bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early mobilization reduces delirium after coronary artery bypass graft surgery
Authors: Shirvani Fahimeh , Naji Seyed Ali , Davari Elham , Sedighi Mohsen 
Published: August 2020

Background Postoperative delirium is common in patients undergoing coronary artery bypass grafting, characterized by cognitive decline. This study aimed to evaluate the effect of early planned mobilization on delirium after coronary artery bypass grafting. Methods This double-blind randomized clinical trial enrolled 92 consecutive patients who underwent coronary artery bypass grafting from September to December 2018. The patients were divided into two groups of 46: a mobilization protocol was applied in the intervention group in the first 2 days after surgery; the control group received routine nursing care only. Demographic data, medical records, and Neecham confusion scores were analyzed. Results Patients in the control group used cigarettes (31.1% vs. 11.1%, p = 0.020) and opium poppy for recreation (35.6% vs. 8.9%, p = 0.002) more frequently, had longer intubation times (11.91 ± 3.87 vs. 10.23 ± 2.71 h, p = 0.020), and fewer blood components infused (15.6% vs. 33.3%, p = 0.05). More patients in the intervention group had normal function on the 2nd postoperative day compared to the control group (25 vs. 2, respectively, p = 0.001). The intervention group had significantly higher Neecham scores on postoperative day 2 (22.49 ± 2.03 vs. 26.82 ± 2.10, p = 0.001). Multivariable analysis showed significant associations between Neecham score and age ( p = 0.022), ejection fraction ( p = 0.015), myocardial infarction ( p = 0.016), systolic pressure ( p = 0.009), and diastolic pressure ( p = 0.008). Conclusions Early planned mobilization was effective in reducing postoperative delirium in patients undergoing coronary artery bypass grafting.
Mitral valve repair for infective endocarditis: Kobe experience
Authors: Okada Yukikatsu , Nakai Takeo , Muro Takashi , Ito Hisato , Shomura Yu 
Published: August 2020

Objectives We retrospectively analyzed our experience of mitral valve repair for native mitral valve endocarditis in a single institution. Methods From January 1991 to October 2011, 171 consecutive patients underwent surgery for infective endocarditis. Of these, 147 (86%) had mitral valve repair. At the time of surgery, 98 patients had healed (group A) and 49 had active infective endocarditis (group B). Repair procedures included resection of all infected tissue and thick restricted post-infection tissue, leaflet and annulus reconstruction with treated autologous pericardium, chordal reconstruction with polytetrafluoroethylene sutures, and ring annuloplasty if necessary. Fifty-two (35%) patients required concomitant procedures. The study endpoints were overall survival, freedom from reoperation, and freedom from valve-related events. The median follow-up was 78 months. Results There was one hospital death (hospital mortality 0.7%). Survival at 10 years was 88.5% ± 3.5% with no significant difference between the two groups ( p = 0.052). Early reoperation was required in 4 patients in group B due to persistent infection or procedure failure. Freedom from reoperation at 5 years was 99% ± 1.0% in group A and 89.6 ± 4.0% in group B ( p = 0.024). Event-free survival at 10 years was 79.3% ± 4.8% (group A: 83.4% ± 5.9%, group B: 72.6% ± 6.9%, p = 0.010). Conclusions Mitral valve repair was highly successful using autologous pericardium, chordal reconstruction, and ring annuloplasty if required. Long-term results were acceptable in terms survival, freedom from reoperation, and event-free survival. Mitral valve repair is recommended for mitral infective endocarditis in most patients.
Imaging findings of pelvic venous insufficiency in patients with postural orthostatic tachycardia syndrome
Authors: Knuttinen Martha-Gracia , Zurcher Kenneth S , Khurana Neal , Patel Indravadan , Foxx-Orenstein Amy , Harris Lucinda A , Lawrence Andrew , Aguilar Francisco , Sichlau Michael , Smith B. Holly , Smith Steven J 
Published: August 2020

