bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fetal proximal and distal limb anomalies following exposure to mycophenolate mofetil during pregnancy: A case report and review of the literature
Authors: Abdulaziz Hoda MM , Shemies Rasha Samir , Taman Mohamed , Mosbah Alaa , Elkannishy Ghada 
Published: June 2021

Background Mycophenolate mofetil (MMF) is currently used in a wide spectrum of autoimmune diseases and has been rendered very effective in the management of systemic lupus erythematosus and lupus nephritis. MMF is known to be teratogenic (FDA category D) and therefore, women in childbearing period receiving MMF should be counselled to use effective contraceptive methods to avoid an unplanned pregnancy. Case A 22-year-old lady accidentally discovered to be pregnant while using MMF as a treatment of lupus nephritis which was replaced later on by azathioprine. After maternal and fetal evaluation, maternal lupus flare was confirmed and multiple fetal skeletal deformities associated with intrauterine growth restriction (IUGR) were diagnosed by 4-dimensional ultrasound. Termination of pregnancy was decided after shared decision making. Conclusion Women in childbearing period should be advised to postpone pregnancy for at least six weeks after stoppage of MMF therapy because of its potential teratogenic effects during pregnancy.
Management of cataracts secondary to intravitreal chemotherapy injections for retinoblastoma seeding
Authors: Koç İrem , Taylan Şekeroğlu Hande , Kıratlı Hayyam , Lotfisadigh Sepideh 
Published: June 2021

Purpose: To report our experience in the management of cataracts presumably due to intravitreal chemotherapy administration in eyes with vitreous disease associated with retinoblastoma. Methods: This retrospective study consisted of a cohort of five eyes of five retinoblastoma patients who developed cataracts secondary to intravitreal chemotherapy administration and who then underwent cataract surgery. All patients underwent lensectomy and anterior vitrectomy with/without intraocular lens implantation via clear corneal approach. All cases were administered intraoperative intravitreal melphalan (35–40 mcg) and topotecan (10–20 mcg) at the end of cataract surgery as a preventive measure against retinoblastoma spread. Injections were repeated as needed in monthly follow-ups. Main outcome measures were enucleation rate and disease-free survival time. Results: The age at surgery ranged between 5 and 10 years. Follow-up time varied from 12 to 16 months. Treatment-free period before surgery ranged between 3 and 20 months. Time from last injection to cataract detection was: 2, 2, 10, 6, and 7 months; and time from last injection to cataract surgery was: 8, 3, 20, 7, and 15 months in cases 1–5, respectively. None of the eyes required enucleation. Tumor control was achieved in all patients at the end of follow-up. Conclusions: Injection of melphalan and topotecan into anterior parts of the vitreous may lead to cataract formation. This can be safely managed with lensectomy and anterior vitrectomy and the use of intravitreal administration of melphalan and topotecan at the conclusion of the surgery as a precautionary measure against the potential risk of extraocular spread.
Arteriovenous fistula as the vascular access contributes to better survival of hemodialysis patients with COVID-19 infection
Authors: Murt Ahmet , Yadigar Serap , Yalin Serkan Feyyaz , Dincer Mevlut Tamer , Parmaksiz Ergun , Altiparmak Mehmet Riza 
Published: June 2021

