggingface dataset:
Spinal Tranexamic Acid—A New Killer in Town
Authors: Palanisamy A. , Kinsella S.M. 
Published: May 2020

(Anaesthesia. 2019;74:831–833)
Tranexamic acid has become an important component in the management of postpartum hemorrhage since the WOMAN trial was published in 2017. A recent article by Patel and colleagues identified 21 case reports of accidental spinal administration of tranexamic acid, with several occurring in women receiving spinal anesthesia for cesarean delivery. These drug errors resulted in a mortality rate >50% and permanent neurological injuries in many survivors.
Prevalence and Main Outcomes of Placenta Accreta Spectrum: A Systematic Review and Meta-analysis
Authors: Jauniaux E. , Bunce C. , Grønbeck L. , Langhoff-Roos J. 
Published: May 2020

(Am J Obstet Gynecol. 2019;221:208–218)
Placenta accreta spectrum occurs when the villous tissue of the placenta adheres or invades the uterine wall, at times even connecting surrounding pelvic organs and vasculature. During delivery, these adherent villi result in either parts or the entire placenta failing to detach spontaneously from the uterine wall. Access to specialist centers, blood banks, and neonatal and maternal intensive care is inconsistent in some high-income countries and often restricted or nonexistent in most low- and middle-income countries. This study was a systematic review and meta-analysis evaluating the prevalence of placenta accreta spectrum in studies of the general population. Specifically the authors evaluated the heterogeneity across studies in clinical diagnostic criteria reporting to assess the impact on incidence of maternal outcomes.
Risk Factors, Etiologies, and Screening Tools for Sepsis in Pregnant Women: A Multicenter Case-Control Study
Authors: Bauer M.E. , Housey M. , Bauer S.T. , Behrmann S. , Chau A. , Clancy C. , Clark E.A.S. , Einav S. , Langen E. , Leffert L. , Lin S. , Madapu M. , Maile M.D. , McQuaid-Hanson E. , Priessnitz K. , Sela H.Y. , Shah A. , Sobolewski P. , Toledo P. , Tsen L.C. , Bateman B.T. 
Published: May 2020

(Anesth Analg. 2019;129:1613–1620)
Sepsis is the third leading cause of maternal morbidity and mortality, making up ∼12.7% of pregnancy-related deaths. Early identification and prompt treatment of patients can improve maternal outcomes. However, it is difficult to diagnose sepsis in pregnancy because physiological changes of pregnancy can mimic the signs of sepsis. The quick Sequential (Sepsis-related) Organ Failure Assessment (qSOFA) criteria, systemic inflammatory response syndrome (SIRS) criteria, and the maternal early warning (MEW) criteria all provide different screening methods that may be useful, but their validity for the identification of early sepsis in pregnancy are unknown. Therefore, the primary objective of this multicenter case-control study was to evaluate the performance characteristics of the SIRS, qSOFA, and MEW criteria for identifying cases of early maternal sepsis during perinatal hospitalization. In addition, the authors sought to identify which of the 3 screening criteria is best used in maternal sepsis.
Maternal Short-term Complications After Planned Cesarean Delivery Without Medical Indication: A Registry-based Study
Authors: Otkjær A.M. , Jørgensen H.L. , Clausen T.D. , Krebs L. 
Published: May 2020

(Acta Obstet Gynecol Scand. 2019;98:905–912)
In Denmark, the cesarean delivery rate increased from 12.8% in 1996 to 20.8% in 2006. Since then the rate has stabilized to ∼20%. Many hospitals in Denmark have been striving to reduce cesarean delivery rates, based on the belief that there are higher rates of maternal complications with cesarean delivery compared with vaginal delivery. However, whether the rate of complications for healthy women requesting a planned cesarean delivery (PCD) without medical indication is actually increased has been called into question. This large, retrospective, population-based cohort study used the Danish Medical Birth Registry to compare short-term maternal outcomes between PCD and planned vaginal delivery (PVD) in term, low-risk women.
Measuring Childbirth Outcomes Using Administrative and Birth Certificate Data
Authors: Glance L.G. , Hasley S. , Glantz J.C. , Stevens T.P. , Faden E. , Kreso M.A. , Pyne S.G. , Wissler R.N. , Fichter J. , Gloff M.S. , Dick A.W. 
Published: May 2020

