bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influential factors of surgical decompression for ulnar nerve neuropathy in Guyon’s canal
Authors: Huang Chen-Wen , Yin Cheng-Yu , Huang Hui-Kuang , Chen Tung-Ming , Hsueh Kuang-Kai , Yang Chen-Yuan , Huang Yi-Chao , Chang Ming-Chau , Wang Jung-Pan 
Published: July 2021

Background:
Guyon’s canal syndrome is nerve compressive pathology which can lead to sensory and/or motor function deficits. This problem is usually difficult to distinguish from cubital tunnel syndrome and relatively less common than cubital tunnel syndrome. This study evaluated the functional results and patient-reported outcomes following decompression of the ulnar nerve in Guyon’s canal.

Methods:
Patients who were diagnosed with Guyon’s canal syndrome confirmed by electrodiagnostic studies and underwent nerve decompression surgery were included in this study. The functional improvement by examining the Froment’s sign, Wartenberg’s sign, static two-point discrimination, and Semmes Weinstein monofilament examination as physical examination scores was evaluated. The visual analogue scale of satisfaction and the disabilities of the arm, shoulder, and hand questionnaire were used for the postoperative patient-reported outcome evaluation.

Results:
From 2003 to 2019, 38 cases had been enrolled with a mean age of 53 years, ranging from 19 to 85 years. There were seven patients with comorbidity of diabetes mellitus and 28 patients who received additional neurolysis combined with the Guyon’s release procedure. There were 19 patients with a good response to surgery and 10 patients with a poor surgical outcome due to persistent paresthesia or weakness. After statistical analysis, it was revealed that several influential factors could have been related to a compromised functional outcome, including a symptom duration of more than 3 months, combination with additional neurolysis of ipsilateral extremity, and/or comorbidity with diabetes mellitus.

Conclusion:
It was concluded that promising functional outcomes after surgical release of ulnar neuropathy in Guyon’s canal could be achieved if the patients did not need additional neurolysis or the symptom duration was within 3 months.
Erector Spinae Plane Block
Authors: Sharp Ashley , Mudda Galaxy , Braehler Matthias R. , Gesthalter Yaron B. 
Published: July 2021

Background:
Anesthesia and analgesia for thoracic procedures, specifically pleuroscopy, present unique challenges given the spectrum of underlying pulmonary disease and susceptibility to respiratory complications. This study describes efforts to reduce postoperative pain and minimize opioid analgesia after thoracoscopic procedures through the use of erector spinae plane block (ESPB).

Methods:
This is a single center, retrospective case series of all patients who underwent rigid pleuroscopy with ESPB plus monitored anesthesia care (MAC) from November 2018 through September 2020. The primary outcome measures were postoperative pain scores and analgesic medication requirements.

Results:
Twenty-six patients underwent pleuroscopy with ESPB plus MAC. Average intraoperative and postoperative opioid consumption in oral morphine equivalents were 18.4±15.8 and 11.2±19.6 mg, respectively. There was no significant difference between average preoperative and postoperative subjective numerical pain scores (P=0.221). There were no complications associated with ESPB.

Conclusion:
This case series demonstrates the feasibility of utilizing single shot ESPB in combination with MAC as the primary anesthetic for thoracoscopic procedures.
Advances in management of hepatorenal syndrome
Authors: Khemichian Saro , Francoz Claire , Nadim Mitra K. 
Published: July 2021

Purpose of review
Hepatorenal syndrome (HRS) is encountered frequently in patients with end-stage liver disease and remains an important cause of morbidity and mortality in this patient population. This review will focus and provide updates on pathophysiology, assessment of kidney function, new definitions, and treatment and prevention of HRS.

Recent findings
Pathophysiology of HRS has been elucidated more recently and in addition to hemodynamic changes, the role of systemic inflammatory response contributes significantly to this process. Assessment of kidney function in patients with liver cirrhosis remains challenging. Novel glomerular filtration rate equations have been developed in patients with liver disease to better estimate kidney function and changes made in the definition of acute kidney injury (AKI), which are more aligned with KDIGO criteria for AKI. Vasoconstrictors, especially terlipressin, along with albumin remain the mainstay of pharmacological treatment of HRS-AKI. Biomarkers have been useful in differentiating ATN from HRS at an early stage.

