bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of pulse contour technology for continuous blood pressure monitoring in pediatric patients
Authors: Alharash Hussam , Hossain Md Jobayer , Bhattacharjee Abhishek , Levenbrown Yosef 
Published: July 2020

Objectives
This study evaluates the accuracy of continuous blood pressure monitoring using pulse contour technology with the ClearSight monitoring device, a noninvasive alternative to placing an invasive arterial line, in pediatric patients.

Methods
Children younger than 18 years admitted to a pediatric ICU, who required an arterial line, and fit into the ClearSight finger cuff were included. Blood pressure measurement for systolic, diastolic, and mean arterial pressures (MAP) obtained by the ClearSight device were compared with those obtained with the intra-arterial catheter as well as automated cuff measurements using the mixed-effects model. Analysis was conducted for entire cohort, and measurements obtained with and without vasopressor use.

Results
There were 213 measurements from 10 patients. There was a statistically significant difference in systolic blood pressure when comparing arterial line and ClearSight systolic and diastolic measurements between the two methods (P < 0.001). There was no statistical difference between arterial MAP and ClearSight MAP (P = 0.957). Results were similar when ClearSight measurements were compared with automated cuff measurements. Both the vasopressor use and nonvasopressor use groups showed a statistically significant difference between arterial and ClearSight measurements for systolic and diastolic pressures, but not for the MAP.

Conclusions
Measurements of MAP obtained by the ClearSight device were almost identical to those obtained by the intra-arterial catheter. Although there was a difference in systolic blood pressures between the two methods, in those patients receiving inotropic support, the difference was within the range of what is considered acceptable in validating blood pressure devices.
Molecular profiling in sarcoidosis
Authors: Arger Nicholas K. , O’Connor Brian , Koth Laura L. 
Published: July 2020

Purpose of review
Sarcoidosis is a systemic disease characterized by granulomatous inflammation of unknown cause. There is extensive heterogeneity between patients with respect to the number and types of organs involved, disease course, and response to therapy. Recent research in the field has leveraged ‘omics’ techniques such as transcriptomics to identify important ‘molecular profiles’ in the disease. These tools may help in identifying clinically useful biomarkers and targets for therapy.

Recent findings
Several studies have used gene expression profiling of predesignated lists or the entire genome to find genes and markers that differentiate sarcoidosis from healthy controls, but only a few have compared sarcoidosis patients based on disease phenotypes and organ involvement. The common gene pathways that have been repeatedly identified include those related to the interferon response, T-cell receptor signaling, and the major histocompatibility complex.

Summary
While the molecular profiling studies to date offer the ability to compare sarcoidosis and health as well as across tissues, further longitudinal studies that include sarcoidosis patients with varying outcomes with respect to organ involvement and response to treatment are needed to identify clinically important phenotypes in the disease that can then be differentiated based on molecular features.
Contemporary evaluation and management of tall cell variant of papillary thyroid carcinoma
Authors: Cartwright Sara , Fingeret Abbey 
Published: July 2020

Purpose of review
The purpose of this review is to describe the contemporary evaluation and management of tall cell variant of papillary thyroid carcinoma with an emphasis on the clinical features.

Recent findings
Tall cell variant of papillary thyroid carcinoma is the most common aggressive subtype. Within the last few years, the diagnostic criteria for this entity have evolved. Studies have elucidated a better understanding of the clinical implications and pathophysiology of this variant. In this review, the studies presented reflect cumulative and aggregated data from metaanalyses, systematic reviews, and large database investigations utilizing the current diagnostic criteria.

Summary
Overall, tall cell variant of papillary thyroid carcinoma represents an aggressive subtype of well-differentiated thyroid carcinoma with more prevalent high-risk features and a poorer clinical outcome.
Secretion of severe acute respiratory syndrome coronavirus 2 in urine
Authors: Brönimann Stephan , Rebhan Katharina , Lemberger Ursula , Misrai Vincent , Shariat Shahrokh F. , Pradere Benjamin 
Published: July 2020

Purpose of review
Despite the plethora of publications discussing the severe respiratory coronavirus 2 (SARS-CoV-2), evidence of viral secretion in urine is sparse.

Recent findings
We could identify 34 publications including a total of 2172 patients. Among those, 549 patients were tested for SARS-CoV-2 secretion in urine, which was detected in only 38 patients (6.9%). Within the seven studies displaying positive results, the majority of positive patients (86.8%) was from not yet peer-reviewed studies including weak data and heterogeneous techniques for sample testing. Furthermore, none of the studies available in the literature addressed the virulence of detected viral RNA in urine.

