bluuebunny/crossref_metadata_2025_split huggingface dataset:
A CARE-compliant article: Unicentric Castleman disease presenting as a retroperitoneal mass of the upper edge of the pancreas
Authors: Zhou You-Xin , Ji Yong , Wu Sheng 
Published: March 2020

Abstract

Rationale:
Castleman disease (CD) is a rare lymphoproliferative disease with a poorly understood etiology. The occurrence of CD in the abdominal cavity is very rare, especially in the retroperitoneal peripancreatic region.

Patient concerns:
A 33-year-old woman was referred to our department on March 1, 2018 for a detailed physical examination due to retroperitoneal peripancreatic lymph node enlargement over 15 days.

Diagnosis:
Enhanced magnetic resonance imaging of the epigastrium showed the mass with abundant blood supply is located between the liver and the stomach in the upper margin of the pancreas. Postoperative pathological examination revealed CD, type of unicentric Castleman disease.

Interventions:
We performed an open surgery on this patient and completely removed the mass. There was no postoperative radiochemotherapy.

Outcomes:
The patient was followed-up for more than 12 months after the operation and showed good recovery.

Lessons:
CD is a rare disorder that is hard to diagnose early and complete resection of the tumor is still the most effective treatment.
Association between dietary patterns and disease recurrence in Thai colorectal cancer patients
Authors: Kunnavuttivanich Vorraaud , Pramyothin Pornpoj , Ithimakin Suthinee 
Published: March 2020

Abstract
Beside established anti-cancer treatment, dietary modification is one of the most promising approaches for reducing the probability of colorectal cancer (CRC) recurrence. Many Western studies showed a relationship between shortened survival and increased amounts of Western diet (meat and processed meat). Given that Thai food is dissimilar to Western diet, we aimed to explore the association between dietary patterns and disease recurrence among Thai CRC patients.
Early-stage CRC patients who were disease-free at the end of a 2-year period or patients with disease recurrence within 2 years were enrolled. Patients were administered a food frequency questionnaire to evaluate their dietary lifestyle. Quantitative comparison within individual food groups among patients who were disease-free and among those with recurrence was performed. Proportion of patients with recurrence and disease-free survival was compared between patients who had consumed the lowest and highest tertile of each dietary pattern.
A total of 225 CRC patients were enrolled (151 disease-free and 74 recurrence). There were no significant differences in demographic or tumor parameters between patients with or without disease recurrence. From the questionnaire, 45 food items were assigned to 1 of 12 food groups according to similarity in nutritional profile. Patients who consumed high amounts of pickled fish or chili-paste had significantly lower recurrence rates compared to patients who had never eaten those foods (P < .01). From the factor analysis, meat/wheat, vegetarian, and fast-food/processed fruit patterns were identified as the major dietary patterns. There was no significant association between intakes of individual dietary patterns and CRC recurrence.
Among CRC patients with Thai dietary lifestyles there was no association between meat/wheat, fast-food/processed fruit, or vegetarian dietary patterns and CRC recurrence. Greater consumption of some unique Thai foods, such as chili-paste or pickled fish, may relate to better outcomes for CRC patients.
Prophylactic cognitive enhancers for improvement of cognitive function in patients undergoing electroconvulsive therapy
Authors: Niu Yunlian , Ye Dan , You Yijie , Wu Jian 
Published: March 2020

Abstract

Objective:
Cognitive enhancers, including cholinesterase inhibitors and memantine, are used to treat dementia, but their effect for reducing post-electroconvulsive therapy (post-ECT) cognitive side effects is unclear. We conducted a systematic review and meta-analysis to assess the effectiveness of cognitive enhancers in the prevention of cognitive side effects due to ECT.

Methods:
We identified relevant studies by searching electronic databases (e.g., PubMed, EMBASE, Web of Science, Cochrane Library). Only studies published up to October 2019 comparing cognitive enhancer vs placebo for cognitive function after ECT were included. The primary outcome extracted from the studies was cognitive function score.

Results:
Five studies with 202 patients were included in this study. The cognitive enhancer group (CEG) had a significantly higher cognitive function score. Moreover, sensitivity analysis showed that no individual study had a significant impact on the overall results.