(Anesthesiology. 2019;131:238–253)
In recent years, complications after childbirth have become more prevalent, and the quality of obstetric care throughout the United States is uneven. By reporting risk-adjusted maternal and neonatal outcomes, hospitals may be provided with feedback, and quality of care can be evaluated. This study used administrative and birth data to develop a risk-adjusted composite outcome of severe maternal morbidity and severe newborn morbidity.
Association Between Self-reported Prenatal Cannabis Use and Maternal, Perinatal, and Neonatal Outcomes
Authors: Corsi D. , Walsh L. , Weiss D. , Hsu H. , El-Chaar D. , Hawken S. , Fell D. , Walker M. 
Published: May 2020

(JAMA. 2019;322:145–152)
The rate of cannabis use among pregnant women in Canada was 2% in 2017. With recent legalization, it is anticipated that cannabis use among pregnant women will continue to rise. Cannabinoids can cross the placenta and enter the fetal blood supply. Previous studies have demonstrated a relationship between pregnant mothers who use cannabinoids and increased incidence of low birth weight, small for gestational age (SGA), stillbirth, and admission to neonatal intensive care. The aim of this study was to evaluate associations between reported prenatal cannabis use and maternal, perinatal, and neonatal outcomes.
Racial and Ethnic Inequities in Postpartum Pain Evaluation and Management
Authors: Johnson J.D. , Asiodu I.V. , McKenzie C.P. , Tucker C. , Tully K.P. , Bryant K. , Verbiest S. , Stuebe A.M. 
Published: May 2020

(Obstet Gynecol. 2019;134:1155–1162)
Racial disparities in perinatal outcomes have been extensively researched, but discrepancies in health care and health outcomes among black women and neonates still remain. One nonobstetric example of racial disparity in medical care is the inconsistency of narcotic pain medication administered to white patients and black patients who present with migraines or back pain in emergency departments. The current investigators conducted their study to assess whether obstetric care given at a tertiary academic medical center in North Carolina was inequitable between minority patients and white patients based on the frequency of pain assessment and how patients’ postcesarean pain was treated.
Hyperoxygenation in Pregnancy Exerts a More Profound Effect on Cardiovascular Hemodynamics Than is Observed in the Nonpregnant State
Authors: McHugh A. , El-Khuffash A. , Bussmann N. , Doherty A. , Franklin O. , Breathnach F. 
Published: May 2020

(Am J Obst Gynecol. 2019;220:397.e1–397.e8)
Supplemental oxygen, or hyperoxygenation, in the pregnant population is used in a number of clinical scenarios. Studies have shown that maternal hyperoxygenation (MHO2) improves fetal oxygen levels and fetal heart rate (FHR) patterns. Yet, we lack data to demonstrate improvement in maternal and neonatal outcomes with this therapy. Despite wide use of hyperoxygenation in obstetric practice, there is also no clear guidance on indication, dose range, duration, and benefit. This study aimed to compare the effect of hyperoxygenation on cardiac index, systemic vascular resistance (SVR), stroke volume, blood pressure, and heart rate in third trimester pregnant women to the hemodynamic effects of hyperoxygenation in nonpregnant women.
The Importance of Nontechnical Performance for Teams Managing Postpartum Hemorrhage: Video Review of 99 Obstetric Teams
Authors: Brogaard L. , Kierkegaard O. , Hvidman L. , Jensen K. , Musaeus P. , Uldbjerg N. , Manser T. 
Published: May 2020

(BJOG. 2019;126:1015–1023)
Major postpartum hemorrhage contributes to almost a quarter of worldwide maternal deaths. Effective management and team collaboration could reduce mortality. Competencies supporting successful performance of teams during time-critical and stressful moments are referred to as nontechnical skills. During postpartum hemorrhage, lacking skills of communication, teamwork, leadership, and decision-making can contribute to adverse events. This study aimed to analyze videos of obstetric teams managing actual patients with major postpartum hemorrhage.
Severe Maternal Morbidity During Delivery Hospitalization in a Large International Administrative Database, 2008-2013: A Retrospective Cohort
Authors: Lipkind H.S. , Zuckerwise L.C. , Turner E.B. , Collins J.J. , Campbell K.H. , Reddy U.M. , Illuzi J.L. , Merriam A.A. 
Published: May 2020

