bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prescribing Patterns of Amantadine During Pediatric Inpatient Rehabilitation After Traumatic Brain Injury: A Multicentered Retrospective Review From the Pediatric Brain Injury Consortium
Authors: McLaughlin Matthew J. , Caliendo Eric , Lowder Ryan , Watson William D. , Kurowski Brad , Baum Katherine T. , Blackwell Laura S. , Koterba Christine H. , Hoskinson Kristen R. , Tlustos Sarah J. , Zimmerman Kanecia O. , Shah Sudhin A. , Suskauer Stacy J. 
Published: July 2021

Objectives:
To describe dosing practices for amantadine hydrochloride and related adverse effects among children and young adults with traumatic brain injury (TBI) admitted to pediatric inpatient rehabilitation units.

Setting:
Eight pediatric acute inpatient rehabilitation units located throughout the United States comprising the Pediatric Brain Injury Consortium.

Participants:
Two-hundred thirty-four children and young adults aged 2 months to 21 years with TBI.

Design:
Retrospective data revie.

Main Outcome Measures:
Demographic variables associated with the use of amantadine, amantadine dose, and reported adverse effects.

Results:
Forty-nine patients (21%) aged 0.9 to 20 years received amantadine during inpatient rehabilitation. Forty-five percent of patients admitted to inpatient rehabilitation with a disorder of consciousness (DoC) were treated with amantadine, while 14% of children admitted with higher levels of functioning received amantadine. Children with DoC who were not treated with amantadine were younger than those with DoC who received amantadine (median 3.0 vs 11.6 years, P = .008). Recorded doses of amantadine ranged from 0.7 to 13.5 mg/kg/d; the highest total daily dose was 400 mg/d. Adverse effects were reported in 8 patients (16%); nausea/abdominal discomfort and agitation were most common, each reported in 3 patients. The highest reported dose without an adverse effect was 10.1 mg/kg/d.

Conclusion:
During pediatric inpatient rehabilitation, amantadine was prescribed to children across a range of ages and injury severity and was most commonly prescribed to older children with DoC. Dosing varied widely, with weight-based dosing for younger/smaller children at both lower and higher doses than what had been previously reported. Prospective studies are needed to characterize the safety and tolerability of higher amantadine doses and optimize amantadine dosing parameters for children with TBI.
The Effect of Written and Video Discharge Instructions After Mild Traumatic Brain Injury on Healthcare Costs and Productivity Costs
Authors: Hoek Amber E. , Geraerds A. J. L. M. , Rood Pleunie P. M. , Joosten Marieke , Dippel Diederik W. J. , van Beeck Ed F. , van den Hengel Leandra , Dijkstra Björn , Papathanasiou Dafni , van Rijssel Daphne , van den Hamer Maaike , Schuit Stephanie C. E. , Burdorf Alex , Haagsma Juanita A. , Polinder Suzanne 
Published: July 2021

Objective:
To compare healthcare and productivity costs between patients with mild traumatic brain injury (mTBI) who received verbal discharge instructions only and patients who received an additional flyer with or without video instructions.

Setting:
Emergency departments (EDs) of 6 hospitals in the Netherlands.

Participants:
In total, 1155 adult patients with mTBI (384 with verbal instructions; 771 with additional flyer with or without video instructions) were included.

Design:
Cost study with comparison between usual care and intervention.

Methods:
Medical and productivity costs up to 3 months after presentation at the ED were compared between mTBI patients with usual care and mTBI patients who received the intervention.

Results:
Mean medical costs per mTBI patient were slightly higher for the verbal instructions–only cohort (€337 vs €315), whereas mean productivity costs were significantly higher for the flyer/video cohort (€1625 vs €899). Higher productivity costs were associated with higher working age, injury severity, and postconcussion symptoms.

Conclusion:
This study showed that the implementation of flyer (and video) discharge instructions for patients with mTBI who present at the ED increased reports of postconcussion symptoms and reduced medical costs, whereas productivity costs were found to be higher for the working population in the first 3 months after the sustained head injury.
The Impact of Night-time Emergency Department Presentation on Upper Gastrointestinal Hemorrhage Outcomes
Authors: Alayo Quazim A. , Oyenuga Abayomi O. , Adejumo Adeyinka C. , Pottathil Vijay , Grewal Damanpreet , Okafor Philip N. 
Published: July 2021

Goals:
The aim was to investigate the impact of night-time emergency department (ED) presentation on outcomes of patients admitted for acute upper gastrointestinal hemorrhage (UGIH).

