bluuebunny/crossref_metadata_2025_split huggingface dataset:
The long-term prognosis of pneumomediastinum associated with dermatomyositis: a two-centre retrospective cohort study
Authors: Li Can , Liang Mei’e , Jiang Hui , Zhao Jiuliang , Wu Chanyuan , Wang Qian , Zhang Liyun , Zhao Yan 
Published: August 2020

Abstract

Objectives
Pneumomediastinum (PnM) is a rare but life-threatening complication of DM. The present study aims to characterize the long-term prognosis and prognostic factors of DM-associated PnM.

Methods
Inpatients with DM-associated PnM were retrospectively enrolled from two tertiary referral centres for rheumatic disease. The enrolled patients were divided into survivors or non-survivors. Information about the demographics, clinical manifestations, CT scan features, laboratory findings and outcomes were collected from their medical records. A least absolute shrinkage and selection operator regularized Cox regression model was used to select the most relevant factors. Prognosis was analysed using a Kaplan–Meier curve. A Cox proportional hazards model was used to identify independent predictive factors for long-term survival.

Results
A total of 62 patients (26 women) with DM-associated PnM were enrolled. The mean age was 44.3 years (s.d. 11.7). The median follow-up duration was 17 days (quartiles 7, 266.5). Thirty-five patients died during follow-up. The survival rates were 75.4% at 1 week, 46.2% at 3 months and 41.9% at 1 year. The Cox proportional hazards model identified the development of fever [hazard ratio (HR) 3.23 (95% CI 1.25, 8.35), P = 0.02] and a decrease in the number of lymphocytes [HR 2.19 (95% CI 1.10, 4.39), P = 0.03] as independent risk factors for death.

Conclusion
The results suggest poor overall survival among patients with DM-associated PnM. Survival during the first 3 months is crucial for long-term survival. Meanwhile, the development of fever and a decrease in the number of lymphocytes were associated with long-term mortality. Early recognition and prompt treatment of this high-risk group of DM patients is therefore important.
Comparison of fracture risk between proton pump inhibitors and histamine-2 receptor antagonists in ANCA-associated vasculitis patients: a nested case–control study
Authors: Miyano Shinako , Michihata Nobuaki , Sada Ken-Ei , Uda Kazuaki , Matsui Hiroki , Fushimi Kiyohide , Nangaku Masaomi , Yasunaga Hideo 
Published: August 2020

Abstract

Objective
Whether acid suppressants [proton pump inhibitors (PPIs) and histamine-2 receptor antagonists (H2RAs)] are associated with bone fractures in patients with ANCA-associated vasculitis (AAV) treated with glucocorticoids remains unclear. This study compared PPIs with H2RAs in terms of the risk of bone fractures in patients with AAV who received in-hospital induction therapy with glucocorticoids.

Methods
We retrospectively identified 149 patients with fractures among 22 821 patients newly diagnosed with AAV in 1730 hospitals using a nationwide inpatient database from July 2010 to March 2018. We conducted 1:4 case–control matching. Age, sex, duration of AAV treatment and fiscal year were matched between the cases and controls. A conditional logistic regression analysis was conducted to assess the association between acid suppressants and fractures.

Results
Of all enrolled patients with fractures, the median age was 77 years, and 99 (66%) were female. The median duration from AAV treatment to fracture was 52 days. The proportion of patients using PPIs was 91.3% (136 of 149) and 80.2% (478 of 596) in the case and control groups, respectively. Compared with H2RA use, PPI use was significantly associated with fractures after adjustment for age, sex, BMI, smoking habit, Charlson comorbidity index, renal failure, bisphosphonate and same fiscal year according to a multivariate analysis (adjusted odds ratio, 3.76; 95% CI: 1.37, 10.3).

Conclusion
PPI users had a higher risk of fractures than H2RA users among mostly advanced-age patients with AAV with remission induction therapy.
Dopamine and Glutamate in Antipsychotic-Responsive Compared With Antipsychotic-Nonresponsive Psychosis: A Multicenter Positron Emission Tomography and Magnetic Resonance Spectroscopy Study (STRATA)
Authors: Egerton Alice , Murphy Anna , Donocik Jacek , Anton Adriana , Barker Gareth J , Collier Tracy , Deakin Bill , Drake Richard , Eliasson Emma , Emsley Richard , Gregory Catherine J , Griffiths Kira , Kapur Shitij , Kassoumeri Laura , Knight Laura , Lambe Emily J B , Lawrie Stephen M , Lees Jane , Lewis Shôn , Lythgoe David J , Matthews Julian , McGuire Philip , McNamee Lily , Semple Scott , Shaw Alexander D , Singh Krish D , Stockton-Powdrell Charlotte , Talbot Peter S , Veronese Mattia , Wagner Ernest , Walters James T R , Williams Stephen R , MacCabe James H , Howes Oliver D 
Published: August 2020

