bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of a novel oral health promotion program on routine oral hygiene among socioeconomically disadvantaged smokers: results from a randomized semi-pragmatic trial
Authors: McClure Jennifer B , Anderson Melissa L , Krakauer Chloe , Blasi Paula , Bush Terry , Nelson Jennifer , Catz Sheryl L 
Published: February 2019

Abstract
Smokers are at high risk of oral disease and report sub-optimal oral hygiene. Improving smokers’ oral hygiene could reduce their future disease risk. The purpose of this study is to assess the effects of a novel, multi-modal oral health promotion program (Oral Health 4 Life; OH4L) targeted to socioeconomically disadvantaged smokers and delivered through state-funded tobacco quitlines. Smokers (n = 718) were randomized to standard quitline care or standard care plus OH4L. OH4L recipients received a comprehensive behavioral intervention and were advised of the benefits of routine oral hygiene, encouraged to brush and floss daily (for better oral health and to manage cigarette cravings), and provided a toothbrush and floss. Participants were followed for 6 months to assess the intervention effects on routine oral hygiene (brushing and flossing) and changes in motivation and self-efficacy. Data were collected between 2015 and 2017. At 2-month follow-up, OH4L participants were more likely to meet the American Dental Association (ADA) recommendations for brushing twice daily (adjusted RR = 1.15 [1.04, 1.27], p = .006), flossing daily (adjusted RR = 1.20 [1.03, 1.39], p = .02), and for both brushing and flossing (adjusted RR = 1.33 [1.10, 1.61], p = .003). Daily flossing was more likely at 6-month follow-up (adjusted RR = 1.21 [1.04, 1.42], p = .02) among OH4L participants. The change in self-efficacy and motivation for daily flossing from baseline to 2 months was significantly greater among OH4L participants and mediated the intervention effect on flossing at 6 months. Integrating oral hygiene promotion with standard tobacco quitline services improved oral health self-care.
Are outcome measures in allergic diseases relevant for the WHO's International Classification of Diseases in allergology?
Authors: Tanno Luciana Kase , Demoly Pascal 
Published: February 2019

Purpose of review
To review and understand the impact of the outcome measures of allergic and hypersensitivity conditions for the WHO's International Classification of Diseases (ICD) and its impact in the management of anaphylaxis and identify potential strategies to improve patients’ care and prevention.

Recent findings
The pioneer chapter addressed to allergic and hypersensitivity conditions in the 11th version of the WHO's ICD is the result of the evidence-based academic technical actions consistently following of collaborations of the allergy community and integrated international initiatives in order to reach quality outcomes measures of allergies worldwide.

Summary
Allergic and hypersensitivity conditions are increasing worldwide, however, they have never been well represented in the international classification systems, such as the ICD. The ALLERGY in ICD-11 initiative has been launched in 2012 in order to gather a better representation of these conditions in the ICD-11. As a result of the evidence-based academic technical actions acknowledged by the Joint Allergy Academies and the WHO, the pioneer chapter Allergy and hypersensitivity conditions has been constructed. This framework can be considered a milestone in the history of the allergy specialty. More reliable, accurate and comparable epidemiological data will be able to provide a big picture of these conditions and will support improvements in many levels of the health system. As knowledge derived from populations is key information for more realistic decision-making, the construction of the new section addressed to allergic and hypersensitivity conditions in the ICD-11 will allow the collection of more accurate epidemiological data to support quality management of patients, and better facilitate healthcare planning to implement public health measures to prevent and reduce the morbidity and mortality attributable to these conditions.
Intravenous Acetaminophen Before Pelvic Organ Prolapse Repair
Authors: Turner Lindsay C. , Zyczynski Halina M. , Shepherd Jonathan P. 
Published: February 2019

OBJECTIVE:
To compare the effect of preoperative intravenous (IV) acetaminophen compared with placebo on pain scores after pelvic organ prolapse surgery.

METHODS:
This double-blind placebo-controlled multicenter trial randomized women undergoing prolapse surgery to IV acetaminophen (1,000 mg) or preoperative saline stratified by surgical route (laparoscopic or vaginal). The primary outcome was the change from baseline in patient-reported visual analog scale pain scores at 24 hours after surgery. Secondary outcomes included narcotic use measured in morphine milligram equivalents, satisfaction and quality of life (QOL) using validated questionnaires on postoperative days 1 and 7, and overall side effects.

