bluuebunny/crossref_metadata_2025_split huggingface dataset:
Delayed posttraumatic vertebral body collapse “Kummell disease”
Authors: Adamska Olga , Modzelewski Krzysztof , Stolarczyk Artur , Kseniuk Jurij 
Published: April 2021

Abstract

Introduction:
Kummell disease(KD) is a relatively rare condition, which refers to a lack of blood supply to the bone leading to collapse. It typically presents in the thoracic vertebrae of elderly patients, as a compressive deformation of the vertebral body and its osteonecrosis. It appears as a result of minor trauma experienced weeks to months before the onset of the disease. Osteoporosis tends to be the biggest risk factor for KD, hence its high frequency in the affected patient population.

Patients concerns:
A 67-year-old female patient presented to the hospital with a back pain deteriorating since 1 year, limiting her daily activities. Over the time it progressed to involve extremities and caused hypersensitivity of the skin at the level of the affected thoracic region. She had a history of osteoporotic vertebral compression fracture 2 years earlier after a fall. It was treated by conservative methods.

Diagnosis:
Computed tomography procedure revealed a compression fracture at the level of Th11. Further investigation and collection of the past medical history showed a delayed nonunion of the vertebral fracture and intravertebral vacuum cleft. The final diagnosis was KD. Conservative treatment of the patient's condition in another hospital resulted in non-healing.

Interventions:
As there is no specific treatment for patients suffering from delayed posttraumatic vertebral body collapse, an attempt of the most promising surgical combination of methods was performed. SpineJack system procedure resulted in satisfactory vertebral height improvement. This included vertebroplasty and minimally invasive percutaneous transpedicular fixation using bone-cement screw augmentation, providing stabilization and kyphotic angle correction. All these procedures facilitated pain relief and alleviation of spinal symptoms.

Outcomes:
The radiological outcomes of the patient's condition showed improvement after the surgery. Patient reported subjective improvement in daily life functioning. Follow up period at 6 and 9 months postoperatively showed stable condition and a satisfactory feedback from the patient.

Conclusion:
The conservative treatment in this patient, provoked an occurrence of markedly diminished vertebral height, debilitating back pain and neurological symptoms. These features caused a significantly lower quality of life. An accurate diagnosis of KD requires a detailed medical history and awareness of this rare condition and its irreversible complications. The treatment chosen for specific cases should primarily involve a meticulous observation of the efficacy of conservative methods. Furthermore, after the appearance of any deterioration of vertebral fracture, surgical method should be planned in order to avoid undesirable effects.
An autopsy case of Nocardia meningitis patient presenting with multiple folliculitis
Authors: Yamamoto Shintaro , Mukai Tomoyuki , Fujita Shunichi , Nishimura Hirotake , Yaguchi Takashi , Morita Yoshitaka 
Published: April 2021

Abstract

Rationale:

Nocardia is widespread in the soil and causes life-threatening infections in the central nervous system, such as meningitis. Nocardia infection can develop in immunocompetent individuals, not just in immunocompromised persons. Nocardia is a slow-growing bacterium, which makes its detection difficult during routine microbial examinations, resulting in a delayed diagnosis and poor prognosis.

Patient concerns:
A 64-year-old Japanese man was admitted with fever, headache with meningeal irritation, and multiple folliculitis on his face and neck. Cerebrospinal fluid revealed neutrophilic pleocytosis. All cultures, including cerebrospinal fluid examination, were negative, and serum procalcitonin levels were normal.

Diagnoses:
The tentative diagnosis was culture-negative bacterial meningitis or meningeal neuro-Behçet disease.

Intervention:
Meropenem was administered for 12 days, along with corticosteroids. His symptoms were temporarily relieved but worsened again, and finally, he died suddenly on the 37th day of hospitalization. An autopsy revealed extensive infiltration of inflammatory cells in the subarachnoid space, especially the brain stem, cerebellum, whole spinal cord, and cerebral base, where Nocardia species were detected. The final diagnosis was Nocardia meningitis.