Abstract
The variability in the response to antipsychotic medication in schizophrenia may reflect between-patient differences in neurobiology. Recent cross-sectional neuroimaging studies suggest that a poorer therapeutic response is associated with relatively normal striatal dopamine synthesis capacity but elevated anterior cingulate cortex (ACC) glutamate levels. We sought to test whether these measures can differentiate patients with psychosis who are antipsychotic responsive from those who are antipsychotic nonresponsive in a multicenter cross-sectional study. 1H-magnetic resonance spectroscopy (1H-MRS) was used to measure glutamate levels (Glucorr) in the ACC and in the right striatum in 92 patients across 4 sites (48 responders [R] and 44 nonresponders [NR]). In 54 patients at 2 sites (25 R and 29 NR), we additionally acquired 3,4-dihydroxy-6-[18F]fluoro-l-phenylalanine (18F-DOPA) positron emission tomography (PET) to index striatal dopamine function (Kicer, min−1). The mean ACC Glucorr was higher in the NR than the R group after adjustment for age and sex (F1,80 = 4.27; P = .04). This was associated with an area under the curve for the group discrimination of 0.59. There were no group differences in striatal dopamine function or striatal Glucorr. The results provide partial further support for a role of ACC glutamate, but not striatal dopamine synthesis, in determining the nature of the response to antipsychotic medication. The low discriminative accuracy might be improved in groups with greater clinical separation or increased in future studies that focus on the antipsychotic response at an earlier stage of the disorder and integrate other candidate predictive biomarkers. Greater harmonization of multicenter PET and 1H-MRS may also improve sensitivity.
Toxoplasma gondii Infection and Clinical Characteristics of Patients With Schizophrenia: A Systematic Review and Meta-analysis
Authors: Sutterland Arjen L , Mounir David A , Ribbens Juul J , Kuiper Bouke , van Gool Tom , de Haan Lieuwe 
Published: August 2020

Abstract
Schizophrenia is associated with an increased prevalence of IgG antibodies against Toxoplasma gondii (T. gondii seropositivity), whereby the infection seems to precede the disorder. However, it remains unclear whether a T. gondii infection affects clinical characteristics of schizophrenia. Therefore, a systematic review and meta-analysis was conducted following PRISMA guidelines examining the association between T. gondii seropositivity and severity of total, positive, or negative symptoms or age of onset in schizophrenia. PubMed, Embase, and PsycInfo were systematically searched up to June 23, 2019 (PROSPERO #CRD42018087766). Random-effects models were used for analysis. Furthermore, the influence of potential moderators was analyzed. Indications for publication bias were examined. From a total of 934 reports, 13 studies were included. No overall effect on severity of total, positive, or negative symptoms was found. However, in patients with a shorter duration of illness T. gondii seropositivity was associated with more severe positive symptoms (standardized mean difference [SMD] = 0.32; P &lt; .001). Similar but smaller effects were seen for total symptoms, while it was absent for negative symptoms. Additionally, a significantly higher age of onset was found in those with T. gondii seropositivity (1.8 y, P = .015), although this last finding was probably influenced by publication bias and study quality. Taken together, these findings indicate that T. gondii infection has a modest effect on the severity of positive and total symptoms in schizophrenia among those in the early stages of the disorder. This supports the hypothesis that T. gondii infection is causally related to schizophrenia, although more research remains necessary.
Effect of Delayed Versus Immediate Umbilical Cord Clamping on Maternal Blood Loss in Term Cesarean Delivery: A Randomized Clinical Trial
Authors: Purisch S.E. , Ananth C.V. , Arditi B. , Mauney L. , Ajemian B. , Heiderich A. , Leone T. , Gyamfi-Bannerman C. 
Published: August 2020

