bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bladder Instillations With Triamcinolone Acetonide for Interstitial Cystitis–Bladder Pain Syndrome
Authors: Cardenas-Trowers Olivia O. , Abraham Alyce G. , Dotson Thomas K. , Houlette Brooke A. , Gaskins Jeremy T. , Francis Sean L. 
Published: April 2021

OBJECTIVE:
To evaluate the utility of adding triamcinolone acetonide to a standard bladder instillation solution for treatment of interstitial cystitis–bladder pain syndrome.

METHODS:
This was a single-center, randomized, double-blind trial that compared symptom response in women with interstitial cystitis–bladder pain syndrome who underwent six bladder instillations with triamcinolone acetonide or six instillations without. All instillation solutions contained heparin, viscous lidocaine, sodium bicarbonate, and bupivacaine. The primary outcome was the change in interstitial cystitis–bladder pain syndrome symptoms from the first to sixth bladder instillation between groups based on the total OLS (O'Leary-Sant Questionnaire) score. Assuming a 4.03-point or larger difference in the mean total OLS score from the first to sixth bladder instillation as compared between the groups, 64 participants were needed to show a significant difference with 80% power at the 0.05 significance level.

RESULTS:
From January 2019 to October 2020, 90 women were enrolled—45 per group; 71 (79%) completed all six bladder instillations. Randomization resulted in groups with similar characteristics. There was no difference between groups in the primary outcome (bladder instillation with triamcinolone acetonide: mean OLS change −6.7 points, 95% CI 4.6–8.8 and bladder instillation without triamcinolone acetonide: mean OLS change −5.8 points, 95% CI 3.4–8.1; P=.31). Women in both groups had improvement in their interstitial cystitis–bladder pain syndrome symptoms as indicated by a decrease in the total OLS score from the first to sixth bladder instillation.

CONCLUSION:
The addition of triamcinolone acetonide to a standard bladder instillation solution does not improve symptoms associated with interstitial cystitis–bladder pain syndrome.

CLINICAL TRIAL REGISTRATION:

ClinicalTrials.gov, NCT03463915.
Current co-morbidities burden in patients living with HIV in low- and middle-income countries
Authors: Ponatshego Ponego Lloyd , Youssouf Nabila Farah , Mosepele Mosepele 
Published: April 2021

Purpose of review
The present review aims to decipher common co-morbidities faced by people living with HIV in low- to middle-income countries, and in particular the sub-Saharan region, which hosts the majority of the HIV burden worldwide.

Recent findings
Well-controlled chronic HIV disease is strongly associated with an increased risk of developing cardiovascular disease. This is partly due to the natural aging process, however recent studies show that using antiretroviral therapy as well as the HIV disease itself may be predisposing factors to the development of cardiovascular diseases, creating a new burden for healthcare facilities in the region. Furthermore, newly completed studies assessing inflammation marker albuminuria and age-related syndrome frailty have been found in a higher prevalence than in non-HIV infected people, with increased morbidity and mortality.

Summary
As antiretroviral medication continues to be well supplied in the region and well tolerated by patients living with HIV, this group is now reckoning with cardiovascular ailments faced by all ageing population therefore there is a need for cardiovascular care systems to be better integrated within the existing, well-performing HIV care systems to address this burden.
Frailty: the current challenge for aging people with HIV
Authors: Falutz Julian , Brañas Fátima , Erlandson Kristine M. 
Published: April 2021

Purpose of review
Older adults account for the majority of people with HIV (PWH) in high-income countries and have increasingly complex clinical profiles related to premature aging. Frailty is an important geriatric syndrome affecting a minority of PHW. Frailty negatively affects PHW's clinical status and quality of life. This review will update care providers on the current state of frailty that limits the healthspan of PWH.

Recent findings
Ongoing low-level HIV replication in treated PWH leads to immune activation and chronic inflammation contributing to the destabilization of normally autoregulated physiologic systems in response to environmental and biologic challenges characteristic of frailty. Understanding these underlying mechanisms will determine potential intervention options. Potentially reversible risk factors that promote progression to and reversion from the dynamic state of frailty are being studied and will help prevent frailty. Simple assessment tools and treatment strategies for frailty are being adapted for aging PWH.