RESULTS:
Between 2014 and 2017, 204 women were enrolled and primary-outcome data from 162 were analyzed. Women had a mean (±SD) age of 66±10 years, were predominantly Caucasian (96%) and postmenopausal (96%). Acetaminophen was administered to 52 of the 101 women undergoing vaginal surgery, and 50 of the 101 women undergoing laparoscopy. There were no overall or route of surgery differences in mean change from baseline pain scores at 24 hours between acetaminophen and placebo (overall 25±26 vs 21±24 mm; vaginal 29±28 vs 21±23 mm; laparoscopic 20±26 vs 21±25 mm). There were no differences in 24-hour morphine milligram equivalent narcotic use (overall 38±25 vs 40±25 mg; vaginal 32±24 vs 33±25 mg; laparoscopic 45±24 vs 47±24 mg). No differences were seen in patient satisfaction, QOL, or side effects, except for urinary retention.

CONCLUSION:
In women undergoing prolapse repair, preoperative IV acetaminophen did not reduce pain scores or opioid use and had no effect on patient satisfaction or QOL. Routine use of preemptive IV acetaminophen alone is not supported by this study.

CLINICAL TRIAL REGISTRATION:

ClinicalTrials.gov, NCT02155738.
Obstetrics and Gynecology Residents' Perspectives on Wellness
Authors: Morgan Helen Kang , Winkel Abigail Ford , Nguyen Anh T. , Carson Sandra , Ogburn Tony , Woodland Mark B. 
Published: February 2019

OBJECTIVE:
To examine U.S. obstetrics and gynecology residents' perceptions of wellness, burnout, and perceived effectiveness of wellness programming.

METHODS:
In January 2017, a six-item survey was administered at the time of the Council on Resident Education in Obstetrics and Gynecology in-training examination. Respondents voluntarily completed the survey electronically before starting the examination, and responses were anonymous and only linked to postgraduate year.

RESULTS:
Of the 5,376 eligible U.S. examinees, 4,999 (93%) completed the survey, provided residency year status, and were included in the analysis. There was a high prevalence of self-identified wellness problems (burnout 51.2%, depression 32.0%, binge drinking 12.6%, eating disorder 4.7%, drug use 1.1%, and suicide attempt 0.4%). First-year residents were most likely to state that wellness was a priority in their program. The number of residents reporting any problem with wellness increases significantly between the first year (49.8%) and second year (63.7%, P<.001), after which it remains elevated throughout training. Residents who responded that wellness was not a priority in their program were more likely to report wellness issues and burnout (P<.001). When asked what single intervention all residency programs should provide, 41.2% (2,059) felt that dedicated time for wellness maintenance was the most important intervention.

CONCLUSION:
These findings highlight the high prevalence of wellness problems in obstetrics and gynecology residents, and how essential it will be to engage learners in the development of effective, evidence-based interventions.
Gestational Weight Gain and Severe Maternal Morbidity at Delivery Hospitalization
Authors: Platner Marissa H. , Ackerman Christina , Howland Renata E. , Xu Xiao , Pettker Christian M. , Illuzzi Jessica L. , Reddy Uma M. , Chung Sophie , Lipkind Heather S. 
Published: February 2019

OBJECTIVE:
To examine whether women who varied from recommended gestational weight gain guidelines by the Institute of Medicine (IOM, now known as the National Academy of Medicine) were at increased risk of severe maternal morbidity during delivery hospitalization compared with those whose weight gain remained within guidelines.

METHODS:
We conducted a retrospective cohort study using linked 2008–2012 New York City discharge and birth certificate data sets. Cases of severe maternal morbidity were identified using International Classification of Diseases, 9th Revision, Clinical Modification codes based on the Centers for Disease Control and Prevention criteria, which consists of 21 indicators of possible life-threatening diagnoses, life-saving procedures, or death. Multivariable logistic regression was used to evaluate the association between gestational weight gain categories based on prepregnancy body mass index (BMI) and severe maternal morbidity adjusting for maternal demographics and socioeconomic status. The analysis was stratified by prepregnancy BMI categories.