Background: While COVID-19 in chronic hemodialysis patients has high mortality and the pandemic will not end in the near future, effective follow up strategies should be implemented for these patients. Surgeries have been triaged according to their level of urgencies and arteriovenous fistula (AVF) operations were among elective surgeries. This study aimed to analyze the effect of vascular access on the outcomes of hemodialysis patients who had COVID-19. Methods: One hundred four hemodialysis patients who had COVID-19 were retrospectively analyzed. Seventy-two of them had AVF as the vascular access while 32 of them had tunneled catheters. Inflammatory markers and outcomes of patients with AVFs and catheters were compared. A logistic regression analysis was performed in order to define factors that contribute to better outcomes in hemodialysis patients. Results: COVID-19 had high mortality rate in hemodialysis patients (36.5%). Patients with catheters have higher peak ferritin levels ( p = 0.02) and longer hospital stay ( p = 0.00). Having AVF as the vascular access (OR = 3.36; 95% CI: 1.05–10.72; p = 0.041) and using medium cut-off dialyzers (OR = 7.99; 95% CI: 1.53–41.65; p = 0.014) were related to higher survival of the patients. COVID severity was inversely proportional to the survival ( p = 0.000) Conclusions: AVFs contribute to higher survival of hemodialysis patients with COVID-19. Even in the pandemic era, end stage renal disease patients should be given the opportunity to have their vascular access properly created.
Huge Non-parasitic Mesothelial Splenic Cyst in a Child: A Case Report and Literature Review
Authors: Krichen Imed , Maazoun Kais , Kitar Murad , Kamal Naglaa M , Khan Ubaidullah , Khalif Mostafa YL , A Rasha , Assiri Haifa , Bokari Kawthar Abdulrhim 
Published: June 2021

Background: Splenic cysts are one of the relatively rare conditions in pediatric surgery practice. Primary non-parasitic splenic cysts are even more scarce. Case presentation: A 13-years-old female patient presented with chronic left hypochondrial pain of 2 months duration. Abdominal ultrasonography and computed tomography revealed huge 18 cm × 14 cm × 10 cm splenic cyst. Deroofing of the cyst was done which was complicated by secondary infection. Subsequently, the patient was re-operated on and partial splenectomy done with good outcome at 6 months follow up. Conclusion: Partial splenectomy is the best management strategy for huge non-parasitic splenic cysts in children. There is also less recurrence rate of splenic cysts with preservation of splenic functions.
The lived experiences of social workers working with refugees in Lebanon
Authors: Cecil David P , Hagues Rachel J , Mansour Rania , Ghanem Aimee , Robbins David E 
Published: June 2021

Refugee care in Lebanon Understanding the lived experiences of social workers. Summary This mixed methods study examines the status of social work in its response to the refugee crisis within Lebanon, a country with the highest per capita refugee population in the world. Findings A structured interview guide and brief ordinal instrument were administered through interviews ( n = 10) and 10 focus groups ( n = 37) ( N = 47). Participants were recruited with the help of Lebanese social work colleagues. We explored professional roles, greatest refugee needs, social worker coping, and recommendations for refugee social work trainers and educators. Qualitative results are presented as themes with examples of direct quotations. Culturally specific services accurately targeting needs are among the major themes identified. Quantitative results, primarily using descriptive statistics and one Pearson’s r correlation statistic, report on participants’ overall stress levels, sense of effectiveness in refugee practice, and connection of faith/religion to motivation for refugee work. Applications This work is applied as best practice recommendations for social work education and for front-line training of those in social work roles working with refugees in Lebanon. This work also raises awareness about one of the most critical humanitarian crises in history.
Social workers’ use of critical reflection
Authors: Taiwo Akin 
Published: June 2021

Summary This article explores critical reflection as practiced by social workers in the context of their personal and professional privilege. It was found that social workers in direct practice were not invested in critical reflection about oppressive discourses in their consciousness when interacting with clients. Rather, critical reflection often happened in times of crises or when social workers encountered difficult client situations. Using the phenomenological methodology of Van Manen and the social constructionist perspective, I present and discuss the findings of a qualitative study of semi-structured interviews with 20 social workers in direct practice. Findings Data analysis indicated that critical reflection is not a priority for direct practice social workers in the context of privilege. Three themes are identified: (1) No time for reflection, (2) Fear of reflection, and (3) Too much reflection. Nevertheless, social workers were still able to reflect alone, with colleagues and with supervisors, and they outlined the benefits of reflection. Applications Social work agencies should provide infrastructure for reflection, create an atmosphere for workers to freely discuss challenges and difficulties, and reduce their fear of reprisals from management. This article broadens the idea of phenomenological reflection by Van Manen.
Social Workers’ Impact on Policy Through Regulations: A Case Study of the U.S. Long-Term Care Ombudsman Program
Authors: Beltran Susanny J , Miller Vivian J , Hamler Tyrone 
Published: June 2021