Summary
Insight into underlying biologic mechanisms and adapting proven geriatric principles of interdisciplinary care will inform the healthy aging of PWH.
Virtual Reality as a Nonpharmacological Strategy in Pediatric Pain Control During Procedures With Needle Use
Authors: Pestana-Santos Marcia , Santos Daniela , Pinto Jéssica , Nunes Sara , Lomba Lurdes 
Published: April 2021

Introduction
Needle procedures can be very painful for children and generate stress and anxiety. Virtual reality (VR) has been used to enhance a child's distraction for pain control during these procedures. This study aims to identify the advantages and limitations of VR used for pain control in procedures using needles in pediatrics.

Methods
Studies were limited to children aged 4–18 years undergoing a procedure involving needles and the use of VR with goggles, headset, or helmet. A comprehensive search strategy using CINAHL Complete, MedicLatina, Medline Complete, B-on, LILACS, and SciELO databases was undertaken to find relevant studies published from January 2015 to April 2020. The retained studies included experimental and quasi-experimental, randomized controlled trials and nonrandomized controlled trials as well as prospective and retrospective studies.

Results
The search yielded 80 articles. Of these, six articles met the inclusion criteria. Advantages found with the use of VR were (a) decrease of pain; (b) improvement of communication; (c) increased probability of success in performing the procedures; (d) reduction of anxiety, stress, distress, and fear; (e) easier handling of equipment; (f) almost complete isolation of external noise; and (g) low cost, lightness, and ease of transportation. Disadvantages reported were goggles' size and annoyance from repeated play and the occasional side effect of nausea.

Discussion
VR is considered an interactive digital therapeutic toy used with positive effects in clinical practice. As children become calmer, VR can also reduce nursing stress and improve communication between children and nurses.
Estimating Prevalence of Hepatitis B Virus Coinfection Among Adults With Tuberculosis
Authors: Wong Robert J. , Hubbard Ashley , Bagley Laurie , Shiau Rita , Chitnis Amit S. 
Published: April 2021

Background:
While patients with hepatitis B virus (HBV) infection and tuberculosis (TB) have similar risk factors, little is known regarding the prevalence of HBV and TB coinfection. We aim to evaluate the prevalence of HBV among patients with TB across world regions.

Methods:
We systematically reviewed the literature using PubMed from inception through September 1, 2019, to identify studies that provided data to calculate HBV coinfection prevalence among adults with TB infection. Prevalence estimates of HBV coinfection among TB patients were stratified by world regions and calculated using meta-analyses with random-effects models.

Results:
A total of 36 studies met inclusion criteria (4 from the Africa region, 6 from the Americas region, 5 from the Eastern Mediterranean region, 2 from European region, 6 from Southeast Asia region, and 13 from the Western Pacific region). On meta-analysis, overall pooled HBV coinfection prevalence among TB patients was 7.1%, but varied by world region. Region-specific pooled HBV prevalence among TB patients was highest in Africa region [11.4%, 95% confidence interval (CI): 3.45-19.31] and Western Pacific region (10.8%, 95% CI: 8.68-12.84), and was lowest in the Americas (2.2%, 95% CI: 0.78-3.53). Sensitivity analyses yielded similar HBV prevalence estimates across world regions.

Conclusions:
In this meta-analysis, we observed HBV coinfection prevalence among TB patients to be 38% to 450% higher than published estimates from the Polaris group of region-specific overall HBV prevalence. Timely identification of HBV infection among TB patients will improve patient outcomes by allowing for closer clinical monitoring and management, which may reduce the risk of liver dysfunction and liver failure related to TB treatment.
Artificial Intelligence and Early Detection of Pancreatic Cancer
Authors: Kenner Barbara , Chari Suresh T. , Kelsen David , Klimstra David S. , Pandol Stephen J. , Rosenthal Michael , Rustgi Anil K. , Taylor James A. , Yala Adam , Abul-Husn Noura , Andersen Dana K. , Bernstein David , Brunak Søren , Canto Marcia Irene , Eldar Yonina C. , Fishman Elliot K. , Fleshman Julie , Go Vay Liang W. , Holt Jane M. , Field Bruce , Goldberg Ann , Hoos William , Iacobuzio-Donahue Christine , Li Debiao , Lidgard Graham , Maitra Anirban , Matrisian Lynn M. , Poblete Sung , Rothschild Laura , Sander Chris , Schwartz Lawrence H. , Shalit Uri , Srivastava Sudhir , Wolpin Brian 
Published: April 2021