Summary
HRS remains a significant cause of morbidity and mortality for patients with end-stage liver disease. Newer understanding of mechanisms in development and pathophysiology of HRS have helped with elucidation of the disease process.
Emerging non-pharmacological interventions in ADPKD: an update on dietary advices for clinical practice
Authors: Meijer Esther , Gansevoort Ron T. 
Published: July 2021

Purpose of review
Patients with Autosomal Dominant Polycystic Kidney Disease (ADPKD) reach kidney failure at a median age of 58 years. There has been a strong interest in medical interventions to improve prognosis. With increasing understanding of the underlying pathophysiology, there is also a rationale for non-pharmaceutical interventions. However, these have received little attention. This review, therefore, focuses on dietary interventions in ADPKD.

Recent findings
Recent studies regarding salt, protein and water intake, caloric restriction, BMI, caffeine and alcohol are discussed in this review. In general, these studies suggest that advices do not need to be different from those in chronic kidney disease (CKD). On the basis of research in the general population and CKD, these advices will likely decrease cardiovascular morbidity and mortality. With respect to delaying ADPKD progression, evidence for salt restriction is growing. For increasing water intake and targeting glucose metabolism by intermittent fasting, preclinical studies are promising. Long-term randomized human intervention studies are, however, lacking.

Summary
In ADPKD, advices regarding dietary interventions can, in general, be the same as in CKD to decrease cardiovascular morbidity and mortality. Whether these interventions also delay disease progression needs further study.
Paediatric polyposis syndromes: burden of disease and current concepts
Authors: Phen Claudia , Rojas Isabel 
Published: July 2021

Purpose of review
Polyposis syndromes are rare but significant entities that often present during childhood and adolescence. Polyposis syndromes should remain high on the differential diagnoses for any child presenting with rectal bleeding, protein-losing enteropathy or intussusception in the setting of multiple polyps in the gastrointestinal tract. There are three primary paediatric polyposis syndromes: Juvenile polyposis syndrome (JPS), Familial adenomatous polyposis (FAP) and Peutz-Jeghers syndrome (PJS). This review will cover recent guidelines for these conditions and advances in genetic testing.

Recent findings
The first set of paediatric guidelines were released in 2019 by the European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) for FAP, JPS and PJS. Even with advances in genetic testing, a significant proportion of patients with polyposis syndromes have no identifiable genetic mutations. Recent research has shown that polyps behave differently in patients with and without disease-causing variants, emphasizing the role of genetic testing in the diagnosis and management of polyposis syndromes.

Summary
Polyposis syndromes in the paediatric population are growing due to increased recognition and advances in genetic testing. A timely diagnosis and surveillance of a paediatric polyposis syndrome are pivotal for the management of disease burden and early identification of cancers within the gastrointestinal tract and beyond. Paediatricians, paediatric gastroenterologists, paediatric oncologists and paediatric surgeons should be familiar with the presentation and comorbidities of polyposis syndromes in children and adolescents. Further research into genotype-phenotype correlations is needed to tailor the care for paediatric patients with polyposis syndromes.
Electrosurgery or laser for benign prostatic enlargement: trumpcard or pitfalls
Authors: Pallauf Maximilian , Herrmann Thomas , Oswald David , Törzsök Peter , Deininger Susanne , Lusuardi Lukas 
Published: July 2021

Purpose of review
To summarize and comment on publications of the last 2 years in the field of endoscopic surgery for benign prostatic enlargement, focusing on similarities and differences of laser and electrosurgery.

Recent findings
Because of good hemostasis and safety, invasive endoscopic surgery has evolved to a choice of treatment for vulnerable patients with ongoing antithrombotic medication and in same-day surgery. Recent publications show a good perioperative course and no deterioration in the postoperative outcome. Furthermore, alterations to the original surgical techniques of resection, enucleation, and vaporization have increased the preservation rate for antegrade ejaculation, advancing them to an appealing choice of treatment for sexually active men. Favorable outcomes can be achieved in both laser and electrosurgery. Only the choice of the surgical technique determines the outcome.