RESULTS:
During 2008–2012, there were 515,148 term singleton live births in New York City with prepregnancy weight and gestational weight gain information. In 24.8%, 35.1%, 32.1%, and 8.0% of these births, women gained below, within, 1–19 lbs above, and 20 lbs or more above the IOM guidelines, respectively. After adjusting for maternal demographic and socioeconomic characteristics, women who had gestational weight gain 1–19 lbs above (adjusted odds ratio [AOR] 1.08, 95% CI 1.02–1.13) or 20 lbs or more above the IOM recommendations (AOR 1.21, 95% CI 1.12–1.31) had higher odds of overall severe maternal morbidity compared with women who gained within guidelines. Although the increased odds ratios (ORs) were statistically significant, this only resulted in an absolute rate increase of 2.1 and 6 cases of severe maternal morbidity per 1,000 deliveries for those who gained 1–19 and 20 lbs or more above recommendations, respectively. Women with gestational weight gain 20 lbs or more above recommendations had significantly higher ORs of eclampsia, heart failure during a procedure, pulmonary edema or acute heart failure, transfusion, and ventilation.

CONCLUSION:
Women whose gestational weight gain is in excess of IOM guidelines are at increased risk of severe maternal morbidity, although their absolute risks remain low.
Pessary Compared With Vaginal Progesterone for the Prevention of Preterm Birth in Women With Twin Pregnancies and Cervical Length Less Than 38 mm
Authors: Dang Vinh Q. , Nguyen Linh K. , Pham Toan D. , He Yen T. N. , Vu Khang N. , Phan Minh T. N. , Le Thanh Q. , Le Cam H. , Vuong Lan N. , Mol Ben W. 
Published: February 2019

OBJECTIVE:
To compare the effectiveness of cervical pessary to vaginal progesterone for the prevention of preterm birth in women with twin pregnancies and short cervix.

METHODS:
This randomized controlled trial was conducted at My Duc Hospital, Vietnam. Asymptomatic women with twin pregnancies and cervical length less than 38 mm were randomized to Arabin pessary or vaginal progesterone (400 mg once a day) group. The primary outcome was preterm birth at less than 34 weeks of gestation. Secondary outcomes were adverse maternal and perinatal complications. We planned a subgroup analysis according to quartile of cervical length. Analysis was conducted on an intention-to-treat basis. We estimated that the primary outcome would occur in 28.4% of women treated with progesterone. Thus a total sample size of 290 women divided equally into two groups was required to detect a 14% absolute risk difference in the primary outcome between the two groups (power 80%, alpha-error 5%, 10% loss to follow-up).

RESULTS:
Between March 2016 and June 2017, we randomized 300 women, 150 women in each group. Preterm birth at less than 34 weeks of gestation occurred in 24 (16%) women in the pessary group and 33 (22%) women in the progesterone group (relative risk [RR] 0.73, 95% CI 0.46–1.18). The use of pessary significantly reduced the composite of poor perinatal outcomes (19% vs 27%; RR 0.70, 95% CI 0.43–0.93). In women with cervical length of 28 mm or less (25th percentile), pessary significantly reduced the preterm birth rate at less than 34 weeks of gestation from 46% (16/35) to 21% (10/47) (RR 0.47, 95% CI 0.24–0.90) and significantly improved the composite of poor perinatal outcomes.

CONCLUSION:
Cervical pessary and 400 mg vaginal progesterone resulted in similar rates of preterm birth at less than 34 weeks of gestation in women with twin pregnancies and cervical length less than 38 mm.

CLINICAL TRIAL REGISTRATION:
ClinicalTrials.gov, NCT02623881.
Changing rates in fracture trends are temporally associated with declining testing and treatment: reality or ecologic fallacy?
Authors: Wright Nicole C. , Blackston J. Walker , Saag Kenneth G. 
Published: February 2019

Purpose of review
The changing patterns of osteoporosis treatment and fragility fractures have led to what leaders are calling a ‘crisis in the osteoporosis.’ We address data on changing patterns in fractures, and highlight strengths and limitations of recently published data.

Recent findings
Declines in hip fracture rates have been shown in studies from around the world. However, recently, using national Medicare data, Michael Lewiecki and colleagues show a plateau in the decline of hip fracture incidence in the United States from 2012 to 2015. Population-based data is integral for evaluating temporal trends; however, researchers must consider the biases associated with them including: age effects, period effects, and cohort effects. Rosengren and colleagues conducted the most comprehensive evaluation of age, period, and birth cohort effects in their study of hip fracture trends from 1987 to 2010 in Denmark and Sweden, in which they identified changes in hip fracture rates based on age, period, and cohort effects.