Lessons:
Given the very close timing of the onset of signs of meningitis and multiple folliculitis, the most reasonable and probable idea is that the patient had disseminated nocardiosis. In patients with meningitis with multiple skin infection lesions, such as folliculitis, nocardiosis should be considered a differential diagnosis.
Stroke Risk Scores as Predictors of Severe Outcomes in Atrial Fibrillation: A Comprehensive Review
Authors: Ivănescu Andreea Cristina , Buzea Cătălin Adrian , Delcea Caterina , Dan Gheorghe-Andrei 
Published: April 2021

Background:
Atrial fibrillation (AF) is the most frequent sustained arrhythmia. It increases the risk of stroke, heart failure, death, hospitalizations, and costs.

Area of uncertainty:
Several scores were introduced to stratify the stroke risk and need for anticoagulation in patients (pts) with AF . CHA2DS2-VASc, the most frequently used score, as well as other stroke risk scores have been additionally applied to estimate outcomes for different other conditions, with inhomogeneous results. To date, there has been no consensus regarding the usefulness of these scores to estimate outcomes outside of thromboembolic risk assessment, and their value in estimating different end-point outcomes is still a subject of debate. We conducted this review to investigate whether the stroke risk scores' utility can be extended for the prediction of other severe outcomes in pts with AF.

Data sources:
We searched PubMed database and included studies that stratified the outcome of pts with AF by different stroke risk scores. We also included studies with a separate analysis of the pts with AF subpopulation.

Results:
Mortality rates increased with higher CHADS2 [from 2.28% (2.00%–2.58%) to 13.2% (8.24%–20.8%) per year] and CHA2DS2-VASc scores [risk ratio 1.26 (1.21–1.32), P < 0.0001 for score ≥3]. CHADS2 and CHA2DS2-VASc predicted poor outcome in stroke [odds ratio (OR) ranging 1.42–6 for CHADS2 and 1.3–7.3 for CHA2DS2-VASc]. Acute myocardial infarction rates increased with higher CHADS2 [OR 2.120 (1.942–2.315) P < 0.001] and CHA2DS2-VASc [OR 1.63 (1.53–1.75), P < 0.001]. Limited data were reported for ABC( Age, Biomarkers, Clinical histoty) and R2CHADS2. No statistically significant correlation was found for major bleeding.

Conclusions:
CHADS2 and CHA2DS2-VASc are useful tools in identifying pts with AF at higher risk for all-cause death, regardless of other pathologies. Both scores correlated with the development of acute myocardial infarction, cardiovascular hospitalization, outcome in stroke, major adverse cardiovascular events, and major adverse cardiovascular and cerebral events, but not with serious bleeding.
The impact of inflammatory bowel disease on women's lives
Authors: Truta Brindusa 
Published: April 2021

Purpose of review
Inflammatory bowel disease (IBD) affects women differently than men. This review outlines the current thinking on the impact of IBD, Crohn's disease and ulcerative colitis, on women's health.

Recent findings
IBD symptoms worsen during the menstrual cycle without corelating to disease activity. Endometriosis is more frequent in women with than those without IBD. Low fertility rate is rather because of voluntary childlessness than severe disease, perianal involvement, and ileal pouch anal anastomosis (IPAA) surgery. For women with ulcerative colitis, in-vitro fertilization successfully overcomes the post-IPAA infertility. The use of biologics and thiopurines throughout pregnancy is well tolerated for both the mother and the child but the use of small molecule therapy still needs more data. These medications increase the risk of cervical cancer, anal cancer, and aggressive vulvar cancer. More screening efforts are required to keep patients healthy. Women with Crohn's disease report worse psychological well being less resilience than men but they develop more escape and avoidance strategies to cope with the disease. Depression impairs the quality of sexual life but sexual dysfunction is rarely discussed with the provider.

Summary
Understanding the effects of sex on IBD allows personalized care and improves women's quality of life.
Long-term outcomes of treatments for achalasia
Authors: Nullens Sara , Fockens Paul , Bredenoord Albert J. 
Published: April 2021

Purpose of review
Idiopathic achalasia is a primary motility disorder of the esophagus that results in dysphagia, weight loss, and impaired quality of life. Several treatment options are available to gastroenterologists, and insights on the long-term outcome of these modalities are discussed.

