bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Total Ankle Arthroplasty and Ankle Arthrodesis in End-Stage Hemophilic Arthropathy
Authors: Ahn Jungtae , Yoo Myung Chul , Seo Jeunghwan , Park Moonsu , Jeong Bi O 
Published: June 2020

Background: Total ankle arthroplasty (TAA) can result in excellent outcomes in patients with end-stage arthritis, but most patients with end-stage hemophilic ankle arthropathy (ESHAA) still undergo ankle arthrodesis (AA). The purpose of this study was to analyze clinical and radiological results of TAA and AA for ESHAA. Methods: A total of 29 cases (16 TAAs and 13 AAs) of painful ESHAA were included. For clinical outcome evaluation, visual analog scale (VAS) for pain, Foot Function Index (FFI), and range of motion (ROM) were analyzed. Postoperative clinical and radiological complications were also analyzed. The mean duration of follow-up was 6.8 ± 3.0 years. The mean age was 44.1 ± 9.9 years. Results: The VAS for pain was significantly improved from 5.5 ± 2.3 to 0.9 ± 1.2 ( P < .001). The FFI scale was significantly improved from 61.6% ± 15.5% to 16.6% ± 15.4% ( P < .001). In FFI disability and activity subscales, the TAA group exhibited meaningful outcomes relative to those of the AA group ( P = .012 and .036, respectively). The total ROM in the TAA group changed from 30.8 ± 12.6 degrees to 37.3 ± 12.8 degrees at final follow-up ( P = .090). Three cases of osteolysis and 1 case of heterotopic ossification were noted in the TAA group. No cases of nonunion were noted in the AA group. Progressive arthrosis of adjacent joints after AA was observed in 1 case. Conclusion: Both TAA and AA in ESHAA exhibited significant improvement in pain based on VAS and FFI scales. Compared to AA, TAA resulted in superior outcomes in FFI disability and activity subscales, suggesting that TAA may be considered as a surgical option alongside AA for ESHAA. Level of Evidence: Level III, retrospective comparative study.
Evaluation of whisker stress in cats
Authors: Slovak Jennifer E , Foster Taylor E 
Published: June 2020

Objectives The aim of this study was to determine if cats fed from a commercially advertised whisker-friendly dish vs their normal food dish would spend more time at the food dish, eat more and drop less food. Methods Forty indoor cats were enrolled in the study. Owners fasted their cats for 12 h and fed them their normal measured amount of dry food in their normal dish. Owners filmed their cats eating for up to 5 mins, and measured how much food was eaten and dropped from the dish. Owners then switched to feeding their cats from a whisker-friendly dish for a 7-day transition period. Following this transition, owners were instructed to fast their cats for 12 h and then feed them their normal food from the new dish and film them eating, as previously described. The following day the owners offered food in both dishes to determine their cat’s preference. Results No evidence was found that eating from the whisker-friendly dish increased the amount of time spent eating ( P = 0.8), decreased the amount of food dropped ( P = 0.9) or increased the amount of food eaten ( P = 0.7). The estimated probability for the cats to prefer the whisker-friendly dish was 0.74 with a 95% confidence interval. Conclusions and relevance Cats fed from a whisker-friendly dish did not spend more time eating, drop less food or eat more food in a 5-min period. Some cats appeared to prefer the new whisker-friendly dish over their normal food dish. Overall, food dish-associated whisker stress did not affect the eating habits of the study cats.
Iris-fixated phakic intraocular lens explantation
Authors: Duignan Emma S , Quigley Clare , Treacy Maxwell P , Aldouri Azher , O’Keefe Michael 
Published: June 2020

Background/aims: To evaluate the visual outcomes and indication for surgery in a series of patients who underwent explantation of a phakic intraocular lens (PIOL). Methods: A retrospective case series of patients who underwent PIOL explantation in our institution was performed. The indication for explantation and visual and refractive outcomes were examined. The method of explantation is described. Results: Twenty-two eyes of 16 patients underwent PIOL explantation with a mean time to explantation of 7 ± 3 years (range 3–11.4). The mean age at explantation was 50.3 ± 9.3 years. Sixteen Artisan PIOLs and six Artiflex PIOLs were explanted. The indications for explanation were cataract development (17/22), endothelial cell loss (4/22) and synechiae formation (1/22). All patients with cataract underwent a combined procedure with explantation and phacoemulsification and the placement of a posterior chamber IOL. Mean corrected vision after explantation was 0.22 ± 0.10 logMAR (range 0.1–0.3 logMAR). One patient with endothelial cell loss required a Descemet’s Stripping Endothelial Keratoplasty (DSEK). Conclusion: Removal of PIOLs was necessitated most frequently by cataract followed by endothelial cell loss. Both explantation alone and explantation with concurrent phacoemulsification are safe procedures with good visual outcomes and will become more frequent in the future as more patients with PIOLs reach cataractous age.
Multiple deep tissue cultures in primary total hip arthroplasty: prognostic value for periprosthetic infection
Authors: Ferro Fernando P , Bessa Felipe S , Miyahara Hélder , Ejnisman Leandro , Vicente Jose RN , Croci Alberto T 
Published: June 2020