Summary Involvement in the political process in the United States is critical for social work professionals, as social policies dictate funding and programming in social work practice. Yet, there is little to no focus given to the regulation writing process in the social work literature in the United States. This article contributes to the scant body of knowledge that addresses the regulatory process from a social work perspective. A brief overview of the regulation writing process is provided, followed by a case study using the regulations for the U.S. Older Americans Act Long-Term Care Ombudsman Program to illustrate the process. Findings A total of 85 comments, submitted to the Federal Register docket, were analyzed using content analysis. Findings reveal that comment submissions varied greatly in terms of length, source, and input. Notably, findings indicate low participation from the social work profession. Application The open comment period of the regulation writing process offers a free, but effortful, window of opportunity for social workers to engage in post-legislative advocacy. There is a need to support the involvement of the social work profession in the regulation writing process, through practice and training enhancements.
Prenatal electrocardiogram testing and postpartum depression: A population-based cohort study
Authors: Zipursky Jonathan S , Thiruchelvam Deva , Redelmeier Donald A 
Published: June 2021

Background Cardiovascular symptoms in pregnancy may be a clue to psychological distress. We examined whether electrocardiogram testing in pregnant women is associated with an increased risk of subsequent postpartum depression. Methods We conducted a population-based cohort study of pregnant women who delivered in Ontario, Canada comparing women who received a prenatal ECG to women who did not. Results In total, 3,238,218 women gave birth during the 25-year study period of whom 157,352 (5%) received an electrocardiogram during prenatal care. Receiving an electrocardiogram test was associated with a one-third relative increase in the odds of postpartum depression (odds ratio 1.34; 95% confidence interval 1.29–1.39, p < 0.001). Conclusion The association between prenatal electrocardiogram testing and postpartum depression suggests a possible link of organic disease with mental illness, and emphasizes that cardiovascular symptoms may be a clinical clue to the presence of an underlying mood disorder.
The safety of drugs for inflammatory bowel disease during pregnancy and breastfeeding: the DUMBO registry study protocol of GETECCU
Authors: Chaparro María , Donday María G. , Abad-Santos Francisco , Martín de Carpi Francisco Javier , Maciá-Martínez Miguel Ángel , Montero Dolores , Acosta Diana , Brenes Yanire , Gisbert Javier P. 
Published: June 2021

Background: Active disease during conception and pregnancy in women with inflammatory bowel disease (IBD) increases the risk of pregnancy complications and adverse neonatal outcomes. The use of IBD treatments during pregnancy should be weighed against their adverse effects on the neonate, but longer-term safety data and data on serious infection rates and malignancies postnatally are lacking, particularly for newer drugs, such as tofacitinib, vedolizumab and ustekinumab. Methods: This ongoing, prospective registry study being conducted at 70 centres in Spain is enrolling pregnant women who are ⩾18 years, are at any point in pregnancy up to the end of the second trimester and have a diagnosis of Crohn’s disease, ulcerative colitis or unclassified IBD. Patients will receive treatment decided independently by their IBD specialist. Each incident gestation will be followed up through pregnancy and the first 4 years postnatally. Three cohorts will be compared: biologicals exposed, immunomodulatory exposed and non-exposed. The primary endpoint is the risk of severe infection in newborns postnatally up to 4 years of age; other endpoints include serious adverse events (SAEs) such as pregnancy and delivery complications, neonatal SAEs, development [Ages and Stages Questionnaire-3 (ASQ3)], and malignancy incidence, up to 4 years of age. IBD specialists will collect maternal data (baseline/end of each trimester/1 month post-delivery), neonatal birth data, and the SAE and ASQ3 data in children exposed during pregnancy, reported every 3 months by the mother. Statistical analysis will include summary statistics for quantitative variables, comparisons of qualitative variables with significance set at p < 0.025 and a binary logistic regression model to determine the risk factors for severe infections. Results: Enrolment began in September 2019 and study completion is expected in September 2028. Conclusions: This prospective, controlled study will provide evidence on the long-term safety profile in children after intrauterine and lactation exposure to biological and immunomodulatory IBD treatments, including data on postnatal severe infections, development and malignancies. ClinicalTrials.gov identifier: NCT03894228
Return to Play and Performance in Golfers After Total Knee Arthroplasty: Does Component Type Matter?
Authors: Tramer Joseph S. , Maier Lindsay M. , Klag Elizabeth A. , Ayoola Ayooluwa S. , Charters Michael A. , North W. Trevor 
Published: June 2021