Conclusions:
This meta-analysis revealed that cognitive enhancers might improve cognitive function and reduce ECT-induced cognitive side effects. Nevertheless, more high-quality randomized controlled trials (RCTs) with long-term follow-up are still needed to make the final conclusion.
Benefits and effectiveness of using a wrist heart rate monitor as a telerehabilitation device in cardiac patients
Authors: Batalik Ladislav , Dosbaba Filip , Hartman Martin , Batalikova Katerina , Spinar Jindrich 
Published: March 2020

Abstract

Background:
Telerehabilitation in cardiology has the potential to become the alternative to regular outpatient cardiac rehabilitation. Our study focuses on the wrist heart rate monitor as a telerehabilitation device, defines detected limitations, and compares results between home-based and regular outpatient rehabilitation methods, related to physical fitness, quality of life, and training adherence. The study design was a randomized controlled trial.

Methods:
Eligible 56 cardiac rehabilitation patients were randomized into a 12-week regular outpatient training group (ROT) and interventional home-based telerehabilitation group (ITG). For both groups, the intensity of the training was prescribed to be performed at 70% to 80% of heart rate reserve for 60 minutes, 3 times a week. The ITG patients started their training with a wrist heart rate monitor in their home environment. These patients received feedback once a week, reflecting data uploaded on the internet application. The ROT patients performed their exercise under the direct supervision of a physical specialist in a regular outpatient clinic. Physical fitness and health-related quality of life were assessed at baseline and after 12 weeks. Training adherence in both groups was determined and compared.

Results:
Fifty-one patients comleted the intervention (91%); no serious adverse events were recorded. Physical fitness expressed as peak oxygen uptake showed significant improvement (P < .001) in ROT group from 23.4 ± 3.3 to 25.9 ± 4.1 mL/kg/min and (P < .01) in ITG group from 23.7 ± 4.1 to 26.5 ± 5.7 mL/kg/min without significant between-group differences after 12 weeks of intervention. The training adherence between groups was similar.

Conclusion:
Our study shows that telerehabilitation via wrist heart rate monitor could become an alternative kind of cardiac rehabilitation which deserves attention and further analyzing.
Comparison of the short-term effects of hyperbaric oxygen therapy and complex decongestive therapy on breast cancer-related lymphedema
Authors: Koo Jung Hoi , Song Sun Hong , Oh Ho Suk , Oh Se Hyun 
Published: March 2020

Abstract
Although there have been some reports that hyperbaric oxygen therapy (HBOT) is effective in treating breast cancer-related lymphedema (BCRL), controversy regarding its therapeutic effects remains.
We sought to evaluate the efficacy of HBOT in addition to conventional complex decongestive therapy (CDT) for BCRL.
A prospective observational study was conducted on 10 patients with BCRL. After screening, the subjects were stratified into a CDT-only group and a CDT and HBOT combination (CDT–HBOT) group. All patients received a total of 10 treatments over 2 weeks. Changes in the circumference of the upper limbs, quality-of-life questionnaire results, and bioelectrical impedance values were compared between the 2 groups.
Between both groups, there were no significant differences in demographic or clinical characteristics and in the quality-of-life outcomes for lymphedema of the limbs. The parameters measured by bioimpedance spectroscopy showed more significant improvements in the CDT–HBOT group than in the CDT-only group.
In patients with BCRL, HBOT may be recommended as an adjunct treatment to the existing therapies.
Amenorrhea, fertility preservation, and counseling among young women treated with anthracyclines and taxanes for early-stage breast cancer, a retrospective study
Authors: Abdel-Razeq Hikmat N. , Mansour Razan A. , Ammar Khawla S. , Abdel-Razeq Rashid H. , Zureigat Hadil Y. , Yousef Lina M. , Shahin Omar A. 
Published: March 2020

