bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy and safety of a modified method for blind bedside placement of post-pyloric feeding tube: a prospective preliminary clinical trial
Authors: Bing Xiong , Yinshan Tang , Ying Jin , Yingchuan Shen 
Published: February 2021

Objective To compare the efficacy and safety of a new modified method of bedside post-pyloric feeding tube catheterization with the Corpak protocol versus electromagnetic-guided catheterization. Materials and Methods We conducted a single-center, single-blinded, prospective clinical trial. Sixty-three patients were treated with a non-gravity type gastrointestinal feeding tube using different procedures: modified bedside post-pyloric feeding tube placement (M group), the conventional Corpak protocol (C group), and standard electromagnetic-guided tube placement (EM group). Results The success rate in the M group, C group, and EM group was 82.9% (34/41), 70.7% (29/41), and 88.2% (15/17), respectively, with significant differences among the groups. The time required to pass the pylorus was significantly shorter in the M group (26.9 minutes) than in the C group (31.9 minutes) and EM group (42.1 minutes). The proportion of pylorus-passing operations completed within 30 minutes was significantly higher in the M group than in the C group and EM group. No severe complications occurred. Conclusion This modified method of bedside post-pyloric feeding tube catheterization significantly shortened the time required to pass the pylorus with no severe adverse reactions. This method is effective and safe for enteral nutrition catheterization of patients with dysphagia and a high risk of aspiration pneumonia.
Bidirectional Correlations Between Dopaminergic Function and Motivation in Parkinson’s Disease
Authors: Hinkle Jared T. , Mills Kelly A. , Perepezko Kate , Pontone Gregory M. 
Published: February 2021

Objective: To test the hypothesis that striatal dopamine function influences motivational alterations in Parkinson disease (PD), we compared vesicular monoamine transporter 2 (VMAT2) and dopamine transporter (DaT) imaging data in PD patients with impulse control disorders (ICDs), apathy, or neither. Methods: We extracted striatal binding ratios (SBR) from VMAT2 PET imaging (18F-AV133) and DaTscans from the Parkinson’s Progression Markers Initiative (PPMI) multicenter observational study. Apathy and ICDs were assessed using the Movement Disorders Society-revised Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) and the Questionnaire for Impulsive-Compulsive Disorders in Parkinson’s Disease (QUIP), respectively. We used analysis of variance (ANOVA) and log-linear mixed-effects (LME) regression to model SBRs with neurobehavioral metrics. Results: Among 23 participants (mean age 62.7 years, mean disease duration 1.8 years) with VMAT2 imaging data, 5 had apathy, 5 had an ICD, and 13 had neither. ANOVA indicated strong groupwise differences in VMAT2 binding in right anterior putamen [F(2,20) = 16.2, p < 0.0001), right posterior putamen [F(2,20) = 16.9, p < 0.0001), and right caudate [F(2,20) = 6.8, p = 0.006)]. Post-hoc tests and repeated-measures analysis with LME regression also supported right striatal VMAT2 elevation in the ICD group and reduction in the apathy group relative to the group with neither ICD nor apathy. DaT did not exhibit similar correlations, but normalizing VMAT2 with DaT SBR strengthened bidirectional correlations with ICD (high VMAT2/DaT) and apathy (low VMAT2/DaT) in all striatal regions bilaterally. Conclusions: Our findings constitute preliminary evidence that striatal presynaptic dopaminergic function helps describe the neurobiological basis of motivational dysregulation in PD, from high in ICDs to low in apathy.
Effect of different bleaching techniques on DNA damage biomarkers in serum, saliva, and GCF
Authors: Sürmelioğlu D , Gündoğar H , Taysi S , Bağiş YH 
Published: February 2021