Summary
Overall, only seven studies were able to detect SARS-CoV-2 secretion in urine, all of them with a considerably low rate of positivity. However, these studies were of rather low quality considering their methodology. Despite this, as SARS-CoV-2 has been detected in urine, it is of importance to discuss safety and urinary hygiene protocols. Until further research provides valid data on viral shedding and virulence in urine, potential risk of transmission through urine cannot be ruled out. Therefore, safety and hygiene measures need to be discussed.
Radiographic Pneumonia in Febrile Infants 60 Days and Younger
Authors: Florin Todd A. , Ramilo Octavio , Hoyle John D. , Jaffe David M. , Tzimenatos Leah , Atabaki Shireen M. , Cohen Daniel M. , VanBuren John M. , Mahajan Prashant , Kuppermann Nathan ,   for the Febrile Infant Working Group of the Pediatric Emergency Care Applied Research Network (PECARN)
Published: July 2020

Objective
Few prospective studies have assessed the occurrence of radiographic pneumonia in young febrile infants. We analyzed factors associated with radiographic pneumonias in febrile infants 60 days or younger evaluated in pediatric emergency departments.

Study Design
We conducted a planned secondary analysis of a prospective cohort study within 26 emergency departments in a pediatric research network from 2008 to 2013. Febrile (≥38°C) infants 60 days or younger who received chest radiographs were included. Chest radiograph reports were categorized as “no,” “possible,” or “definite” pneumonia. We compared demographics, Yale Observation Scale scores (>10 implying ill appearance), laboratory markers, blood cultures, and viral testing among groups.

Results
Of 4778 infants, 1724 (36.1%) had chest radiographs performed; 2.7% (n = 46) had definite pneumonias, and 3.9% (n = 67) had possible pneumonias. Patients with definite (13/46 [28.3%]) or possible (15/67 [22.7%]) pneumonias more frequently had Yale Observation Scale score >10 compared with those without pneumonias (210/1611 [13.2%], P = 0.002) in univariable and multivariable analyses. Median white blood cell count (WBC), absolute neutrophil count (ANC), and procalcitonin (PCT) were higher in the definite (WBC, 11.5 [interquartile range, 9.8–15.5]; ANC, 5.0 [3.2–7.6]; PCT, 0.4 [0.2–2.1]) versus no pneumonia (WBC, 10.0 [7.6–13.3]; ANC, 3.4 [2.1–5.4]; PCT, 0.2 [0.2–0.3]; WBC, P = 0.006; ANC, P = 0.002; PCT, P = 0.046) groups, but of unclear clinical significance. There were no cases of bacteremia in the definite pneumonia group. Viral infections were more frequent in groups with definite (25/38 [65.8%]) and possible (28/55 [50.9%]) pneumonias than no pneumonias (534/1185 [45.1%], P = 0.02).

Conclusions
Radiographic pneumonias were uncommon, often had viruses detected, and were associated with ill appearance, but few other predictors, in febrile infants 60 days or younger.
Uncommon Complication of Pediatric Umbilical Hernia-Spontaneous Evisceration
Authors: Chouikh Taieb , Echaieb Anis , Belkhir Dahmane , Audry Georges , Raquillet Claire 
Published: July 2020

Abstract
The umbilical hernia is common in children. Most of the cases have a spontaneous regression around the age of 3 years. Complications are very rare, and thus surgery is not routinely indicated before the age of 3 years. We report an exceptional case of spontaneous rupture of an umbilical hernia with emphasis on the management of this rare complication and a literature review of similar cases.
Effects of High-Frequency Neuronavigated Repetitive Transcranial Magnetic Stimulation in Fibromyalgia Syndrome
Authors: Bilir Ibrahim , Askin Ayhan , Sengul Ilker , Tosun Aliye 
Published: July 2020

Objective
The primary aim of the study was to investigate the effect of 10-Hz repetitive transcranial magnetic stimulation to the left dorsolateral prefrontal cortex on pain in fibromyalgia. Secondary aims were to determine its effects on stiffness, fatigue, quality of life, depression/anxiety, and cognitive functions.

