bluuebunny/crossref_metadata_2025_split huggingface dataset:
Time to Positivity of Neonatal Blood Cultures for Early-onset Sepsis
Authors: Kuzniewicz Michael W. , Mukhopadhyay Sagori , Li Sherian , Walsh Eileen M. , Puopolo Karen M. 
Published: May 2020

Background:
In newborns at risk for early-onset sepsis, empiric antibiotics are often initiated while awaiting the results of blood cultures. The duration of empiric therapy can be guided by the time to positivity (TTP) of blood cultures. The objective of the study was to determine the TTP of neonatal blood cultures for early-onset sepsis and the factors which may impact TTP.

Methods:
Observational study of blood cultures growing pathogenic species obtained within 72 hours of birth from infants born at 23–42 weeks gestation, at 19 hospitals in Northern California, Boston, and Philadelphia. TTP was defined as the time from blood culture collection to the time organism growth was reported by the microbiology laboratory.

Results:
A total of 594 blood cultures growing pathogenic bacteria were identified. Group B Streptococcus and Escherichia coli accounted for 74% of blood culture isolates. Median TTP was 21.0 hours (interquartile range, 17.1–25.3 hours). Blood cultures were identified as positive by 24 hours after they were obtained in 68% of cases; by 36 hours in 94% of cases; and by 48 hours in 97% of cases. Neither the administration of maternal intrapartum antibiotic prophylaxis, gestational age <35 weeks, nor blood culture system impacted median TTP.

Conclusions:
Pathogens are isolated by 36 hours after blood culture collection in 94% of neonatal early blood cultures, regardless of maternal antibiotic administration. TTP information can inform decisions regarding the duration of empiric neonatal antibiotic therapies.
Nonspecific Symptoms in Children Referred to a Lyme Borreliosis Center
Authors: Zomer Tizza P. , Bruinsma Reitze A. , Vermeeren Yolande M. , Landman Gijs W. , van Hees Babette C. , van Bemmel Thomas , van Kooten Barend 
Published: May 2020

Background:
Nonspecific symptoms in children suspected of Lyme borreliosis (LB) are challenging for clinicians. We assessed whether nonspecific symptoms are more prevalent among children with positive immunoglobulin G (IgG) serology or a history of clinical LB.

Methods:
We included children (<18 years) suspected of LB who visited the Lyme Center Apeldoorn of Gelre Hospital between 2008 and 2017. Serum samples were taken, and questionnaires on nonspecific symptoms completed. Clinical data were collected from patients’ medical records. The prevalence of nonspecific symptoms was compared between patients with positive versus negative IgG serology and between patients with versus without previous LB with the χ2 and Fisher exact tests with Bonferroni correction. A history of LB was anamnestically determined. Patients with active Lyme manifestations were excluded.

Results:
Included were 149 children (66% female; median age 13 years); 29 (19%) had positive IgG serology; 36 (24%) had previous LB; 12 (8%) had both. Common nonspecific symptoms were sleep disturbances (58%), severe fatigue (57%) and headache (42%). The prevalence of nonspecific symptoms was similar in children with positive versus negative IgG serology. None of the nonspecific symptoms occurred more frequently in children with previous LB compared with children without. More prevalent in children without previous LB were sleep disturbances (40 vs. 66%; P = 0.002) and tingling (6 vs. 34%; P < 0.001).

Conclusions:
Nonspecific symptoms were not more prevalent in children with positive IgG serology nor in children with previous LB, where some were significantly less prevalent. Hence, questionnaires on nonspecific symptoms cannot be used to identify children for serologic testing in Lyme centers.
Cost-analysis of Withdrawing Immunoprophylaxis for Respiratory Syncytial Virus in Infants Born at 33–35 Weeks Gestational Age in Quebec
Authors: Papenburg Jesse , Saleem Mahwesh , Teselink Johannes , Li Abby , Caouette Georges , Massé Édith , Lanctôt Krista L. 
Published: May 2020

Background:
In 2015, the Quebec Ministry of Health limited palivizumab prophylaxis for respiratory syncytial virus (RSV) in premature infants to those born at <33 weeks gestational age (wGA), unless other indications were present. We compared RSV-related costs for 2 seasons before the change (2013–2014, 2014–2015) and 2 seasons after (2015–2016, 2016–2017) in premature infants 33–35 wGA.