Objectives Some patients with postural orthostatic tachycardia syndrome (POTS) demonstrate improved dysautonomic symptoms following treatment for pelvic venous insufficiency (PVI). This study assessed the prevalence of significant left common iliac vein (LCIV) compression in POTS patients. Methods Radiologists retrospectively reviewed CT images of pelvic veins for 216 women (191 with POTS and 25 age-comparable controls).Quantitative vascular analysis identified percent-diameter compression of the LCIV by the right common iliac artery. Significant LCIV compression was defined as >50%. Results Significant LCIV compression was found in 69% (131/191) of females with POTS versus 40% (10/25) in controls. The hypothesis that venous compression and presence of POTS are independent was rejected ( p = .005). Conclusions Significant LCIV compression was noted in a majority of female POTS patients, suggesting that incidence of iliac venous obstruction may be higher than the general population. Patients with POTS and symptoms of PVI may benefit from assessment for venous outflow obstruction.
Correlation between three assessment pain tools in subacromial pain syndrome
Authors: Aceituno-Gómez Javier , Avendaño-Coy Juan , Criado-Álvarez Juan José , Ávila-Martín Gerardo , Marín-Guerrero Ana Cecilia , Mohedano Alicia , Viñuela Antonio 
Published: August 2020

Objective: To compare the correlation of Visual Analog Scale with pain subsections of Shoulder Pain and Disability Index and Constant-Murley Score in subacromial pain syndrome patients. Design: Single cross-sectional analysis. Setting: Hospital Rehabilitation Department. Methods: The assessment tools were applied at baseline. Correlations between Visual Analog Scale, Shoulder Pain and Disability Index and Constant-Murley Score pain subsections were assessed by Pearson correlation coefficient. Linear regression models were calculated between scales. Statistical significance was set at two-sided p < 0.05. Results: Forty-three patients were included. Pearson’s correlation between assessments was for Visual Analog Scale-Shoulder Pain Disability Index-pain ( r = 0.61, p < 0.001) and for Visual Analog Scale-Constant Murley Score-pain were ( r = −0.74, p < 0.001). Visual Analog Scale-Shoulder Pain and Disability Index-pain determination coefficient was r2 = 0.37 and r2 = 0.54 for Visual Analog Scale-Constant-Murley Score-pain. Conclusions: Visual Analog Scale showed better correlation with Constant Murley Score-pain than with Shoulder Pain and Disability Index-pain in subacromial pain syndrome patients.
Acute myocardial injury following hydrogen sulfide poisoning
Authors: Mo Weichun , Shen Jie , Huang Xiaochun , Zhang Yuanlong , Zhang Zhihua 
Published: August 2020

Background: Hydrogen sulfide poisoning can cause severe myocardial injury, but the damage is subtle and can be easily misdiagnosed. This report presents the dynamic observation of myocardial injury associated with hydrogen sulfide poisoning. Case report: Two young men presented with symptoms of “lightning-like” death immediately after entering a tank. They were found and rescued in 20 min at a time when they were already in a coma. Case 1 had no spontaneous breathing and pulse, while case 2 had spontaneous breathing and a pulse. Upon transfer to a local hospital, case 1 received continuous cardiopulmonary resuscitation which led to the recovery of his heart rate 3 min after arriving at the hospital. However, the patient remained in a Glasgow coma scale of 3. He was transferred to our hospital where he, unfortunately, died on the seventh day due to multiple organ failure. Case 2 was also transferred to the intensive care unit in our hospital and on the fourth day of hospitalization, the patient presented ST-segment elevation and dynamic changes in markers of myocardial injury. Changes in electrocardiogram and markers of myocardial injury were monitored and examination improved through conventional echocardiography, coronary artery CT, radionuclide myocardial perfusion imaging, and two-dimensional speckle tracking imaging strain. The treatment gradually improved the patient’s myocardial injury and was discharged from the hospital. Conclusion: Hydrogen sulfide poisoning can cause damage to myocardial function and the damage can be more insidious in nature and with a delayed onset. Recovery from myocardial damage can be very slow.
Development and Psychometric Evaluation of the Preconception Health Knowledge Questionnaire
Authors: Cairncross Zoe , Dennis Cindy-Lee , Brennenstuhl Sarah , Ravindran Saranyah , Enders Joanne , Graves Lisa , Mill Catriona , Telner Deanna , Brown Hilary K. 
Published: August 2020

