bluuebunny/crossref_metadata_2025_split huggingface dataset:
Palliative Paracentesis in the Home Setting: A Case Series
Authors: Ota Ken S. , Schultz Nicholas , Segaline Nicole A. 
Published: September 2020

Background: Management of ascites-related symptoms in home hospice and palliative care patients can be challenging. Ultrasound-guided paracentesis is a standard intervention for this indication, but generally requires transfer to a hospital or outpatient interventional-radiology (IR) setting; thus, such interventions are often not practical or attainable for home hospice and palliative care patients. Objective: To describe a mobile, in-home service that provides home-based palliative paracentesis (HBPP) as an interventional palliative option for patients with distressing symptoms related to ascites. Design: Retrospective case series. Setting/Subjects: Thirty patients with ascites, confirmed by portable bedside ultrasound, who underwent HBPP at their residence. Results: Thirty-three patients were referred for HBPP for symptomatic abdominal distention from March 1, 2019 to March 1, 2020. Thirty (91%) patients had ultrasound-confirmed ascites and received HBPP. All 30, verbalized appreciable symptom relief post-intervention. There were no reported post-procedural complications. Conclusion: Home-based palliative paracentesis is a safe, effective, and convenient intervention for hospice and palliative care patients with symptomatic ascites.
Degree of Asymmetry Between Patients With Complete and Incomplete Cleft Lips
Authors: Jodeh Diana S. , Soni Sara , Cray James J. , Rottgers S. Alex 
Published: September 2020

Introduction: Surgical outcomes for patients with complete cleft lips are not as ideal as those achieved for milder phenotypes. We hypothesized that in addition to the greater width of the cleft, patients with complete cleft lip and palate exhibit a greater degree of hypoplasia and asymmetry. Methods: Stereophotographs of 14 infants with unrepaired unilateral complete and 14 with incomplete cleft lips were measured using Vectra imaging software (Canfield Imaging). Unpaired t tests were used to compare measured asymmetry between groups. Measurements included nasion to endocathion, sn-sbal, subnasale to alare (sn-al), subnasale to crista philtra, subalare to crista philtra (sbal-cphi), chelion to crista philtra, lateral lip element fullness, medial lip element fullness (mef), and non-cleft lip fullness. Duplicate measurements allowed Pearson correlation to be used to determine intra-rater reliability. Statistical significance was set at P < .05. Results: Degree of asymmetry of the nasal base, sn-al, and sn-sbal was significantly greater for patients with complete clefts ( P = .0001, P = .0001). Hypoplasia of the lateral lip element was seen when comparing lateral and mef ( P = .04, P = .004) and lateral lip height (sbal-cphi’’; P = .002). The degree of cupid’s bow asymmetry did not differ between groups ( P = .23). Intrarater reliability was high for all facial measures, ranging from 0.70 to 0.99. Conclusions: More severe, complete cleft lips demonstrate statistically significant greater asymmetry in surgically relevant dimensions. There was greater width of the nasal base. Vertical asymmetry of cupid’s bow was unaffected by cleft severity, but that asymmetry was greater in patients with complete clefts due to hypoplasia of the lateral lip element. This may contribute to the less favorable results in these patients.
Impact of a New Parent Behavioral-Schema Training on Children with ADHD: A Pragmatic Control Trial
Authors: Solan Maly , Brunstein Klomek Anat , Ankori Galia , Bloch Asheda , Apter Alan , Plishty Sarit 
Published: September 2020

Objectives: To examine whether adding schema therapy strategies to the conventional parent behavioral program prevents symptom relapse in children with attention deficit hyperactivity disorder (ADHD). Method: The intervention was designed as an adaptive pragmatic control trial. The parent behavioral training and schema-enhanced parent behavior therapy (SPBT) protocols were delivered to the control group (40 parents of 23 children) and experimental group (97 parents of 54 children), respectively. Participants were assessed at baseline, mid-treatment, and termination. Parents and teachers indicated the severity of ADHD and comorbid symptoms through their responses to standardized questionnaires designed for this purpose. Results: A nested growth curve analysis demonstrated that participants in the schema-enhanced intervention group had a lower risk of symptom relapse than the control group. Conclusion: Participation in the SPBT program significantly reduced relapse rates by the end of the intervention. Future research may determine the long-term effects of the treatment.
Comparison of viscoelastic test results from blood collected near simultaneously from the jugular and saphenous veins in cats
Authors: Fudge James Mack , Cano Katherine S , Page Bernie , Jeffery Unity 
Published: September 2020