Methods:
Using payer and societal perspectives, costs associated with hospitalizations for RSV and lower respiratory tract infection (LRTI) in infants born at 33–35 wGA were estimated. Inputs were from a 2013–2017 retrospective cohort study in 25 Quebec hospitals of RSV/LRTI hospitalizations among infants <6 months old at the start of, or born during, the RSV season. Resource utilization data (hospital stay, procedures, visits, transportation, out-of-pocket expenses and work productivity) were collected from charts and parent interviews allowing estimation of direct and indirect costs. Costs, including palivizumab administration, were derived from provincial sources and adjusted to 2018 Canadian dollars. Costs were modeled for preterm infants hospitalized for RSV/LRTI pre- and postrevision of guidelines and with matched term infants hospitalized for RSV/LRTI during 2015–2017 (comparator).

Results:
Average total direct and indirect costs for 33–35 wGA infants were higher postrevision of guidelines ($29,208/patient, 2015–2017; n = 130) compared with prerevision ($16,976/patient, 2013–2015; n = 105). Total costs were higher in preterm infants compared with term infants (n = 234) postrevision of guidelines ($29,208/patient vs. $10,291/patient).

Conclusions:
Immunoprophylaxis for RSV in infants born at 33–35 wGA held a cost advantage for hospitalizations due to RSV/LRTI.
Change of Eyelid Parameters in Patients With Marin-Amat Syndrome
Authors: Chao Yu-Jang , Tsai Chieh-Chih , Huang Yu-Yun , Lin Che-Yu , Yu Wei-Kuang , Kau Hui-Chuan , Liu Catherine Jui-Ling 
Published: May 2020

Purpose:
Marin-Amat syndrome is an acquired facial synkinesis manifesting as involuntary eyelid closure on jaw movement. The authors investigate the clinical features, especially the quantitative changes in eyelid parameters of patients with Marin-Amat syndrome.

Methods:
Patients with Marin-Amat syndrome between 2015 and 2017 in a medical center were collected. Clinical features and the change of eyelid parameters, including margin reflex distance 1 (MRD-1), margin reflex distance 2 (MRD-2), and palpebral fissure height, were evaluated.

Results:
There were 5 men and 3 women with a mean age of 76 years. All had a history of facial palsy. The mean time to onset of Marin-Amat syndrome was 4.4 years after facial palsy. Seven patients (87.5%) developed subsequent ipsilateral facial spasm after facial palsy. Most patient complaints were ptosis (62.5%) and ptosis on eating (37.5%). The mean palpebral fissure height of involved eyes decreased from 5.88 to 2 mm on jaw opening (p = 0.011), which resulted from decrease in MRD-1 (from 2.06 to 0.06 mm, p = 0.012) and MRD-2 (from 3.81 to 1.94 mm; p = 0.012). Botulinum toxin A (Botox) injection into the periorbital orbicularis muscle in 6 patients significantly relieved the change of palpebral fissure height on jaw opening compared with that before injection (9.9% vs. 68.6 %, p = 0.027).

Conclusions:
Most patients with Marin-Amat syndrome present with ptosis and might be overlooked or underestimated. The reduction in palpebral fissure height in our patients with Marin-Amat syndrome was due to involuntary orbicularis oculi muscle contraction, resulting in decrease of both the MRD-1 and MRD-2 on jaw opening.
Imbalance of proresolving lipid mediators in persistent allodynia dissociated from signs of clinical arthritis
Authors: Allen Benjamin L. , Montague-Cardoso Karli , Simeoli Raffaele , Colas Romain A. , Oggero Silvia , Vilar Bruno , McNaughton Peter A. , Dalli Jesmond , Perretti Mauro , Sher Emanuele , Malcangio Marzia 
Published: May 2020