Summary
Various invasive endoscopic surgical techniques are available, offering different advantages and disadvantages for the patient. All of them can be performed with laser and electrosurgery. Therefore, focusing on the proper choice of surgical technique instead of the energy source will guarantee the patient to benefit most.
Tissue engineering: recent advances and review of clinical outcome for urethral strictures
Authors: Saad Sanad , Osman Nadir I. , Chapple Christopher R. 
Published: July 2021

Purpose of review
Urethrotomy remains the first-line therapy in the treatment of a urethral stricture despite data showing no real chance of a cure after repeated urethrotomies. An anastomotic or an augmentation urethroplasty using oral mucosa can be offered to patients following failed urethrotomy. The potential for a tissue engineered solution as an alternative to native tissue has been explored in recent years and is reviewed in this article.

Recent findings
More than 80 preclinical studies have investigated a tissue-engineered approach for urethral reconstruction mostly using decellularized natural scaffolds derived from natural extracellular matrix with or without cell seeding. The animal models used in preclinical testing are not representative of disease processes seen with strictures in man. The available clinical studies are based on small noncontrolled series.

Summary
There is a potential role for tissue engineering to provide a material for substitution urethroplasty and work has demonstrated this. Further work will require a rigorous basic science programme and adequate evaluation of the material prior to its introduction into clinical practice. The research with tissue engineering applied to the urethra has not yet been resulted in a widely available material for clinical use that approaches the efficacy seen with the use of autologous grafts.
State of the art on stress incontinence management after benign prostatic obstruction surgery
Authors: Sabbagh Paul , Dupuis Hugo , Cornu Jean-Nicolas 
Published: July 2021

Purpose of review
Stress urinary incontinence (SUI) is mostly seen after prostate surgery (radical prostatectomy or benign prostatic obstruction [BPO] relief). As new surgical techniques (laser, endoscopic enucleation) have been dramatically expanded in the past decade, a focus on postoperative SUI is necessary to provide the best management in this iatrogenic situation.

Recent findings
Surgery is the main option for curative management of SUI after BPO as no oral medication is recommended. Preoperative work-up is mandatory to assess concomitant bladder dysfunction. All available surgical options (peri-urethral injections, periurethral balloons, various male slings, and artificial urinary sphincter) have been studied, but the level of evidence is very low. In this setting, SUI after BPO management is widely inspired from post-PR SUI management, mainly based on clinical experience.

Summary
The available literature regarding persistent SUI after BPO relief is very scarce and further studies are warranted in this specific population.
Validity and Usefulness of an Electronic Health Care Record-Generated Mobility Ambulation Tool
Authors: Kawar Lina Najib , Crawford Cecelia L. , Mendoza Rosalina G. , Harrison Staci J. , Thibodeaux Mariaelena Washington , Spicer Jerry E. 
Published: July 2021

Background:
Mobility is a vital function of human life. Nurses have an essential role in preventing hospitalized patient complications through movement and ambulation.

Purpose:
This study examined the integration, accuracy, and precision of a paper-based mobility/ambulation tool into an electronic health record (EHR) to assess inpatient mobility/ambulation status.

Methods:
This multisite mixed-methods study was a time-series correlational evaluation of a mobility/ambulation tool into the EHR.

Results:
Sustainability data revealed strong correlations between nurse responses and EHR levels (r = 0.602; scores r = 0.624). Cronbach's α values were 0.737 and 0.761. Nurses' anecdotes supported the findings.

Conclusion:
Findings revealed that the EHR-Mobility Ambulation Tool is a valid, reliable, and stable tool. EHR-generated scores can assist in reducing charting burden, care planning, and inform the interdisciplinary health team at all patient care stages. Tool adoption could potentially assist nurses plan interventions suitable to maintain or increase hospitalized patients' mobility status and contribute to discharge planning.
Long-Term Care Nurses' Experiences With Patient Safety Incident Management
Authors: Serre Nicole , Espin Sherry , Indar Alyssa , Bookey-Bassett Sue , LeGrow Karen 
Published: July 2021

Background:
Global trends in the aging population will increase the demands for long-term care (LTC) resources. Due to recent pressures to deliver more complex care, there is further risk to resident safety in LTC. Emphasis on the management and the delivery in safe and quality resident care in LTC is required.