Bleaching agents containing a high concentration of H2O2 in the dental market lead to formation of reactive oxygen species, which have genotoxic effects. However, ozone bleaching, one of the most effective oxidants known, stimulates blood circulation and immune response and thus it has strong antimicrobial activity against viruses, bacteria, fungi, and protozoa. For these reasons, one of our hypothesis was ozone bleaching would reduce local and systemic DNA damage in the body. Hence, we aimed to determine the oxidative DNA damage biomarker levels in serum, saliva, and gingival crevicular fluid (GCF) by measuring 8-hydroxy-2′-deoxyguanosine (8-OHdG) after different bleaching methods. Forty-eight volunteers who requested dental bleaching were divided into three treatment groups ( n = 16). Group 1: ozone bleaching with the ozone-releasing machine; Group 2: chemical bleaching with 40% hydrogen peroxide (H2O2) gel; Group 3: 40% H2O2 gel activated with the diode laser. Initial and post-operative (immediately after bleaching and two weeks later) color measurements were performed with a spectrophotometer. The color changes were calculated with the CIEDE2000 (Δ E 00) formula. 8-OHdG levels in serum, saliva, and GCF samples were determined with ELISA. All three treatments resulted in efficient and statistically similar bleaching. The 8-OHdG levels in the serum and saliva were not affected by all bleaching methods ( p > 0.05), but a temporary increase was observed in the GCF for chemical and laser-assisted groups except the ozone group ( p > 0.05). According to the findings, chemical and laser-assisted bleaching can affect DNA damage locally but not systemically. Bleaching with ozone may eliminate this local DNA damage.
Response to Pulp Vitality Tests in Teeth Submitted to Orthodontic Movement, Adjacent to the Cleft Area
Authors: Pinheiro Claudia Ramos , de Castro Pinto Lidiane , Mateo-Castillo José Francisco , Siqueira Viviane da Silva , Garib Daniela 
Published: February 2021

Objective: To evaluate the pulp vitality in teeth adjacent to the cleft area submitted to orthodontic movement into the alveolar graft area in individuals with complete unilateral cleft lip and palate (CUCLP). Design: Cold sensitivity, vertical, and horizontal percussion tests were conducted on the teeth adjacent to the cleft and the contralateral teeth. Setting: Endodontics Sector in the Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo (HRAC/USP). Patients: One hundred patients with CUCLP and hypodontia of the upper lateral incisor in orthodontic movement and after successful alveolar bone graft in the cleft area. Main Outcome Measures: The cleft study group (SG) was composed of 200 teeth, adjacent to the cleft area. The control group (CG) consisted of 200 contralateral teeth. Statistical analysis was performed using the chi-square test for comparisons between groups ( P < .05). Results: In the SG, 82.0% of teeth presented positive response to the cold sensitivity testing, 13.5% had negative response, and 4.5% had marked response, with statistically significant difference in relation to the CG. The vertical and horizontal percussion tests on teeth in the SG revealed the same results, in which 95.0% presented negative response and 5.0% responded positively, without significant difference compared to teeth in the CG, for both tests. Conclusions: Teeth adjacent to the cleft area presented changes in the physiological conditions of the pulp, which were observed by reduction of positive response to the cold sensitivity testing or presence of pulp hypersensitivity in cases of marked response.
The safe handling of chemotherapy drugs in low- and middle-income countries: An overview of practices
Authors: von Grünigen Sandrine , Geissbühler Antoine , Bonnabry Pascal 
Published: February 2021

Introduction The rising burden of cancer in low- and middle-income countries (LMICs) has led to substantial efforts to improve access to chemotherapy. The present study’s objectives were to obtain an overview of the safe handling practices implemented in LMICs’ healthcare facilities when dealing with chemotherapy drugs and to prioritize opportunities for improving them. Methods We conducted an online survey, from June 2018 to April 2019, among LMIC healthcare facilities dealing with chemotherapy drugs. Facilities were asked to self-assess their chemotherapy handling processes using Cyto-SAT, a self-assessment tool incorporating 134 items organized into 10 domains (management, personnel, logistics, prescription, preparation, administration, incident management, waste management, cleaning, and patient counselling). Data were recorded on an online platform ( www.datapharma.ch/cyto-SAT ). Results The survey enrolled 53 healthcare facilities (15 from low-income, 26 from lower-middle-income, and 12 from upper-middle-income countries). The median level of implementation of safe practices was 63% (Q1:39%–Q3:77%). Facilities in low-income countries (LICs) reported lower median levels of safe practices than middle-income countries (MICs) [LICs: 32% (Q1:24%–Q3:62%), Lower-MICs: 63% (Q1:49%–Q3:70%), Upper-MICs: 85% (Q1:77%–Q3:93%)]. The biggest differences between country categories were observed in the domains related to personnel, preparation processes, and incident management. Conclusion This overview of practices highlighted a large variability and major gaps in the safe handling of chemotherapy drugs in LMICs. Improvement strategies are needed to increase patient and staff safety and limit environmental contamination, especially in LICs. Safe handling programs should be part of continuing efforts to improve access to quality cancer drugs and should be integrated into national cancer control programs.
Inferior oblique recession associated to partial temporal inferior rectus recession in unilateral congenital superior oblique palsy
Authors: Burgos-Blasco Barbara , Hernandez-Garcia Elena , Llorente-La-Orden Carlos , Gomez-de-Liaño Rosario 
Published: February 2021