Purpose: To develop and psychometrically test a comprehensive measure of preconception health knowledge. Design: Cross-sectional survey, in May and June, 2019. Setting: Alberta, Ontario, and Québec, Canada. Sample: One thousand seven hundred seventy-seven women and men with ≥1 children born in the last 5 years or planning a pregnancy in the next 5 years. Measures: Using prior literature and input from public health nurses and physicians, the Preconception Health Knowledge Questionnaire (PHKQ) was developed and comprised 25 multiple choice questions on reproductive history, sexual health, infectious diseases, chronic medical conditions, mental health, medications, immunizations, lifestyle behaviors, psychosocial stressors, and environmental exposures. Analysis: Psychometric testing was undertaken to evaluate item difficulty, discrimination, quality of response alternatives, internal consistency, and construct validity. Results: Participants had a mean total score of 15.8/25 (SD = 3.9); women and men had mean total scores of 16.2 (SD = 3.6) and 13.8 (SD = 4.7), respectively. Most items were neither too difficult nor too easy, discriminated well between participants with high and low knowledge, and had appropriate response alternatives. High internal consistency (KR-20 = 0.87) and construct validity, shown via significant correlations with education level and previous preconception care receipt, were demonstrated. Conclusion: The PHKQ is a reliable and valid tool for measuring preconception health knowledge and may be useful in identification of high-risk groups in need of preconception health education and evaluation of preconception health interventions.
Uremic solutes of indoxyl sulfate and p-cresol enhance protease-activated receptor-2 expression in vitro and in vivo in keratinocytes
Authors: Kim SJ , Zhang X , Cho SB , Kim CH , Park HC , Moon SJ 
Published: August 2020

Objectives: Uremic pruritus is common in patients with chronic kidney disease (CKD). The retention of uremic solutes is thought to be associated with uremic pruritus. Meanwhile, activation of protease-activated receptor-2 (PAR-2) has been suggested to play an important role in pruritus. The present study was performed to investigate the effects of uremic solutes on the expression of PAR-2 in the skin. Methods: Indoxyl sulfate (IS), p-cresol (PC), and uremic sera from CKD patients were used to stimulate PAR-2 expression in normal human epidermal keratinocytes (NHEKs). Also, NHEKs were additionally pretreated with soybean trypsin inhibitor to evaluate its inhibitory effect on PAR-2 expression. Patterns of cutaneous PAR-2 expression were investigated in skin samples from five CKD patients and CKD mice. Results: In NHEKs, IS, PC, and sera from CKD patients significantly induced PAR-2 mRNA and protein expression. Soybean trypsin inhibitor significantly decreased PAR-2 mRNA and protein expression in NHEKs treated with IS, PC, and CKD sera. NHEKs treated with IS and PC exhibited significant increases in protease activity. Skin from both CKD patients and mice exhibited marked upregulation of PAR-2 expression compared to control skin. Conclusions: Results from the present study suggest that uremic solutes either directly or indirectly affect PAR-2 expression in the skin of CKD subjects, potentially playing an important role in the pathogenesis of uremic pruritus.
Cosmetic camouflage improves health-related quality of life in women with systemic lupus erythematosus and permanent skin damage: A controlled intervention study
Authors: Oliveira Fernando Afrânio Palmeira de , Santos Fabiana de Miranda Moura dos , Dias Ana Flávia Madureira de Pádua , Neiva Claudia Lopes Santoro , Telles Rosa Weiss , Lanna Cristina Costa Duarte 
Published: August 2020

Objective To investigate the effect of cosmetic camouflage in health-related quality of life (HRQoL) in women with systemic lupus erythematosus (SLE) and permanent facial skin damage. Methods This is a randomized controlled clinical trial (Universal Trial Number: U1111-1210-2554e) with SLE women from outpatients using ACR/1997 and/or SLICC/2012 criteria, aged over 18 years old, with modified SLEDAI 2k < 4 and permanent facial skin damage, recruited in two tertiary centers to use cosmetic camouflage (n = 36) or no intervention (n = 20). Endpoints were score variations in SLE Quality of Life (SLEQoL) (total and each domain), Dermatology Life Quality Index (DLQI), Rosenberg self-esteem scale and Hospital Anxiety and Depression Scale (HADS), after daily use of cosmetic camouflage for 12 +/−2 weeks (Phase I), “as needed” use of cosmetic camouflage for another 12 +/−2 weeks (Phase II), and during total follow up (24 +/−2 weeks). Univariate and multivariate linear regressions were conducted by protocol analysis. Results Both groups were similar at baseline regarding age, disease duration, socio-demographic, clinical, laboratory and treatment characteristics. The comparison of score variations between intervention and control groups showed an independent HRQoL improvement in total SLEQoL score after using cosmetic camouflage in Phase I [β −27.56 (CI 95% −47.86 to −7.27) p = 0.009] and total follow up [β −28.04 (CI 95% −48.65 to −7.44) p = 0.09], specifically in mood, self-image and physical functioning domains. Also, there was an improvement in DLQI scores during Phase I [β −7.65 (CI 95% −12.31 to −3.00) p = 0.002] and total follow up [β −8.97(CI95% −12.99 to −4.94) p < 0.001). Scores for depression [β −1.92 (CI 95% −3.67 to −0.16) p = 0.033], anxiety [β −2.87 (CI 95% −5.67 to −0.07] p = 0.045] and self-esteem [β 2.79 (CI 95% 0.13 to 5.46) p = 0.041] improved considering the total follow up. No significant changes occurred in the control group scores. Conclusion The use of cosmetic camouflage improved the HRQoL in female SLE patients with permanent facial skin damage.
Geographic Variation in Knowledge of Palliative Care Among US Adults: Findings From 2018 Health Information National Trends Survey
Authors: Chen Guanming , Hong Young-Rock , Wilkie Diana J. , Kittleson Sheri , Huo Jinhai , Bian Jiang 
Published: August 2020