Design
Twenty participants were randomized into two groups. Group A received 10-Hz repetitive transcranial magnetic stimulation to left dorsolateral prefrontal cortex and group B received sham stimulation. Visual analog scale for pain, visual analog scale–stiffness, Fibromyalgia Impact Questionnaire, and Fatigue Severity Scale were assessed at the baseline, 2nd, and 6th weeks, whereas Hospital Anxiety Depression Scale and Addenbrooke’s cognitive examination were assessed at the baseline and 6th week.

Results
There was no significant difference in visual analog scale–pain and Fatigue Severity Scale within and between groups over time (P > 0.05). In group A, significant improvement was found in visual analog scale–stiffness and fibromyalgia impact questionnaire at the 2nd week in comparison to the baseline (P < 0.05). However, no significant difference was detected in comparison with group B. There was no significant change in Hospital Anxiety Depression Scale scores between and within groups. All cognitive measures were similar in terms of differences from baseline between the groups (P > 0.05).

Conclusions
High-frequency repetitive transcranial magnetic stimulation to the left dorsolateral prefrontal cortex did not show any significant beneficial effect on pain, stiffness, fatigue, quality of life, mood, and cognitive state over sham stimulation.
Influence of Pulse Waveform and Frequency on Evoked Torque, Stimulation Efficiency, and Discomfort in Healthy Subjects
Authors: Rabello Rodrigo , Fröhlich Matias , Maffiuletti Nicola Angelo , Vaz Marco Aurélio 
Published: July 2020

Objective
The aim of the study was to determine the influence of neuromuscular electrical stimulation pulse waveform and frequency on evoked torque, stimulation efficiency, and discomfort at two neuromuscular electrical stimulation levels.

Design
This is a repeated measures study. The quadriceps muscle of 24 healthy men was stimulated at submaximal (neuromuscular electrical stimulationsub) and maximal (neuromuscular electrical stimulationmax) levels using two pulse waveforms (symmetrical, asymmetrical) and three pulse frequencies (60, 80, 100 Hz). Repeated measures analysis of variance and effect sizes were used to verify the effect of pulse waveform and pulse frequency on stimulation efficiency (evoked torque/current intensity) and discomfort and to assess the magnitude of the differences, respectively.

Results
Stimulation efficiency was higher for symmetrical (neuromuscular electrical stimulationsub = 0.88 ± 0.21 Nm/mA; neuromuscular electrical stimulationmax = 1.27 ± 0.46 Nm/mA) compared with asymmetrical (neuromuscular electrical stimulationsub = 0.77 ± 0.21 Nm/mA; neuromuscular electrical stimulationmax = 1.02 ± 0.34 Nm/mA; P ≤ 0.001; effect size = 0.56–0.66) but did not significantly differ between frequencies (P = 0.17). At both neuromuscular electrical stimulation levels, there were no statistically significant differences in discomfort between pulse waveforms or frequencies.

Conclusions
The higher stimulation efficiency of symmetrical pulses suggests that this waveform would be preferred to asymmetrical pulses in clinical practice. Stimulation frequencies between 60 and 100 Hz can be used interchangeably because of similar efficiency and discomfort.
Comparison of Ultrasound-Guided Local Ozone (O2-O3) Injection Versus Corticosteroid Injection in Patients With Mild to Moderate Carpal Tunnel Syndrome
Authors: Forogh Bijan , Mohamadi Hossein , Fadavi Hamid Reza , Madani Seyed Pezhman , Aflakian Negar , Ghazaie Fateme , Babaei-Ghazani Arash 
Published: July 2020

Objective
Recently, ozone injection has been used to treat various musculoskeletal diseases. This study was performed to compare ultrasound-guided corticosteroid versus ozone injections in the treatment of carpal tunnel syndrome.

Design
Forty patients with mild to moderate carpal tunnel syndrome were enrolled and randomly placed in one of the two groups of receiving a corticosteroid or ozone injection under ultrasound guidance. To determine the effectiveness of both injection techniques and compare their outcomes, visual analog scale and scores of Boston Carpal Tunnel Questionnaire, as well as ultrasound and electrodiagnostic criteria, were followed at 0, 6, and 12 wks after the injection.

Results
Both groups showed improvement in visual analog scale and Boston Carpal Tunnel Questionnaire at week 6, and this improvement continued until the 12th week after the injections. However, electrodiagnostic values of sensory nerve action potentials and compound motor action potentials latency, and ultrasound carpal tunnel syndrome criteria showed significant improvement only among the subjects in the corticosteroid group at 6 and 12 wks after the injection (P < 0.05).