Background: Golf is a popular sport among patients undergoing total knee arthroplasty (TKA). The golf swing requires significant knee rotation, which may lead to changes in golfing ability postoperatively. The type of implant used may alter the swing mechanics or place different stresses on the knee. The purpose of this study was to evaluate golf performance and subjective stability after TKA and compare outcomes between cruciate-retaining (CR) and posterior-stabilized (PS) implants. Hypothesis: Patients with CR implants will experience better stability during the golf swing compared to patients with PS implants. Study Design: Retrospective cohort study. Level of Evidence: Level 3. Methods: Patients who underwent primary TKA were identified from the medical record and sent an electronic questionnaire focusing on return to play (RTP), performance, pain, and stability during the golf swing. Knee injury and Osteoarthritis Outcome Scores (KOOS) were collected before and at multiple time points after surgery. Patients were surveyed postoperatively and asked to evaluate overall performance, pain, and stability before and after surgery. Outcomes were compared based on implant type. Results: Most patients (81.5%) were able to return to golf at an average of 5.3 ± 3.1 months from surgery. The average postoperative KOOS was 74.6 ± 12.5 in patients able to RTP compared with 64.4 ± 9.5 in those who were not ( P < 0.05). Knee pain during golf significantly improved from 6.4 ± 2.1 to 1.8 ± 2.2 ( P < 0.01). There were no significant differences in pain, performance, or stability between the CR and PS patients. Conclusion: Most patients can successfully return to golfing after TKA. Knee replacement offers patients reliable pain relief during the golf swing and fewer physical limitations during golf, with no detriment to performance. There is no difference in performance or subjective knee stability based on component type. Clinical Relevance: Understanding associated outcomes of different TKA knee systems allows for unbiased and confident recommendations of either component to golfers receiving total knee replacement.
Diagnostic Yield of Electroencephalography When Seizure Is Suspected in Acute Ischemic Stroke
Authors: AlGaeed Mohanad , Grewal Manjot , Hareesh Prarthana , Sadeghikhah Soha , Chen Hai , Gholipour Taha , Guerrero Christopher R. Leon 
Published: June 2021

Introduction: Seizures are a common complication after an ischemic stroke. Electroencephalography can assist with the diagnosis of seizures however, the diagnostic yield of its use when seizure is suspected in the setting of acute ischemic stroke is unknown. We aim to evaluate the yield and cost of EEG in the acute ischemic stroke setting. Methods: We conducted a retrospective chart review of patients admitted to a single academic tertiary care center in the United States between September 1, 2015 to November 30, 2019 with a primary diagnosis of acute ischemic stroke and who were monitored on electroencephalography (EEG) for suspected seizures (total number of 70 patients). The primary outcome was how often EEG monitoring changed clinical management defined as starting, stopping, or changing the dose of an anti-epileptic drug. Secondary analysis was estimating the cost of EEG monitoring per change in management. Results: We identified 126 patients admitted with acute ischemic stroke who underwent EEG of which 70 met all inclusion and exclusion criteria. EEG monitoring resulted in a change in management in 22 patients (31%). Predictors associated with EEG monitoring resulting in a change in management were admission to the ICU, pre-existing atrial fibrillation, and symptomatic hemorrhagic transformation. Estimated cost of EEG per change in management was $1374.96 USD. Conclusion: EEG monitoring resulted in a changed management in nearly one-third of patients admitted with acute ischemic stroke suspected of having seizures.
Sylvian fissure arteriovenous malformations: case series and systematic review of the literature
Authors: Tarokhian Aidin , Sabahi Mohammadmahdi , Dmytriw Adam A , Arjipour Mahdi 
Published: June 2021

