bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidemiology of pediatric visits to the emergency department due to foreign body injuries in South Korea
Authors: Park Joong Wan , Jung Jin Hee , Kwak Young Ho , Jung Jae Yun 
Published: May 2019

Abstract
Foreign body (FB) injuries mainly occur in young children and may cause serious complications. The purpose of this study was to describe the epidemiological and clinical characteristics of FB injuries among children visiting the emergency department (ED) in South Korea and to compare the incidence and the ED results of FB injuries.
Using data from the National Emergency Department Information System, FB injury-related ED visits among children (<7 years) between January 2010 and December 2014 were included. Epidemiological characteristics were analyzed in different age groups, and metropolises were compared with provinces regarding the incidence of ED visits, admission, and transfer of patients with FB injuries.
In total, 51,406 pediatric patients with FB injuries visited 118 EDs over 5 years, and the annual incidence of FB injuries among children increased throughout the study period (215.1–436.5 per 100,000 population [<7 years], P for trend <.001). The most common anatomical site of the FB injury was the nose (18,479; 36.0%), followed by the pharynx (10,285; 20.0%). The most common age of patients was 1 year for alimentary tract, 2 years for nose, 1 year for respiratory tract, and 4 years for ear FB injuries. The overall admission rate was 1.8%, and the ICU admission rate was 0.04%. Four deaths occurred, and all of them were caused by respiratory FB injuries. The incidence of transfer of patients with FB injuries to other hospitals was higher in provinces than in metropolises.
The incidence of FB injury-related ED visits among children younger than 7 years old in South Korea has been high and has been increasing recently. In particular, the incidence of FB injuries of the alimentary and respiratory tracts was high, especially around the age of 1. Preventive measures should be taken to decrease FB injuries among young children in South Korea.
Adverse events of benralizumab in moderate to severe eosinophilic asthma
Authors: Liu Wanshu , Ma Xuesu , Zhou Weikang 
Published: May 2019

Abstract

Background:
Benralizumab, a humanized, anti-interleukin-5 (anti-IL-5) receptor α monoclonal antibody that directly and rapidly depletes eosinophils, has shown significant efficacy in reducing asthma exacerbations and improving lung function in moderate to severe eosinophilic asthma patients. However, there is some controversy regarding the adverse events (AEs) of benralizumab and a comprehensive analysis of these AEs has not been performed. This study aimed to assess the incidence of these AEs in published randomized controlled trials (RCTs).

Methods:
We searched for RCTs in the Embase, PubMed and Cochrane databases that compared benralizumab with placebo in moderate to severe eosinophilic asthma patients. The outcome was the incidence of AEs during the observation period.

Results:
Eight RCTs were analyzed in this study. Patients treated with benralizumab had a lower risk of overall AEs (risk ratio (RR) 0.94; 95% confidence interval (CI) 0.90–0.98), serious adverse events (SAEs) (RR 0.82; 95% CI 0.68–0.98), asthma exacerbation (RR 0.72, 95% CI 0.61–0.85), bronchitis (RR 0.76, 95% CI 0.59–0.96) and sinusitis (RR 0.64, 95% CI 0.48–0.85), but had a higher risk of headache (RR 1.42, 95% CI 1.07–1.87) and pyrexia (RR 2.26, 95% CI 1.32–3.87) than patients treated with placebo. No increased incidence of death, hypersensitivity, injection-site reactions, nasopharyngitis, rhinitis, upper respiratory tract infection, influenza, cough, nausea, back pain or arthralgia was observed with benralizumab compared with placebo.

Conclusions:
Benralizumab reduced the risk of SAEs, asthma exacerbation, bronchitis and sinusitis, and aggravated the risk of headache and pyrexia. Other AEs were comparable between the benralizumab group and placebo group. Therefore, benralizumab is a relatively safe drug, but vigilance regarding AEs is imperative during long-term treatment.
Is hypertriglyceridemia atherogenic?
Authors: Huet Fabien , Roubille Camille , Roubille François 
Published: May 2019

Purpose of review
Hypertriglyceridemia occurs mainly because of metabolic disorders secondary to diabetes, alcohol intake, and/or overweight. Genetic factors have also been clearly identified in most severe cases. Triglycerides are generally considered as ‘bystanders’ for cardiovascular diseases. However, biological and basic research provides strong data suggesting that triglyceride-rich lipoproteins could be involved in the pathophysiology of cardiovascular diseases.