(BJOG. 2019;126:1223–1230)
Despite programs to improve maternal health, maternal mortality in the United States has increased over the past few decades. Other developed countries such as England and Australia, by contrast, have decreasing rates. As the incidence of maternal morbidity increases, evaluating cases of severe maternal morbidity (SMM) functions as a proxy for risk factors of mortality. This study aimed to utilize Centers for Disease Control and Prevention (CDC) SMM diagnostic codes to examine SMM rates in the United States, England, and Australia in the Dr Fosters Global Comparators Project (GC).
Isoniazid Preventive Therapy in HIV-Infected Pregnant and Postpartum Women
Authors: Gupta A. , Montepiedra G. , Aaron L. , Theron G. , McCarthy K. , Bradford S. , Chipato T. , Vhembo T. , Stranix-Chibanda L. , Onyango-Makumbi C. , Masheto G.R. , Violari A. , Mmbaga B.T. , Aurpibul L. , Bhosale R. , Mave V. , Rouzier V. , Hesseling A. , Shin K. , Zimmer B. , Costello D. , Sterling T.R. , Chakhtoura N. , Jean-Philippe P. , Weinberg A. 
Published: May 2020

(N Engl J Med. 2019;381:1333–1346)
Among persons with human immunodeficiency virus (HIV) infection who reside in low-income and middle-income countries, tuberculosis (TB) is the leading cause of health complications and death. Among women, TB predominantly affects those of reproductive age. When developing during pregnancy or the early postpartum period, TB is associated with adverse maternal, pregnancy, and infant outcomes. While consensus exists for the net benefit of treating TB during pregnancy, safety and efficacy data are lacking regarding isoniazid (INH) preventive therapy in pregnant women who are receiving antiretroviral therapy (ART).
Serious Adverse Events Attributed to Remifentanil Patient-controlled Analgesia During Labour in The Netherlands
Authors: Logtenberg S.L.M. , Vink M.L. , Godfried M.B. , Beenakkers I.C.M. , Schellevis F.G. , Mol B.W. , Verhoeven C.J. 
Published: May 2020

(Int J Obstet Anesth. 2019;39:22–28)
Although epidural analgesia remains the preferred method of labor analgesia, remifentanil patient-controlled analgesia (PCA) is a popular alternative due to its quick onset and rapid metabolic properties. Remifentanil PCA has been used in Europe for several years, but its safety has been questioned by some due to concerns about potential serious side effects, such as respiratory depression for both mother and neonate. Since the current rate of serious adverse events (SAEs) connected to remifentanil PCA use during labor is unknown, the current investigators conducted this study to measure the frequency of SAEs, as well as examine the clinical circumstances associated with SAEs and the management of those events.
Remifentanil Patient-controlled Intravenous Analgesia During Labour: A Retrospective Observational Study of 10 Years’ Experience
Authors: Murray H. , Hodgkinson P. , Hughes D. 
Published: May 2020

(Int J Obstet Anesth. 2019;39:29–34)
Remifentanil patient-controlled analgesia (PCA) has been an analgesic option for labor on several obstetric units for 15 to 20 years. It is not as efficacious as epidural analgesia for providing pain relief during labor, but it is considered to have a satisfactory analgesic effect. However, there have been reports of respiratory arrest in obstetric patients receiving remifentanil PCA. The current investigators routinely offer remifentanil for labor analgesia at their institution. They conducted this retrospective study to determine delivery outcomes in women receiving remifentanil PCA compared with women receiving intramuscular (IM) diamorphine or epidural analgesia.
Dural Puncture Epidural Analgesia for Labor: A Randomized Comparison Between 25 and 27 G Pencil Point Spinal Needles
Authors: Contreras F. , Morales J. , Bravo D. , Layera S. , Jara A. , Riaño C. , Pizarro R. , De La Fuente N. , Aliste J. , Finlayson R. , Tran D. 
Published: May 2020

(Reg Anesth Pain Med. 2019;44:750–753)
Dural puncture epidural analgesia (DPEA) is the technique of passing a small gauge spinal needle through a Tuohy needle located in the epidural space to create a hole in the dura. Following the creation of this hole, the spinal needle is withdrawn without injection of intrathecal medication, and a catheter is placed within the epidural space. DPEA performed with 25 and 26 G pencil point spinal needles have demonstrated shorter onset time and improved sacral blockade compared with the traditional epidural technique; however, a large prospective trial demonstrated an increased incidence of postdural puncture headache (PDPH) after using a 25 G compared with a 27 G needle. Thus, the goal of this study was to compare DPEA using 25 and 27 G pencil point spinal needles. The primary outcome was onset time, which was defined as the temporal interval required after catheter placement to obtain a pain score ≤1 using a 0 to 10 Numeric Rating Scale.
A Randomized Controlled Trial of Phenylephrine and Noradrenaline Boluses for Treatment of Postspinal Hypotension During Elective Caesarean Section
Authors: Mohta M. , Garg A. , Chilkoti G.T. , Malhotra R.K. 
Published: May 2020

