bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of Anticipatory Batching of Pharmacy Compounded Sterile Products on Time to Nurse Administration
Authors: Pathan Sophia , Sullinger Danine , Avino Laura J. , Culli Samuel E. 
Published: June 2021

Background: Timely medication administration is integral to patient care, and operational delays can challenge timely administration. Within an inpatient pharmacy of an academic medical center, intravenous medications were historically compounded on a patient-specific basis. In 2020, the pharmacy began batching frequently-utilized medications. This analysis explored the impact of compounded sterile batching on pharmacy and nursing services. Methods: This pre- and post-interventional study compared data from February through March 2020 with a seasonally matched period from 2019. The primary endpoint was difference in time to administration of urgent (STAT) medications. Secondary endpoints included timeframes for a pharmacy technician to prepare, a pharmacist to check, and a nurse to administer the medications, as well as reprinted labels and estimated waste. Results: On average, it took one hour and 43 minutes to administer a STAT medication in 2019 and one hour and 57 minutes in 2020 ( p = 0.122). It took about four hours to administer routine medications in 2019 and 2020 ( p = 0.488). The number of labels reprinted decreased from 616 in 2019 to 549 in 2020 ( p = 0.195), relating to decreased missing doses. The mean time to check and send a medication decreased from 2019 to 2020 for STAT orders ( p < 0.001), and there was no difference in wasted medications looking at all orders in this time. Conclusion: Anticipatory batching decreased time to prepare, check, and send medications, though there was no effect on waste or on time to administration. Future studies can examine the correlation between pharmacy operations and medication administration.
Effectiveness of Presurgical Nasoalveolar Molding Appliance in Infants With Complete Unilateral Cleft Lip and Palate
Authors: Dinh Thao Thi Nhu , Van Nguyen Dau , Dien Vu Hoa Anh , Dong Tham Khac 
Published: June 2021

Objective: To assess the effectiveness of the presurgical nasoalveolar molding appliance among infants with unilateral cleft lip and palate. Methods: In this prospective study, 95 pairs of casts of infants with unilateral cleft lip and palate treated by presurgical nasoalveolar molding were selected at the Children’s Hospital 1 at Ho Chi Minh City, Vietnam. The average time of treatment was 3 months. All casts were scanned and measured using 3-dimensional technology before and after treatment. Paired t tests were applied for comparisons. Results: There was a statistically significant increase in the nostril height in cleft side ( P < .001), decrease in the nostril width and columella angle ( P < .001), and decrease in cleft width and midline deviation ( P < .001) after treatment with presurgical nasoalveolar molding appliance. Conclusions: Nasoalveolar molding appliance is effective in improving the morphology of nostril and maxillary alveolar. Understanding this helps orthodontists and surgeons in treatment outcome expectations.
A case report of fulminant hepatitis due to ribociclib with confirmed by liver biopsy in breast cancer
Authors: Topcu Atakan , Yasin Ayse Irem , Shbair Abdallah TM , Besiroglu Mehmet , Simsek Melih , Sucuoglu Zehra , Yurtsever Ismail , Gucin Zuhal , Seker Mesut , Turk Haci Mehmet 
Published: June 2021

Introduction Breast cancer is the most frequently diagnosed cancer in women worldwide. Ribociclib is now frequently used in the treatment of metastatic hormone-positive and human epidermal growth factor receptor 2 (HER 2)-negative breast cancer. Case Report A 54-year-old woman with breast cancer presented at a clinic in November 2017 with multiple lung and bone metastases. After receiving multiple lines of treatment due to disease progression, ribociclib and fulvestrant were initiated. Grade 4 toxicity was observed due to ribociclib during follow-up, and ribociclib was discontinued permanently. Management & Outcome: Given that liver transaminases and bilirubin elevation persisted despite discontinuation of the treatment, other reasons for liver toxicity were investigated. Abdominal MRI showed no liver metastases, although there was acute hepatitis. A liver biopsy was performed to determine the etiology. The pathology result was compatible with drug-induced acute fulminant toxic hepatitis. After liver biopsy, prednisolone treatment was initiated, after which the laboratory findings normalized. Discussion Although there are reported cases showing improvement in liver enzymes after ribociclib discontinuation, in our case, no recovery from hepatotoxicity was noticed. The treatment was changed to another hormonal pathway therapy option, exemestane. To the best of our knowledge, this is the first case in the literature reporting this rare side effect of ribociclib, which is a liver biopsy-proven fulminant hepatitis.
Capecitabine induced Steven–Johnson syndrome: A rare case report
Authors: Karthikeyan Kavya , Sameera K V , Shaji Shintu , Swetha M Ann C , Madhu C S 
Published: June 2021