Objectives The aim of this study was to compare viscoelastic test results from samples collected from a jugular vein using a 20 G needle and a medial saphenous vein using a 22 G needle in cats presenting for elective ovariohysterectomy (OHE) or castration. Methods Forty apparently healthy cats (20 males and 20 females) presenting for elective OHE or castration were included in a prospective study observing viscoelastic test results from central and peripherally collected whole blood. Cats were anesthetized during blood collection with a standardized protocol including buprenorphine, ketamine, dexmedetomidine and isoflurane. Blood samples from jugular and saphenous veins were collected near simultaneously. Viscoelastic evaluations of whole blood were performed using a point-of-care device measuring clot time (CT), clot formation time (CFT), alpha angle (α), maximum clot formation (MCF), and amplitude at 10 and 20 mins (A10 and A20, respectively). Viscoelastometry continued post-clot time to determine a lysis index at 30 and 45 mins (LI30 and LI45, respectively) to assess fibrinolysis. Results Studied cats had a median age of 18 months (range 5 months to 5 years) and a median weight of 3.6 kg (range 2.7–5.9 kg). A total of 80 samples were available for analysis. While lysis indices were not different, viscoelastic measures of coagulation differed between sampling sites (CT, P <0.005; CFT, P = 0.01; α, P <0.05; MCF, P <0.0005; A10, P <0.0005; A20, P <0.0005). Conclusions and relevance Viscoelastic results from jugular venous blood samples appear to be more hypercoagulable than those collected from the medial saphenous vein, suggesting that the same site should be used consistently for serial monitoring or for collecting study data.
Comparison between different techniques for treatment of submacular haemorrhage due to Age-Related Macular Degeneration
Authors: Kishikova Lyudmila , Saad Ahmed Abdelwahab A , Vaideanu-Collins Daniela , Isac Marco , Hamada Dina , El-Haig Wael M 
Published: September 2020

Purpose: To compare the outcome of vitrectomy, subretinal tissue plasminogen activator (TPA), and gas with and without subretinal air versus Intravitreal TPA and gas in the treatment of submacular haemorrhage (SMH) due to Neovascular age related macular degeneration. Methods: We analysed the notes of 29 cases presented with SMH in the period between 01/2016 and 09/2018 at James Cook University Hospital. Presenting visual acuity (BCVA), size and location of SMH, Procedure done, final BCVA at 6 months and any surgical complications were recorded. 11 Cases (Group 1) received intravitreal TPA (50 µg in 0.1 ML), 0.3 ml of pure sulfur hexafluoride (SF6). 18 cases (Group 2) received 23 G Pars Plana vitrectomy, Subretinal TPA injection (25 µg in 0.1 ml), and 20% SF6 gas filling. Group 2 was further divided into 2A (10 patients) who received only subretinal TPA and group 2B (8 patients) who received additional 0.1 ml subretinal air. Results: The mean BCVA at presentation was 0.0068 in group 1 and 0.0067 in group 2 ( p = 0.8734). The mean postoperative BCVA at 6 months was 0.31 in group 1 and 0.58 in group 2 ( p = 0.0015). Subgroup analysis of group 2 didn’t show statistically significant difference in outcome when adding subretinal air to the vitrectomy procedure ( p = 0.7009). Conclusion: Vitrectomy, gas and subretinal TPA has more successful displacement rate and better visual outcome than Intravitreal TPA & Gas alone in treating SMH involving the fovea in age-related macular degeneration. Additional subretinal air doesn’t seem to improve the outcome in cases having vitrectomy.
Xen Gel Stent as a minimally invasive option for intraocular pressure control after DSAEK: A case study
Authors: Lippera Myrta , Lippera Stefano , Ferroni Piero , Pallotta Giuseppe , Morodei Sabrina , Iannone Alessia , Cagini Carlo 
Published: September 2020