Background:
The relationship between time of ED presentation and outcomes of gastrointestinal hemorrhage is unclear.

Study:
Using the 2016 and 2017 Florida State Inpatient Databases which provide times of ED arrival, we identified and categorized adults hospitalized for UGIH to daytime (07:00 to 18:59 h) and night-time (19:00 to 06:59 h) based on the time of ED presentation. We matched both groups with propensity scores, and assessed their clinical outcomes including all-cause in-hospital mortality, in-hospital endoscopy utilization, length of stay (LOS), total hospitalization costs, and 30-day all-cause readmission rates.

Results:
Of the identified 38,114 patients with UGIH, 89.4% (n=34,068) had acute nonvariceal hemorrhage (ANVH), while 10.6% (n=4046) had acute variceal hemorrhage (AVH). Compared with daytime patients, ANVH patients admitted at night-time had higher odds of in-hospital mortality (odds ratio: 1.32; 95% confidence interval: 1.06-1.60), lower odds of in-patient endoscopy (odds ratio: 0.83; 95% confidence interval: 0.77-0.90), higher total hospital costs ($9911 vs. $9545, P<0.016), but similar LOS and readmission rates. Night-time AVH patients had a shorter LOS (5.4 vs. 5.8 d, P=0.045) but similar mortality rates, endoscopic utilization, total hospitalization costs, and readmission rates as daytime patients.

Conclusions:
Patients arriving in the ED at night-time with ANVH had worse outcomes (mortality, hospitalization costs, and endoscopy utilization) compared with daytime patients. However, those with AVH had comparable outcomes irrespective of ED arrival time.
Improving Delivery of Care through Standardized Monitoring in Children with Eosinophilic Esophagitis
Authors: Shukla-Udawatta Monica , Russo John , Gunderman Lauren , Pearlstein Haley , Wood Eric , Boyle Brendan , Erwin Elizabeth 
Published: July 2021

Introduction:
Eosinophilic esophagitis (EoE) is a chronic, antigen-driven disorder for which endoscopic monitoring and multidisciplinary care are recommended to achieve histologic remission. The EoE team at our large academic center developed a quality improvement (QI) initiative aimed to reduce variability in monitoring. This QI project focused on completing 3 process metrics within 6 months of diagnosis: (1) outpatient follow-up with a gastroenterologist; (2) referral to an allergist; and (3) Follow-up esophagogastroduodenoscopy (EGD).

Methods:
In January 2015, our QI team developed a registry of newly diagnosed EoE patients and maintained ongoing, weekly tracking of the process measures. Interventions to increase the completion of the process metrics included educational sessions, proactive reminders to providers, and targeted communications with patient families. Missed opportunities were evaluated by more in-depth chart review and categorized as provider- or patient-driven.

Results:
We tracked 6-month process metrics from 2015 through 2018. During this interval, follow-up visit rates in GI improved from 77% to 86%, and the percentage of referrals placed to allergy increased from 65% to 77%. The percentage of patients completing a repeat EGD improved from 33% to 61%. Among patients without a repeated EGD, nearly 70% of those missed opportunities were provider-driven.

Conclusions:
In patients newly diagnosed with EoE, QI interventions, including patient registry development, implementation of a local standard of care, and creating a patient tracking system, improved adherence with national EoE monitoring guidelines.
Rare Brain Metastasis in Parotid Adenoid Cystic Carcinoma Detected on 68Ga-PSMA PET/CT
Authors: Datta Gupta Shreya , Arora Geetanjali , Kumar Deepak , Seith Bhalla Ashu , Sikka Kapil , Shamim Shamim A. 
Published: July 2021