Introduction Steven–Johnson syndrome (SJS) is a serious mucocutaneous reaction, characterized by fever, influenza-like symptoms and followed by dermatological manifestations. Capecitabine is an oral fluoropyrimidine carbamate analogue of 5-Fluorouracil (5-FU). It is widely accepted for many malignancies because of its better safety profile and tolerability. Hand-foot syndrome is the common dermatological toxicity associated with Capecitabine and SJS is the rarest manifestation. Case presentation: We report a case of Capecitabine induced SJS in a 70 years old male patient with metastatic carcinoma pancreas. He was treated with intravenous Gemcitabine and Carboplatin initially and then switched to oral therapy with Capecitabine 1000 mg twice daily. After ten days of treatment with Capecitabine, he developed vomiting, mucositis, hyperpigmentation, itching and scrotal mucosal peeling. The clinical status of the patient was suggestive of SJS, which was confirmed by dermatologic consultation. According to Naranjo, WHO-UMC, and Hartwig’s scale, the reaction was found to be probable and severe. Pharmacological as well as supportive care measures were provided, but the condition progressively worsened, and the patient was deceased. Conclusion Capecitabine can cause severe hypersensitivity reactions which can be dangerous and life-threatening. Health care providers must be aware of all rare adverse effects, including SJS. Clinicians and clinical pharmacists should educate and counsel the patients regarding the likely adverse effects of their chemo drugs because the early identification of toxic symptoms is crucial to reduce further complications to the patient.
Two novel compound heterozygous SAG mutations in an Italian patient with Oguchi disease: A genetic and multimodal retinal imaging study
Authors: Pilotto Elisabetta , Trevisson Eva , Nacci Elisabetta Beatrice , Longhin Evelyn , Guidolin Francesca , Midena Edoardo 
Published: June 2021

Background: Oguchi disease is a rare autosomal recessive retinal dystrophy, characterized by congenital stationary blindness and caused by pathogenic variants in SAG and GRK1 genes. The present study aimed to report an Italian patient affected by Oguchi disease, evaluated by means of a multimodal retinal imaging study and harboring two novel heterozygous pathogenic variants in the SAG gene. Materials and methods: A 60-year-old female complaining congenital stationary night blindness was investigated through fundus photograph, optical coherence tomography (OCT), electroretinography (ERG), and genetic testing. Results: Fundus examination showed a golden-grayish fundus aspect. The rod response of the scotopic ERG was undetectable and mixed rod-cone response was electronegative. Fundus photographs obtained in light and in prolonged dark-adapted conditions allowed to detect the Mizuo-Nakamura phenomenon. Light condition OCT over the abnormal retinal regions showed high-intensity areas in the outer photoreceptor segment layer, that reduced with prolonged dark adaption. Genetic testing identified two rare heterozygous sequence variants in the SAG gene: NM_000541.5:c.807delA p.(Glu270Lysfs*9) and NM_000541.5:c.1047-1G>C confirming the diagnosis of Oguchi disease. Conclusions: We identified the first Italian compound heterozygous patient harboring two novel alterations in the SAG gene (a frameshift deletion and a splicing variant). The involvement of the SAG gene in Oguchi disease is a common finding in Japanese population, but rarely identified in Caucasians. Clinical suspicion should prompt the molecular analysis of genes associated with this condition.
How do intracranial tumors associated with visual pathways affect quadrant and sectoral based optical coherence tomography measurements: The effect of intracranial tumors on RNFL and GC-IPL thickness
Authors: Özcan Yasin , Talıpınar Sinan , Kayıran Alp , Türe Uğur 
Published: June 2021