Conclusions
Ozone might be as effective as corticosteroid injection in reducing pain and improving the function. Objective improvements in electrodiagnostic and ultrasound criteria of carpal tunnel syndrome were shown only among patients after corticosteroid injection.
Feasibility and Efficacy of Cardiopulmonary Rehabilitation After COVID-19
Authors: Hermann Matthias , Pekacka-Egli Anna-Maria , Witassek Fabienne , Baumgaertner Reiner , Schoendorf Sabine , Spielmanns Marc 
Published: July 2020

Abstract
The COVID-19 pandemic affects a large number of patients with a rapid progression of respiratory failure often requiring hospitalization or intensive care unit treatment in some patients. Survivors of severe COVID-19 experience persistent weakness and cardiorespiratory failure. Feasibility and potential benefit of cardiopulmonary rehabilitation after COVID-19 remains unclear. Therefore, we retrospectively analyzed a cohort of COVID-19 patients in a single-center inpatient rehabilitation clinic and describe performance and outcome during cardiopulmonary rehabilitation.
Patients were referred from acute care hospitals for rehabilitation after severe COVID-19. The cohort (N = 28) was divided in ventilated or not ventilated patients for further analysis. Fifty percent were female, the mean age was 66 yrs, and patients stayed in the acute hospital for 19.3 ± 10.7 days before referral for cardiopulmonary rehabilitation. Seventeen patients (61%) needed previous intensive care unit treatment in the acute care hospital. Risk factors, assessments, and questionnaires on admission were comparable in both groups. Significant enhancements were observed in 6-min walking test and feeling thermometer, which were independent of previous ventilation status.
In conclusion, comprehensive cardiopulmonary rehabilitation after COVID-19 is safe, feasible, and effective. Improvements in physical performance and subjective health status were independent of previous ventilation.
Cancer Drugs in Asian Populations
Authors: Goh Boon-Cher , Lim Jeremy Fung-Yen 
Published: July 2020

Abstract
Accessibility to effective cancer treatments is a goal of Universal Health Coverage; yet, achieving this in the context of escalating costs in a diversity of Asian nations with different socioeconomic development is extremely challenging. Value-based assessments within the context of each health care system, financing infrastructure that will facilitate appropriate prioritization of high-cost medications, transparency in international pricing and reducing out-of-pocket costs through national insurance programs are measures that Asian countries should take toward Universal Health Coverage for cancer care. Encouraging sharing data on pricing through the World Health Organization, sharing expertise in health technology assessments and regulatory approvals, and exploring bulk negotiations would also strengthen the process of price control. For each individual country, rational selection of national cancer formulary, aiming at price reduction and sound procurement strategies for each drug, is important toward ensuring affordable access to quality cancer medications.
Interventional Pharmacoeconomics
Authors: Goldstein Daniel A. , Strohbehn Garth W. , Serritella Anthony V. , Hyman David A. , Lichter Allen S. , Ratain Mark J. 
Published: July 2020

Abstract
The increasing cost of health care is a major challenge around the world, but particularly in the United States. One reason for increased costs is the rapidly rising cost of oncology drugs. Potential solutions to this problem involve broad changes to health policy. However, an alternative solution is the development of lower-cost off-label treatment regimens, based on pharmacologic rationale, with significant potential economic impact. The pharmacologic and clinical properties of many drugs allow for a variety of different strategies. We describe this approach of interventional pharmacoeconomics and provide multiple individual examples.
HIV-associated plasmablastic lymphoma in the era of HAART: a single-center experience of 21 patients
Authors: Mai Brenda , Wang Wei , Lin Mei , Hu Shimin , Wang Xiaohong I. , Chen Lei , Wahed Amer , Nguyen Andy , Ma Hillary Y. , Medeiros L. Jeffrey , Hu Zhihong 
Published: July 2020

Objectives:
Patients with HIV infection have an increased risk of developing plasmablastic lymphoma (PBL). In this study, we reviewed the clinicopathologic features of PBL in HIV+ patients in the era of HAART from a single health center.

Design:
Retrospective study.

Methods:
The morphologic, immunophenotypic, and clinical features were reviewed in these HIV+ patients with PBL and univariate analysis was employed to determine the survival prognosis.