Background: The risk of infection after total hip replacement (THR) is significant, with negative impact on quality of life and high costs. Bacteria can contaminate the surgical site despite aseptic techniques; however, there is debate regarding the benefit of identifying bacteria during the primary procedure. Although taking multiple samples for culture is a well-established practice in revision arthroplasty, doing so in primary cases remains controversial. We aimed to investigate whether there is a prognostic value in the culture of samples taken during primary THR, seeking a correlation between the positivity of the cultures and subsequent prosthetic joint infection (PJI). Methods: Deep samples (capsule, femoral and acetabular bone) were collected from 426 patients undergoing elective primary THR. Follow-up was at least 3 years. Microbiological profiles of cultures were analysed. Patient data were reviewed for the identification of risk factors presumably associated with a higher risk of PJI. Results: 54 surgeries (12.6%) had positive cultures. 16 cases (3.8%) developed infection, of which 5 had a positive culture in the primary surgery. Infection rate was 9.3% in patients with positive culture and 3% in those with negative culture ( p < 0.05), with an odds ratio of 3.34 (95% CI, 1.09–10.24). Patients with previous hip surgery had an infection rate of 8.5%, compared to 2.9% in patients with no previous surgery ( p < 0.05). Conclusions: Routinely harvesting microbiologic samples in primary THR is not justified, as it has no consequence in clinical decision for most patients. It might be recommended in selected cases that are suspected to be at high risk for infection, especially previously operated patients (conversion arthroplasty).
The Effect of Nail Lacquer on Taxane-Induced Nail Changes in Women With Breast Cancer
Authors: Alshari Osama , Aleshawi Abdelwahab , Al Sharie Ahmed H , Msameh Ala’a , Al-Omari Isra , Msameh Renad , Almegdadi Abdallah , Albals Dima 
Published: June 2020

Objective: Taxane-induced nail changes are considered as an important cosmetic manifestation with an incidence that reaches up to 44% of patients treated with taxane-included therapeutic regimens. In this article, we represent a clinical observational study to evaluate the effect of cosmetic nail lacquer on taxane-induced nail changes in female patients diagnosed with breast cancer. Methods: Prospectively, we identified those women who were diagnosed with breast cancer, scheduled to have AC-Taxol protocol. Any female with previous dermatological or systemic disorders that affect nails was excluded from the study. Patients were categorized into 2 groups based on the utilization of nail lacquer. The first group includes women who started to use the nail lacquer after development of nail changes. The second group comprises those women who did not use the nail lacquer at any occasion. Results: A total of 59 female patients were included in the study; 46 (78%) of them developed nail changes and the main change was nail discoloration. The first group which has used nail lacquer (17, 28.8%) showed an improvement among 15 (78.9%) patients, whereas 2 (7.4%) of them continued to have worsening symptoms. On the contrary, most of the second group (25, 92.9%) did not show any improvement in nail changes. A statistical significance between the tested groups was observed ( P = .000). There is no statistical association between the progression of nail changes and the age of patients. Conclusions: Taxane-induced nail changes are considered as an important clinical, cosmetic, and psychological complication, especially for female patients with cancer. This article suggests that nail lacquer may have an effect in the improvement of nail changes, especially nail discoloration. Further investigations are recommended to prove the efficacy of nail lacquer.
Comparison of Vancomycin Pharmacokinetics in Cystic Fibrosis Patients Pre and Post-lung Transplant
Authors: White Shannon , Sakon Colleen , Fitzgerald Linda , Kam Charissa , McDade Erin , Wong Alanna 
Published: June 2020