Purpose: This case study describes the implantation of a Xen45 Gel Stent in a patient that had previously undergone Descemet stripping automated endothelial keratoplasty (DSAEK). Glaucoma might worsen after corneal transplant, and while medical treatment is the first-line therapy to achieve intraocular pressure (IOP) control, a surgical approach is required when medication does not reach the target IOP. Methods: In 2017, the patient underwent treatment in both eyes with ocular hypotensive eye drops for pseudoexfoliative (PXF) glaucoma. In May 2017, DSAEK was performed on the right eye because of the presence of a pseudophakic bullous keratopathy. An increase in IOP, resistant to medical treatment, was observed after the corneal transplant. In November 2017, a Xen45 Gel Stent was implanted. Results: The patient had a positive outcome with a Xen45 Gel Stent implant in surgical glaucoma treatment after DSAEK. The case demonstrated excellent postoperative IOP control, stable vision and a healthy ocular graft at short-term and long-term follow-ups. Conclusion: Studies with larger numbers of patients in this particular form of therapy are required. Nevertheless, Xen45 Gel Stent implantation appears to be a promising option in preventing or limiting glaucoma in patients who have previously undergone DSAEK. It is a brief, minimally invasive procedure with reduced postoperative inflammation, faster visual recovery and a lower risk of graft damage or hypotony, even in the case of PXF glaucoma.
A modified laparoscopic peritoneal dialysis insertion technique, the ‘one scar technique’ can minimise short and long term complications: A retrospective cohort study
Authors: Musbahi Aya , Kanakala Venkatesh 
Published: September 2020

Introduction: Peritoneal dialysis is a renal replacement therapy that has advanced in technique over the last few decades. In this study, we describe a novel method for laparoscopic peritoneal dialysis catheter insertion and fixation and compare its outcome to standard laparoscopic insertion technique with better cosmetic outcome. Method: Peri-operative and follow up data was collected retrospectively for 184 patients undergoing peritoneal dialysis catheter insertion from September 2012 to September 2018. Results: The post-modification technique showed no difference in catheter blockage rates, incisional hernia or catheter replacement rates. A significant difference was found in catheter migration rate and exit site infections and overall complication rates, found to be lower using the new technique. Conclusion: A modification of the laparoscopic peritoneal dialysis technique is superior to standard laparoscopic insertion with a cosmetically more appealing outcome due to one visible.
Comparing older people’s drinking habits in four Nordic countries: Summary of the thematic issue
Authors: Tigerstedt Christoffer , Agahi Neda , K Bye Elin , Ekholm Ola , Härkönen Janne , Jensen Heidi Rosendahl , Lau Cathrine Juel , Makela Pia , Moan Inger Synnøve , Parikka Suvi , Raninen Jonas , Vilkko Anni , Bloomfield Kim 
Published: September 2020

Aim: The present article summarises status and trends in the 21st century in older people’s (60–79 years) drinking behaviour in Denmark, Finland, Norway and Sweden and concludes this thematic issue. Each country provided a detailed report analysing four indicators of alcohol use: the prevalence of alcohol consumers, the prevalence of frequent use, typical amounts of use, and the prevalence of heavy episodic drinking (HED). The specific aim of this article is to compare the results of the country reports. Findings: Older people’s drinking became more common first in Denmark in the 1970s and then in the other countries by the 1980s. Since 2000 the picture is mixed. Denmark showed decreases in drinking frequency, typically consumed amounts and HED, while in Sweden upward trends were dominant regarding prevalence of consumers and frequency of drinking as well as HED. Finland and Norway displayed both stable indicators except for drinking frequency and proportion of women consumers where trends increased. In all four countries, the gender gap diminished with regard to prevalence and frequency of drinking, but remained stable in regard to consuming large amounts. In Norway the share of alcohol consumers among women aged 60–69 years exceeded the share among men. During the late 2010s, Denmark had the highest prevalence of alcohol consumers as well as the highest proportion drinking at a higher frequency. Next in ranking was Finland, followed by Sweden and Norway. This overall rank ordering was observed for both men and women. Conclusion: As the populations aged 60 years and older in the Nordic countries continue to grow, explanations for the drivers and consequences of changes in older people’s drinking will become an increasingly relevant topic for future research. Importantly, people aged 80 years and older should also be included as an integral part of that research.
The Finnish Drinking Habits Survey: Implications for alcohol policy and prevention
Authors: Warpenius Katariina , Mäkelä Pia 
Published: September 2020

