bluuebunny/crossref_metadata_2025_split huggingface dataset:
The relationship between presystolic wave and nondipper hypertension
Authors: Kahyaoglu Muzaffer , Bayam Emrah , Gunay Nuran , Gecmen Cetin , Candan Ozkan , Yilmaz Yusuf , Guner Ahmet , Celik Mehmet , Cakmak Ender Ozgun , Uyan Cihangir 
Published: January 2020

Background
A presystolic wave (PSW) is commonly seen on Doppler examination of the left ventricular outflow tract (LVOT), and the possible mechanism for PSW is considered to be left ventricular stiffness and impaired LV compliance. We aimed to compare the relationship between PSW and dipper, nondipper hypertension.

Patients and methods
A total of 83 patients were included in the study. The participating patients were divided into two groups as 42 patients with dipper hypertension and 41 patients with nondipper hypertension based on the results of ambulatory blood pressure monitoring.

Results
Left ventricular mass index (91.6 ± 12.9 vs. 106.1 ± 7.9, P < 0.001) and E/Em (7.4 [6.6–8.3] vs. 10 [8–12], P < 0.001) were significantly higher, and Em (9.9 ± 2.7 vs. 7.9 ± 3.4, P = 0.004) was significantly lower in the nondipper group compared with dipper group. And also, the PSW was found to be higher in the nondipper group. The nondipper group had markedly increased frequencies of PSW compared with the dipper group (68 vs. 38%, respectively, P = 0.008). In the multivariate logistic regression test, E/Em [odds ratio (OR) 1.464, 95% confidence interval (CI): 1.113–1.926, P = 0.006] and the presence of PSW (OR 3.115, 95% CI: 1.061–9.143, P = 0.039) were determined as independent predictive parameters for nondipper hypertension.

Conclusion
The presence of PSW on transthoracic echocardiography suggests that we may come across nondipper hypertension and a high risk of end-organ damage. PSW may be used as a useful parameter in risk stratification in hypertensive patients.
Use of feedback on medium-term blood pressure measurement skills in medical students: a randomized controlled trial
Authors: Bastos e Castro Margareth Alves , Lucchetti Alessandra Lamas Granero , Tibiriçá Sandra Helena Cerrato , da Silva Ezequiel Oscarina , Lucchetti Giancarlo 
Published: January 2020

Background
The objective of this study was to assess the effect of feedback on medium-term blood pressure (BP) measurement skills in medical students versus a control group.

Methods
A randomized controlled trial in first-year medical students was conducted. After theoretical-practical training on measuring BP, the students were randomized into a control group or intervention group. The skill was assessed immediately after the training (T1) by evaluating students with a simulated standardized patient using a checklist. Students in the intervention group received feedback immediately after assessment, whereas the control group received no feedback. After 3 months (T2), each student was reassessed in the same way as for (T1).

Results
Ninety-two first-year medical students took part in the study (45 in control group and 47 in intervention group). At T1, there were no differences in the skill measured. At T2 (after three months), there was a significant difference in the intervention group (score = 23.97 ± 3.82) compared with the control group (score = 20.91 ± 4.87), P < 0.001, d = 0.69. In the intervention group, the scores were maintained at 3 months (T1 = 23.23 and T2 = 23.97, P = 0.335), whereas in the control group, scores declined significantly (T1 = 23.44 and T2 = 20.91; P = 0.002).

Conclusion
Receiving feedback promotes retention of learning of BP measurement skills over the medium term. Further studies applying feedback to other skills should be conducted.
Clinical comparison study between a newly developed optical-based fractional flow reserve device and the conventional fractional flow reserve device
Authors: Saka Yuki , Tanaka Akihito , Ishii Hideki , Takashima Hiroaki , Suzuki Akihiro , Nakano Yusuke , Sakurai Shinichiro , Ando Hirohiko , Murohara Toyoaki , Amano Tetsuya 
Published: January 2020

Background
Fractional flow reserve (FFR) measurement is the gold standard for identifying the functional severity of coronary artery disease. Although we can use newly developed pressure wires with optical fibers are now available, their safety and accuracy for FFR measurement are not clear. Therefore, we planned a clinical comparison study between pressure wires with optical fibers and the conventional FFR device.

Methods
We prospectively enrolled 51 patients (51 lesions) with intermediate coronary artery stenosis. For these lesions, FFR measurements with pressure wires with optical fibers were compared with those obtained with a conventional wire.