Summary
Recent findings show clear temporal trends in changing fracture rates. Studies, which evaluated these biases largely attribute increased hip fracture rates to various age, period, and cohort effects, highlighting the importance of appropriate screening and treatment.
Outcomes After Extracorporeal Cardiopulmonary Resuscitation of Pediatric In-Hospital Cardiac Arrest: A Report From the Get With the Guidelines-Resuscitation and the Extracorporeal Life Support Organization Registries
Authors: Bembea Melania M. , Ng Derek K. , Rizkalla Nicole , Rycus Peter , Lasa Javier J. , Dalton Heidi , Topjian Alexis A. , Thiagarajan Ravi R. , Nadkarni Vinay M. , Hunt Elizabeth A. 
Published: February 2019

Objectives:
The aim of this study was to determine cardiac arrest– and extracorporeal membrane oxygenation–related risk factors associated with unfavorable outcomes after extracorporeal cardiopulmonary resuscitation.

Design:
We performed an analysis of merged data from the Extracorporeal Life Support Organization and the American Heart Association Get With the Guidelines—Resuscitation registries.

Setting:
A total of 32 hospitals reporting to both registries between 2000 and 2014.

Patients:
Children younger than 18 years old who suffered in-hospital cardiac arrest and underwent extracorporeal cardiopulmonary resuscitation.

Interventions:
None.

Measurements and Main Results:
Of the 593 children included in the final cohort, 240 (40.5%) died prior to decannulation from extracorporeal membrane oxygenation and 352 (59.4%) died prior to hospital discharge. A noncardiac diagnosis and preexisting renal insufficiency were associated with increased odds of death (adjusted odds ratio, 1.85 [95% CI, 1.19–2.89] and 4.74 [95% CI, 2.06–10.9], respectively). The median time from onset of the cardiopulmonary resuscitation event to extracorporeal membrane oxygenation initiation was 48 minutes (interquartile range, 28–70 min). Longer time from onset of the cardiopulmonary resuscitation event to extracorporeal membrane oxygenation initiation was associated with higher odds of death prior to hospital discharge (adjusted odds ratio for each 5 additional minutes of cardiopulmonary resuscitation prior to extracorporeal membrane oxygenation initiation, 1.04 [95% CI, 1.01–1.07]). Each individual adverse event documented during the extracorporeal membrane oxygenation course, including neurologic, pulmonary, renal, metabolic, cardiovascular and hemorrhagic, was associated with higher odds of death, with higher odds as the cumulative number of documented adverse events during the extracorporeal membrane oxygenation course increased.

Conclusions:
Outcomes after extracorporeal cardiopulmonary resuscitation reported by linking two national registries are encouraging. Noncardiac diagnoses, preexisting renal insufficiency, longer time from onset of the cardiopulmonary resuscitation event to extracorporeal membrane oxygenation initiation, and adverse events during the extracorporeal membrane oxygenation course are associated with worse outcomes.
Study of the Effects of Epinephrine on Cerebral Oxygenation and Metabolism During Cardiac Arrest and Resuscitation by Hyperspectral Near-Infrared Spectroscopy
Authors: Nosrati Reyhaneh , Lin Steve , Mohindra Rohit , Ramadeen Andrew , Toronov Vladislav , Dorian Paul 
Published: February 2019

Objectives:
Epinephrine is routinely administered to sudden cardiac arrest patients during resuscitation, but the neurologic effects on patients treated with epinephrine are not well understood. This study aims to assess the cerebral oxygenation and metabolism during ventricular fibrillation cardiac arrest, cardiopulmonary resuscitation, and epinephrine administration.

Design:
To investigate the effects of equal dosages of IV epinephrine administrated following sudden cardiac arrest as a continuous infusion or successive boluses during cardiopulmonary resuscitation, we monitored cerebral oxygenation and metabolism using hyperspectral near-infrared spectroscopy.

Settings:
A randomized laboratory animal study.

Subjects:
Nine healthy pigs.

Interventions:
None.