Results:
During the interval of 1 January 2008 to 30 December 2018, we identified 95 HIV+ patients with aggressive non-Hodgkin B-cell lymphomas. Among these patients, there were 21 (22%) patients with PBL (19 men and two women; median age: 45 years). Seven patients had PBL at their initial HIV diagnosis and 14 developed PBL after a median interval of 7.7 months of HIV diagnosis. Lymph nodes (n = 10), oral cavity/sinonasal mass (n = 6), and rectal masses (n = 5) were the common involved sites, and five of 15 (33%) had bone marrow involvement. Lymphoma cells were immunoreactive for MUM-1/IRF4 (100%), CD138 (90%), CD45 (63%), CD79a (47%), and CD30 (25%). Proliferation rate assessed by Ki67 was at least 90% in 18 of 20 cases. Eighteen patients received chemotherapy including etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin (n = 13) and cyclophosphamide, doxorubicin, vincristine, and prednisone (n = 2). With a median follow-up time of 19 months, nine out of 17 patients died. Bone marrow involvement was associated with a poorer overall survival (median: 4.7 months, P = 0.015).

Conclusion:
PBL is the second most common type of aggressive lymphoma and often presents in lymph nodes of patients with poorly controlled HIV infection. Bone marrow involvement is associated with a poorer outcome.
Hounsfield's Legacy
Authors: Wildberger Joachim Ernst , Prokop Mathias 
Published: July 2020

Abstract
Computed tomography (CT) has evolved over decades, offering superb morphologic imaging with isotropic resolution at rapid acquisition times. The latest developments in hardware, such as photon-counting and ultrahigh-resolution detectors, together with breakthroughs in software technology have further improved spatial and temporal resolution while steadily reducing radiation exposure. These achievements enable CT for functional imaging and make high-quality imaging more accessible through workflow automation. Radiomics, integrated diagnostics, and data science will further push CT applications beyond their current limits.
Superior primary fascial closure rate and lower mortality after open abdomen using negative pressure wound therapy with continuous fascial traction
Authors: Rasilainen Suvi , Mentula Panu , Salminen Paulina , Koivukangas Vesa , Hyöty Marja , Mäntymäki Leena-Mari , Pinta Tarja , Haikonen Jyrki , Rintala Jukka , Rantanen Tuomo , Strander Tapani , Leppäniemi Ari 
Published: July 2020

BACKGROUND
Open abdomen (OA) is a useful option for treatment strategy in many acute abdominal catastrophes. A number of temporary abdominal closure (TAC) methods are used with limited number of comparative studies. The present study was done to examine risk factors for failed delayed primary fascial closure (DPFC) and risk factors for mortality in patients treated with OA.

METHODS
This study was a multicenter retrospective analysis of the hospital records of all consecutive patients treated with OA during the years 2009 to 2016 at five tertiary referral hospitals and three secondary referral centers in Finland.

RESULTS
Six hundred seventy-six patients treated with OA were included in the study. Vacuum-assisted closure with continuous mesh-mediated fascial traction (VACM) was the most popular TAC method used (N = 398, 59%) followed by VAC (N = 128, 19%), Bogota bag (N = 128, 19%), and self-designed methods (N = 22, 3%). In multivariate analysis, enteroatmospheric fistula and the number of needed TAC changes increased the risk for failed DPFC (odds ratio [OR], 8.9; 95% confidence interval [CI], 6.2–12.8; p < 0.001 and OR, 1.1; 95% CI, 1.0–1.3; p < 0.001, respectively). Instead, VACM and ruptured abdominal aortic aneurysm as cause for OA both decreased the risk for failed DPFC (OR, 0.1; 95% CI, 0.0–0.3; p < 0.001 and OR, 0.2; 95% CI, 0.1–0.7; p = 0.012). The overall mortality rate was 30%. In multivariate analysis for mortality, multiorgan dysfunction (OR, 2.4; 95% CI, 1.6–3.6; p < 0.001), and increasing age (OR, 4.5; 95% CI, 2.0–9.7; p < 0.001) predicted increased mortality. Institutional large annual patient volume (OR, 0.4; 95% CI, 0.3–0.6; p < 0.001) and ileus and postoperative peritonitis in comparison to severe acute pancreatitis associated with decreased mortality (OR, 0.2; 95% CI, 0.1–0.4; p < 0.001; OR, 0.5; 95% CI, 0.3–0.8; p = 0.009). Kaplan-Meier analysis showed increased survival in patients treated with VACM in comparison with other TAC methods (LogRank p = 0.019).

CONCLUSION
We report superior role for VACM methodology in terms of successful primary fascial closure and increased survival in patients with OA.

LEVEL OF EVIDENCE
Therapeutic/care management, level IV.