Aim: To investigate the quantitative sectoral and regional changes of retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer (GC-IPL) thickness in different types of intracranial tumors associated with visual pathways. Methods: This comparative retrospective study included 58 eyes of 30 patients with intracranial tumors and the data of 62 eyes of 31 healthy subjects. The RNFL and GCIPL thicknesses were analyzed using spectral-domain optical coherence tomography (OCT). The tumors were classified into ones that affect pre-geniculate and post-geniculate pathway Results: The mean RNFL thickness in temporal quadrant was significantly thinner in eyes with intracranial tumors affecting the pre-geniculate optic pathway compared to controls ( p  = 0.04). In contrast, the mean superior quadrant RNFL thickness was significantly thicker in eyes with brain tumors associated with post-geniculate optic pathway ( p  = 0.01). The mean GC-IPL thicknesses of the inner ring superotemporal, superonasal, inferotemporal and inferionasal sectors and outer ring superonasal and inferonasal sectors were significantly thinner in eyes with intracranial tumors affecting the pre-geniculate optic pathway compared to control eyes ( p = 0.02, p = 0.001, p = 0.02, p = 0.003, p = 0.008 and p = 0.03 respectively). Conclusion: The results of this study showed that significant changes can be seen in the different RNFL quadrants and GC-IPL sectors in eyes with intracranial tumors affecting pre-geniculate or post-geniculate optic pathway. OCT is a very useful imaging technique to quantify these structural changes which take place during the neurodegeneration process of visual pathways in intracranial tumors.
Lessons learnt and future directions in managing dialysis access during the COVID 19 pandemic: Patient and provider experience in the United States
Authors: Agarwal Anil K , Sequeira Adrian , Oza-Gajera Bharvi P , Ramani Karthik , Packer Jeffrey , Litchfield Terry , Nations Mary Lea , Lerma Edgar V 
Published: June 2021

Background: The COVID 19 pandemic adversely impacted delivery of preventive, routine, urgent, and essential care worldwide. Dialysis access care was particularly affected due to the lack of specific guidelines regarding procedures for its creation and maintenance. Early guidance by Centers for Medicare and Medicaid was inadvertently interpreted as guidance to stop dialysis access procedures. Prompt action by professional societies was needed to furnish detailed guidance to establish essential nature of these procedures. Methods: The American Society of Diagnostic and Interventional Nephrology (ASDIN) issued a joint statement with Vascular Access Society of the Americas (VASA) – “Maintaining Lifelines for ESKD Patients” to clearly establish the role of vascular access as a lifeline for ESKD (End Stage Kidney Disease) patients and the importance and urgency of its timely management. ASDIN also conducted a survey in mid-2020, that was administered to the ASDIN database as well as shared with the general public via the organization’s social media platforms. The respondents reported their experiences in the care of dialysis access, practice patterns and the utility of the ASDIN-VASA statement during the COVID 19 pandemic. Results: Of the 2030 individual surveys sent, 581 were opened and 53 (9.1%) responses were received from different parts of the country and from different practice settings. ASDIN COVID 19 triage document was frequently utilized and 83% of respondents found the document valuable. The survey also revealed multiple obstacles, including logistical and financial issues that led to significant disruption of services. Conclusions: The care of dialysis access was significantly affected in the United States during the COVID 19 pandemic due to multiple reasons. ASDIN actions provided valuable specific guidance regarding and explored barriers to dialysis access care. We describe those results and discuss strategies to prevent COVID 19 transmission with innovative strategies of providing access care. Individualized decision making is of essence when considering dialysis access procedures.
Autoimmune glomerulonephritis in a multiple sclerosis patient after cladribine treatment
Authors: Schönfelder Kristina , Schuh Helene , Pfister Frederick , Krämer Julia , Eisenberger Ute , Skuljec Jelena , Hackert Jana , Ruck Tobias , Pfeuffer Steffen , Fleischer Michael , Gäckler Anja , Hagenacker Tim , Kribben Andreas , Meuth Sven G , Kleinschnitz Christoph , Pul Refik 
Published: June 2021

