bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Wolf in Sheep’s Clothing: An Unusual Presentation of Diabetic Myonecrosis
Authors: Boinpally Harika , Howell Raelina S. , Mazzie Joseph , Slone Eric , Woods Jon S. , Gillette Brian M. , Castellano Michael , Gorenstein Scott 
Published: August 2018

ABSTRACT
Diabetic myonecrosis is a rare complication of poorly controlled diabetes mellitus that presents similarly to many common conditions such as cellulitis, abscess, and fasciitis. Therefore, a high index of suspicion is required for diagnosis. Magnetic resonance imaging is the investigative test of choice. Treatment includes antiplatelet therapy, nonsteroidal anti-inflammatory agents, and glycemic control.

GENERAL PURPOSE:
To provide information about the diagnosis and treatment of diabetic myonecrosis (DMN).

TARGET AUDIENCE:
This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care.

LEARNING OBJECTIVES/OUTCOMES:
After participating in this educational activity, the participant should be better able to:
1. Cite the incidence and symptomatology of diabetic myonecrosis.
2. Identify the diagnostic tests associated with DMN.
3. Summarize the evidence-based treatments for DMN.
Diagnosis and primary care management of focal segmental glomerulosclerosis in children
Authors: Wong Angela Y. , John Rita Marie 
Published: August 2018

Abstract:
Focal segmental glomerulosclerosis (FSGS) is a pattern of kidney damage that can occur in individuals at any age, including children. Pediatric patients with FSGS require medication monitoring, growth, and psychological health. This article discusses the NP's role in the clinical presentation, diagnostic workup, and treatment of FSGS in pediatric patients.
Managing lupus nephritis
Authors: Cadet Myriam Jean , Tucker Lorna 
Published: August 2018

Abstract:
Lupus nephritis (LN) is a severe manifestation of systemic lupus erythematosus, an autoimmune disease that results in multiple organ injuries. LN is challenging to manage because it mimics the clinical presentations of other diseases. This article highlights recommendations for the management of lupus erythematosus to improve quality of life. In addition, it provides NPs with evidence-based guidelines for managing patients with LN for positive health outcomes.
Evaluation of Liquid From the Papanicolaou Test and Other Liquid Biopsies for the Detection of Endometrial and Ovarian Cancers
Authors: Wang Yuxuan , Li Lu , Douville Christopher , Cohen Joshua D. , Yen Ting-Tai , Kinde Isaac , Sundfelt Karin , Kjær Susanne K. , Hruban Ralph H. , Shih Ie-Ming , Wang Tian-Li , Kurman Robert J. , Springer Simeon , Ptak Janine , Popoli Maria , Schaefer Joy , Silliman Natalie , Dobbyn Lisa , Tanner Edward J. , Angarita Ana , Lycke Maria , Jochumsen Kirsten , Afsari Bahman , Danilova Ludmila , Levine Douglas A. , Jardon Kris , Zeng Xing , Arseneau Jocelyne , Fu Lili , Diaz Luis A. , Karchin Rachel , Tomasetti Cristian , Kinzler Kenneth W. , Vogelstein Bert , Fader Amanda N. , Gilbert Lucy , Papadopoulos Nickolas 
Published: August 2018

(Abstracted from Sci Transl Med 2018;10:eaap8793)
Although the Papanicolaou (Pap) test has dramatically decreased mortality from cervical cancer in the screened population, the test generally is unable to detect endometrial or ovarian cancers. These 2 cancers are usually diagnosed at an advanced stage when the prognosis is poor and treatment does not increase relative survival.
Ibuprofen Is Deleterious for the Development of First-Trimester Human Fetal Ovary Ex Vivo
Authors: Leverrier-Penna S. , Mitchell R. T. , Becker E. , Lecante L. , Ben Maamar M. , Homer N. , Lavoué V. , Kristensen D. M. , Dejucq-Rainsford N. , Jégou B. , Mazaud-Guittot S. 
Published: August 2018

(Abstracted from Hum Reprod 2018;33(3):482–493)
Nonsteroidal anti-inflammatory drugs (NSAIDs) are one of the most commonly used over-the-counter medications for treatment of pain, inflammation, and fever. In 2013, up to 28.3% of pregnant women reported the use of ibuprofen at some stage during their pregnancy.
Clinical Updates in Women’s Health Care Summary: The Role of Physical Therapy in Obstetric–Gynecologic Practice
Authors: Butler Rachel 
Published: August 2018