Recent findings
The REDUCE-IT trial recently showed that icosapent ethyl reduces major cardiovascular events and related death.

Summary
For many years, low-density lipoproteins (LDLs) have been considered the Holy Grail for atherosclerotic cardiovascular disease management. New data from basic research in biology, epidemiology, genetics, and preliminary clinical trials support the hypothesis that triglyceride-rich lipoproteins could be the causal factors for atherosclerotic cardiovascular disease; hence, triglyceride should be taken into consideration in the management of these patients. Omega-3-fatty acids used in the REDUCE-IT trial reduced the residual cardiovascular risk efficiently beyond statins. However, its effect has to be completely understood as it seems to be unrelated to LDLc or triglyceride reduction, but linked to pleiotropic effects involving inflammation, platelet adhesion, and plaque instability reduction, paving the way for trials that will target more specific potential pathophysiologic pathways.
Imaging in congenital hypothyroidism
Authors: Livett T. , LaFranchi S. 
Published: May 2019

Purpose of review
Congenital hypothyroidism is a common worldwide condition. Due in part to increasingly widespread newborn screening, the number of patients with this diagnosis is increasing. In this review, we discuss currently available imaging techniques and the benefits and limitations of these techniques in evaluating congenital hypothyroidism.

Recent findings
Recent work has demonstrated an increasing diagnosis of congenital hypothyroidism with normally located glands and mildly decreased thyroid function. Increasingly more genetic abnormalities have been recognized in the hormone synthesis pathways. These cases may have lower or shorter term treatment requirements than the more common severe forms of congenital hypothyroidism, and the ability to distinguish between these situations may become increasingly more important to management and counseling.

Summary
Imaging studies for congenital hypothyroidism may be unlikely to change immediate management in the majority of cases. The common modalities of imaging include thyroid ultrasound and radionuclide uptake scanning with either technetium or iodine. These can help establish an etiology for the condition, and in less-common causes of congenital hypothyroidism may have implications on treatment decisions, prognosis, and counseling.
Update on childhood/adolescent obesity and its sequela
Authors: Kohut Taisa , Robbins Jennifer , Panganiban Jennifer 
Published: May 2019

Purpose of review
We aim to describe current concepts on childhood and adolescent obesity with a strong focus on its sequela. Childhood obesity is a national epidemic with increasing prevalence over the past three decades placing children at increased risk for many serious comorbidities, previously felt to be only adult-specific diseases, making this topic both timely and relevant for general pediatricians as well as for subspecialists.

Recent findings
Childhood obesity develops through an interplay of genetics, environment, and behavior. Treatment includes lifestyle modification, and now metabolic and bariatric surgery is more commonly considered in carefully selected adolescents. The off-label use of adjunct medications for weight loss in childhood and adolescent obesity is still in its infancy, but will likely become the next logical step in those with lifestyle modification refractory obesity. Obesity can lead to several comorbidities, which can persist into adulthood potentially shortening the child's lifespan.

Summary
Efforts should be focused primarily on reducing childhood and adolescent obesity, and when indicated treating its sequela in effort to reduce future morbidity and mortality in this precious population.

Video abstract

http://links.lww.com/MOP/A36.
Reengineering Skilled Nursing Facility Discharge
Authors: Popejoy Lori L. , Wakefield Bonnie J. , Vogelsmeier Amy A. , Galambos Colleen M. , Lewis Alexandria M. , Huneke Diane , Petroski Greg , Mehr David R. 
Published: May 2019