(JAMA. 2019;322:1869–1876)
In 2017, the American College of Obstetricians and Gynecologists recommended that providers delay umbilical cord clamping for at least 30 to 60 seconds after the birth of a preterm or term neonate, assuming that the neonate does not require resuscitation. While the literature strongly supports this recommendation as a neonatal benefit, studies on maternal outcomes are lacking. Furthermore, information regarding the impact of delayed umbilical cord clamping on the mother and neonate during cesarean delivery is also lacking. This study aimed to compare the impact of maternal blood loss when the umbilical cord was clamped immediately as compared with delayed during cesarean delivery.
International Consensus Statement on the Use of Uterotonic Agents During Cesarean Section
Authors: Heesen M. , Carvalho B. , Carvalho J.C.A. , Duvekot J.J. , Dyer R.A. , Lucas D.N. , McDonnell N. , Orbach-Zinger S. , Kinsella S.M. 
Published: August 2020

(Anaesthesia. 2019;74:1305–1319)
Uterotonics are routinely used after delivery to manage uterine tone. While various guidelines exist for general management during cesarean deliveries, management of uterine tone following vaginal delivery, and treatment of postpartum hemorrhage, no previous international guideline has addressed uterotonic management during and following cesarean section. The use of uterotonics is largely based on tradition and varies in the choice of drug, timing of administration, dose, route, and speed, and maintenance of administration. Both first-line (oxytocin, carbetocin) and second-line uterotonics carry risk for adverse effects such as hypotension, tachycardia, and ST-segment depression. This consensus statement provides 10 recommendations for the use of uterotonic agents during cesarean section.
Dural Puncture Epidural Versus Conventional Epidural Block for Labor Analgesia: A Systematic Review of Randomized Controlled Trials
Authors: Heesen M. , Rijs K. , Rossaint R. , Klimek M. 
Published: August 2020

(Int J Obstet Anesth. 2019;40:24–31)
The technique of dural puncture epidural (DPE) involves creating a dural hole with a small-gauge spinal needle inserted through a Tuohy needle after the epidural space is identified without injection of medication into the intrathecal space. This modification has been described as allowing epidurally administered medication to access the subarachnoid space to enable a faster onset of analgesia compared with epidural placement alone. Some authors posit that DPE also reduces side effects associated with the combined spinal-epidural technique. Studies comparing neuraxial block quality between DPE and continuous epidural analgesia have yielded mixed results. This systematic review aimed to analyze all available randomized controlled trials comparing DPE and epidural analgesia.
The Impact of Occupational Shift Work and Working Hours During Pregnancy on Health Outcomes: A Systematic Review and Meta-analysis
Authors: Cai C. , Vandermeer B. , Khurana R. , Nerenberg K. , Featherstone R. , Sebastianski M. , Davenport M.H. 
Published: August 2020

(Am J Obstet Gynecol. 2019;221:563–576)
Women make up a significant proportion of the workforce, and most work during their pregnancies. While studies have found an association between adverse pregnancy outcomes and various working hours, such as shift work or working longer than the standard 40-hour work week, the results have been conflicting. The aim of this study was to assess the impact of shift work and long working hours during pregnancy on maternal and fetal outcomes, and to determine if there is a relationship between the length of working hours and these outcomes.
Vascular Balloon Occlusion and Planned Cesarean Hysterectomy for Morbidly Adherent Placenta: A Systematic Review
Authors: Makary M. , Chowdary P. , Westgate J.A. 
Published: August 2020

(Aust N Z J Obstet Gynaecol. 2019;59:608–615)
Morbidly adherent placenta (MAP) is a rare but serious complication that can result in severe hemorrhage. Over time, there has been an increase in the occurrence of MAP due to Increasing maternal age as well as a higher cesarean section rate. Improved imaging techniques have resulted in the identification of MAP antenatally in many patients. This then allows obstetricians to proactively develop delivery plans that are focused both on minimizing and being prepared for managing blood loss during delivery. One technique is the preoperative placement of intra-arterial catheters into vessels such as the internal iliac and common iliac arteries for vascular balloon occlusion to prevent or control hemorrhage. While this approach is theorized to be effective, limited research has been conducted to clearly demonstrate it improves outcomes during planned or emergency cesarean hysterectomy (CH). The current investigators performed a systematic review to evaluate both the efficacy and rate of complications of vascular balloon occlusion in patients undergoing planned CH for MAP.
An Enhanced Recovery After Surgery Pathway for Cesarean Delivery Decreases Hospital Stay and Cost
Authors: Fay E.E. , Hitti J.E. , Delgado C.M. , Savitsky L.M. , Mills E.B. , Slater J.L. , Bollag L.A. 
Published: August 2020