Background: Oral cladribine is an approved disease-modifying drug for the treatment of relapsing multiple sclerosis. In controlled clinical trials as well as in post marketing safety assessments, autoimmune conditions have not yet been reported as a specific side effect of cladribine. Objective and Results: Here, we report a case of anti-glomerular basement membrane antibody-mediated glomerulonephritis that occurred shortly after the fourth cladribine treatment cycle. Conclusion: Neurologists should be attentive to the development of secondary autoimmunity in cladribine-treated patients.
Childhood exposure to physical and emotional violence over a 57-year period in Sweden
Authors: Lucas Steven , Janson Staffan 
Published: June 2021

Aims: The aim of the present study was to examine the prevalence of childhood experiences of physical violence (CPV) and emotional violence (CEV) at the hands of parents over a 57-year period among adults born between 1937 and 1993. Methods: In 2012, a survey among women and men aged 18–74 years in Sweden was undertaken to examine the lifetime prevalence of physical, psychological and sexual violence and associations with current health in adulthood. Questionnaires were based on the Adverse Childhood Experiences study and a previous national survey of violence exposure. Descriptive statistics were used to analyse the frequency of exposure to CPV and CEV, and changes over time were analysed using analysis of variance and logistic regression. Results: A total of 10,337 individuals participated (response rates: 56% for women and 48% for men). CPV decreased significantly over the time period studied, particularly for those born after 1983. This decrease was more evident for male respondents. Throughout the time period studied, the proportion of women reporting CEV was higher than for men. Among both genders there was a steady rise in CEV rates from those born in the late 1930s to those born in the mid-1980s, after which there was a decline that was more marked for men. Conclusions: A significant group of children in Sweden experience violence at the hands of parents. However, our data corroborate previous national studies that children’s exposure to violence has decreased. Clear gender differences indicate that these changes have affected girls and boys differently.
miR-28-5p improved carotid artery stenosis by regulating vascular smooth muscle cell proliferation and migration
Authors: Liu Qiangrui , Yan Shibiao , Yuan Yangyi , Ji Shishun , Guo Long 
Published: June 2021

Objectives Abnormal proliferation and migration of vascular smooth muscle cells (VSMCs) are involved in carotid artery stenosis. The purpose of this study was to investigate the diagnostic value of serum miR-28-5p in asymptomatic carotid artery stenosis and its regulation on the proliferation and migration of VSMCs. Methods Serum miR-28-5p levels in 65 healthy controls and 68 asymptomatic carotid artery stenosis patients were detected by qRT–PCR. The receiver-operating characteristic curve was applied to elucidate the diagnostic value of serum miR-28-5p for carotid artery stenosis patients. The specificity of miRNA targets was detected by luciferase reporter assay. CCK-8 and Transwell assay were applied to detect proliferation and migration of cells. Pearson correlation test was used to investigate the correlation between Forkhead box subclass O 1 (FOXO1) and serum miR-28-5p. Results Serum miR-28-5p was significantly reduced in asymptomatic carotid artery stenosis patients. Moreover, miR-28-5p could distinguish asymptomatic carotid artery stenosis patients from healthy controls, with sensitivity and specificity of 86.8% and 81.5%, respectively, indicating its high diagnostic value. The overexpression of miR-28-5p inhibited the proliferation and migration of VSMCs, while inhibition of miR-28-5p resulted in the opposite effect. What is more, FOXO1, a direct target of miR-28-5p, was significantly increased in asymptomatic carotid artery stenosis patients. Inhibition of miR-28-5p in VSMCs reversed the reduction of FOXO1 levels in patients. Conclusions miR-28-5p is a valuable diagnostic biomarker for asymptomatic carotid artery stenosis and can affect the proliferation and migration of VSMCs by regulating FOXO1.
Differences in disease prevalence among homeless and non-homeless veterans at an urban VA hospital
Authors: Tannis Candace , Rajupet Sritha 
Published: June 2021