Abstract
We present the case of a 45-year-old woman with known adenoid cystic carcinoma of the right parotid gland, postexcision and postoperative radiation therapy. She was followed up on 18F-FDG PET/CT, which revealed minimal local residual disease and bilateral lung nodules, for which chemotherapy was initiated. Postchemotherapy, 18F-FDG PET/CT showed residual lung metastases. As a part of ongoing project, 68Ga-PSMA PET/CT done revealed additional focal uptake in the right cerebellum, missed on FDG PET/CT. The brain lesion was confirmed upon MRI.
Sentinel Lymph Node Biopsy in Prostate Cancer Using the SENSEI® Drop-In Gamma Probe
Authors: Abascal Junquera Jose Maria , Mestre-Fusco Antoni , Grootendorst Maarten Ruben , Vidal-Sicart Sergi , Fumado Lluis 
Published: July 2021

Abstract
Minimally invasive surgery in the form of laparoscopic and robot-assisted procedures has been widely adopted in the field of prostate cancer. When performing minimally invasive radioguided surgery, conventional rigid laparoscopic gamma probes have limited maneuverability and control due to their form factor, which may hinder detection of radiotracer-avid lesions in anatomically challenging areas. A drop-in gamma probe has been developed to address these limitations. Our group report on the first clinical use of this probe (SENSEI®) as part of an ongoing prospective, international, multicenter clinical trial in primary prostate cancer patients undergoing 99mTc-nanocolloid sentinel lymph node biopsy.
Vesicoureteral Reflux in Nonfunctioning Renal Allograft Incidentally Detected in a Posttransplant 99mTc-DTPA Scan
Authors: Qutbi Mohsen 
Published: July 2021

Abstract
In the present note, a case with rising serum creatinine shortly posttransplantation was referred for 99mTc-DTPA scan. The previous nonfunctioning renal allograft in the left hemipelvis showed no finding during dynamic phase of scan and filling phase of bladder but revealed a high-grade vesicoureteral reflux (VUR) in postvoid image, which can be responsible, partly, for the patient’s present and prior symptoms.
A Striking Case of Perfusion-Metabolism “Flip-Flop” in a Patient With Left Anterior Descending Artery Total Occlusion
Authors: Juweid Malik E. , Doudeen Rahma M. , Alkhawaldeh Khaled 
Published: July 2021

Abstract
A 57-year-old man diagnosed with left anterior descending artery chronic total occlusion underwent rest gated 99mTc-MIBI scan showing moderately to markedly decreased perfusion with abnormal wall motion in the apex, anterior, anteroseptal, and apical anterolateral walls. 18F-FDG PET showed a “flip-flop” phenomenon with markedly increased FDG uptake in the hypoperfused regions and absent/markedly decreased uptake in the normally perfused, normokinetic myocardium, presumably due to the predominant use of free fatty acids under normoxic conditions. After coronary artery bypass grafting, left ventricular motion normalized except for surgery-related paradoxical septal motion and the left ventricular ejection fraction improved from 52% to 68%.
Invasive Fungal Infection in COVID-19–Recovered Patient Detected on 18F-FDG–Labeled Leukocytes PET/CT Scan
Authors: Manda Divya , Sen Ishita , Thakral Parul , Das Subha Shankar , CB Virupakshappa , Malik Dharmender 
Published: July 2021

Abstract
Occurrence of invasive fungal infections has gained significant attention during recent times in patients with COVID-19. Patients with severe form of COVID-19, such as those treated in the intensive care unit with prolonged steroid use, are particularly vulnerable to secondary bacterial and fungal infections. Disseminated systemic mycosis is a life-threatening condition, especially in immunocompromised patients. Here, we report a case of a recovered severe COVID-19 patient, who presented with persistent fever. 18F-FDG–labeled leukocyte scan revealed focal accumulation of radiotracer in the small intestine and right lung lower lobe. Subsequently, performed biopsy revealed mucormycosis.
Barriers and Resources to Cleft Lip and Palate Speech Services Globally: A Descriptive Study
Authors: Baigorri Miriam , Crowley Catherine J. , Sommer Chelsea L. , Moya-Galé Gemma 
Published: July 2021

Background:
Although a number of international cleft organizations and cleft professionals in low- and middle-income countries (LMICs) have built and supported comprehensive cleft care and speech therapy models to address the shortage of speech services in LMICs, the specific speech needs of individuals with cleft lip and palate (CLP) in such countries remain unknown. The objective of this study was to evaluate the barriers to accessing speech services for patients with CLP as well as the resources and models of speech services that are currently available for individuals with CLP in LMICs, with the goal of better understanding the needs of this population.