Purpose:
The purpose of this study was to describe nurses' experiences with patient safety incident (PSI) management involving residents living in LTC.

Methods:
Using a qualitative descriptive approach, 9 nurses were recruited in 3 LTC homes. Semistructured interviews were conducted, and data were analyzed using inductive content analysis.

Results:
Three main categories emerged: commitment to resident safety, workplace culture, and emotional reaction.

Conclusions:
Providing nurses with an opportunity to share their PSI management experiences highlights the current factors influencing frontline resident safety in LTC. Study results can inform nursing practice and policy development to support PSI identification and management.
Automating Case Reporting of Chlamydia and Gonorrhea to Public Health Authorities in Oregon Clinics
Authors: Todd Jonathan V. , Collins Natalie Viator , Oakley Jee , Menza Timothy , Barber Michelle , Kasarskis Irina , Weresch Andrew , Morgan Shane , Jellison Jim , Mishra Ninad , Pérez Alejandro , Karki Saugat 
Published: July 2021

Background
Optimizing sexually transmitted disease (STD) reporting to state public health authorities is important to reduce incidence and manage outbreaks of STDs. Electronic laboratory reporting (ELR) is the standard through which local clinics report STDs to state public health authority. Electronic case reporting (eCR) is an alternative approach which automates transmission of case reports to public health jurisdictions using electronic health record (EHR) data.

Methods
Working with 3 community health centers in Oregon between February 3, 2020 and May 15, 2020, we piloted an automated eCR approach for gonorrhea (GC) and chlamydia (CT) from these clinics to the Oregon Health Authority. We compared the eCR approach to the existing ELR approach to determine completeness of case reporting for GC/CT.

Results
A total of 365 eCRs from 206 unique patients were generated. Among 154 instances where the case detection logic was satisfied for CT, 37% (54 instances) were based on the presence of a diagnosis and 63% (97 instances) were based on laboratory data. Among 232 instances where logic was satisfied for GC, 44% (102 instances) reflected a diagnosis and 56% (130 instances) reflected laboratory results. Data completeness was uniformly equal or higher for eCRs versus ELRs.

Conclusions
The eCR approach was successful in identifying CT and GC cases and provided a more complete set of information to assist public health authorities when compared with ELRs. Electronic case reporting has the potential to automate and relieve staff burden on an important reporting requirement for clinical providers.
Direct and Indirect Cost Savings From Sexually Transmitted Infection Testing, Treatment, and Counseling Among Foster Youth
Authors: Kennedy Andrea K. , Kaushik Gaurav , Dubinsky Emma L. , Huseynli Aytakin , Jonson-Reid Melissa , Plax Katie 
Published: July 2021

Background
Sexually transmitted infection (STI) prevention programs can decrease the economic burden of STIs. Foster youth have higher rates of STIs compared with their peers; however, information on direct costs and indirect costs averted by STI testing, treatment, and counseling among foster youth is lacking.

Methods
This study used data from a comprehensive medical center for foster youth over a 3-year study period from July 2017 to June 2020. Direct and indirect costs averted by testing and treatment of chlamydia, gonorrhea, and syphilis, as well as HIV testing and counseling, were calculated based on formulas developed by the Centers for Disease Control and Prevention and adjusted for inflation.

Results
Among the 316 youth who received medical services during this time, 206 were sexually active and tested for STIs and/or HIV. Among 121 positive STI test results, 64.5% (n = 78) were positive for chlamydia, 30.6% (n = 37) were positive for gonorrhea, and 5.0% (n = 6) were positive for syphilis. Treatment was provided to all. Overall, $60,049.68 in direct medical costs and $73,956.36 in indirect costs were averted.