Abstract
Chemotherapy may cause ovarian toxicity and infertility. Cancer patients are usually overwhelmed, and focus exclusively on cancer diagnosis and may not pay attention to fertility-related issues. In this paper we look at the rate of amenorrhea and fertility counseling among such young patients.
Premenopausal women with early-stage breast cancer treated with adjuvant or neoadjuvant chemotherapy were recruited. Amenorrhea was defined as absence of menstruation for ≥12 months after the completion of chemotherapy.
A total of 94 patients met the eligibility criteria and were included in this analysis. Median age at diagnosis was 35.7 (range, 22–44) years. Seventy-nine (85.9%) respondents were counseled about amenorrhea and 37 (40.2%) were considering having children. Long-term amenorrhea was reported by 51 (54.3%) patients. The addition of taxanes to anthracyclines, in 2 different regimens, increased the risk of amenorrhea to 69.2% and 66.7% compared to 38.9% with anthracycline-alone, P < .0001. Longer duration of chemotherapy (≥24 weeks) might also be associated with higher rate of amenorrhea (67.7%) compared to 43.4% in those who had shorter duration (<24 weeks), P = .031.
The addition of taxanes to anthracycline-based chemotherapy increased the risk of amenorrhea. However, shorter duration of chemotherapy, even with taxanes, may lower such risk. Our study highlights the importance of fertility counseling to improve fertility preservation rates. Given the importance of taxanes, shorter regimens are associated with lower amenorrhea rates and should be preferred over longer ones.
Use of Personal Communication Devices in Clinical Settings
Authors: Conant Jessica , Elmore Rachael , Moore Aline , Blake Stacie , Peacock Ashley , Ward-Smith Peggy 
Published: March 2020

OBJECTIVE
This survey study describes how nurses use personal communication devices while providing direct patient care and identifies generational differences.

BACKGROUND
Personal communication devices enhance and distract from patient care. Generational differences exist and these should be included in workplace policies.

METHODS
A study-specific survey was developed. Data were collected from 335 qualified participants and descriptively analyzed in total, then by generational specific study groups.

RESULTS
The perception of these participants is that personal communication devices do not pose a serious work distraction nor have a negative effect on patient care. Yet generational differences exist related to the presence of these devices in providing patient care.

CONCLUSIONS
Access to personal communication devices, while at work, is an expectation. The reasons for accessing these devices, and the perception that these devices have a negative impact on work performance, should be included when developing workplace policies.
Preparing for an Influenza Pandemic: Hospital Acceptance Study of Filtering Facepiece Respirator Decontamination Using Ultraviolet Germicidal Irradiation
Authors: Nemeth Christopher , Laufersweiler Dawn , Polander Emily , Orvis Christianna , Harnish Del , Morgan Sherwin E. , O’Connor Michael , Hymes Saul , Nachman Sharon , Heimbuch Brian 
Published: March 2020

Objectives
Predictions estimate supplies of filtering facepiece respirators (FFRs) would be limited in the event of a severe influenza pandemic. Ultraviolet decontamination and reuse (UVDR) is a potential approach to mitigate an FFR shortage. A field study sought to understand healthcare workers’ perspectives and potential logistics issues related to implementation of UVDR methods for FFRs in hospitals.

Methods
Data were collected at three hospitals using a structured guide to conduct 19 individual interviews, 103 focus group interviews, and 285 individual surveys. Data were then evaluated using thematic analysis to reveal key themes.

Results
Data revealed noteworthy variation in FFR use across the sample, along with preferences and requirements for the use of UVDR, unit design, and FFR reuse. Based on a scale of 1 (low) to 10 (high), the mean perception of safety in a high mortality pandemic wearing no FFR was 1.25 of 10, wearing an FFR for an extended period without decontamination was 4.20 of 10, and using UVDR was 7.72 of 10.

Conclusions
In addition to technical design and development, preparation and training will be essential to successful implementation of a UVDR program. Ultraviolet decontamination and reuse program design and implementation must account for actual clinical practice, compliance with regulations, and practical financial considerations to be successfully adopted so that it can mitigate potential FFR shortages in a pandemic.
A Call for the Application of Patient Safety Culture in Medical Humanitarian Action: A Literature Review
Authors: Biquet Jean-Marc , Schopper Doris , Sprumont Dominique , Michel Philippe 
Published: March 2020

Objectives
The aims of the study were to assess lessons learned on patient safety in Organization for Economic Cooperation and Development (OECD) countries and to assess whether they are applied or can be applied to the humanitarian medicine.