Background: Vancomycin is commonly used to treat acute cystic fibrosis (CF) exacerbations associated with methicillin-resistant Staphylococcus aureus (MRSA). Multiple studies have demonstrated pharmacokinetic differences of antimicrobials in the CF population. Very little data exist regarding pharmacokinetics postlung transplant, but 2 studies have noted changes in tobramycin pharmacokinetics. No such studies exist evaluating vancomycin in CF patients postlung transplant. Methods: A retrospective cohort review of CF patients who underwent lung transplantation and received vancomycin pre- and posttransplant was conducted. CF patients who underwent transplant between 2007 and 2016 at 4 medical centers throughout the United States were included. The primary endpoint was the change in elimination rate constant. The secondary endpoints were subgroup analyses of patients grouped by age, time posttransplant, and number of nephrotoxic medications. Results: A total of 25 patients were included, of which just under half were pediatric. Patients were significantly older and heavier posttransplant and had higher serum creatinine and number of nephrotoxic medications. The change in elimination rate constant from pre- to posttransplant was −0.50 hr−1 which was statistically significant ( P < .001). This significant decrease was consistent among all subgroups of patients evaluated with the exception of pediatric patients. Conclusion: Vancomycin pharmacokinetics are significantly altered in CF patients in the posttransplant setting as evidenced by a decrease in elimination rate constant. This decrease may be related to a decrease in renal clearance and higher numbers of nephrotoxic medications posttransplant. Regardless, pretransplant vancomycin regimens may not predict appropriate posttransplant regimens.
Disability outcomes of early cerebellar and brainstem symptoms in multiple sclerosis
Authors: Le Minh , Malpas Charles , Sharmin Sifat , Horáková Dana , Havrdova Eva , Trojano Maria , Izquierdo Guillermo , Eichau Sara , Ozakbas Serkan , Lugaresi Alessandra , Prat Alexandre , Girard Marc , Duquette Pierre , Larochelle Catherine , Alroughani Raed , Bergamaschi Roberto , Sola Patrizia , Ferraro Diana , Grammond Pierre , Grand’ Maison Francois , Terzi Murat , Boz Cavit , Hupperts Raymond , Butzkueven Helmut , Pucci Eugenio , Granella Franco , Van Pesch Vincent , Soysal Aysun , Yamout Bassem I. , Lechner-Scott Jeannette , Spitaleri Daniele LA , Ampapa Radek , Turkoglu Recai , Iuliano Gerardo , Ramo-Tello Cristina , Sanchez-Menoyo Jose Luis , Sidhom Youssef , Gouider Riadh , Shaygannejad Vahid , Prevost Julie , Altintas Ayse , Fragoso Yara Dadalti , McCombe Pamela Ann , Petersen Thor , Slee Mark , Barnett Michael H , Vucic Steve , Van Der Walt Anneke , Kalincik Tomas 
Published: June 2020

Background: Cerebellar and brainstem symptoms are common in early stages of multiple sclerosis (MS) yet their prognostic values remain unclear. Objective: The aim of this study was to investigate long-term disability outcomes in patients with early cerebellar and brainstem symptoms. Methods: This study used data from MSBase registry. Patients with early cerebellar/brainstem presentations were identified as those with cerebellar/brainstem relapse(s) or functional system score ⩾ 2 in the initial 2 years. Early pyramidal presentation was chosen as a comparator. Andersen-Gill models were used to compare cumulative hazards of (1) disability progression events and (2) relapses between patients with and without early cerebellar/brainstem symptoms. Mixed effect models were used to estimate the associations between early cerebellar/brainstem presentations and expanded disability status scale (EDSS) scores. Results: The study cohort consisted of 10,513 eligible patients, including 2723 and 3915 patients with early cerebellar and brainstem symptoms, respectively. Early cerebellar presentation was associated with greater hazard of progression events (HR = 1.37, p < 0.001) and EDSS (β = 0.16, p < 0.001). Patients with early brainstem symptoms had lower hazard of progression events (HR = 0.89, p = 0.01) and EDSS (β = −0.06, p < 0.001). Neither presentation was associated with changes in relapse risk. Conclusion: Early cerebellar presentation is associated with unfavourable outcomes, while early brainstem presentation is associated with favourable prognosis. These presentations may be used as MS prognostic markers and guide therapeutic approach.
Natural Orifice Transluminal Endoscopic Surgery: Long-Term Experience with Hybrid Transvaginal Cholecystectomies
Authors: Rössler Fabian , Keerl Andreas , Bieri Uwe , Slieker Juliette , Nocito Antonio 
Published: June 2020