Abstract
Despite considerable research efforts, pancreatic cancer is associated with a dire prognosis and a 5-year survival rate of only 10%. Early symptoms of the disease are mostly nonspecific. The premise of improved survival through early detection is that more individuals will benefit from potentially curative treatment. Artificial intelligence (AI) methodology has emerged as a successful tool for risk stratification and identification in general health care. In response to the maturity of AI, Kenner Family Research Fund conducted the 2020 AI and Early Detection of Pancreatic Cancer Virtual Summit (www.pdac-virtualsummit.org) in conjunction with the American Pancreatic Association, with a focus on the potential of AI to advance early detection efforts in this disease. This comprehensive presummit article was prepared based on information provided by each of the interdisciplinary participants on one of the 5 following topics: Progress, Problems, and Prospects for Early Detection; AI and Machine Learning; AI and Pancreatic Cancer—Current Efforts; Collaborative Opportunities; and Moving Forward—Reflections from Government, Industry, and Advocacy. The outcome from the robust Summit conversations, to be presented in a future white paper, indicate that significant progress must be the result of strategic collaboration among investigators and institutions from multidisciplinary backgrounds, supported by committed funders.
Impact of Antidepressant Prescriptions on Suicidal Behavior in Times of Severe Financial Strain
Authors: Sacchi Valentina , Mattei Giorgio , Musetti Laura , Galeazzi Gian Maria 
Published: April 2021

Abstract
This descriptive study observes the relationship between antidepressant prescriptions and the suicide rate in Italy in the 2000s to the mid-2010s, which includes a period of severe economic crisis. The observation period was from 2000 to 2015. Suicide and unemployment rates disaggregated by age and sex were collected from the Italian Institute of Statistics. Statistical analyses were performed using correlations between suicide rates and the defined daily dose, with reference to selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TCAs), and other types of antidepressants. Fixed-effects panel regressions were also run. Increases in SSRIs prescriptions were associated with decreases in suicide rates among both men and women. However, when the analyses were adjusted for the rate of growth of the unemployment rate and for gross domestic product, the associations were weaker. The potential protective factor of SSRIs with respect to suicidal behavior may be reduced by severe recessions, especially when unemployment increases.
Impact of COVID-19–Related Social Distancing on Delivery of Intensive Case Management
Authors: Rosenheck Robert , Johnson Barbara , Deegan Debbie , Stefanovics Elina 
Published: April 2021

Abstract
Social distancing due to COVID-19 may adversely impact treatment of adults with serious mental illness, especially those receiving intensive forms of community-based care, in part through weakening of the therapeutic alliance. Veterans and staff at a Veterans Affair (VA) medical center were surveyed 3 months after social distancing disrupted usual service delivery in intensive community-based treatment programs. Veterans (n = 105) and staff (n = 112) gave similar multi-item ratings of service delivery after social distancing, which involved far less face-to-face contact and more telephone contact than usual and rated their therapeutic alliances and clinical status similarly as “not as good” on average than before social distancing. Self-reported decline in therapeutic alliance was associated with parallel decline in clinical status indicators. Both veterans and staff indicated clear preference for return to face-to-face service delivery after the pandemic with some telehealth included.
The Population-Level Effect of Screening for Mycoplasma genitalium on Antimicrobial Resistance: A Quasi-Experimental Study
Authors: Kenyon Chris , De Baetselier Irith , Vanbaelen Thibaut , Buyze Jozefien , Florence Eric 
Published: April 2021

Background
No studies have evaluated the utility and risks of screening for Mycoplasma genitalium in men who have sex with men taking preexposure prophylaxis (PrEP). We made use of a quasi-experimental design to evaluate the effect of screening for M. genitalium in a demonstration PrEP cohort with 3-monthly follow-up.

Methods
We compared the proportion of PrEP participants with M. genitalium clearance, the duration of persistence, proportion with incident symptoms, the incidence of fluoroquinolone and macrolide resistance, and the proportion of noncleared infections with resistance-associated mutations between 2 groups: those in whom the first episode of M. genitalium was treated and those in whom it was not treated.