Purpose: To evaluate the effectiveness of inferior oblique recession with contralateral partial temporal inferior rectus recession in patients with decompensated congenital unilateral superior oblique palsy (SOP) in correcting moderate vertical deviations in primary position. Methods: The medical records of patients with SOP who underwent inferior oblique recession with contralateral partial temporal inferior rectus recession were reviewed retrospectively. Vertical deviation in primary position, subjective torsion, diplopia, residual deviation, and the deviation decrease were evaluated. Results: Four patients (three males and one female, age range 29–56 years) with congenital unilateral SOP and mean vertical deviation of 21.0 ± 5.3PD (range 14–25D) in primary position were included. Mean correction of hypertropia in primary position with this technique was 15.5 ± 5.3PD (range 10–20PD). The mean hypertropia on gaze to the contralateral side changed from 30.0 ± 10.8D before surgery to 9.3 ± 7.9D after surgery. Torsion had a mean change of 4.8° of incyclodeviation. Preoperatively, all patients had head tilt and diplopia, which was resolved in all but one patient, who will need surgery. Patients were followed an average of 18 months. No adverse events were reported in any subjects. Conclusion: When performing recession of inferior oblique muscles in SOP associated to a full recession of the contralateral inferior rectus, there is a risk of overcorrection in those with moderate angles. Performing a partial recession in the contralateral inferior rectus eye corrected up to 20PD in primary position in our series, reducing this risk.
Ultrasound guided percutaneous cephalic venipuncture for implantation of cardiac implantable electronic devices
Authors: Yalniz Ahmet , Cam Isa , Bozyel Serdar 
Published: February 2021

Background: Preoperative ultrasound (US) for cephalic cut-down is related to shorter procedure time and higher success rate. This study aimed to assess efficiency of US-guided percutaneous cephalic vein (CV) puncture for placement of cardiac implantable electronic devices (CIEDs). Methods: Patients undergoing a procedure including both US-guided pectoral nerve block (PECS) and percutaneous CV puncture were retrospectively investigated. Patient medical history and demographic data was collected. Clinical features of the procedures and intra- and post-operative complications occurring were collected from patient records. Clinical data included target vessel features, and the time taken for the following: CV puncture; CV and PECS puncture; total procedure. Results: In total 34 patients had CV puncture with US-guided PECS block was attempted in all patients and the procedure was successful in 27 of 34 (79.4%) patients. The total number of CV puncture attempts was 62 for 34 leads (mean attempts per lead = 1.82). The mean ± standard deviation time for CV puncture was 137.5 ± 27.4 s. There were no venous access-related complications. Conclusion: US-guided CV puncture appears feasible and safe with an acceptable success rate. In case of failure of the US-guided axillary or subclavian vein approach, it may be preferred as an alternative to the cephalic cut-down procedure, where the success rate is relatively lower and the risk of bleeding is higher.
Arteriovenous fistulas thrombosis in hemodialysis patients with COVID-19
Authors: Desbuissons Geoffroy , Michon Arthur , Attias Philippe , Burbach Maren , Diaconita Mirela , Karie-Guiges Svetlana , Novelli Luigi , Abou Rjeili Marawa , Awad Sameh , Besse Francis , Viglietti Denis , Beaudreuil Severine , Zaidan Mohamad , Lefèvre Edouard , Hebibi Hadia 
Published: February 2021