Objective. To assess outcome and safety of 571 hybrid natural orifice transluminal endoscopic surgery (NOTES) cholecystectomies. Methods. We retrospectively analyzed all consecutive NOTES cholecystectomies performed at our center between June 2009 and January 2018. All procedures were performed using a hybrid transvaginal technique, including an umbilical small-size trocar. End points, calculated at discharge, 30 and up to 90 days postoperatively, included intra- and postoperative morbidity assessed by the validated Clavien–Dindo classification and the Comprehensive Complication Index (CCI). Special focus was held on outcome and necessity of pre- and postoperative gynecological examinations. Results. We performed 571 hybrid NOTES cholecystectomies within 9 years. The vast majority were elective, 9.6% were emergency cholecystectomies. 6.7% of patients developed at least one complication until discharge, most of them minor (≤grade II). 30- and 90-day complication rates were 10.7% and 11%, respectively. Mean CCI at discharge and postoperative days 30 and 90 was 1.45 (±6.4), 2.3 (±7.7), and 2.4 (±7.8), respectively. Major complications (≥grade IIIa) occurred in 1.6% of patients, and 4 patients required emergency reoperation. No mortality was observed. In 9.8%, an additional abdominal trocar was placed. All patients underwent routine gynecological examination, whereof only 5 were rejected for transvaginal access preoperatively. In no case transvaginal access was discontinued intraoperatively due to gynecological disease. Conclusion. Hybrid NOTES transvaginal cholecystectomy represents a safe and feasible alternative to standard laparoscopic cholecystectomy. Preoperative gynecological examination is no longer routinely necessary, as intraoperative assessment is adequate.
The association of chronic diseases and mammography among Medicare beneficiaries living in Appalachia
Authors: Elewonibi Bilikisu , Nkwonta Chigozie 
Published: June 2020

Objective: This study assessed the relationship between presence and number of chronic disease and reception of mammogram in women 65 years and older, and how this relationship is influenced by primary care provider visits. Methods: A total of 3306 women diagnosed with breast cancer from 2006 to 2008 from cancer registries in four Appalachian states were analyzed. Results: Having a mammogram within the past 2 years was associated with having at least one chronic disease. The presence of a chronic disease was associated with an increased likelihood of breast cancer screening adherence but was not a strong predictor when demographic variables were added. Conclusion: This study supports the findings that women with more primary care provider visits were more likely to adhere to breast cancer screening guidelines but having several chronic diseases presents a barrier to achieving guideline-concordant mammography screening, highlighting the importance of preventive screening for patients managing chronic diseases.
Synthesis, characterization, and antimicrobial activities of novel double-armed benzo-15-crown-5 and their sodium and potassium complexes
Authors: Şener Cemaloğlu Öznur , Ogutcu Hatice , Hayvalı Zeliha 
Published: June 2020

New aldehyde- and halogen- (Cl, Br, I) substituted double-armed benzo-15-crown-5 derivatives are synthesized by the reactions of 4′,5′-bis(bromomethyl)benzo-15-crown-5 with 5-chlorosalicylaldehyde, 5-bromosalicylaldehyde, or 5-iodosalicylaldehyde. The sodium and potassium complexes are obtained by reaction of crown ether with sodium perchlorate and potassium iodide, respectively. Novel Schiff base compounds containing three groups of benzo-15-crown-5 are obtained from the condensation of aldehydes with 4′-aminobenzo-15-crown-5. The structures of all compounds are elucidated by elemental analysis, 1H, 13C NMR, IR, and mass spectra. The antifungal and antibacterial effects of the synthesized ligands are evaluated against pathogenic microorganisms and show varying degrees of inhibitory effects against the growth of different pathogenic strains. Graphical abstract
Real-life experience with high-frequency chest wall oscillation vest therapy in adults with non-cystic fibrosis bronchiectasis
Authors: Barto Tara Lynn , Maselli Diego Jose , Daignault Sarah , Stiglich John , Porter Jared , Kraemer Carlye , Hansen Gary 
Published: June 2020