Results

M. genitalium was detected in 70 of 179 individuals. The first episode of infection was treated in 46 individuals. Treatment was not significantly associated with the incidence of symptomatic infections or the acquisition of genotypic resistance. Treatment was associated with a higher probability of clearance of infection but at the expense of increasing the proportion of remaining infections that were resistant. In the nontreated group, the infections that did not clear were less likely to be fluoroquinolone resistant (1/6 [16.7%]) than those that did clear (4/4 [100%]; P = 0.048). In contrast, in the treated group, there was no significant difference in the proportion of fluoroquinolone resistance between the infections that persisted and cleared.

Conclusions
If screening and treatment increase the ratio of resistant to susceptible M. genitalium in a population, then this could play a role in the spread of antimicrobial resistance.
Evidence-Based Approach to Timing of Nerve Surgery
Authors: MacKay Brendan J. , Cox Cameron T. , Valerio Ian L. , Greenberg Jeffrey A. , Buncke Gregory M. , Evans Peter J. , Mercer Deana M. , McKee Desirae M. , Ducic Ivica 
Published: April 2021

Abstract
Events causing acute stress to the health care system, such as the COVID-19 pandemic, place clinical decisions under increased scrutiny. The priority and timing of surgical procedures are critically evaluated under these conditions, yet the optimal timing of procedures is a key consideration in any clinical setting. There is currently no single article consolidating a large body of current evidence on timing of nerve surgery. MEDLINE and EMBASE databases were systematically reviewed for clinical data on nerve repair and reconstruction to define the current understanding of timing and other factors affecting outcomes. Special attention was given to sensory, mixed/motor, nerve compression syndromes, and nerve pain. The data presented in this review may assist surgeons in making sound, evidence-based clinical decisions regarding timing of nerve surgery.
Fibroadipose Vascular Anomaly of the Upper Extremity
Authors: Strübing Felix , Sadick Maliha , Porubsky Stefan , Harhaus Leila , Bigdeli Amir , Kneser Ulrich 
Published: April 2021

Abstract
Alomari and colleagues described in 2014 for the first time a distinct combination of vascular malformation, fibrofatty muscular infiltration and contracture which was termed fibroadipose vascular anomaly (FAVA) (J Pediatr Orthoped 34, 109–117 (2014). So far only few publications (J Pediatr Orthoped (2014) 34, 109–117; J Hand Surg (2020). 45, 68.e1, 68.e13; Ann Vasc Dis (2014) 7, 316–319; Pediatr Radiol 46, 1179–1186 (2016)) concerning this newly described disease have been published, covering only a limited number of cases. We present a case of a 19-year-old male patient suffering from a FAVA of the proximal forearm with a severe contracture of the infiltrated flexor musculature. Upon surgery, we observed infiltration of the ulnar nerve. We were able to successfully resect the vascular malformation. Secondary tendon transfer was performed after extensive resection of the flexor musculature.
FAVA presents a differential diagnosis in patients with solid growth of the upper or lower extremity and contracture of the involved extremity. We conclude that patients suffering from FAVA of the upper extremity should be referred to a center specialized in oncologic extremity surgery and reconstructive hand and microsurgery.
Does the Use of Intraoperative Angiography Reduce the Incidence of Postoperative Wound and Flap Complications in Complex Lower Extremity Oncologic Reconstruction?
Authors: Kapadia Kailash , Dalena Maragaret , Cavanaugh Zachary , Ayyala Haripriya , Ippolito Joesph , Beebe Kathleen , Benevenia Joseph , Lee Edward S. 
Published: April 2021

Introduction
Intraoperative laser angiography via indocyanine green (ICG) has become a valuable tool in objectively assessing tissue perfusion in reconstructive procedures. Studies have demonstrated the utility of ICG angiography (ICGA) for decreasing both mastectomy skin flap necrosis and wound healing complications in abdominal wall reconstruction. This tool has not been studied in lower extremity oncologic reconstruction. The objective of this study was to compare postoperative complications in lower extremity oncologic reconstruction managed with or without laser-assisted ICGA.

Methods
A retrospective chart review was performed of patients undergoing complex lower extremity oncologic reconstruction at a single institution between 2000 and 2018. Patient information regarding demographics, comorbidities, operative procedures, and postoperative complications was analyzed.