Objectives Approximately 10% of homeless adults in the US are veterans and that number is increasing. Veterans who experience homelessness tend to do so for longer periods compared to non-veterans; and homelessness is associated with more chronic disease complications. We compared the prevalence of five chronic, ambulatory-care sensitive conditions in homeless and domiciled individuals who received primary care at an urban VA hospital. Methods Data were obtained from the Veteran’s Hospital Administration clinical data warehouse. Differences in disease prevalence were compared between the two groups using chi-square analyses and then adjusted for age, gender, race/ethnicity, BMI, and other risk factors where appropriate, using logistic regression. All analyses were conducted using SAS version 9.4. Results Homeless individuals were 46% more likely to have asthma (OR 1.46, 95% CI 1.16–1.84) and 40% more likely to have COPD (OR 1.40, 95% CI 1.14–1.73) after adjustment for age, gender, race/ethnicity, BMI, and tobacco use status. After adjustment for covariates, there was no difference between homeless and domiciled veterans in the prevalence of diabetes, hypertension, or congestive heart failure. Discussion Future quality improvement projects should identify social-environmental risk factors like employment characteristics, and housing quality that can impact chronic respiratory illness prevalence and associated complications.
Experiences of mental health professionals providing services to adults with intellectual disabilities and mental health problems: A systematic review and meta-synthesis of qualitative research studies
Authors: Ee Jonathan , Stenfert Kroese Biza , Rose John 
Published: June 2021

Background: Mental health professionals play an important role in providing care and treatment for adults with intellectual disabilities. A number of studies use qualitative methods to explore the experiences of these professionals and their perspectives regarding the mental health services for this population. A systematic review using meta-ethnographic approach was undertaken to summarise this research. Method: A systematic search found 14 relevant studies which were critically appraised. Key themes from these studies were extracted and synthesised. Results: Three main themes were identified: 1) Understanding the person, 2) Relational interaction and 3) Organisational factors. Conclusions: The findings of this review identified the issues mental health professionals raised in relation to their work. They described the complex presenting problems as intense yet fulfilling therapeutic relationships with their clients and their wish to improve their knowledge and skills. They identified organisational issues that need to be addressed to improve staff morale and efficiency.
Dual mobility trapeziometacarpal prosthesis: a prospective study of 107 cases with a follow-up of more than 3 years
Authors: Lussiez Bruno , Falaise Cyril , Ledoux Pascal 
Published: June 2021

We report the results of a prospective study using a dual mobility trapeziometacarpal prosthesis (Touch®) in 107 patients with a minimum follow-up of 3 years. One-hundred and two patients (95%) were very satisfied or satisfied with the functional outcomes and the mean pain intensity in visual analogue scale decreased from 7.4 to 0.8 ( p < 0.001). Thumb opposition (Kapandji score) index increased from an average of 8.0 to 9.4, while the mean QuickDASH score improved from 38 preoperatively to 20 at follow-up ( p < 0.01). Key-pinch strength improved from 3.5 kg (range 0.5–9.5) to 5.5 kg (range 3.0–11.5). There was a 4.6% rate of complications, including cup loosening and wear of polyethylene, which required revision, but no cases of prosthetic dislocation were seen. Applying the dual mobility principle to trapeziometacarpal arthroplasty may significatively improve the stability of these prostheses. Radiolucent zones around the components of the prostheses are not systematic predictors of future loosening. Level of evidence: IV