Results
All procedures were successfully completed without any complications. The procedure time with pressure wires with optical fibers and a conventional wire was 6.8 ± 3.0 and 6.9 ± 2.6 minutes (P = 0.89), respectively. There was no significant difference in FFR values between pressure wires with optical fibers and a conventional wire (0.83 ± 0.10 vs. 0.83 ± 0.12, P = 0.66). An excellent correlation was observed between FFR obtained with pressure wires with optical fibers and FFR obtained with a conventional wire (r = 0.81, P < 0.001). The pressure drift before and after FFR measurements was not significantly different between pressure wires with optical fibers and a convention wire (−0.01 ± 0.02 vs. −0.02 ± 0.06, P = 0.42). There was no significant difference in pressure drift defined as >0.03 or <−0.03 between pressure wires with optical fibers and a convention wire (13.7 vs. 17.6%, P = 0.79).

Conclusion
Excellent correlations were observed between FFR values measured using pressure wires with optical fibers and a conventional wire. Furthermore, measurement of FFR with pressure wires with optical fibers was as well tolerated and reliable as that with a conventional wire.
Effectiveness of vitamin D for adult patients with gingivitis
Authors: Feng Yao , Yang Dian-Song , Tang Hai-Bo , Ding Yuan-Sheng , Li Xiao-Guang 
Published: January 2020

Abstract

Background:
This study aims to explore the effectiveness of vitamin D for the management of adult patients with gingivitis.

Methods:
We will perform a comprehensive search from the following electronic databases: Cochrane Library, PUBMED, EMBASE, AMED, CINAHL, WANGFANG, VIP, CBM, and China National Knowledge Infrastructure. All databases will be searched from their inceptions to the present without language limitation. We will also search for unpublished data to avoid missing more potential studies. Two authors will carry out study selection, data extraction, and methodological quality evaluation, respectively. RevMan 5.3 software will be utilized for statistical analysis.

Results:
This study will summarize the up-to-date evidence about the anti-inflammatory effect of vitamin D for the management of adult patients with gingivitis through assessing modified gingival, gingival bleeding indices, inflammatory factors, plaque, quality of life, and any adverse events.

Conclusion:
This study may provide helpful evidence of vitamin D for the management of adult patients with gingivitis for clinical practice.

Systematic review registration:
PROSPERO CRD42019156561.
A case report of pulmonary thromboembolism following allergic bronchopulmonary aspergillosis
Authors: Pan Ying , Xu Feng , Ou-yang Wei 
Published: January 2020

Abstract

Rationale:
Allergic bronchopulmonary aspergillosis (ABPA) complicated with pulmonary thromboembolism (PTE) is rare. This report describes a patient who was diagnosed with ABPA and soon developed PTE.

Patient concerns:
A 64-year-old man was diagnosed with ABPA in hospital for recurrent fever with cough. Two months later, the patient was readmitted to the hospital because of PTE.

Diagnoses:
ABPA was diagnosed during the first hospitalization, and laboratory tests showed an increase in serum IgE and Aspergillus fumigatus-specific IgG. Sputum culture suggested A. fumigatus and high-resolution computed tomography (HRCT) showed inflammation of both lungs and central bronchiectasis. During the second hospitalization, the patient's chest angiography showed PTE.

Interventions:
The patient began treatment with antifungal drugs and corticosteroids, and was discharged from the hospital when his condition improved. Two months after discharge, the patient was treated with anticoagulant drugs due to PTE.

Outcomes:
The patient got better after taking anticoagulant drugs and was discharged from the hospital. The patient appears for regular follow-up visits in our outpatient clinic every 2 months and is currently in good condition.

Lessons:
Patients with ABPA may be concurred with PTE. The risk of PTE in ABPA should be assessed in advance and preventive strategies also need to be taken beforehand. Pulmonary artery examination is necessary once it happened.
Inappropriate antibiotic prescriptions among pediatric inpatients in different type hospitals
Authors: Miao Ruixue , Wan Chaomin , Wang Zhiling , Zhu Yu , Zhao Yun , Zhang Liling , Liu Juan , Qin Jing , Xia Jialing , Yan Huiqiong 
Published: January 2020