(Am J Obstet Gynecol. 2019;221:349.e1–349.e9)
Obstetric care providers are encouraged to use enhanced recovery after surgery (ERAS) guidelines following cesarean delivery (CD), one of the most commonly performed surgeries in the United States. While ERAS protocols have been shown to optimize patient recovery and shorten hospital stays for patients in a variety of surgical subspecialties, little research has been done evaluating the use of an ERAS protocol for planned and unplanned CDs. The aim of this study was to examine hospital length of stay and postoperative costs of CD patients before and after implementation of an ERAS protocol.
Massive Blood Transfusion in Relation to Delivery: Incidence, Trends, and Risk Factors: A Population-based Cohort Study
Authors: Thurn L. , Wikman A. , Westgren M. , Lindqvist P.G. 
Published: August 2020

(BJOG. 2019;126:1577–1586)
Obstetric hemorrhage is a major contributor to maternal mortality resulting in ∼100,000 annual deaths worldwide. Massive transfusion may be an indicator of a “near miss event” and is defined as the transfusion of 10 U or more of red blood cells (RBCs) within 24 hours. Recent reports have shown an increase in the rate of massive blood transfusions for postpartum hemorrhage. Yet, the incidence and risk factors of pregnant women requiring massive transfusions is unknown. The aim of this study was to estimate the incidence, trends, and risk factors for massive blood transfusion before and at delivery. In addition, the plasma and RBC transfusion ratio was evaluated as well as the association between massive transfusion and peripartum hysterectomy.
A Survey of Antenatal and Peripartum Provision of Information on Analgesia and Anesthesia
Authors: Brinkler R. , Edwards Z. , Abid S. , Oliver C.M. , Lo Q. , Stewart A. 
Published: August 2020

(Anaesthesia. 2019;74:1101–1111)
Women in labor often need to make important medical decisions quickly, and experiencing a lack of control or undergoing unplanned procedures can contribute to a negative birth experience. While laboring women are capable of discussing treatment options and making these decisions, information regarding anesthetic care should ideally be given to patients well before these decisions must be made. Previous studies in the United Kingdom have found that ∼45% of expectant mothers participate in antenatal classes while 75% use the Internet to find information on obstetric analgesia and anesthesia. Only 31% were aware of the National Health Service’s information for parents Web site. This large multicenter study examined the provision of anesthesia information to pregnant women in London hospitals.
Comparison of Nitroglycerin and Terbutaline for External Cephalic Version in Women Who Received Neuraxial Anesthesia: A Retrospective Analysis
Authors: Katz D. , Riley K. , Kim E. , Beilin Y. 
Published: August 2020

(Anesth Analg. 2019. doi: 10.1213/ANE.0000000000004155)
At term, about 3% to 4% of worldwide pregnancies have a fetus in the breech presentation, a common risk factor for delivery complications. The current recommendation to reduce perinatal morbidity and mortality with breech presentation is to perform a cesarean delivery. An alternative is external cephalic version, in which the fetus is manually rotated into vertex position to allow for an attempted vaginal delivery. The success rate of this procedure increases via utilization of neuraxial anesthesia, which allows for the relaxation of abdominal muscles, and via tocolytic agents which provide uterine relaxation. Two examples of such tocolytic agents are nitroglycerin and terbutaline. The authors of this study hypothesized that no difference in the successful cephalic version rate would exist between nitroglycerin and terbutaline.
Four Years’ Experience of a ROTEM-Guided Algorithm for Treatment of Coagulopathy in Obstetric Hemorrhage
Authors: McNamara H. , Kenyon C. , Smith R. , Mallaiah S. , Barclay P. 
Published: August 2020

(Anaesthesia. 2019;74:984–991)
Although many advances have been made in the care of obstetric patients, maternal hemorrhage is still a major contributor to morbidity and mortality. Fibrinogen levels, like most coagulation factors, are increased during normal pregnancy, which contributes to an increased risk of venous thromboembolism. In the setting of obstetric hemorrhage, though, a low fibrinogen level is associated with a greater risk of developing severe postpartum hemorrhage. Until 2012, the standard treatment for obstetric hemorrhage at the investigators’ institution was the administration of a standardized shock pack containing fresh frozen plasma, packed red blood cells, and platelets. After July 2012, the transfusion practice was changed and blood therapy was informed by rotational thromboelastometry (ROTEM) coagulation test results. For patients with ongoing hemorrhage, administration of fibrinogen concentrate was a component of the treatment. This observational study examined 4 years of cumulative data on the ROTEM-directed algorithm treatment for patients with obstetric hemorrhage, including assessment of blood product and fibrinogen concentrate usage.
Comparison of Outcome Between Intrauterine Balloon Tamponade and Uterine Artery Embolization in the Management of Persistent Postpartum Hemorrhage: A Propensity Score–matched Cohort Study
Authors: Ramler P.I. , Henriquez D.D.C.A. , van den Akker T. , Caram-Deelder C. , Groenwold R.H.H. , Bloemenkamp K.W.M. , van Roosmalen J. , van Lith J.M.M. , van der Bom J.G. 
Published: August 2020