(Anaesthesia. 2019;74:850–855)
Phenylephrine is the preferred vasopressor for treating spinal-induced hypotension during cesarean delivery due to its rapid onset, short duration of action, and lack of adverse effects on fetal acid-base status. However, norepinephrine is often used in critical care settings, especially in patients with septic shock, and may be less likely than phenylephrine to cause bradycardia. Although several studies have been conducted in recent years on the use of norepinephrine for the treatment and prevention of spinal-induced hypotension during cesarean delivery, there are limited data comparing phenylephrine and norepinephrine in terms of safety, efficacy, neonatal outcomes, and side effects. This study aimed to compare the rate of maternal bradycardia between the 2 drugs when administered as intravenous boluses to treat hypotension during elective cesarean delivery with spinal anesthesia.
Dexmedetomidine for Every Cesarean Delivery … Maybe Not?
Authors: Bautista L. , George R. 
Published: May 2020

(Can J Anesth/J Can Anesth. 2019;66:751–754)
Perioperative shivering is a commonly observed clinical problem for women undergoing cesarean delivery (CD). The median incidence of shivering in patients having a CD with epidural or spinal anesthesia is estimated to be 52%. Previous studies have analyzed pharmacologic agents such as meperidine, butorphanol, clonidine, fentanyl, tramadol, and dexmedetomidine and their ability to reduce shivering following neuraxial anesthesia. However, side effects including nausea, hypotension, vomiting, and excessive sedation limit the utility of these agents.
Successful Recovery From a Delayed Amniotic Fluid Embolism
Authors: Guo F. , Yan Z. , Zhu Y. , Yu Y. 
Published: May 2020

(J Clin Anesth. 2019;56:4–5)
Amniotic fluid embolism (AFE) is a catastrophic syndrome that typically occurs during labor and delivery. Most cases occur during labor (70%), but it can also occur after a vaginal delivery (11%) or a cesarean delivery (19%).
Cervical spine subdural hematoma
Authors: Shearer James Levi , Sciandra Rebecca , Gendron Brett 
Published: May 2020

ABSTRACT
Spinal subdural hematomas (SSDH) are a rare radiographic finding that can lead to significant long-term disability. Many clinicians are unfamiliar with this condition and the available treatment options. This article describes one approach to managing a patient with an SSDH.
Vitamin D, melanoma risk, and tumor thickness in PLCO cancer screening trial patients
Authors: Hyde Mark A. , Grossman Douglas , Wu Yelena P. , Buys Saundra , Gren Lisa H. , Hashibe Mia 
Published: May 2020

ABSTRACT

Objective:
The incidence of melanoma is increasing. Other than limiting UV exposure, few factors prevent or reduce the risk of melanoma. The aim of this study is to evaluate the relationship between vitamin D intake and melanoma risk in the Prostate, Lung, Colorectal, and Ovarian (PLCO) cancer screening trial.

Methods:
A secondary data analysis was performed on PLCO data. More than 1,300 participants developed melanoma.

Results:
Melanoma risk may be increased among men within the highest quartile of vitamin D intake (HR 1.27, 95% CI 0.99, 1.61). Women in the highest quartile of vitamin D intake had a decreased risk of invasive melanoma (HR 0.63, 95% CI 0.41, 0.96). Higher education and being white corresponded with deeper tumors (P < .001).

Conclusion:
High reported vitamin D intake resulted in an increased risk of melanoma among men. Vitamin D intake yielded a protective effect against invasive melanoma in women.
Sex differences in disease activity and efficacy of treatment in spondyloarthritis: is body composition the cause?
Authors: Ibáñez Vodnizza Sebastián , van der Horst-Bruinsma Irene 
Published: May 2020

Purpose of review
The body composition and fat distribution is different between men and women, with different levels of circulating adipokines. These differences become more evident when suffering from an inflammatory disease, such as spondyloarthritris. In this review, we will explore the influence of obesity, body composition and adipokines on the differences in disease activity, progression and response to treatment, between men and women with spondyloarthritis.

Recent findings
Obesity, mainly determined by the body fat content, which is higher in women, is related to worse disease activity scores. Men with higher disease activity lose more muscle mass than women. Leptin, which is usually found at higher levels in overweight women, seems to be associated with greater spinal radiographic progression when it rises during the course of the disease. Being a woman and obesity, mainly because of the body fat content, are related to a worse response to TNF-α blockers.