Recent findings
Peroral endoscopic myotomy (POEM) represents a novel endoscopic technique in the treatment of achalasia. Studies on long-term outcomes and comparison to other well-known treatment modalities such as laparoscopic Heller myotomy (LHM) and pneumodilation have recently been published. POEM and LHM both have excellent 2-year success rates for relieving achalasia symptoms, but reflux disease and erosive esophagitis are more prevalent following POEM.

Summary
Several treatment modalities with excellent long-term outcomes are available for the treatment of achalasia. The different options should be discussed with patients and treatments should be tailored to their individual needs.
The current state of artificial intelligence in cardiac transplantation
Authors: Goswami Rohan 
Published: April 2021

Purpose of review
The field of heart transplantation is a complex practice that combines both science and art to optimize the quality and quantity of an organ transplant recipient's life span. In the current age of Transplant Medicine there are many limiting factors that prevent potentially usable organs to be transplanted in addition to the many unknown factors in assessing the risk of posttransplant complications in a proactive manner. This review focuses on the current state, and potential use, and implementation of artificial intelligence technologies in the field of heart transplantation. Furthermore, the utilization of predictive algorithms to assess donor quality, graft function, posttransplant complications and prediction of high-risk complications will be discussed. Artificial intelligence technologies in the pretransplant population is also explored.

Recent findings
Artificial intelligence process use has been increasing over the past decade. Early adoption in radiology and laboratory medicine have shown promise for future applications. Implementation of nascent technologies within the field of transplant medicine remains in its infancy. Cardiac and renal medicine have been recent focuses of large-scale artificial intelligence projects because of the wealth of data, the main limiting factor for producing accurate models. Understanding the true role of artificial intelligence in medicine is key – and has been divided into three areas of focus: data quality, interpretation, and clinical application. These areas allow the clinician to translate problems facing patients into algorithms utilized by data scientists to create solutions, which may provide in-depth analysis and detection of relationships not immediately clear. Although some published data has led to commercial products for cardiac, diabetic, and dermatologic applications -- widespread adoption remains limited to specialized centers.

Summary
Artificial intelligence applications with clinically relevant models in transplant medicine have the potential to optimize organ utilization, prediction of complications, and potential pretransplant management, which may mitigate the need for transplant. Further translational projects are under development at major centers, with proof of concepts demonstrating validity and safety in the clinical setting. Limiting factors of infrastructure, expertise, and data availability continue to be addressed. Ongoing efforts for commercialization and large-scale trials will provide a foundation for the development of artificial intelligence applications in transplant medicine.
Lung transplantation: candidate selection and timing of transplant
Authors: Shah Purav , Neujahr David C. 
Published: April 2021

Purpose of review
Over the past two decades, lung transplant has become the mainstay of treatment for several end-stage lung diseases. As the field continues to evolve, the criteria for referral and listing have also changed. The last update to these guidelines was in 2014 and several studies since then have changed how patients are transplanted. Our article aims to briefly discuss these updates in lung transplantation.

Recent findings
This article discusses the importance of early referral of patients for lung transplantation and the concept of the ‘transplant window’. We review the referral and listing criteria for some common pulmonary diseases and also cite the updated literature surrounding the absolute and relative contraindications keeping in mind that they are a constantly moving target. Frailty and psychosocial barriers are difficult to assess with the current assessment tools but continue to impact posttransplant outcomes. Finally, we discuss the limited data on transplantation in acute respiratory distress syndrome (ARDS) due to COVID19 as well as extracorporeal membrane oxygenation bridge to transplantation.

Summary
The findings discussed in this article will strongly impact, if not already, how we select candidates for lung transplantation. It also addresses some aspects of lung transplant such as frailty and ARDS, which need better assessment tools and clinical data.
Electrodermal Activity of Auricular Acupoints in Pediatric Patients With Functional Abdominal Pain Disorders
Authors: Borlack Rachel E. , Shan Sophie , Zong Amanda M. , Khlevner Julie , Garbers Samantha , Gold Melanie A. 
Published: April 2021