Background:There is a need to adopt evidence-based approaches to discharge planning in the skilled nursing facility (SNF) short stay population.Purpose:This article describes implementation of the Reengineered Discharge (RED) process in SNFs and makes recommendations for its future implementation.Methods:The methods included a pre- and postanalysis of an 18-month RED implementation with a contemporaneous comparison of 4 Midwestern SNFs randomly assigned to 2 different RED implementation strategies. The Standard facilities received less implementation than Enhanced facilities.Results:Standard SNFs made more improvements and were more satisfied with the improved process than Enhanced SNFs. Field notes revealed that corporate willingness to make process changes impacted the Standard group's capacity for change; both groups were heavily influenced by external forces, and turnover was an impediment to RED implementation.Conclusion:This research revealed that discharge processes are similar across settings and that evidence-based programs such as RED can be adapted to the SNF setting.
The National Network of Sexually Transmitted Disease Clinical Prevention Training Centers Turns 40—A Look Back, a Look Ahead
Authors: Stoner Bradley P. , Fraze Jami , Rietmeijer Cornelis A. , Dyer Janine , Gandelman Alice , Hook Edward W. , Johnston Christine , Neu Natalie M. , Rompalo Anne M. , Bolan Gail 
Published: May 2019

Abstract
Since 1979, the National Network of Sexually Transmitted Disease (STD) Clinical Prevention Training Centers (NNPTC) has provided state-of-the-art clinical and laboratory training for STD prevention across the United States. This article provides an overview of the history and activities of the NNPTC from its inception to present day, and emphasizes the important role the network continues to play in maintaining a high-quality STD clinical workforce. Over time, the NNPTC has responded to changing STD epidemiological patterns, technological advances, and increasing private-sector care-seeking for STDs. Its current structure of integrated regional and national training centers allows NNPTC members to provide dynamic, tailored responses to STD training needs across the country.
Electromyography Evaluation of Bodyweight Exercise Progression in a Validated Anterior Cruciate Ligament Injury Rehabilitation Program
Authors: Zebis Mette Kreutzfeldt , Sørensen Mads Hjorth , Lauridsen Hanne Bloch , Bencke Jesper , Andersen Christoffer Højnicke , Carlsbæk Jacob B. , Jespersen Patrick , Kallehauge Anders H. , Andersen Lars Louis 
Published: May 2019

Objectives
Regaining muscle strength is essential for successful outcome after anterior cruciate ligament injury, why progression of exercise intensity in anterior cruciate ligament injury rehabilitation is important. Thus, this study evaluated hamstring and quadriceps muscle activity progression during bodyweight exercises used in a validated anterior cruciate ligament injury rehabilitation program.

Design
The study design involved single-occasion repeated measures in a randomized manner. Twenty healthy athletes (nine females) performed nine bodyweight exercises (three exercises per rehabilitation phase). Surface electromyography signals were recorded for hamstring (semitendinosus, biceps femoris) and quadriceps (vastus medialis, vastus lateralis) muscles and normalized to isometric peak electromyography.

Results
Hamstring muscle activity did not increase from one rehabilitation phase to the next, ranging between 8% and 45% normalized electromyography for semitendinosus and 11% and 54% normalized electromyography for biceps femoris. Only one exercise (Cook hip lift) exhibited hamstring muscle activities more than 60% normalized electromyography. By contrast, quadriceps muscle activity increased, and late-phase exercises displayed high normalized electromyography (vastus lateralis >60% and vastus medialis >90% normalized electromyography).

Conclusions
The examined bodyweight exercises did not progress for hamstring muscle activity but successfully progressed for quadriceps muscles activity. This study highlights the need for consensus on exercise selection when targeting the hamstring muscles in the rehabilitation after anterior cruciate ligament injury.
Personal protective equipment for viral hemorrhagic fevers
Authors: Raj Deepa , Hornsey Emilio , Perl Trish M. 
Published: May 2019

Purpose of review
Viral hemorrhagic fevers (VHF) encompass many organisms that have caused sporadic outbreaks with high case fatality rates. This article reviews VHF with reported human-to-human transmission and describes updates about personal protective equipment (PPE) for healthcare personnel (HCP) and others. We summarize existing information about appropriate PPE use, training, and compliance for care of VHF patients in endemic and nonendemic countries, as well as addresses the challenges HCP experience when using PPE.