Background: High frequency chest wall oscillation (HFCWO) has long been used for airway clearance for patients with cystic fibrosis. Only limited research has evaluated this therapy in adult patients with non-cystic fibrosis bronchiectasis (NCFB). Methods: Data from 2596 patients from a registry of adult bronchiectasis patients using HFCWO therapy was used to evaluate hospitalization patterns before and after initiation of HFCWO therapy, as well as antibiotic use and self-reported metrics of quality of life. Self-reported outcomes were also reviewed by cross-checking with sampled patient charts and found to be consistent. Results: The number of patients who had at least one respiratory-related hospitalization decreased from 49.1% (192/391) in the year before to 24.0% (94/391) in the year after starting HFCWO therapy ( p-value < 0.001). At the same time, the number of patients who required three or more hospitalizations dropped from 14.3% (56/391) to 5.6% (22/391). Patients currently taking oral antibiotics for respiratory conditions decreased from 57.7% upon initiation of therapy to 29.9% within 1 year ( p < 0.001). Patients who subjectively rated their “overall respiratory health” as good to excellent increased from 13.6% upon initiation of therapy to 60.5% in 1 year ( p < 0.001) and those who rated their “ability to clear your lungs” as good to excellent increased from 13.9% to 76.6% ( p < 0.001). Conclusion: NCFB patients showed improved self-reported outcomes associated with the initiation of HFCWO therapy as measured by number of hospitalizations, antibiotic use, and the subjective experience of airway clearance. The improvement was observed early on after initiation of therapy and sustained for at least 1 year. The reviews of this paper are available via the supplemental material section.
Building for Change: Comparative Case Study of Hospital Architecture
Authors: Pilosof Nirit Putievsky 
Published: June 2020

Objective: This study assesses how architectural design strategies impact the flexibility of hospitals to change over time. Background: Most hospitals are designed for highly specialized medical functions, which is often in conflict with the need to design the hospital facility to accommodate evolvement and change of functions over time. Architectural design strategies provide different approaches to the need to design for a specific medical program while planning for its future change. Methods: The study compares two hospital buildings with a very similar configuration and medical program but with significantly different architectural design strategies: One was designed for an unknown future medical function, and the second was designed for a specific medical function. The study analyses the two hospital buildings by their design strategy, planning, design process, and construction by phases and compares their change in practice over the last twelve years. Results: The design strategy to fit a specific function limited the hospital affordance to make changes during the design process, construction, and occupancy phases. Systematic design of system separation for an unknown function, in contradiction to a “tailor-made” approach in the design for a specific function, was found to support a variety of changing medical programs. Conclusions: Architectural design strategies developed in an early stage of the design process has a major impact on the future evolution of the hospital facility. The different results between the two projects also demonstrate the greater influence of healthcare policies, hospital organization culture, and infrastructure funding models on the architecture and flexibility of hospitals.
Neurological Outcomes of Patients With Mycotic Aneurysms in Infective Endocarditis
Authors: Shi Hang , Parikh Neal S. , Esenwa Charles , Zampolin Richard , Shah Harsh , Khasiyev Farid , Valenzuela Ives , Lavine Sean , Gutierrez Jose , Willey Joshua 
Published: June 2020

Background and Purpose: Mycotic aneurysms (MA) are rare neurovascular complications of infective endocarditis (IE). The natural history and outcomes of MA under contemporary medical therapy have not been well characterized. The purpose of this study is to describe treatments and outcomes of patients with ruptured and unruptured MA in IE, specifically in relation to medical versus surgical/endovascular treatment. Methods: Retrospective chart review was performed at 3 US academic medical centers of adult patients with IE and MA. Information was collected regarding risk factors, imaging, treatments, and outcomes, including ischemic stroke, intracerebral hemorrhage, MA size changes, and inhospital mortality. Results: Thirty-five patients with IE had 63 MA. Nineteen patients had at least one ruptured MA; 13 patients underwent invasive treatment and 6 received antibiotics alone. Of 19 patients on antibiotics alone (6 with at least one ruptured MA and 13 with unruptured MA), 14 underwent repeat imaging and 5 had enlarging MA. Of 16 patients treated invasively, 2 had unruptured MA initially treated with antibiotics but ultimately underwent intervention. No MA ruptured after aneurysm discovery. Fifteen patients underwent cardiothoracic surgery (CTS), of which 11 had unsecured MA and 4 had secured MA. No patients suffered perioperiative neurological events attributable to their MA. Three patients treated with antibiotics alone and 3 patients treated invasively died from causes unrelated to their MAs. Conclusions: For patients with unruptured MA, treatment with antibiotics alone may have similar outcomes to invasive treatment. Further investigation is warranted to determine the risk of undergoing CTS with unsecured MA.