Methods
This is (a) a 2013–2018 rapid literature review of reviews and systematic reviews articles (PubMed database) on “patient safety” and “medical error” to look for lessons learned regarding patient safety in OECD countries and (b) a rapid literature review (PubMed and Embase databases) on “humanitarian medicine” and “patient safety,” from their creation to 2018, to find any articles related to patient safety in humanitarian medicine. In both reviews were excluded articles specifically related to one device, disease, or medical act. These reviews were complemented by a Google search.

Results
Of the 245 references retrieved, 104 met the inclusion criteria. Of 308 references, 39 respected the inclusion criteria. In OECD countries, patient safety comprises correlated measures taken at three levels. The micro level focuses on individual staff involved in healthcare provision or management; the meso level focuses on medical institutions; the macro level focuses on national healthcare systems. Only one reference mentioned the implementation of a medical error reporting and analysis system in medical humanitarian organization.

Conclusions
The adoption of strategies and a culture of safety will need to be adapted to address the variety of intervention contexts and to respond first to the fears and expectations of humanitarian staff. Medical humanitarian organizations, in the absence of an overarching authority for the sector, have a major responsibility in the development of a general patient safety policy applicable in all their operations.
Continuous Drug Delivery is Significantly Affected by Relative Height Changes Between Patient and Syringe Driver
Authors: Zahid Aisha , Raffaj Dusan , Wignell Andrew , Davies Patrick 
Published: March 2020

Objective
Syringe drivers are the principle method of giving small-volume continuous infusions of important drugs to patients. Many of these drugs are critical for the maintenance of normal physiology. Anecdotal evidence abounds of severe patient instability on movement of syringe drivers during infusion. We aimed to define the variation in drug delivery seen in three syringe drivers, with changes in relative height between the syringe driver and the end of the giving set.

Design
Three syringe drivers (Alaris CC [Becton Dickinson], Perfusor Space [B Braun], and Synamed μSP6000 [Arcomed]) were analyzed for reliability of flow at 0.5, 1, 2, and 5 mL/h.

Setting and subjects
This is an in vitro investigation.

Interventions
A small air bubble was introduced into the giving set, and the progression of this was documented before and after a vertical movement of the syringe driver by 25 or 50 cm upward or downward relative to the delivery port.

Measurements and Main Results
For all pumps, delivery was interrupted on movement of the pumps downward, and a bolus was given with movement of the pump upward. Delivery halted at lower pump speeds for longer than higher pump speeds. The maximum delivery interruption was 11.8 minutes. Boluses given on moving the pump up were calculated as the equivalent number of minutes needed to deliver the bolus volume at steady state. The maximum bolus given was equivalent to 15.8 minutes of delivery. We were unable to eliminate the effects seen by very slow, steady movement of the pumps up or down. Static height differences made no difference to delivery.

Conclusions
Syringe drivers should not be moved vertically in relation to the patient. Critical drug delivery is interrupted for up to 12 minutes with relative downward movements, and significant boluses of drugs are given with relative upward movements. As far as possible, elimination of relative height movements is advised, and extreme caution is necessary if any movements are unavoidable.
Preventing Operating Room Fires: Impact of Surgical Drapes on Oxygen Contamination of the Operative Field
Authors: Culp William C. , Muse Kenisha W. 
Published: March 2020

Objective
The aim of the study was to measure underdrape oxygen pooling, surgical site oxygen contamination, and time to restoration of 21% oxygen concentration after cessation of oxygen delivery by measuring oxygen concentration under simulated clinical conditions with various drapes.

Methods
In a 2-part study, oxygen permeability of four differing surgical drapes was measured (Part A) and a mannequin was used to measure underdrape oxygen pooling and surgical site oxygen contamination (Part B). In Part A, a container of high concentration oxygen was sealed with a surgical drape. Oxygen concentrations on both sides of the drape were then measured over time to quantify drape oxygen permeability. Part B included a mannequin model draped for a hypothetical surgical site with oxygen administered by face mask. Oxygen concentration was measured at both the surgical site and under the drape nearest the surgical site.

Results
Oxygen permeability varied significantly between drapes tested. The surgical site oxygen concentration ranged from 20% to 58% (P = 0.0001). The commonly used woven 100% cotton operating room (OR) towel was highly permeable. The plastic occlusive drape created an impermeable barrier, which did not allow for any oxygen contamination but created the longest time to return to 21% oxygen concentration at the underdrape site after cessation of oxygen delivery.