Aims/materials: This reflection piece reviews some of the key results and conclusions from the book Näin Suomi juo ( This is how Finns drink, 2018), based on the Finnish Drinking Habits Survey. Our aim was to go through the results taking the perspective of prevention workers and policymakers: how could they benefit from the scientific findings when tackling alcohol-related harm? Results/reflections: The reflections displayed in this article provide some useful arguments and justifications for population-level alcohol policy in the controversial alcohol policy debate. Harms do not only arise among the heaviest drinkers, and efficient methods to prevent harm may be found among the prevention efforts that apply to populations rather than only to the heaviest drinkers. The article also illustrates how the results from a population survey can be used in order to identify specific challenges and solutions for alcohol prevention in a given population. The results help in identifying the population groups and situations with an elevated risk of alcohol-related harm and in characterising the drinking patterns and social situations in which drinking takes place in these vulnerable parts of the population. Conclusions: The review illustrates that a many-sided understanding of alcohol consumption and the related harm, based on survey results, is more far-reaching in terms of prevention and policy than a knowledge base built solely on register data on the development of alcohol consumption and harm. For example, the respondents’ drinking patterns are linked not only to their attitudes and risk perceptions but also to what people consider to be appropriate means to reduce alcohol use and the related harm in terms of alcohol policy, informal social control and people’s life management.
Drinking patterns among Finns aged 60 years and over from the 1990s onwards
Authors: Tigerstedt Christoffer , Härkönen Janne , Mäkelä Pia , Parikka Suvi , Vilkko Anni 
Published: September 2020

Aim: To analyse prevalence and trends in older people’s (60+) alcohol use in Finland in 1993–2018. Data and method: Data on people aged 65+ were obtained from the Health Behaviour and Health among the Finnish Elderly study (HBHFE) for the years 1993–2011 and from its successor the National FinSote Survey for the years 2013–2018. Data for 60–64-year-olds and for the reference group (20–59-year-olds) were obtained from the Health Behaviour and Health among the Finnish Adult Population (HBHFA) study for the years 1993–2011 and from the FinSote study for the years 2013–2018. Four measures were chosen to describe prevalence and trends in drinking patterns in five-year age groups among men and women aged 60+: prevalence of current drinking, prevalence of frequent drinking, typical amounts of drinking and prevalence of heavy episodic drinking (HED). Results: Regarding prevalence of current drinking and frequent drinking, older women have been catching up with men, but older men still consume larger amounts of alcohol per occasion. The long-lasting increase in the prevalence of current drinkers continued in most older female age groups into the 2010s, settled in most older male and some female age groups, and shifted downwards in the oldest male age groups. In most older male and female age groups, the increasing trend in frequent drinking continued to the present. Data on typical amounts consumed and HED were only available for 2013–2018. In that period those measures remained rather stable. Conclusion: More detailed research on drinking patterns among people aged 60+ years is needed for two reasons: older people’s drinking is a new cultural phenomenon and alcohol-related social and health harms are increasing in older age groups.
Reliability and accuracy assessment of morphometric measurements obtained with software for three-dimensional reconstruction of brain aneurysms relative to cerebral angiography measures
Authors: Munarriz Pablo M , Bárcena Eduardo , Alén Jose F , Castaño-Leon Ana M , Paredes Igor , Moreno-Gómez Luis Miguel , García-Pérez Daniel , Jiménez-Roldán Luis , Gómez Pedro A , Lagares Alfonso 
Published: September 2020

Objective To analyze the reliability and accuracy of morphological measurements of software employed to three-dimensionally reconstruct aneurysms and vessels (VMTKlab, version 1.6.1,) with computed tomography angiography (CTA) as the source of images. Agreement with measurements from three-dimensional digital subtraction angiography (3 D-DSA) was evaluated. Methods We evaluated 40 patients presenting with aneurysmal subarachnoid hemorrhage (aSAH). We analyzed four main variables of the aneurysm morphology: absolute height (size), neck (maximum neck width), perpendicular height, and maximum width. The CTA images were uploaded to the software and then segmented to reconstruct the aneurysm. This new method was compared to the current gold standard—3D reconstruction of pretreatment cerebral angiography. We used intraclass correlation coefficient (ICC) and Bland-Altman plot analyses to evaluate the agreement between these methods. Results The ICCs obtained for absolute height, neck, perpendicular height, and maximum width were 0.85, 0.57, 0.85, and 0.89, respectively. This implied good agreement except for the neck of the aneurysm (moderate agreement). Bland-Altman plots are presented for the four indexes. The average of the differences was not significant in terms of absolute height, perpendicular height, and maximum width indicating good agreement. However, it was significant for the neck of the aneurysm. Conclusions We report good agreement between the values generated using VMTKlab and cerebral angiography for three of the four main variables. Discrepancies in neck diameter are not surprising and its underestimation with a traditional delineation from cerebral angiography has been reported before.
FOLFIRINOX after first-line gemcitabine-based chemotherapy in advanced pancreatic cancer: a retrospective comparison with FOLFOX and FOLFIRI schedules
Authors: Foschini Francesca , Napolitano Fabiana , Servetto Alberto , Marciano Roberta , Mozzillo Eleonora , Carratù Anna Chiara , Santaniello Antonio , De Placido Pietro , Cascetta Priscilla , Butturini Giovanni , Frigerio Isabella , Regi Paolo , Silvestris Nicola , Delcuratolo Sabina , Vasile Enrico , Vivaldi Caterina , Bianco Cataldo , De Placido Sabino , Formisano Luigi , Bianco Roberto 
Published: September 2020