Recent findings
PPE is essential in protecting HCP from exposure to disease-causing pathogens. Recent evidence shows that anyone involved in care, management, and transport of certain VHF patients must use elements of PPE as part of appropriate infection prevention and control (IPC) practices. Strict adherence to standard precautions has effectively interrupted human-to-human transmission of a number of VHF. However, unclear protocols, inconsistent training, climate challenges, and cultural sensitivities impede proper PPE use. Appropriate PPE use can drastically reduce the risk of HCP exposure to VHF.

Summary
Infections caused by certain VHFs can be highly pathogenic and associated with significant morbidity and mortality. Though it is well documented that use of PPE and good IPC practices are critical to reducing transmission, little conclusive evidence exists about the ideal PPE ensemble or components. Concerns with comfort, compliance, training, and usability may impede proper PPE use. Basic PPE elements, used appropriately as part of stringent IPC, must always form the foundation of care for HCP-treating patients with VHF. More research is required to identify the ideal PPE ensemble for caring for VHF patients in various settings.
Comparing Ketorolac With Ibuprofen for Postoperative Pain: A Randomized Clinical Trial
Authors: Dwarica Denicia S. , Pickett Stephanie D. , Zhao Yan D. , Nihira Mikio A. , Quiroz Lieschen H. 
Published: May 2019

Objectives
The objective of this study was to identify differences in pain perception and satisfaction with pain control in women receiving nonsteroidal anti-inflammatory drugs postoperatively.

Methods
This was a prospective, randomized controlled trial including urogynecology surgical patients. After surgery, all patients were randomized to receive either intravenous (IV) ketorolac or ibuprofen. The patients completed 3 visual analog scales (VAS) assessing pain at rest, pain with ambulation, and satisfaction with pain control. Postoperative opioid use was also measured.

Results
A total of 224 patients (112 in each arm) were included. Pain scores (SD) at rest in all patients who received ketorolac versus those who received ibuprofen was 2.30 (2.1) versus 2.68 (2.34) (P = 0.20). Pain scores (SD) with ambulation was 3.94 (2.57) versus 4.16 (2.73) (P = 0.57) in patients who received ketorolac and ibuprofen, respectively. Patients who received ketorolac rated their satisfaction with their pain regimen similarly to those who received ibuprofen (P = 0.50). The average amount (SD) of hydromorphone used in the ketorolac and ibuprofen arm was 3.68 (4.58) mg and 4.04 (4.97) mg, respectively (P = 0.58). A subgroup analysis based on type of surgery showed decreased pain at rest (VAS, 2.77 vs 4.88; P = 0.04) and increased satisfaction (VAS, 1.69 vs 4.67; P = 0.003) in patients who had laparotomy and received ketorolac.

Conclusions
There was no difference in pain and satisfaction with IV ketorolac compared with IV ibuprofen in patients who underwent all modalities of urogynecologic surgery. A subgroup of patients who underwent laparotomy had less pain with ketorolac.
Pelvic Floor Sensations After the First Vaginal Delivery: A Qualitative Study
Authors: Egger Marlene J. , Sanchez-Birkhead Ana C. , Clark Lauren , Curiel Roxanna , Garcia Gabriela , Fernandez Cecilia , Nygaard Ingrid E. 
Published: May 2019

Objectives
Current validated instruments to screen for pelvic organ prolapse and its sequelae address bulge symptoms, bowel and bladder changes, and sexual intimacy. However, sensitivity is lower in younger women, and there is no instrument specifically designed to screen in postpartum, primiparous women for early changes, that is, changes that may be noticed before the symptom of a bulge or signs of pelvic organ prolapse occur. Our goal was to elucidate early sensations of pelvic floor support changes in primiparous women after their first vaginal delivery. These could be the focus of future studies differentiating such sensations from a normal postpartum, aiding identification of women for further follow-up.

Methods
Using comparative focused ethnographic methods, we purposefully sampled and interviewed 17 multiparous women diagnosed with pelvic organ prolapse and 60 primiparous women, half Euro-American and half Mexican American, English or Spanish speaking. Audiotapes were transcribed and then translated. Using inductive coding and matrix analysis, we used constant comparison across transcript data and clustered coded data into body systems–level matrices to arrive at categories of early changes.