Results
Sixty-one patients were identified in our study. As some patients underwent multiple reconstructive surgeries, a total of 76 reconstructive procedures were analyzed. Patients with plastic surgery reconstruction using ICGA (n = 36) were compared with those without, non-ICGA (n = 40). No significant differences in age, sex, smoking status, chemotherapy, or radiation history were identified between cohorts. The total number of postoperative complications did not statistically differ between cohorts. There was no statistically significant difference in the number of required reoperation because of a postoperative complication between the ICGA and non-ICGA groups (0.44 vs 0.4).

Conclusions
The incidence of postoperative wound complications after complex lower extremity oncologic reconstruction remains high. The findings of our study suggest that clinical judgment of flap and soft tissue viability, as compared with ICGA, may lead to comparable operative outcomes and be more cost-effective. Long-term follow-up and prospective studies are needed to further investigate this trend.
The Addition of a Nerve Transfer to the Treatment of Peroneal Neuropathy Secondary to Intraneural Ganglion
Authors: Winter Jessica , Zhang Yiyang , Clark Tod A. , Giuffre Jennifer L. 
Published: April 2021

Abstract
Peroneal intraneural ganglia are rare, and their management is controversial. Presently, the accepted treatment of intraneural ganglia is decompression and ligation of the articular nerve branch. Although this treatment prevents recurrence of the ganglia, the resultant motor deficit of foot drop in the case of intraneural peroneal ganglia is unsatisfying. Foot drop is classically treated with splinting or tendon transfers to the foot. We have recently published a case report of a peroneal intraneural ganglion treated by transferring a motor nerve branch of flexor hallucis longus into a nerve branch of tibialis anterior muscle in addition to articular nerve branch ligation and decompression of the intraneural ganglion to restore the patient's ability to dorsiflex. We have since performed this procedure on 4 additional patients with appropriate follow-up. Depending on the initial onset of foot drop and time to surgery, nerve transfer from flexor hallucis longus to anterior tibialis nerve branch may be considered as an adjunct to decompression and articular nerve branch ligation for the treatment of symptomatic peroneal intraneural ganglion.
Silver diamine fluoride and oral health-related quality of life: A network meta-analysis
Authors: Ruff Ryan Richard , Whittemore Rachel , Grochecki Martyna , Bateson Jillian , Barry-Godin Tamarinda 
Published: April 2021

AbstractObjectiveSilver diamine fluoride (SDF) is an effective non-surgical treatment for dental caries which may also impact oral health-related quality of life (OHRQoL). The objective of this study was to conduct a network meta-analysis of SDF versus other standard of care therapies on OHRQoL.Data SourcesStudies published in PubMed/MEDLINE, Scopus, or Web of Science through March 2021 with no date or language restrictions.Study SelectionAny randomized controlled trial, cohort, or case-control study that included silver diamine fluoride as either a single or combinative treatment for dental caries and a quantitatively measured outcome for oral health-related quality of life was included.Data Extraction and SynthesisPotentially eligible studies were screened by two independent reviewers trained in conducting systematic reviews. Studies meeting inclusion criteria underwent a full-text review with data being extracted using a standardized form, including publication details, study methodology, outcomes, assessors, and sample information. Studies underwent a risk of bias assessment and quality of evidence evaluation. Quantitative synthesis was performed using network meta-analysis.Main Outcome(s) and Measure(s)Oral health-related quality of life.Results19 articles were returned following search strategies. Following screening, ten studies were evaluated for full-text eligibility and five were retained for meta-analyses. Studies included in quantitative synthesis were classified as a high degree of evidence, suggesting estimated effects are similar to true effects. Direct and indirect estimates from network meta-analysis indicated that OHRQoL in children was not significantly different when treated with SDF versus atraumatic restorations (d = 0.02, 95% CI = -0.32, 0.36) or placebo (d = 0.03, 95% CI = -0.16, 0.22).ConclusionsEvidence from the literature consistently shows no discernible impact on OHRQoL across various non-surgical treatments for dental caries. Overall oral health-related quality of life may increase regardless of treatment protocol due to treatment of the underlying disease. Concerns over the staining of dental decay and oral mucosa resulting from treatment with silver diamine fluoride do not seem to affect OHRQoL.