Summary
Overlooking biological sex variation in body composition, circulating adipokines and hormonal levels, and the subsequent differences in clinical presentation, may ultimately hamper clinical treatment.
Comparison of Staged Versus Same-day Bilateral Hip Surgery in Nonambulatory Children With Cerebral Palsy
Authors: Louer Craig R. , Nunez Jason , Bomar James D. , Fischer-Colbrie Megan E. , Chambers Henry G. , Upasani Vidyadhar V. 
Published: May 2020

Background:
Bilateral hip reconstructions with osteotomies are commonly required in patients with severe cerebral palsy (CP) and dysplasia. These procedures can be performed by staging each hip surgery, separated by weeks to months, or by addressing both hips in a single-event surgery. The optimal timing of such surgery is yet to be determined. The purpose of this study was to retrospectively compare major complications between the staged and single-event approaches.

Methods:
Medical records of patients who underwent bilateral hip osteotomies, with at least one side including a pelvic osteotomy, were retrospectively reviewed. Subjects were identified who had a diagnosis of nonambulatory CP (defined by Gross Motor and Functional Classification System level IV or V), and at least 1 year of clinical follow-up. All hips were treated by 1 of 7 surgeons: 2 surgeons who always performing single-event surgery and 5 who always perform staged surgeries. Complications were stratified by the Modified Clavien-Dindo Classification (grades 1 to 5). The primary outcome was major complications (grade ≥3), while minor complications, readmissions, reoperations, and resource utilization outcomes were investigated secondarily.

Results:
Sixty-five patients met our inclusion criteria: 35 received single-event surgery and 30 received staged surgery. The staged group had a higher rate of major complications per patient (0.30 vs. 0; P=0.013). Unplanned readmissions and reoperations were likewise increased in the staged group. Minor complication rates were high in both groups, with no differences observed between staged and single-event approaches (3.27 per patient vs. 2.91; P=0.952). There were no complications causing permanent disability or death. The total length of stay (6.2 vs. 4.0 d; P<0.001) and mean nonsurgical operating room time (65.7 vs. 45.6 min; P<0.001) were increased in the staged group versus the single-event group.

Conclusions:
The staged approach to bilateral hip reconstructions in the nonambulatory CP population was associated with a higher rate of major complications compared with a single-event approach. Minor complications were similar for both approaches. Both approaches can have an acceptable safety profile with no observed grade 4 or 5 complications.

Level of Evidence:
Level III.
Vertebral Osteomyelitis After Spine Surgery
Authors: Breuninger Marianne , Yagdiran Ayla , Willinger Anja , Biehl Lena Maria , Otto-Lambertz Christina , Kuhr Kathrin , Seifert Harald , Fätkenheuer Gerd , Lehmann Clara , Sobottke Rolf , Siewe Jan , Jung Norma 
Published: May 2020

Study Design.
Prospective cohort study.

Objective.
We aimed to determine the 2-year survival and to identify clinical and microbiological characteristics of patients with native vertebral osteomyelitis (VO) as compared to postoperative VO to find further strategies for improvement of the management of VO.

Summary of Background Data.
A relevant subgroup (20%–30%) of patients with VO has a history of spine surgery. Infection in these patients might be clinically different from native VO. However, clinical, microbiological, and outcome characteristics of this disease entity have not been well studied as most trials either excluded these patients or are limited by a small cohort and short observation period.

Methods.
Between 2008 and 2013, patients who presented at a tertiary care center with symptoms and imaging findings suggestive of VO were reviewed by specialists in infectious diseases, clinical microbiology, and orthopedics to confirm the diagnosis and followed prospectively for a period of 2 years. Statistical analysis for group comparisons, survival analysis, and uni- and multivariable Cox regression models were performed.

Results.
Thirty percent of the patients with VO (56/189) reported a history of spine surgery in the same segment. Patients with postoperative infection had a lower ASA score (American Society of Anesthesiologists) (P = 0.01) and were less likely to suffer from comorbidities compared to native cases (P = 0.003). Infections caused by coagulase-negative staphylococci (33.3 vs. 6.5%, P < 0.001) and other bacteria of the skin flora (15.2 vs. 0%, P = 0.002) were more prevalent in postoperative patients. Suffering from native VO increased the 2-year mortality risk 3-fold, also when adjusted for the remaining risk factors ASA score and number of comorbidities (hazard ratio 2.916 [95% confidence interval 1.215 –6.999], P = 0.017).

Conclusion.
Beside clear microbiological differences, the significant better 2-year survival supports the concept of postoperative VO presenting a distinct disease entity. The subtle disease presentation of patients with postoperative VO should not attenuate clinical suspicion of physicians.

Level of Evidence: 3