Background Sylvian fissure arteriovenous malformations are rare but important vascular lesions, whose importance lies in both haemorrhage and seizure risk. Although surgery has been recommended as a treatment, the overall estimation of success has not been reported to render outcomes easier to understand in comparison to other treatment modalities. Objectives This systematic review of the literature and two cases aims to illustrate the results of surgery as a contemporary treatment option and present a novel anatomical classification system for Sylvian fissure arteriovenous malformations. Materials and methods A systematic review was performed by searching MEDLINE (PubMed), EMBASE and Cochrane electronic bibliographic databases from conception to 2018. The following keywords were used: ‘Sylvian fissure’ AND ‘AVM’ OR ‘arteriovenous malformation’ OR ‘intracranial arteriovenous malformation’ OR ‘cerebral arteriovenous malformation’ OR ‘brain arteriovenous malformation’. The search strategy was not limited by study design but only included keywords in the English language. In addition, two local institution Sylvian fissure arteriovenous malformations are presented and incorporated. Results A total of nine full-text articles were included in the analysis. The results of reported cases and the literature review emphasise the role of surgery in the treatment of Sylvian fissure arteriovenous malformations, with an acceptable result in carefully selected patients. We propose a classification system which may inform the choice of surgical approach for these lesions. Conclusions Surgery remains the cornerstone of Sylvian fissure arteriovenous malformation treatment, which may apply to high-grade lesions in this special anatomical location.
Assessment of Kidney Function After Transcatheter Aortic Valve Replacement
Authors: Kliuk-Ben Bassat Orit , Sadon Sapir , Sirota Svetlana , Steinvil Arie , Konigstein Maayan , Halkin Amir , Bazan Samuel , Grupper Ayelet , Banai Shmuel , Finkelstein Ariel , Arbel Yaron 
Published: June 2021

Background: Transcatheter aortic valve replacement (TAVR), although associated with an increased risk for acute kidney injury (AKI), may also result in improvement in renal function. Objective: The aim of this study is to evaluate the magnitude of kidney function improvement (KFI) after TAVR and to assess its significance on long-term mortality. Design: This is a prospective single center study. Setting: The study was conducted in cardiology department, interventional unit, in a tertiary hospital. Patients: The cohort included 1321 patients who underwent TAVR. Measurements: Serum creatinine level was measured at baseline, before the procedure, and over the next 7 days or until discharge. Methods: Kidney function improvement was defined as the mirror image of AKI, a reduction in pre-procedural to post-procedural minimal creatinine of more than 0.3 mg/dL, or a ratio of post-procedural minimal creatinine to pre-procedural creatinine of less than 0.66, up to 7 days after the procedure. Patients were categorized and compared for clinical endpoints according to post-procedural renal function change into 3 groups: KFI, AKI, or preserved kidney function (PKF). The primary endpoint was long-term all-cause mortality. Results: The incidence of KFI was 5%. In 55 out of 66 patients patients, the improvement in kidney function was minor and of unclear clinical significance. Acute kidney injury occurred in 19.1%. Estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 was a predictor of KFI after multivariable analysis (odds ratio = 0.93 to develop KFI; confidence interval [95% CI]: 0.91-0.95, P < .001). Patients in the KFI group had a higher Society of Thoracic Surgery (STS) score than other groups. Mortality rate did not differ between KFI group and PKF group (43.9% in KFI group and 33.8% in PKF group) but was significantly higher in the AKI group (60.7%, P < .001). Limitations: The following are the limitations: heterozygous definitions of KFI within different studies and a single center study. Although data were collected prospectively, analysis plan was defined after data collection. Conclusions: Improvement in kidney function following TAVR was not a common phenomenon in our cohort and did not reduce overall mortality rate.