Abstract
Rheumatoid arthritis-associated pain is poorly managed, often persisting when joint inflammation is pharmacologically controlled. Comparably, in the mouse K/BxN serum-transfer model of inflammatory arthritis, hind paw nociceptive hypersensitivity occurs with ankle joint swelling (5 days after immunisation) persisting after swelling has resolved (25 days after immunisation). In this study, lipid mediator (LM) profiling of lumbar dorsal root ganglia (DRG), the site of sensory neuron cell bodies innervating the ankle joints, 5 days and 25 days after serum transfer demonstrated a shift in specialised proresolving LM profiles. Persistent nociception without joint swelling was associated with low concentrations of the specialised proresolving LM Maresin 1 (MaR1) and high macrophage numbers in DRG. MaR1 application to cultured DRG neurons inhibited both capsaicin-induced increase of intracellular calcium ions and release of calcitonin gene-related peptide in a dose-dependent manner. Furthermore, in peritoneal macrophages challenged with lipopolysaccharide, MaR1 reduced proinflammatory cytokine expression. Systemic MaR1 administration caused sustained reversal of nociceptive hypersensitivity and reduced inflammatory macrophage numbers in DRG. Unlike gabapentin, which was used as positive control, systemic MaR1 did not display acute antihyperalgesic action. Therefore, these data suggest that MaR1 effects observed after K/BxN serum transfer relate to modulation of macrophage recruitment, more likely than to direct actions on sensory neurons. Our study highlights that, in DRG, aberrant proresolution mechanisms play a key role in arthritis joint pain dissociated from joint swelling, opening novel approaches for rheumatoid arthritis pain treatment.
Illness Perception After Heart Valve Surgery
Authors: Hansen Malene Haugaard , Primdahl Jette , Riber Lars , Ekholm Ola , Kristensen Katrine Lawaetz , Thrysoee Lars , Thorup Charlotte Brun , Mols Rikke , Christensen Anne Vinggaard , Rasmussen Trine Bernholdt , Berg Selina Kikkenborg , Borregaard Britt 
Published: May 2020

Background
Illness perception is composed of thoughts, ideas, and beliefs about illness, and a negative illness perception is known to be associated with poor outcomes. Among men and women, clinical outcomes after heart valve surgery are known to differ, but knowledge about differences in illness perception is sparse.

Objectives
The aim of this study is to describe the differences in illness perception among men and women after open heart valve surgery and to identify sociodemographic and clinical characteristics associated with worse illness perception in men and women.

Methods
In a national cross-sectional study combined with register-based clinical and sociodemographic information, data on illness perception were collected with the Brief Illness Perception Questionnaire.
Worse illness perception was defined as the worst quartile of each item of the Brief Illness Perception Questionnaire. Multiple logistic regression analyses were conducted to explore characteristics associated with worse illness perception.

Results
Of 1084 eligible patients, 32% (n = 349) completed the questionnaire (67% men; mean age, 68 years). Compared with men, women reported significantly worse scores of illness perception in 6 of 8 items. Furthermore, being female, age, length of stay, and comorbidity were associated with worse illness perception (worse quartile of scores). Age, higher educational level, and comorbidity were found to be associated with worse illness perception for men and length of stay for women.

Conclusion
After open heart valve surgery, illness perception differs among men and women, with women having worse illness perception. Among the total population, being female, age, a longer length of stay, and comorbidity were also associated with worse illness perception.
Effects of Auricular Acupressure in Patients on Hemodialysis
Authors: JUNG Eun Sook , CHANG Ae Kyung 
Published: May 2020

ABSTRACT

Background
Although studies on the effectiveness of self-management in limiting fluid intake in patients on hemodialysis have been conducted extensively, xerostomia, which is a powerful stimulus of fluid intake, has received scarce attention.

Purpose
The purpose of this study was to examine the effects of a 4-week auricular acupressure treatment on xerostomia, salivary flow rate, interdialytic weight gain, constipation, and diet-related quality of life in patients on hemodialysis in Korea.

Methods
This was a randomized controlled trial. Sixty patients on hemodialysis were randomly assigned to either the experimental group (n = 30) or the control group (n = 30). The experimental group received an auricular acupressure intervention, which included the application of skin tape with a Semen vaccariae seed on the five auricular acupoints, including the large intestine (CO7), San Jiao (CO17), middle triangular fossa (TF3), spleen (CO13), and upper tragus (TG1), for 4 weeks. The control group received only the application of skin tape without a seed on the same auricular acupoints for the same period. The outcome variables were as follows: xerostomia, measured using the visual analog scale; salivary flow rate, measured using the unstimulated whole saliva absorbed in oral cotton; interdialytic weight gain; the constipation assessment scale score; and the Quality of Life Related to Dietary Change Questionnaire results.

Results
The experimental group scored significantly better than the control group in terms of xerostomia (p = .004), salivary flow rate (p = .010), constipation (p = .009), and diet-related quality of life (p < .001).