Methods:
Qualitative and quantitative methods consisted of Smile Train partner surveys that were distributed June 25th to July 31st, 2018 worldwide. Surveys were distributed through Smile Train's online medical database, Smile Train Express, which every Smile Train partner uses to report their Smile Train sponsored treatment outcomes. A total of 658 Smile Train partners responded to the surveys. Respondents included surgeons, speech therapists, orthodontists, administrators and nurses who represented non-governmental organizations, hospitals (private or public), hospital groups, and private clinics.

Results:
Results indicated that lack of resources, including access to local speech providers and language materials, as well as financial constraints such as patient travel and speech treatment costs, are the most commonly reported barriers to accessing speech services across all geographic regions surveyed.

Conclusions:
Improving access to CLP speech services in LMICs may require strategies that address lack of speech providers, language materials, and financial constraints.
Managing Bilateral Oro-Sino-Orbital Fistulae in the Setting of Bilateral Tessier IV Clefts
Authors: Pontell Matthew E. , Barahimi Behin , Golinko Michael S. 
Published: July 2021

Abstract
The number IV orofacial cleft is extremely rare, and reports on long-term outcomes are limited. Here we present the management of a child born with bilateral Tessier number IV clefts and microphthalmia, who developed bilateral oro-sino-orbital fistulae. He presented 8 years after his index procedure with persistent ocular drainage and radiographic evidence of bilateral oro-sino-orbital fistulae. His globes maintained light perception, and in order to protect them from chemical reflux he underwent fistula obliteration with demineralized bone matrix and acellular dermal matrix. His orbits were reconstructed by Imre and conjunctival flaps. In the presence of marginally functioning globes, the importance of timely intervention is critical in order to preserve residual ocular function. Light perception vision assists in the maintenance of circadian rhythm and physiologic functions that are critical to the developing pediatric patient. This case also emphasizes the importance of a multi-disciplinary team in the correction of complex craniofacial deformities.
Alar Rim Triangular Flap for Congenital Nasal Cleft Repair in Pediatric Patients
Authors: Yu Bao-Fu , Wei Shu-Yi , Dai Chuan-Chang , Wei Jiao 
Published: July 2021

Background:
According to Tessier classification, number 1 and number 2 craniofacial clefts involve the nasal ala. Congenital nasal cleft is not common and is difficult for reconstruction. Notches in the medial one-third of either nasal ala are typical manifestations in these patients. Herein, we introduce a alar rim triangular flap, which is indeed a local flap, for the treatment of isolated nasal cleft due to congenital deformities in pediatric patients.

Methods:
The authors conducted a retrospective cohort study including 10 consecutive pediatric patients undergoing this surgery. This alar rim triangular flap including 2 triangles was existing nasal tissue near the cleft. The alar rim defect was covered through local tissue re-arrangement. The authors reviewed the photographs and clinical medical notes of these patients carefully. Self-reported satisfactions of patients (or children's parents) with the scar morphology and correction effect of this procedure were evaluated as well at postoperative every follow-up.

Results:
All the cases were followed up regularly, and the average follow-up time was 22 months (ranged from 13–38 months). All the nasal clefts were reconstructed successfully. The alar rim triangular flap survived with no flap loss. The wound created by this procedure healed primarily. No alar retraction, nasal obstruction or step-off deformities were observed during postoperative follow-up. There were no patients unsatisfied with the outcome of the scar morphology and correction effect of this operation.

Conclusions:
The newly designed alar rim triangular flap in this study can be an alternative treatment for correcting isolated congenital nasal cleft with optimal clinical outcome.

Level of evidence:
Level 4.
Contemporary Review on Craniectomy and Cranioplasty; Part 1: Decompressive Craniectomy
Authors: Hatamleh Muhanad M. 
Published: July 2021