Conclusions
Surgical drapes have varying oxygen permeability and can lead to high concentration underdrape oxygen pooling. Oxygen contamination of the surgical site varies widely based on drape material and may reach dangerously high levels, especially with the cotton OR towel. Surgical drape selection may impact OR fire risk.
Identifying Factors Leading to Harm in English General Practices: A Mixed-Methods Study Based on Patient Experiences Integrating Structural Equation Modeling and Qualitative Content Analysis
Authors: Ricci-Cabello Ignacio , Gangannagaripalli Jaheeda , Mounce Luke T. A. , Valderas Jose María 
Published: March 2020

Objective
The aim of the study was to identify the main factors leading to harm in primary care based on the experiences reported by patients.

Methods
We conducted a mixed-methods, cross-sectional study in 45 primary care centers in England. A random sample of 6736 patients was invited to complete the Patient-Reported Experiences and Outcomes of Safety in Primary Care questionnaire. We fitted structural equation modeling on the quantitative data (n = 1244 respondents) to identify contributory factors and primary incidents leading to harm. We conducted content analyses of responses to seven open-ended questions (n = 386) to obtain deeper insight into patient perceptions of the causes of harm experienced. Results from quantitative and qualitative analyses were triangulated.

Results
Patients reported harm related to physical health (13%), pain (11%), and mental health (19%) and harm that increased limitations in social activities (14%). Physical harm was associated with incidents affecting diagnosis (β = 0.43; delayed and wrong), and treatment (0.12; delayed, wrong treatment, or dose), which were in turn associated with incidents with patient-provider communication, coordination between providers, appointments, and laboratory tests. Pain was associated with laboratory tests (0.21; caused when collecting blood or tissue samples) and with problems booking an appointment when needed (0.13; delaying treatment for pain). Harm to mental health was associated with incidents related to the following: diagnosis (0.28), patient-provider communication (0.18), appointments (0.17), coordination between different providers (0.14), and laboratory tests (0.12). Harm increasing limitations in social activities was associated with incidents related to diagnosis (0.42) and diagnostic and monitoring procedures (0.20).

Conclusions
Our findings suggest the need for patient-centered strategies to reduce harm in primary care focusing on the improvement of the quality of diagnosis and patient-provider communication.
Patient Deterioration in Australian Regional and Rural Hospitals: Is the Queensland Adult Deterioration Detection System the Criterion Standard?
Authors: Le Lagadec Marie Danielle , Dwyer Trudy , Browne Matthew 
Published: March 2020

Objective
This study compares the efficiency of six early warning systems (EWSs) to determine whether the EWS used in most public hospitals in Queensland, Australia, The Queensland Adult Deterioration Detection System (Q-ADDS), is best suited for use in small regional and rural hospitals.

Method
In this retrospective case-control study, patients who experienced an in-hospital severe adverse event (index patients) for a 3.5-year period were demographically and diagnostically matched with patients who had uneventful hospital stays (control patients). The EWS efficiency was based on the area under the receiver operator characteristic curve (AUROC) and the number of false and true alerts generated by each EWS.

Result
The incidence of severe adverse events was 1.2% of in-hospital patients, and 2500 sets of vital signs were collected from 159 index and 172 control patients. The EWSs were only able to identify approximately half of the index patients. The AUROC was 0.666 to 0.801 and the EWS generated 2.4 to 7.6 false alerts to every true alert per 1000 admissions. The National Early Warning Score had the best ratio of false to true alerts (2.4:1) but was only able to identify 40.8% of deteriorating patients. The Q-ADDS identified 46.5% of the deteriorating patients and had a false to true alert ratio of 3.2:1. When compared with the National Early Warning Score, systems with higher AUROCs (0.744 and 0.801) also had higher proportion of false alerts. None of the alternative EWSs seem to provide marked benefits over Q-ADDS.

Conclusions
At present, there is insufficient evidence to replace Q-ADDS with an alternative EWS. Because the EWSs were only able to identify half of the deteriorating patients, EWSs should be used in conjunction with good clinical judgment.