Abstract
To investigate the situation of antibiotic consumption and to assess the inappropriate use on pediatric inpatients of different types hospitals in Sichuan, China.
A cross-sectional survey of antibiotic prescriptions among hospitalized children aged 1month -14years were conducted from April 2018 to June 2018 in southwestern China. Antibiotic prescriptions were extracted from electronic records during hospitalization of each inpatient in five different types hospitals.
In this study, the antibiotic prescription rate of hospitalized children was 66.9% (1176/1758). Compared with tertiary children hospital (TC) (46.1%), general hospitals and non-tertiary children hospitals has higher rate of antibiotic prescription (almost 85%) (P
< .001). 93.4% of inpatients received parenteral antibiotic. Overall, the most common antibiotics were Cefoperazone and enzyme inhibitor, Cefixime and Azithromycin. Lower respiratory tract infection (LRTI) was the leading reason for antibiotic consumption in pediatric wards (56.8%), followed by upper respiratory tract infection (URTI) (22.2%). For children with LRTI, Cephalosporins were heavy prescribed, especially broad-spectrum third-generation Cephalosporins (60.3%). The antibiotic prescription proportion of URTI in general hospitals and non-tertiary children hospitals (more than 18%) was higher than TC (8.1%) (P
< .001).
There was inappropriate use of antibiotic in hospitalized children including overuse of parenteral administration, overprescribing of antibiotic on URTI and misuse of third-generation Cephalosporins in pediatric inpatients with LRTI. Compared with tertiary freestanding children hospital, the irrational antibiotic prescription of general hospitals and non-tertiary children hospitals were more serious. Management strategy should be implementer on quality improvement of antibiotic use.
The relationship between low serum magnesium level and intracerebral hemorrhage hematoma expansion
Authors: Zhu Rending , He Xiaolu , Du Yanqun , Chen Nan , Wang Wei , Sun Yue , Sun Jian , Liu Wanjun , Wang Xun , Fang Chuanqin 
Published: January 2020

Abstract

Background:
Hematoma expansion (HE) is related to clinical deterioration and unfavorable prognosis in intracerebral hemorrhage (ICH). Some studies have revealed that low serum magnesium level is associated with larger hematoma volume at admission, HE, and unfavorable outcomes. However, the conclusions remain unsettled. The purpose of this study is to evaluate the association between low serum magnesium level and HE by meta-analysis.

Methods:
We will search the following electronic bibliographic databases: PubMed, Medline, Embase, Web of Science, and The Cochrane Library. Studies will be included if they reported a relationship of low serum magnesium level and HE, mortality or poor outcome.

Results:
The results of this study will be submitted to a peer-reviewed journal for publication.

Conclusion:
This will be the first systematic review and meta-analysis to evaluate the association of HE following ICH with Hypomagnesemia. We look forward to the results will offer scientific proof to predict HE for ICH patients with low serum magnesium level.

PROSPERO registration number:
This protocol has been registered in the PROSPERO network with number: CRD42019135995.
Warfarin prevented de novo portal vein thrombosis after transjugular intrahepatic portosystemic shunt
Authors: Zhang Linhao , Huan Hui , Tong Huan , Wei Bo , Wang Zhidong , Liu Chao , Wu Hao 
Published: January 2020

Abstract
Portal vein thrombosis (PVT) might impair the prognosis of cirrhotic patients. However, formation of de novo PVT after transjugular intrahepatic portosystemic shunt (TIPS) in cirrhotic patients without preexisting PVT was rarely reported. Moreover, it is not known whether warfarin is efficient in preventing de novo PVT after TIPS. The current study aimed to investigate retrospectively the incidence and location of de novo PVT, and preventive effects of warfarin on de novo PVT after TIPS for cirrhotic patients. Patients who received TIPS placement between March 1, 2015 and March 1, 2016 in our hospital were screened retrospectively. Patients without preexisting PVT before TIPS and those who were followed up for at least 12 months were included. There were 2 groups: 1 group received warfarin (warfarin group) post-TIPS, while another group (control group) did not receive prophylactic drug to prevent PVT. Their baseline characteristics and follow-up data were retrieved. The occurrence of PVT, adverse events due to warfarin, difference in stent patency and clinical complications such as stent dysfunction, hepatic encephalopathy, mortality, liver cancer, variceal bleeding, infection, and liver failure, and results of follow-up biochemical examination were compared. Eighty-three patients without preexisting PVT were included. There were 56 patients in the control group and 27 in the warfarin group. The incidence of PVT in the warfarin group was 14.8% (4/27), whereas the incidence in the control group was 42.9% (24/56, P = .013). The location of de novo PVT was mainly at left portal vein. Adverse events due to warfarin was mostly mild, such as hemorrhinia and gingival hemorrhage. No significant difference regarding to stent patency and clinical complications between the 2 groups was found. At 24-month after-TIPS, for the remaining patients in both groups, the total bilirubin was significantly increased while the red blood cell count was significantly decreased in control group compared with those in warfarin group (P < .05). PVT could commonly occur after TIPS in patients without preexisting PVT. Warfarin could prevent PVT in these patients, and might improve patient's liver function.
Dementia screening for elderly in-patients and its association with nursing care satisfaction-an observational study
Authors: Huang Li-Kai , Tsai Jui-Chen , Lee Hsun-Hua , Kuan Yi-Chun , Lee Yao-Tung , Lin Chia-Pei , Chao Shu-Ping , Hu Chaur-Jong 
Published: January 2020