Background: The current Coronavirus disease 2019 (COVID-19) outbreak is associated with significant mortality, especially in patients suffering from end stage renal disease (ESRD) and hemodialysis patients. Several previous studies reported an over-risk of arterial and venous thrombosis, in particular pulmonary embolism and venous thrombosis of catheter in COVID19 patients in intensive care unit. However, arteriovenous fistula (AVF) thrombosis has rarely been reported yet in these patients. AVF thrombosis is a serious complication that impacts significantly patients outcome. Here, we aim to describe characteristics and prognosis of a cohort of COVID-19 hemodialysis (HD) patients presenting with AVF thrombosis. Methods: In the Ile de France region (Paris area) during the March 11th–April 30th 2020 period, fistula thrombosis cases were collected among COVID-19 hemodialysis patients in seven dialysis units and in interventional vascular departments. These patients’ characteristics were analyzed through a review of the patient’s medical records. Results: Seventeen patients were included in our study (median age 69 years). Ten patients (59%) were men. Ten patients (59%) were diabetic and 88% had a high blood pressure. The mortality rate in these patients was 47%. All thrombosis treated with a declotting procedures (64%) were successfully cleared, but with early relapse in 36%. Conclusion: Our study highlights AVF thrombosis as a severe complication in COVID-19 hemodialysis patients that contributed to the severity and accelerated death.
Localized Versus Generalized Granuloma Annulare: A Retrospective Review of 407 Patients
Authors: Yousaf Ahmed , Boustany Osama J. , Gerbo Michael , Waris Shanawar , Davis Stephen , Fang Wei , Powers Roxann 
Published: February 2021

Background Granuloma annulare has been linked to diabetes, dyslipidemia, thyroid disease, collagen vascular disease, malignancies, infectious hepatitis, and systemic infections. However, these associations have not been systematically investigated when categorized by its clinical variants. Objective To evaluate disease associations of localized and generalized granuloma annulare. Methods In total, 407 granuloma annulare patients from 1989 to 2019 were retrospectively reviewed, categorized by clinical variant (localized or generalized), age (pediatric or adult), and diagnostic method (clinical or histologic). Descriptive statistical analyses and multivariate logistic regression analysis were performed. Fisher’s exact tests were conducted to produce unbiased probability values. Results Overall, 75.2% of the study sample was female, 47.2% had dyslipidemia, 24.8% were diabetic, and 24.6% had thyroid disease. Dyslipidemia (OR 2.15, CI 1.95-2.35, P < .001), diabetes (OR 1.16, CI 1.01-1.31, P = .041), and histologic diagnosis (OR 2.08, CI 1.21-3.52, P = .007) were associated with increased risk of GGA compared to LGA. When stratified by adult versus pediatric cases, dyslipidemia and diagnostic method remained significant, but diabetes did not. Conclusions Evaluating granuloma annulare by its clinical variants may help to determine disease associations with each variant.
Impact of the COVID-19 pandemic on the treatment of injuries during lockdown in Norway
Authors: Ohm Eyvind , Hauge Lars J. , Madsen Christian , Grøholt Else K. , Evensen Miriam , Reneflot Anne 
Published: February 2021

Aims: In order to prevent a major outbreak of COVID-19 disease in Norway, a series of lockdown measures was announced on 12 March 2020. The aim of the present paper was to describe the impact of this lockdown on the treatment of injuries. Methods: We collected hospital data on injury diagnoses from a national emergency preparedness register established during the pandemic. We identified the number of injured patients per day in the period 1 January–30 June 2020, and analysed the change in patient volumes over two three-week periods before and during the lockdown by sex, age, level of care, level of urgency, type of contact and type of injury. Results: Compared to pre-lockdown levels, there was an overall reduction of 43% in injured patients during the first three weeks of lockdown. The decrease in patient contacts did not differ by sex, but was most pronounced among young people. Substantial reductions were observed for both acute and elective treatment and across all levels of care and types of contact, with the exception of indirect patient contacts. The change in patient contacts varied considerably by injury type, with the largest reduction observed for dislocations/sprains/strains. The decrease was much lower for burns/corrosions and poisoning. Conclusions: A substantial reduction in the treatment of injuries was observed during lockdown in Norway. Possible explanations for this finding include an overall decrease in injury risk, a redistribution of hospital resources and a higher threshold for seeking medical attention as a result of the pandemic.
Long-term outcomes after corrective cartilaginous joint resection based on arthrographic findings of duplicated thumbs
Authors: Iba Kousuke , Saito Akira , Hanaka Megumi , Yamashita Toshihiko 
Published: February 2021