Results
We identified early changes by ethnic group in pelvic area sensations and bowel, bladder, and sexual function, including sensations not mentioned in extant questionnaires.

Conclusions
Early changes may be distressing but difficult for women to introduce in a clinical conversation. Querying these changes may enhance patient-provider communication. Future research is needed to validate these items in questionnaires designed to identify women with persistent early changes that may lead to subsequent objective pelvic organ prolapse.
Prophylactic Autologous Slings at the Time of Obstetric Fistula Repair: A Randomized Clinical Trial
Authors: Pope Rachel , Browning Andrew , Chipungu Ennet , George Jeredine O. M. , Tamimu Mariatu , Wilkinson Jeffrey 
Published: May 2019

Objective
To compare prophylactic slings for women with obstetric fistulas at high risk of residual incontinence.

Methods
This was a multiple-site randomized controlled trial comparing autologous fascia slings to pubococcygeal (PC) slings at time of fistula repair. Women with a Goh type 3 or 4 vesicovaginal fistula (distal edge of the fistula is ≤2.5 cm from the external urethral orifice) with no prior repair were randomized to receive either a rectus fascia sling or a PC sling while undergoing fistula repair. Interviews were performed before surgery and at follow-up 1 to 6 months later including the Michigan Incontinence Symptom Index and the Incontinence Quality of Life Tool. Pad weights were also collected at this time. Safety analysis was performed after 10 participants were enrolled in each arm.

Results
Eleven participants randomized to a PC sling and 10 to a rectus sling. There was 1 repair breakdown in the PC group and 3 in the rectus group. There was no significant difference noted in pad weights or quality of life scores between groups. Quality of life and Michigan Incontinence Symptom Index scores improved significantly for both groups after surgery. The study was terminated at safety analysis due to the number of breakdowns and difficulty of follow-up at 1 site.

Conclusions
There was no superiority between slings. Randomization proved problematic given the vast heterogeneity between fistula injuries. There is a need for an innovative anti-incontinence technique.

ClinicalTrials.gov identifier: NCT03236922 https://www.clinicaltrials.gov/ct2/show/NCT03236922?cond=vesico-vaginal+fistula&rank=2
Electrophysiological Properties of the Human Diaphragm Assessed by Magnetic Phrenic Nerve Stimulation: Normal Values and Theoretical Considerations in Healthy Adults
Authors: Spiesshoefer Jens , Henke Carolin , Herkenrath Simon , Randerath Winfried , Schneppe Marike , Young Peter , Brix Tobias , Boentert Matthias 
Published: May 2019

Purpose:
This study determined normal values for motor evoked potentials (MEPs) and compound muscle action potentials (CMAPs) of the diaphragm following cortical and cervical magnetic stimulation (COMS and CEMS) of the phrenic nerves in healthy adults.

Methods:
Using surface electrodes, diaphragmatic MEP and CMAP were recorded in 70 subjects (34 ± 13 years, 25 men) following supramaximal cortical magnetic stimulation and CEMS at functional residual capacity and using a standardized inspiratory pressure trigger (−0.5 kPa). All healthy volunteers underwent standard spirometry and measurement of maximum inspiratory and expiratory pressure.

Results:
At functional residual capacity, upper limit of normal for MEP latency was 25 ms in men and 23 ms in women (p < 0.05), and upper limit of normal for CMAP latency was 6 ms. In contrast to MEP and CMAP amplitude, corresponding latencies showed little interindividual and intraindividual variability. Use of an inspiratory pressure trigger enhanced reproducibility and amplitude of diaphragm MEP. Diaphragm responses to both cortical and cervical magnetic stimulation were symmetrical and independent of age (in our cohort), with higher values for latency and amplitude in men (each p < 0.05). Diaphragm CMAP amplitude showed weak–moderate correlations with forced vital capacity (r = 0.47; p < 0.01), maximum inspiratory pressure (r = 0.39; p < 0.01), and maximum expiratory pressure (r = 0.32; p < 0.01).

Conclusions:
Combination of cortical magnetic stimulation and CEMS of the phrenic nerves is feasible and allows noninvasive assessment of both central and peripheral conductivity of the diaphragm and the inspiratory pathway.