Background: Pancreatic adenocarcinoma is the fourth leading cause of cancer-related death. In cases with metastasis, the combination of 5-fluorouracil, irinotecan, and oxaliplatin (FOLFIRINOX) or gemcitabine-based chemotherapy regimens are considered the standard of care. However, the optimal sequence of these regimens is unclear. Methods: This retrospective study initially evaluated 186 patients with locally advanced/metastatic pancreatic cancer at three Italian institutions between February 2013 and October 2019. All patients had progressed after receiving gemcitabine-based first-line chemotherapy and were subsequently offered second-line FOLFIRINOX, FOLFOX-6, or FOLFIRI treatment. This study evaluated progression-free survival (PFS), overall survival from the start of second-line treatment (OS2), overall survival from the start of first-line treatment (OS1), and safety outcomes. Results: A total of 77 patients received ⩾4 cycles of second-line chemotherapy and were considered eligible: 15 patients received FOLFIRINOX, 32 patients received FOLFOX-6, and 30 patients received FOLFIRI. The FOLFIRINOX group had median PFS of 26.29 weeks and median OS2 of 47.86 weeks, while the FOLFIRI group had median PFS of 10.57 weeks and median OS2 of 25.00 weeks ( p = 0.038). No significant differences were observed between the FOLFIRINOX and FOLFOX-6 groups in terms of PFS (26.29 weeks versus 23.07 weeks) or OS2 (47.86 weeks versus 42.00 weeks). The most common grade 3–4 toxicities were anemia, neutropenia, and thrombocytopenia, which occurred more frequently in the FOLFIRINOX and FOLFOX-6 groups. Conclusion: Relative to the FOLFIRI regimen, the FOLFIRINOX regimen had a favorable toxicity profile and better survival outcomes. No significant differences were observed relative to the FOLFOX-6 regimen.
Outcome of oncological patients admitted with COVID-19: experience of a hospital center in northern Italy
Authors: Cherri Sara , Lemmers Daniel H. L. , Noventa Silvia , Abu Hilal Mohammed , Zaniboni Alberto 
Published: September 2020

Background: Recent literature regarding the outcome of cancer patients infected with COVID-19 are not encouraging. Nevertheless, current evidence on the risk and benefits of continuing oncological treatment of cancer patients during the pandemic remains insufficient. We provide our experience in a center with high access for patients with COVID-19-associated pneumonia in Lombardy, Italy. We conducted a retrospective study using a prospectively maintained database of patients admitted to our hospital between 25 February 2020 and 9 April 2020 with a confirmed diagnosis of COVID-19 pneumonia. Results: A total of 53 patients with a history or current oncological disease were included in this study. Sixteen oncological patients (30.2%) died during hospitalization. Multivariable logistic regression analysis found that age (Odds ratio [OR]: 1.17, p = 0.009), diabetes (OR: 15.05, p = 0.028) and active oncological disease (OR 13.60, p = 0.015) were independently associated with in-hospital mortality. The mortality rate of the total number of cancer patients is about twice as high as that of non-oncological patients admitted to our hospital with a diagnosis of COVID-19. Conclusion: The presence of active oncological disease is independently related to mortality as well as age and diabetes. The majority of patients who died were frail. Careful evaluation of the risks and benefits of treatment in frail patients is needed, considering that difficult access to intensive care may have affected the mortality rate.