Background: Public knowledge and awareness of palliative care (PC) is important to its effective use. However, it remains unclear whether the geographic variation in knowledge of PC exits in the United States. This study examined the national geographic variation in knowledge of PC. Methods: The study sample was obtained from the 2018 National Cancer Institute’s Health Information National Trends Survey. Basic knowledge of PC, goal concordant treatment, misconceptions, and primary information source of PC were compared across 4 census regions. Multivariable logistic regression was used to examine factors associated with awareness of PC among 9 census divisions. Results: A total of 3194 respondents (weighted sample size: 229 591 005) were included in this study. Overall, 29% of all respondents reported having knowledge of PC; 32.9% of those residing in Northeast had some knowledge of PC, followed by 30.8% in the South, 26.2% in Midwest, and 25.6% in West. By census divisions, respondents residing in 3 divisions were more likely to have PC knowledge (New England, odds ratio: 3.06, 95% CI: 1.48-6.32, P = .003; South Atlantic, odds ratio: 1.96, 95% CI: 1.15-3.35, P = .014; Pacific, odds ratio: 1.86, 95% CI: 1.12-3.09, P = .018) compared to those in the Mountain division. Conclusions: The variation of PC knowledge on census division and state level in 2018 was consistent with the real-world geographic disparities in the availability of PC programs. These findings represent an opportunity for minimizing the gap of geographic disparity by initiating strategic programs and promoting PC programs nationwide.
Musculoskeletal Pain Survey Outcomes in Cleft Surgeons and Orthodontists
Authors: Kim Justine S. , Chen Wendy , Grunwaldt Lorelei , Losee Joseph E. , Bise Christopher , Schuster Lindsay 
Published: August 2020

Objective: Determine prevalence and characteristics of musculoskeletal pain and pathology in cleft providers. Design: An IRB-exempt survey based on previously validated surveys was administered. Data collected included demographics, practice description, musculoskeletal pain history, formal diagnoses, and interventions. Setting: Survey was sent to all cleft centers approved by the American Cleft Palate-Craniofacial Association worldwide. Patients, Participants: All cleft surgeons and orthodontists at these centers met entry criteria. Eighty-three providers responded. Cleft center coordinators were unable to confirm the number of survey recipients. Main Outcome Measures: The hypothesis formulated prior to data collection was that prevalence would be comparable to general plastic surgeons and other at-risk health care providers. Results: Average age of respondents was 49.8 ± 11.3 years; 33.9% of respondents were female. Average body mass index was 24.8 ± 3.5 kg/m2. Headaches were observed in 62.7% of surveyed respondents while musculoskeletal symptoms were reported in 89.8%. Of the 12 body parts addressed, most commonly affected were the neck (71.2%), shoulders (52.5%), and lower back (67.8%). Pain interfered with hobbies and home life in the majority of respondents (62.7%). Those who reported a formal diagnosis were more likely to undergo treatment including surgery ( P < .01), medication ( P = .03), and physical therapies ( P < .01). Conclusions: Cleft surgeons and orthodontists experience a higher frequency of headaches compared to the general population, and musculoskeletal disorders are more prevalent than reported by general plastic surgeons. Pain interferes with hobbies and home life. Formal diagnosis leads to treatment. Preventative exercises and interventions are presented.
Clinical and Magnetic Resonance Imaging Outcomes of Microfracture Plus Chitosan/Blood Implant vs Microfracture for Osteochondral Lesions of the Talus
Authors: Camurcu Yalkin , Ucpunar Hanifi , Yapici Furkan , Karakose Resit , Ozcan Seckin , Cobden Adem , Duman Serda , Sofu Hakan 
Published: August 2020