(Acta Obstet Gynecol Scand. 2019;98:1473–1482)
Peripartum hysterectomy can be life-saving in the setting of postpartum hemorrhage (PPH). However, it produces infertility and is therefore considered a treatment of last resort. Many other procedures are first attempted to control PPH in an effort to avoid peripartum hysterectomy, such as intrauterine balloon tamponade, uterine compression sutures, and uterine artery ligation or embolization. Uterine artery embolization and intrauterine balloon tamponade have not previously been compared in terms of their effectiveness in preventing maternal death or near miss in women experiencing PPH. Uterine artery embolization is costly and may lead to thromboembolic events and other complications. Intrauterine balloon tamponade has more recently emerged as a more inexpensive strategy for managing PPH. This study aimed to compare the effectiveness of these 2 techniques for the management of persistent PPH.
The Effectiveness and Safety of Introducing Condom-catheter Uterine Balloon Tamponade for Postpartum Hemorrhage at Secondary Level Hospitals in Uganda, Egypt, and Senegal: A Stepped Wedge, Cluster-randomized Trial
Authors: Anger H.A. , Dabash R. , Durocher J. , Hassanein N. , Ononge S. , Frye L.J. , Diop A. , Beye S.B. , Burkhardt G. , Darwish E. , Ramadan M.C. , Kayaga J. , Charles D. , Gaye A. , Eckardt M. , Winikoff B. 
Published: August 2020

(BJOG. 2019;126:1612–1621)
The World Health Organization has recommended uterine balloon tamponade (UBT) as one intervention for postpartum hemorrhage (PPH), a leading cause of maternal mortality worldwide. This is important for low- and middle-income countries (LMICs), where uterotonics, blood products, and skilled surgical teams may not be readily available. A few studies have reviewed the use of condom-catheter UBT in LMICs, but they have demonstrated conflicting findings or lacked robust evidence on its effectiveness. The aim of this study was to examine if condom-catheter UBT reduced maternal morbidity and mortality associated with PPH in LMICs.
Vitamin D Supplementation During Pregnancy and the Prevention of Childhood Asthma
Authors: Von Mutius E. , Martinez F.D. 
Published: August 2020

(N Engl J Med. 2020;382:574–575)
Asthma symptoms often first appear when children are preschool-age, and therefore many efforts to prevent asthma are aimed at the prenatal or early postnatal periods. During the preschool years, asthma symptoms and transient wheeze are nearly identical, so the outcomes of any intervention should be measured once children reach 5 or 6 years old.
Rapid Titration of Intravenous Treprostinil to Treat Severe Pulmonary Arterial Hypertension Postpartum: A Retrospective Observational Case Series Study
Authors: Wang T. , Lu J. , Li Q. , Chen Y. , Ye Q. , Gao J. , Yang D. , Zhao L. , Huang J. , Zhang J. 
Published: August 2020

(Anesth Analg. 2019;129:1607–1612)
Pulmonary arterial hypertension (PAH) in pregnancy, though rare, is associated with significant maternal mortality. Pregnancy in women with PAH is often not advised. Termination of pregnancy is often encouraged if these women conceive, but some women become pregnant regardless. Also there are women diagnosed with PAH during pregnancy who choose against medical advice to proceed with the pregnancy. Intravenous infusion of the prostacyclin epoprostenol remains the mainstay of treatment for PAH, but epoprostenol has a short half-life and requires continuous intravenous infusion with a central venous catheter.
Induction of Labor Versus Expectant Management After Successful External Cephalic Version
Authors: Barbash-Hazan S. , Nattiv N. , Salzer-Sheelo L. , Bergel R. , Hadar E. , Osovsky M. , Shmueli A. 
Published: August 2020

(Birth. 2019;46:623–627)
External cephalic version (ECV) is a well-established procedure that improves maternal and neonatal outcomes. However, the literature has produced varied results as to the risk and rate of cesarean delivery after successful ECV. Differing results also have been reported when comparing spontaneous labor after ECV versus induction of labor after ECV. The aim of this study was to compare obstetrical and neonatal outcomes after successful ECV among those who underwent immediate labor induction versus those who were managed expectantly.