We report greater than 10-year outcomes in duplicated thumbs following corrective cartilaginous resection during the growth period. We have undertaken corrective resection of cartilaginous joint connections based on intraoperative arthrographic findings to reconstruct favourable alignment in six Wassel Type II and IV thumb duplication in six patients. The age at surgery was 13 months (range 10–15), and the average post-surgical follow-up was 134 months (range 120–160). We observed five excellent and one good outcome using the Japanese Society for Surgery of the Hand scoring method. Favourable joint congruency and alignment were preserved, and no growth plate arrest or joint space narrowing was present more than 10 years after surgery. We conclude that corrective resection of the cartilaginous joint based on intraoperative arthrographic findings has long-term reliability for duplicated thumbs, especially those of Wassel Type II and IV, which have a cartilaginous joint connection. Levels of evidence: IV
Effects of Individualized Ischemic Preconditioning on Protection Against Eccentric Exercise–Induced Muscle Damage: A Randomized Controlled Trial
Authors: Santos Cerqueira Mikhail , Kovacs Daniel , Martins de França Ingrid , Pereira Rafael , da Nobrega Neto Sinval Bezerra , Aires Nonato Rúsia Dayanny , De Araújo Moura Lemos Telma Maria , De Brito Vieira Wouber Hérickson 
Published: February 2021

Background: The effects of ischemic preconditioning (IPC) versus a deceptive sham protocol on indirect markers of exercise-induced muscle damage (EIMD) after the application of individualized occlusion pressure were examined. The goal of using a sham protocol is to control for the potential effect of placebo. Hypothesis: IPC would surpass the sham protocol in protecting against EIMD. Study Design: A randomized, double-blinded, clinical trial. Level of Evidence: Level 1. Methods: Thirty healthy young men were randomly assigned to an eccentric exercise for the knee extensor muscles preceded by IPC (4 × 5 minutes of individualized total occlusion pressure) or sham protocol (4 × 5 minutes using 20 mm Hg). Maximal voluntary isometric torque (MVIT), rate of torque development, muscle soreness, pressure pain threshold, knee range of motion, thigh girth, and creatine kinase (CK) activity were assessed before IPC or sham protocol and up to 72 hours after the eccentric EIMD. Affective valence and perceived exertion were also evaluated. Results: MVIT decreased 17.1% in the IPC and 18.1% in the sham groups, with no differences between groups. Differences from baseline were observed in the sham group for muscle soreness at 48 hours ( P < 0.001) and 72 hours ( P = 0.02), and for CK activity at 72 hours ( P = 0.04). Muscle soreness was reduced in the IPC group at 48 hours compared with the sham group (∆ = 15.8 mm; P = 0.008) but without achieving the minimal clinically important difference. IPC induced a smaller perceived exertion than the sham protocol (∆ = 1.1 a.u.; P = 0.02). The remaining outcomes were not statistically different in both groups. Conclusion: IPC does not surpass the sham protocol to protect against mild EIMD of the knee extensors muscles. Clinical Relevance: Although IPC is a noninvasive, low-cost, and easy-to-administer intervention, the IPC effects can, in part, be explained by the placebo effect. In addition, individualized IPC promotes attenuation in perceived exertion during eccentric exercise.
Effects of Different Recovery Times on Internal and External Load During Small-Sided Games in Soccer
Authors: Branquinho Luis , Ferraz Ricardo , Travassos Bruno , Marinho Daniel A. , Marques Mário C. 
Published: February 2021

Background: The ability to maintain a high intensity of exercise over several repetitions depends on recovery from previous exercises. This study aimed to identify the effects of different recovery times on internal and external load during small-sided soccer games. Hypothesis: An increase in recovery time will increase the external training load and decrease the internal exercise load, which will result in a greater physical impact of the exercise. Study Design: Cross-sectional study. Level of Evidence: Level 2. Methods: Twenty male semiprofessional soccer players participated in the present study. They performed the same exercise (5-a-side game format) continuously (1 × 18 minutes) and repeatedly/fractionated (3 × 6 minutes) with different recovery times (30 seconds, 1 minute, 1.5 minutes, and 2 minutes). Their internal load (ie, average heart rate (HR) and maximum HR) and external load (ie, total distance, maximum speed, and ratio meters) were measured using an HR band and an inertial device equipped with a global positioning system, respectively. Results: The manipulation of recovery times induced differences in the internal and external load. For the same total duration, the external and internal load indicators exhibited higher values during the fractionated method, particularly with short recovery periods. Conclusion: The application of small-sided soccer games with different recovery times induced varying responses in training load. To maintain high physical performance and high training load, the fractional method with short recovery periods (ie, 30 seconds) should be used. In contrast, to carefully manage players’ efforts and decrease response to training load, continuous or fractional methods with longer recovery periods (ie, 1-2 minutes) should be used. Clinical Relevance: The proper prescription of recovery time between exercises facilitates enhanced training efficiency and optimized performance.