Abstract
This paper aims to review clinical benefits of decompressive craniectomy (DC) in both adult and paediatric populations; its indications and factors contributing to its postoperative success. The Glasgow Outcome Scale and the Modified Rankin Scale are the most commonly used scales to assess the long-term outcome in patients post DC. In adult traumatic brain injury patients, 2 randomized clinical trials were carried out; DECRA (Decompressive Craniectomy in Diffuse Traumatic Brain Injury) and RESCUEicp (Randomised Evaluation of Surgery with Craniectomy for Uncontrollable Elevation of inter cranial pressure) employing collectively 555 patients. Despite the differences in these trials, their initial results affirm DC can lead to reduced mortality and more favorable outcomes. In ischemic stroke adult patients, different clinical trials of HAMLET (Dutch trial of Hemicraniectomy after middle cerebral artery infarction with life-threatening Edema), DESTINY (German trial of Decompressive Surgery for the treatment of Malignant Infarct of the Middle Cerebral Artery), and DECIMAL (French trial of Decompressive Craniectomy in Malignant Middle Cerebral Artery Infarcts) suggested that DC improves survival compared with best medical management, but with an increased proportion of treated individuals surviving with moderate or severe disability. With regard to the size of bone to be removed, the larger the defect the better the results with a minimum diameter of 11 to 12 cm of bone flap. Cranioplasty timing varies and ranges from 6 weeks to more than 12 months post DC, depending on completion of medical treatment, clinical recovery, resolution of any infection, and an evaluation of soft tissues at the defect site.
Dalbavancin in real life: Economic impact of prescription timing in French hospitals
Authors: Béraud Guillaume , Maupetit Jean-Claude , Darras Audric , Vimont Alexandre , Blachier Martin 
Published: July 2021

SynopsisObjectivesThe extended half-life of dalbavancin justifies a once-a-week dosing schedule and is supposed to favour early discharge. These advantages may therefore compensate for the cost of dalbavancin. We aimed to assess the real-life budget impact of dalbavancin through its impact on the length of stay in French hospitals.MethodsA multicentre cohort based on the French registry of dalbavancin use in 2019 was compared to the French national discharge summary database. Lengths of stay and budget impact related to the infection type, the time of introduction of dalbavancin, the type of catheter and patient subgroups were assessed. An early switch was defined when dalbavancin was administered as the first or second treatment and within less than 11 days of hospitalization.ResultsOne hundred seventy-nine patients were identified in the registry, and 154 were included in our study. Dalbavancin is mostly used for bone and joint infections, infective endocarditis and acute bacterial skin and skin structure infections. When compared to the data for similar patients in the national database, the length of stay was almost always shorter for patients treated with dalbavancin. The budget impact for dalbavancin was heterogeneous but frequently generated savings. Early switching was associated with savings (or lesser costs). Patients who required a deep venous catheter and those with the most severe patients benefited the most from dalbavancin.ConclusionsOur study confirms that dalbavancin is associated with early discharge, which can offset its cost and generate savings. The greatest benefit is achieved with an early switch.
SARS-CoV-2 Antibody Response in Patients Undergoing Kidney Transplantation
Authors: Lubetzky Michelle , Sukhu Ashley , Zhao Zhen , Rand Sophie , Sharma Vijay , Sultan Samuel , Kapur Zoe , Albakry Shady , Hauser Nataliya , Marku-Podvorica Jehona , Craig-Schapiro Rebecca , Lee John R. , Salinas Thalia , Aull Meredith , Kapur Sandip , Cushing Melissa , Dadhania Darshana M. 
Published: July 2021

AbstractThe response of the immune system to COVID-19 in end stage kidney disease patients who undergo kidney transplantation has yet to be described. We report data on 72 patients who underwent SARS-CoV-2 antibody testing both before and after kidney transplantation and were followed for a median of 186 days (range 83, 277). Of the 25 patients with a positive antibody test at the time of transplant, 17 (68%) remained positive after transplantation. Patients were significantly more likely to have a persistently positive test if they reported a symptomatic COVID-19 infection prior to transplant (p=0.01). SARS-CoV-2 IgG index values were measured in a subset of kidney transplant recipients and compared to wait -listed dialysis patients. These assays demonstrated a more significant decline in IgG (58% versus 14% p = 0.008) in transplant recipients when compared to dialysis patients tested during the same time period. Additional analysis of the quality of the immune response measuring the binding of SARS-CoV-2 antibodies to the receptor-binding domain (RBD binding), the antibody neutralizing capability, and the antibody avidity demonstrated a more pronounced effect when comparing pre-transplant values to post-induction therapy/post transplant values. The attenuated IgG response seen in transplant patients compared to dialysis patients after induction therapy requires further study. These data have important implications for post-transplant management of vaccinated dialysis patients.