Abstract
Inappropriate care for patients with cognitive dysfunction in the hospital could worsen quality of care and medical service satisfaction.
All elderly participants were recruited from acute wards of 5 departments in an university hospital. They were administered the Chinese version of Ascertain Dementia 8 (AD8) at admission and the Nursing Service Satisfaction Questionnaire before discharge.
A total of 345 participants completed the study. There were 91 (26.4%) participants with AD8 ≥ 2, the cut-off value of high risk of dementia. The prevalence was much higher than prior community-based reports. The Nursing Service Satisfaction Score was significantly lower in AD8 ≥ 2 than in AD8 < 2 (56.99 ± 0.94 vs 60.55 ± 0.48, P < .01).
Using AD8 in hospital-based screening might be more efficient than in the community in terms of cost-effectiveness due to higher positive rate and easier approach to diagnostic facilities. AD8 ≥ 2 is also an indicator to identify care dissatisfaction among inpatients. By identifying patients with cognitive dysfunction, such as its related communication barriers, care systems could be tailored for more friendly services.
En Bloc lumpectomy of T12 vertebra for progressive hepatocellular carcinoma metastases following liver transplantation
Authors: Hu Jin-Gen , Lu Yang , Lin Xiang-Jin 
Published: January 2020

Abstract

Rationale:
Liver transplantation (LT) is the preferred surgical option for the treatment of early hepatocellular carcinoma (HCC). In contrast, surgical treatment of progressive HCC metastasized to the spine following LT constitutes a considerable challenge. Here, we report the first case of progressive HCC metastasized to the T12 vertebra after local radiotherapy, treated successfully with en bloc lumpectomy following LT for HCC.

Patient concerns:
A 40-year-old man who had undergone LT for the treatment of HCC 2 months prior presented to our clinic with symptoms of progressive back pain. Magnetic resonance imagining (MRI) and positron emission tomography (PET) examinations showed a solitary metastasis at T12 without recurrence in the liver or metastasis to other organs.

Diagnoses:
The patient was diagnosed with HCC metastasized to the T12 vertebra after liver transplantation.

Interventions:
Local radiation therapy of the T12 vertebra was performed; however, the lesion continued to grow one month after irradiation. Accordingly, the patient was treated with en bloc lumpectomy of the T12 vertebra. After surgery, the patient reported significant pain relief. At 11 months post-surgery, a C4 metastasis with spinal cord compression was revealed by MRI. Multiple grafted liver metastases were also detected by ultrasound along with several lung metastases, which were discovered by X-ray. The patient was treated with a pedicle screw system and a mesh cage filled with frozen autografts for C4 metastasis.

Outcomes:
The patient died 15 months after liver transplantation due to recurrence in the liver and metastasis to the lung.

Lessons:
En bloc lumpectomy may be a viable therapeutic option for patients with progressive solitary spinal metastases after LT refractory to radiotherapy. Use of immunosuppressive therapy after LT may significantly inhibit immune function, making patients more susceptible to HCC recurrence and bone metastasis.
Challenges in the diagnosis of Boerhaave syndrome
Authors: Tzeng Ching-Hsuane , Chen Wei-Kung , Lu Huei-Chun , Chen Hsin-Hung , Lee Kuan-I , Wu Yung-Shun , Lee Feng-You 
Published: January 2020

Abstract

Rationale:
Acute chest pain remains one of the most challenging complaints of patients presenting to emergency departments (EDs). The diverse etiologies of chest pain frequently lead to diagnostic and therapeutic challenges. Esophageal perforation is a rare but potentially life-threatening disease. It results in delayed diagnosis and an estimated mortality risk of 20% to 40%. Prompt diagnosis and immediate therapeutic interventions are key factors for a good prognosis.