Measurements and Main Results:
Our study showed that although continuous epinephrine administration had no significant impact on overall cerebral hemodynamics, epinephrine boluses transiently improved cerebral oxygenation (oxygenated hemoglobin) and metabolism (cytochrome c oxidase) by 15% ± 6.7% and 49% ± 18%, respectively (p < 0.05) compared with the baseline (untreated) ventricular fibrillation. Our results suggest that the effects of epinephrine diminish with successive boluses as the impact of the third bolus on brain oxygen metabolism was 24.6% ± 3.8% less than that of the first two boluses.

Conclusions:
Epinephrine administration by bolus resulted in transient improvements in cerebral oxygenation and metabolism, whereas continuous epinephrine infusion did not, compared with placebo. Future studies are needed to evaluate and optimize the use of epinephrine in cardiac arrest resuscitation, particularly the dose, timing, and mode of administration.
Photobiomodulation therapy for acute radiodermatitis
Authors: Robijns Jolien , Lodewijckx Joy , Mebis Jeroen 
Published: February 2019

Purpose of review
The number of clinical trials on the use of photobiomodulation therapy (PBMT) for the management of cancer therapy-related complications is growing steadily. One of the side-effects that is under investigation is acute radiodermatitis (ARD), an inflammatory skin reaction caused by radiotherapy. In this review, an overview is given on the state of art of the application of PBMT for the prevention and management of ARD.

Recent findings
Up to now about seven clinical trials have been performed, investigating the use of PBMT in the prevention and/or management of ARD. Results demonstrate that PBMT can effectively reduce the incidence of severe ARD, decrease the accompanying pain, and improve the patients’ quality of life. Moreover, the technique seems to be well tolerated in oncologic patients.

Summary
On the basis of the available evidence, there could be a strong recommendation to use PBMT in the prevention and management of ARD in cancer patients.
Optimizing the Aesthetic Result of Parotidectomy with a Facelift Incision and Temporoparietal Fascia Flap
Authors: Movassaghi Kiya , Lewis Matthew , Shahzad Farooq , May James W. 
Published: February 2019

Summary:
The 3 most common problems after a parotidectomy are cheek contour deformity, Frey syndrome (gustatory sweating), and a visible scar on the neck. These problems can potentially be prevented by (1) facelift type incisions, which eliminate the neck incision and (2) interposition of temporoparietal fascia at the parotidectomy site that fills the defect and provides a barrier to aberrant neuronal regeneration. We followed 11 patients who underwent parotidectomy (9 superficial and 2 total parotidectomies) for a variety of parotid tumors between December 2001 and January 2018. Facelift type incisions were used in all patients, and temporoparietal fascia flaps were used to fill the parotidectomy defects. The last 6 patients were tested for objective evidence of Frey syndrome with the Minor Starch Iodine test. Patients were then followed for up to 7 years (11 months to 7 years, average 3 years). All patients had well-hidden scars and good contour of the cheeks. None of the patients developed subjective or objective evidence of Frey syndrome. This small series suggests that the aesthetic result after parotidectomy can be improved by using a facelift incision and placement of a temporoparietal fascia flap into the parotidectomy defect. Additionally, the tissue barrier thus provided may also help to prevent Frey syndrome.
Exposed Artificial Plate Covered With Perifascial Areolar Tissue as a Nonvascularized Graft
Authors: Ito Tomoyuki , Akazawa Satoshi , Ichikawa Yuichi , Yamamoto Yusuke , Aoyama Shohei , Kiuchi Tomoki , Nakao Junichi , Onitsuka Tetsuro , Araki Jun , Nakagawa Masahiro 
Published: February 2019

Summary:
Perifascial areolar tissue (PAT) is a loose connective tissue on deep fascia, such as on the groin, thigh, or temporal region, which has abundant vascular plexus and mesenchymal stem cells. Nonvascularized PAT grafts can survive even on hypovascular wound beds. Therefore, PAT grafting is a possible alternative to conventional flap surgery to cover exposed bone or artifacts. In this article, we describe 2 cases of PAT grafting for the treatment of skin ulcers with exposed bone and artificial plate after mandible reconstruction. After negative-pressure wound therapy, PAT was used to covering exposed artificial plate for both cases, and a skin graft onto the PAT graft was performed in 1 case. The ulcers improved in both cases without recurrence. The gold-standard treatment of intractable ulcers and fistulas with an exposed tendon, bone, or artifact is coverage by a well-vascularized skin flap. However, PAT grafting has advantages in similar situations, occasionally together with skin grafting and/or negative-pressure wound therapy, because it is technically simple and less invasive.