Conclusions/Implications for Practice
Auricular acupressure may be an important tool for alleviating the negative symptoms of xerostomia and for improving quality of life in patients on hemodialysis. Nurses caring for patients on hemodialysis with both xerostomia and constipation may teach auricular acupressure to help patients self-manage their discomfort.
Variations in follow-up after atrial fibrillation ablation
Authors: Wood Kathryn A. , Barnes Angel H. 
Published: May 2020

ABSTRACT

Background:
A multidisciplinary patient-centered approach using evidence-based care is recommended in recent atrial fibrillation (AF) guidelines to achieve quality patient outcomes. Professional society guidelines are conflicting and vague in recommendations on timing of follow-up after AF ablation.

Purpose:
The aim of this secondary analysis was to examine whether the type and timing of follow-up care after AF ablation affected patient outcomes.

Methods:
A 2-year, longitudinal, pilot study to explore patient experiences during the first 6 months following an AF ablation was conducted. Patients completed surveys and phone interviews before ablation, and at 1, 3, and 6 months after the ablation. Pearson correlations and repeated-measures analysis of variance were used for comparison of outcomes over time.

Results:
The sample (N = 20) had a mean age of 65 (± 7) years, was 55% female, 35% paroxysmal AF, and 65% persistent AF pre-ablation. Timing of follow-up visits following AF ablation varied widely. Patients reported many concerns and difficulties reflecting the lack of knowledge and unrealistic expectations of post-ablation recovery. Better outcomes were noted in those who were seen at 1-week post-ablation by a nurse practitioner (NP) compared with those who were not seen until 1 or 3 months after ablation by a physician.

Implications for practice:
Atrial fibrillation ablation is routinely performed in the United States, yet there seems to be a lack of standardization concerning the type and timing of follow-up care after AF ablation. These preliminary findings support a standardized approach to include an NP visit at one week after AF ablation to achieve quality AF patient outcomes.
Diagnostic accuracy of strain imaging in predicting myocardial viability after an ST-elevation myocardial infarction
Authors: Mghaieth Zghal Fathia , Boudiche Selim , Haboubi Sofiane , Neji Henda , Ben Halima Manel , Rekik Bassem , Mechri Mehdi , Ouali Sana , Hantous Saoussen , Mourali Mohamed Sami 
Published: May 2020

Abstract
In the acute phase of ST-elevation myocardial infarction (STEMI) viability imaging techniques are not validated and/or not available.
This study aimed to evaluate the ability of strain parameters assessed in the acute phase of STEMI, to predict myocardial viability after revascularization.
Thirty-one STEMI patients whose culprit coronary artery was recanalized and in whom baseline echocardiogram showed an akinesia in the infarcted area, were prospectively included. Bidimensional left ventricular global longitudinal strain (GLS), and territorial longitudinal strain (TLS) in the territory of the infarct related artery were obtained within 24 hours from admission. Delayed enhancement (DE) cardiac magnetic resonance imaging (CMR) was used as a reference test to assess post-revascularization myocardial viability. DE-CMR was performed 3 months after percutaneous coronary intervention. According to myocardial viability, patients were divided into 2 groups; CMR viable myocardium patients with more than half of infarcted segments having a DE <50% (group V) and CMR nonviable myocardium patients with half or more of the infarcted segments having a DE >50% (group NV).
GLS and TLS were lower in group V compared to group NV (respectively: −14.4% ± 2.9% vs −10.9% ± 2.4%, P = .002 and −11.0 ± 4.1 vs −3.2 ± 3.1, P = .001). GLS was correlated with DE-CMR (r = 0.54, P = .002) and a cut off value of −13.9% for GLS predicted viability with 86% sensitivity (Se) and 78% specificity (Sp). TLS showed the strongest correlation with DE-CMR (r = 0.69, P < .001). A cut off value of −9.4% for TLS yielded a Se of 78% and a Sp of 95% to predict myocardial viability.
GLS and TLS measured in the acute phase of STEMI predicted myocardial viability assessed by 3 months DE-CMR. They are prognostic indicators and they can be used to guide the priority and usefulness of percutaneous coronary intervention in these patients.
Extracorporeal shock wave therapy versus corticosteroid injection for chronic plantar fasciitis
Authors: Zhao Jie , Luo Wen Ming , Li Tingting 
Published: May 2020

Abstract

Background:
The outcomes of corticosteroid injection (CSI) and extracorporeal shock wave therapy (ESWT) as primary treatment of plantar fasciitis have been debated. This study was conducted to compare and evaluate the therapeutic effects of ultrasound-guided CSI versus medium frequency ESWT in the treatment of plantar fasciitis among Chinese population.