Patient concerns:
Case 1 involved a 66-year-old man who presented to the ED with acute chest pain radiating to the back and hematemesis. Emergent contrast thoracic computerized tomography (CT) indicated the presence of a massive pneumothorax with pleural effusion. The continuous drainage of a dark-red bloody fluid following emergent thoracic intubation led to the discovery that the patient had experienced severe vomiting after whiskey consumption before admission to the hospital. Re-evaluation of the CT indicated spontaneous pneumomediastinum, whereas barium esophagography confirmed the presence of an esophageal perforation. Case 2 involved an 18-year-old Vietnamese man admitted to our ED with acute chest pain and swelling of the neck after vomiting due to beer consumption. A chest x-ray indicated diffuse subcutaneous emphysema of the neck and upper thorax. Contrast CT indicated pneumomediastinum with extensive emphysema and air in the paraspinal region and spinal canal.

Diagnoses:
Both of the 2 cases were diagnosed as spontaneous perforation of the esophagus (Boerhaave syndrome [BS]).

Interventions:
Case 1 received surgical interventions, whereas case 2 decided not to avail our medical services.

Outcomes:
Case 1 was discharged after a good recovery. Case 2 lost to follow-up.

Lessons:
We recommend all physicians in the ED to raise their index of suspicion for BS when dealing with patients having acute chest pain, dyspnea, confirmed pneumothorax, or newly-developed pleural effusion.
Interventions to Enhance Patient and Family Engagement Among Adults With Multiple Chronic Conditions
Authors: Daniel Obinna , Dest Alex , Munson Alexandra , Pulley Deren V. , Sadeghzadeh Claire , Golin Carol , Cené Crystal W. 
Published: January 2020

Purpose:
In the United States, 42% of adults, and 81% of adults over 65 years of age live with multiple chronic condition (MCC). Current interventions to facilitate engagement in care focus primarily on the patient; however, many individuals with MCC manage and live with their conditions within the context of their family. This review sought to identify interventions used to facilitate patient and/or family engagement among adults with MCC.

Methods:
We adhered as closely as possible to PRISMA guidelines and conducted a systematic scoping review using a modified approach by Arksey and O’Malley. We searched PubMed, Web of Science, and Scopus using terms related to MCC, patient and family engagement, and intervention. We included articles that: (1) were published in English; (2) were peer-reviewed; (3) described an engagement intervention (with or without a comparator); and (4) targeted individuals with MCC. We abstracted data from included articles and classified them using the Multidimensional Framework for Patient and Family Engagement in Health and Health Care, and the Classification Model of Patient Engagement.

Results:
We identified 21 discrete interventions. Six (29%) were classified as having the highest degree of engagement. Eighteen (85%) focused on engagement at the direct care level. Only one was specifically designed to engage families.

Conclusions:
Many engagement interventions currently exist for adults with MCC. Few of these interventions foster the highest degree of engagement; most focus on engagement at the level of direct care and do not specifically target family member involvement.
Clinical Decision Support in the Electronic Medical Record to Increase Rates of Influenza Vaccination in a Pediatric Emergency Department
Authors: Buenger Lauren E. , Webber Emily C. 
Published: January 2020

Objectives
Vaccination against influenza has been shown to decrease the morbidity and mortality from the virus; however, rates remain below the Healthy People 2020 target of 70%. The emergency department (ED) provides a unique opportunity to administer influenza vaccines; however, interventions must be efficient to be successful. During the 2014 to 2015 season, an electronic medical record (EMR) intervention was implemented in an effort to increase influenza vaccination rates.

Methods
Using Lean methodology, a multidisciplinary team designed a series of triggers, alerts, and orders in the EMR to address the barriers to adoption and their root causes. The EMR functionality was implemented for the 2014 to 2015 influenza season. Reports on compliance with each EMR step were completed for the 2014 to 2015 and 2015 to 2016 influenza seasons.

Results
In the 2013 to 2014 influenza season, the ED administered 42 doses of the vaccine, representing 0.3% of eligible visits. After implementation of the EMR tool, the ED administered 1320 doses of influenza vaccine. This represents approximately 8.8% of qualified patients based on age group and eventual discharge from the ED. The results were sustained during the 2015 to 2016 influenza season with 1031 doses administered, representing 6% of eligible visits.

Conclusions
The ED influenza vaccination program vaccinated approximately 20 times the number of eligible patients after automated EMR screening and ordering. Using knowledge of a multidisciplinary team, integration into the existing workflow, and visual cues in the EMR, we were able to increase the number of influenza vaccines administered substantially.