ABSTRACTObjectives:Functional abdominal pain disorders (FAPD) affect approximately 13.5% of children. Pharmacotherapy is often ineffective, leaving providers, and families seeking adjunctive therapies. Auriculotherapy provides treatment for pain and other symptoms, without a defined protocol for FAPD. A handheld point‐finder device measuring transdermal electrical current determines active acupoints, with a higher current indicating a more active acupoint. Our objectives were to determine auricular acupoint (AA) activity in FAPD and to assess participants’ attitudes towards auriculotherapy.Methods:This is a prospective double‐blind study evaluating the electrodermal activity of AAs in pediatric‐aged female participants with FAPD compared to healthy controls (HC). Participants completed surveys regarding demographics and interest in auriculotherapy. The electrodermal assessment evaluated 20 AAs per ear using a point‐finder device. Each AA current measurement was analyzed by average relative rank and median, with a median current measurement ≥50 μA considered active.Results:We enrolled 46 female participants, 22 FAPD (mean age 15.8 years) and 24 HC (mean age 15.4 years). In FAPD, 12 of 40 AAs were active, of which only six were also active in HC. Comparison of median current and average ranking between participants demonstrated consistency. In the post‐assessment survey, 86.4% of FAPD expressed interest in receiving auricular acupressure and 68.2% would travel to the clinic solely for treatment.Conclusions:Based on electrodermal measurements, we propose a treatment protocol using auriculotherapy for FAPD symptom‐management. We demonstrated there is considerable patient interest in auriculotherapy. Further studies are needed to confirm the findings in a larger sample size and validate the efficacy of this treatment protocol.
Superior Mesenteric Artery Blood Flow in Parenterally Fed Versus Enterally Fed Preterm Infants
Authors: Elgendy Marwa M. , El Sharkawy Hamed M. , Elrazek Hussein Abd , Zayton Hossam A. , Aly Hany 
Published: April 2021

ABSTRACTObjectives:The aim of the study was to compare superior mesenteric artery (SMA) flow in premature infants with parenteral and enteral nutrition.Methods:A prospective study was conducted on 2 groups of preterm infants with gestational age of 280/7 to 366/7 weeks: group 1 did not qualify for early enteral feeds and received parenteral nutrition (PN), and group 2 received early enteral feeding. SMA peak systolic velocity (PSV), end diastolic velocity (EDV), and pulsatility index (PI) were measured using Doppler ultrasound before starting feeds at day 1 and at day 5.Results:The study recruited 40 infants; 20 in each group. At baseline, PSV, EDV, and PI did not differ between groups. At day 5, enteral nutrition was associated with significant increases in PSV (91.53 ± 29.15 vs 65.49 ± 19.18, P = 0.003) and EDV (15.91 ± 7.01 vs 11.65 ± 5.58, P = 0.026) and a decrease in PI (1.28 ± 0.40 vs 2.48 ± 0.83, P < 0.001). Regression analysis to control for confounders showed enterally fed infants to have increased PSV (adjusted odds ratio [aOR] = 25.45; 95% confidence interval [CI]: 8.53–42.38, P = 0.004) and EDV (aOR 8.630; 95% CI: 2.987–14.273, P = 004) and decreased PI (aOR = −1.133; 95% CI: −1.603 to −0.664, P < 0.001). Infants in the PN group later developed more frequent feeding intolerance when compared with the enterally fed group (65% vs 15%, respectively, P < 0.001).Conclusions:In preterm neonates, early EF is associated with increased SMA blood flow, decreased vascular intestinal resistance, and less frequent incidence of feeding intolerance.
PedsQL™ Gastroparesis Symptoms Module Domain and Item Development
Authors: Varni James W. , Shulman Robert J. , Self Mariella M. , Febo‐Rodriguez Liz , Charron Heather , Williams Kent , Nurko Sam , Rosen Rachel L. , Chumpitazi Bruno P. ,   Gastroparesis Research Consortium (GpCRC)
Published: April 2021