Methods:
This study was a single-center, randomized, and double-blinded trial. The study protocol was approved by local ethics committee board and subsequently registered in Research Registry. Eighty patients with unilateral plantar fasciitis were randomized to receive either ESWT (3 times once per week) (n = 40) or CSI treatment (a single 1-mL dose of betamethasone sodium plus 0.5 mL of prilocaine under ultrasound guidance by injection into the plantar fascia) (n = 40). The primary outcome measures were visual analog scale and Foot Function Index scores. Secondary outcome measures included the heel tenderness index score and plantar fascia thickness as obtained by ultrasound examination. All of the assessments were performed at baseline and 1, 3, and 6 months after treatment.

Results:
This is a randomized controlled trial evaluating the efficacy of CSI versus ESWT in the treatment of plantar fasciitis. This study has limited inclusion and exclusion criteria and a well-controlled intervention.

Conclusions:
The results of this trial will provide more evidence on which method can better treat plantar fasciitis.

Trial registration:
This study protocol was registered in Research Registry (researchregistry5428).
Comparison between ticagrelor versus clopidogrel in long term outcomes of Taiwanese diabetic subjects with acute coronary syndrome undergoing successful revascularization
Authors: Wang Cheng-An , Hsieh Yi-Chen , Huang Chun-Yao , Liu Ju-Chi , Hsieh Ming-Hsiung , Lin Yung-Kuo , Yeh Jong-Shiuan 
Published: May 2020

AbstractAlthough previous clinical trials demonstrated that ticagrelor could reduce cardiovascular events and mortality versus clopidogrel in patients with acute coronary syndrome (ACS), the real-world evidence of its clinical impacts on East Asian Diabetic population has rarely been investigated.Between November 2013 and June 2015, 1534 patients were recruited into the Acute Coronary Syndrome-Diabetes Mellitus Registry of the Taiwan Society of Cardiology (TSOC ACS-DM registry). After propensity score matching, a total of 730 patients undergoing successful revascularization and discharged on ticagrelor (N = 365) or clopidogrel (N = 365) were analyzed. The primary and secondary endpoints were all-cause mortality and re-hospitalization, respectively. The all-cause death associated with ticagrelor vs clopidogrel was 3.6% vs 7.4% (adjusted hazard ratio (HR) 0.34 [0.15–0.80];P = .0138) at 24 months. The re-hospitalization rate at 24 months was 38.9% vs 39.2% (P = .3258).For diabetic patients with ACS, ticagrelor provided better survival benefit than clopidogrel without an increase of re-hospitalization in 24 months after successful percutaneous coronary intervention. This study in real-world circumstance provided valuable complementary data to externally validate platelet inhibition and patient outcomes (PLATO) finding especially in Asian diabetic population.
Clinical characteristics of Kawasaki disease complicated with Mycoplasma pneumoniae pneumonia
Authors: Lan Yinle , Li Shuxian , Yang Dehua , Zhou Junfen , Wang Yingshuo , Wang Jianhua , Xu Yingchun , Chen Zhimin 
Published: May 2020

Abstract
This study aimed to investigate the inner linkage and mechanism of Mycoplasma pneumoniae (MP) infection and Kawasaki disease (KD), as well as the risk factors of outcome in this cohort of patients.
A retrospective study was performed in 210 patients diagnosed with KD complicated with community acquired pneumonia (CAP) in Children's Hospital, Zhejiang University School of Medicine from January 2014 to December 2017. They were divided into two groups based on MP infection: MP infection group (n = 97) and non-MP infection group (n = 113). We compared the variables of these two groups based on medical records.
The MP infection group had higher ESR than the non-MP infection group. During hospitalization, the non-MP infection group had higher levels of WBC during hospital, LDH, PCT, and lower HB when compared to the MP infection group. No differences were found in the hs-CRP level, N%, PLT, ALT, CKMB, and cytokine levels (IL-2, IL-4, IL-6, IL-10, TNF-α, and IFN-γ) between MP and non-MP infection group. Likewise, no difference was found in fever duration or hospital stays between them. Totally 19 patients in the infection group had CAA with a rate of 19.59%; and 27 (23.89%) patients had CAA in the non-MP infection group. Unfortunately, no difference was found in CAA rate between the two groups.
MP infection may occur simultaneously in children with Kawasaki disease. KD patients with MP infection tended to occur in older population. MP infection may not increase the risk of CAA, which still needs further large-scaled studies to confirm. Clinicians should be alert to KD patients with high level of ESR. MP should be screened and early treatment with macrolides should be given timely.