Background: The aim of this study was to compare the clinical and magnetic resonance imaging (MRI) outcomes of arthroscopic microfracture (MF) plus chitosan-glycerol phosphate/blood implant and MF alone for the treatment of the osteochondral lesions of the talus (OCLTs). Methods: Patients who underwent either MF plus chitosan (group 1, n = 32) or MF alone (group 2, n = 31) between 2015 and 2019 in 2 separate time periods were retrospectively analyzed. Visual analog scale (VAS) score and American Orthopaedic Foot & Ankle Society (AOFAS) score were used for clinical evaluation. The magnetic resonance observation of cartilage repair tissue (MOCART) system was used for MRI evaluation. The mean follow-up time was 32 ± 13 months (range, 12-61 months). Results: Postoperatively, we detected significant improvements in both groups in terms of VAS and AOFAS scores. However, we observed no statistically significant difference between groups in terms of clinical scores, except the mean VAS function score, which was significantly higher in group 1 ( P = .022). According to MOCART scale, complete repair with the filling of the chondral defect and intactness of the surface of the repair tissue were more common in group 1. However, these parameters did not significantly differ between groups ( P = .257 and .242, respectively). Conclusion: Arthroscopic MF plus chitosan glycerol phosphate/blood implant did not result in better clinical and MRI outcomes compared with MF alone in the treatment of OCLTs. Level of Evidence: Level III, retrospective comparative study.
Corneal graft surgery: A monocentric long-term analysis
Authors: Montesel Andrea , Alió del Barrio Jorge L , Yébana Rubio Pilar , Alió Jorge L 
Published: August 2020

Purpose: To investigate indications, outcomes and changes in clinical patterns of keratoplasty surgery in a Spanish tertiary eye center. Setting: Vissum Instituto Oftalmológico, Alicante, Spain. Methods: A retrospective review was performed on clinical records of patients that underwent any kind of corneal transplant from 2001 to 2017 in the study center. Inclusion criteria involved the presence of detailed preoperative examination, surgical report and at least 12 months follow-up after the surgery. A statistical analysis was performed on the indications for keratoplasty, survival rates, type of graft failures, and visual outcomes. Results: A total of 907 keratoplasties procedures were identified. About 432 penetrating keratoplasty (PK), 148 deep anterior lamellar keratoplasty (DALK), and 134 endothelial keratoplasty (EK) met the inclusion criteria. Cumulative survival rate ranged from 94% to 69% in a 1-year period and from 85% to 45% in a 5-years period according to the different graft types. The main cause for failure was immunological rejection for PK, surface diseases for DALK and primary graft failure for EK. Postoperative visual function improved for all the surgical techniques. Conclusion: Corneal transplant is a challenging surgery still complicated by a relevant risk of failure. Our study offers a useful opinion of the current trends on keratoplasty in our country, where the outcomes of the grafts differ considerably in relation to the indications and the different surgical techniques, with lamellar procedures that showed higher rates of success and better visual outcomes than full-thickness grafts.
SD-OCT parameters and visual field defect in chiasmal compression and the diagnostic value of neural network model
Authors: Jeon Hyeshin , Park Keun-hyung , Kim Huikyung , Choi Heeyoung 
Published: August 2020

Purpose: To evaluate the peripapillary retinal nerve fiber layer (RNFL) and macular ganglion cell-inner plexiform layer (GCIPL) measurements using spectral domain optical coherence tomography (SD-OCT) in patients with chiasmal compression and analyze the diagnostic value of a neural network model. Methods: Forty-seven patients with chiasmal compressive disorder were recruited and divided into two groups depending on the visual field defect (perimetric; group 1 and preperimetric; group 2). Fifty-seven normal subjects were also recruited (group 3). Peripapillary RNFL and macular GCIPL were analyzed in each group. A multilayer perceptron was trained using a training dataset and derived a neural network model. The diagnostic performances were compared using the area under the receiver operating curve (AUROC) between each parameters and neural network model. Results: All macular GCIPL parameters, except inferotemporal GCIPL thickness, were thinner in group 1 than in group 2 and group 3, with barely any difference between group 2 and group 3 parameter values. The diagnostic power of the neural network model, minimum GCIPL, and inferonasal GCIPL were superior when compared with other parameters; the diagnostic values of these three parameters are not significantly different in discriminating the patients and normal control. However, the neural network exhibited the best diagnostic power in distinguishing group 2 and group 3. Conclusion: Macular GCIPL was reduced in chiasmal compression patients with visual field defect which was not evident in the preperimetric state. Neural network model showed superior diagnostic value in discriminating the preperimetric patients from normal control. The results suggest that neural networks may be helpful in the early diagnosis of chiasmal compression.