ABSTRACTObjectives:Like adults, children suffer from gastroparesis; however, there are currently no validated instruments to determine the impact of gastroparesis in pediatric patients. The objective of this study was to develop the items and domains to support the content validity of the new Pediatric Quality of Life Inventory (PedsQL™) Gastroparesis Symptoms Module.Methods:Patients were recruited from the National Institute of Diabetes and Digestive and Kidney Diseases Pediatric Gastroparesis Registry. The qualitative methods involved an iterative process comprising a literature review of existing questionnaires and gastroparesis clinical research, an expert review panel of pediatric gastroenterologists who provided feedback on the conceptual framework in developing the semi‐structured interview, and in‐depth focus interviews with six pediatric patients with gastroparesis and five of their parents (one did not participate) in developing relevant domains and item content. In the subsequent cognitive interviews phase, five additional patients with gastroparesis and their parents provided detailed feedback on item content, relevance, importance, and understandability of the domains and items.Results:Ten domains/scales were derived from the qualitative methods, with item content saturation achieved at 67 items, with no further themes or content identified during the final cognitive interviews. The Module is comprised of 10 individual scales measuring nausea, stomach fullness when eating, vomiting, dry heaves, heartburn and reflux, stomach pain and hurt, food and drink limits, bloating, appetite, and worry.Conclusions:Our study supports the content validity of the new PedsQL Gastroparesis Symptoms Module. The Module field test study will be conducted in a multisite national study.
Barriers to and Facilitators of Bedside Nursing Handover
Authors: Clari Marco , Conti Alessio , Chiarini Daniela , Martin Barbara , Dimonte Valerio , Campagna Sara 
Published: April 2021

Background:
Bedside nursing handover (BNH) has been recognized as a contributor to patient-centered care. However, concerns about its effectiveness suggest that contextual factors should be considered before and after BNH implementation.

Purpose:
This review aimed to identify, evaluate, and synthetize the qualitative literature on the barriers to and facilitators of BNH as experienced by nurses and patients.

Methods:
The Joanna Briggs Institute meta-aggregation method was applied. A systematic search was performed to identify qualitative studies published from inception to June 30, 2020. Two independent researchers assessed methodological quality and extracted data.

Results:
Twenty-four articles were included, comprising 161 findings, and 5 synthesized findings emerged with a moderate level of confidence.

Conclusions:
BNH ensures patient safety and increases satisfaction and recognition among patients and nurses. This evidence on the barriers to and facilitators of BNH could help health care providers who have implemented or plan to implement this practice.
Addressing Suffering in Patients With Psychiatric Disorders
Authors: Yager Joel 
Published: April 2021

Background
Patients with psychiatric disorders (as well as general medical conditions) often describe their lives in terms of suffering. Although suffering is honored as a central focus of physicians' concerns, it is not even indexed in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition. Generally connoting severe, prolonged distress, suffering can be distinguished from pain, depression, and anxiety. The aims of this article are to consider whether attending to suffering per se in psychiatric patients merits attention independent of other commonly assessed psychiatric symptoms such as anxiety, depression, and conventional distress, and how targeting suffering per se might add value to psychiatric patient care.

Methods
Sources for this article were obtained via a selective literature search in PubMed using the terms “suffering” in the title and the terms “psychiatric disorder,” “mental illness,” “assessment,” “measurement,” “scale,” “existential suffering,” and “unbearable suffering.” Articles of interest were followed up using a snowball technique to examine “similar articles” and “cited by” titles to find additional pertinent articles.

Results
Definitions of suffering in the medical literature stress its subjectivity, particularity, complexity, and connection to a wide variety of noxious sensations, as well as real and anticipated deficits, losses, and thwarted motivations. These can affect the entire spectrum of universal human needs, from basic biological issues through intrapsychic, interpersonal, and social issues, encompassing existential concerns of meaning, purpose, and transcendence. Based on these factors, a definition of suffering in patients with psychiatric disorders is proposed. Although efforts to measure suffering have been limited and numerous gaps in the literature are evident, several scales may offer suitable bases for the study of suffering in patients with psychiatric disorders.

Conclusions and Implications
Ascertaining sources of suffering may require new types of inquiry and additional time. Well-described, evidence-informed strategies and time-honored psychotherapy techniques are available for addressing the numerous concerns that contribute to suffering. Patients with psychiatric disorders whose distinct, multidimensional sources of suffering are identified, acknowledged, and addressed may experience better treatment quality, greater treatment satisfaction, and possibly better outcomes than those whose clinicians' attention is limited to conventional psychiatric signs and symptoms.