Conclusions
Given the rates of STIs among this population and the economic benefit of STI treatment, it is imperative to continue to provide intensive and comprehensive, individualized sexual health care for foster youth. Traditional care management may miss the opportunity to prevent, identify, and treat STIs that comprehensive wraparound care can achieve. This study suggests that comprehensive wraparound care is a cost-effective way to identify, treat, and prevent STIs among foster youth.
Characteristics and Physiologic Changes After 4% Albumin Fluid Boluses in a PICU
Authors: Gelbart Ben , Fulkoski Nick , Stephens David , Bellomo Rinaldo 
Published: July 2021

OBJECTIVES:
To describe the characteristics, hemodynamic, and physiologic changes after 4% albumin fluid boluses in critically ill children.

DESIGN:
Retrospective observational study.

SETTING:
Single-center PICU.

PATIENTS:
Children in a cardiac and general PICU.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
Between January 2017 and May 2019, there were 1,003 fluid boluses of 4% albumin during 420 of 5,731 admissions (7.8%), most commonly in children with congenital/acquired heart disease (71.2%) and sepsis (7.9%). The median fluid bolus dose was 10 mL/kg (interquartile range, 5.8–14.6 mL/kg), and its duration 30 minutes (interquartile range, 14.0–40.0 min; n = 223). After the fluid bolus, a significant change in mean arterial pressure (2.3 mm Hg [5.1%], 2.7 mm Hg [5.8%], 2.9 mm Hg [6.1%], and 3.8 mm Hg [8.0%] at 1, 2, 3, and 4 hr, respectively [p ≤ 0.001]) only occurred in children less than or equal to 12 months old. A mean arterial pressure response, defined by an increase greater than or equal to 10% from baseline, occurred in 290 of 887 patients (33%) with maximal response at 1 hour. Hypotension at baseline predicted the magnitude of mean arterial pressure increase at 60 (coefficient 24.3 [95% CI, 0.79–7.87]; p = 0.04) and 120 minutes (coefficient 26.1 [95% CI, 2.75–48.2]; p = 0.02). There were no biochemical or hematocrit changes within 4 hours of the fluid bolus. Urine output for the entire cohort was 2 mL/kg/hr at baseline and did not change with the fluid bolus.

CONCLUSIONS:
Fluid boluses of 4% albumin were common and predominantly in children with cardiac disease and sepsis with a median dose of 10 mL/kg given over half an hour. Such treatment was associated with significant hemodynamic changes only in children less than 12 months old, and we failed to identify an association with urine output.
Physical Medicine and Rehabilitation Consultation for Stroke Patients in Acute Care Setting May Be Associated With an Increased Rate of Discharge to the Community From the Inpatient Rehabilitation Facility
Authors: Ikramuddin Farha S. , Guarino A.J. , Siedel Erica , Vonderhor Kathleen , Larson Elizabeth , Battaglino Ricardo , Morse Leslie 
Published: July 2021

Objective
The aim of the study was to determine whether stroke patients who receive physical medicine and rehabilitation consultation in acute care setting are more likely to discharge from inpatient rehabilitation facility to a community setting compared with those who do not.

Design
This was a retrospective analysis of consecutive patients admitted with stroke to inpatient rehabilitation facility between June and October 2018. The primary outcome measure was discharge disposition. Other variables measured included functional independence measures and length of stay. Analysis of baseline covariates was conducted with t tests and analysis of primary outcome measured with Fisher exact test.

Results
We identified 184 consecutive patients, with 62 (33.7%) having and 122 (66.3%) not having a physical medicine and rehabilitation consult; 35 (56.5%) patients versus 51 (41.8%) in physical medicine and rehabilitation consult versus non–physical medicine and rehabilitation group were discharged home (P = 0.042). Between both groups, there were no differences in baseline admission/discharge cognitive or motor functional independence measure scores, total admission/discharge functional independence measure scores, functional independence measure efficiency, or length of stay. However, in both the groups, admission versus discharge overall functional independence measure scores were significantly improved, 71.34 vs. 94.76 and 66.52 vs. 89.94 (P < 0.0001).

Conclusions
Despite no difference in baseline functional scores or length of stay, physical medicine and rehabilitation consultation of poststroke patients in hospital may be associated with discharge home after inpatient rehabilitation facility.