Abstract:
This monograph addresses the diagnosis and management of many neuromusculoskeletal conditions that both obstetrician–gynecologists and physical therapists encounter in their practices. Collaborative care initiated by the physician through consultation with a physical therapist can considerably enhance women’s health outcomes associated with these conditions. Physical therapy techniques are described to enhance physician understanding of the scope of this treatment option. Information is presented in the chronological sequence of a woman’s reproductive life cycle, although some information is universal and affects multiple stages of a woman’s life. Separate sections are devoted to problems of the pelvic floor muscles, pregnancy and postpartum care, and conditions common in older women.
Objective Comparison of the Quality and Reliability of Auditory Brainstem Response Features Elicited by Click and Speech Sounds
Authors: Novis Kimberley , Bell Steven 
Published: August 2018

Objectives:
Auditory brainstem responses (ABRs) are commonly generated using simple, transient stimuli (e.g., clicks or tone bursts). While resulting waveforms are undeniably valuable clinical tools, they are unlikely to be representative of responses to more complex, behaviorally relevant sounds such as speech. There has been interest in the use of more complex stimuli to elicit the ABR, with considerable work focusing on the use of synthetically generated consonant–vowel (CV) stimuli. Such responses may be sensitive to a range of clinical conditions and to the effects of auditory training. Several ABR features have been documented in response to CV stimuli; however, an important issue is how robust such features are. In the current research, we use time- and frequency-domain objective measures of quality to compare the reliability of Wave V of the click-evoked ABR to that of waves elicited by the CV stimulus /da/.

Design:
Stimuli were presented to 16 subjects at 70 dB nHL in quiet for 6000 epochs. The presence and quality of response features across subjects were examined using F
sp and a Bootstrap analysis method, which was used to assign p values to ABR features for individual recordings in both time and frequency domains.

Results:
All consistent peaks identified within the /da/-evoked response had significantly lower amplitude than Wave V of the ABR. The morphology of speech-evoked waveforms varied across subjects. Mean F
sp values for several waves of the speech-evoked ABR were below 3, suggesting low quality. The most robust response to the /da/ stimulus appeared to be an offset response. Only click-evoked Wave V showed 100% wave presence. Responses to the /da/ stimulus showed lower wave detectability. Frequency-domain analysis showed stronger and more consistent activity evoked by clicks than by /da/. Only the click ABR had consistent time–frequency domain features across all subjects.

Conclusions:
Based on the objective analysis used within this investigation, it appears that the quality of speech-evoked ABR is generally less than that of click-evoked responses, although the quality of responses may be improved by increasing the number of epochs or the stimulation level. This may have implications for the clinical use of speech-evoked ABR.
Risk Factors for Knee Stiffness Surgery After Tibial Plateau Fracture Fixation
Authors: Reahl G. Bradley , Marinos Dimitrius , O'Hara Nathan N. , Howe Andrea , Degani Yasmin , Wise Brent , Maceroli Michael , O'Toole Robert V. 
Published: August 2018

Objective:
To determine the risk factors for knee stiffness surgery after tibial plateau fixation.

Design:
Retrospective observational cohort study.

Setting:
Academic Level I trauma center.

Patients/Participants:
A study group of 110 patients who underwent knee stiffness surgery (manipulation while under anesthesia, arthroscopic lysis of adhesion, or quadricepsplasty) at a time remote from open reduction and internal fixation of tibial plateau fractures and a control group of 319 patients with tibial plateau fractures treated with open reduction and internal fixation who did not undergo knee stiffness surgery and who had either a minimum of 1 year of follow-up or clearly documented range of motion ≥110 degrees with a minimum of 90 days of follow-up.

Intervention:
Each case was assessed from the time of index admission through study event, end of minimum follow-up, or achievement of ≥110 degrees range of motion.

Main Outcome Measurements:
Knee stiffness surgery.

Results:
Total number of weeks in an external fixator (odds ratio, 1.5 per week; 95% confidence interval, 1.3–1.7; P < 0.001) and the presence of bilateral tibial plateau fractures (odds ratio, 3.3; 95% confidence interval, 1.2–9.1; P = 0.02) were significant predictors of knee stiffness intervention.

Conclusion:
Clinicians should be aware that the time spent in external fixation and the presence of bilateral tibial plateau injuries are strong risk factors for requiring subsequent surgery to treat knee stiffness.

Level of Evidence:
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Patient-Reported Outcomes Measurement Information System Outcome Measures and Mental Health in Orthopaedic Trauma Patients During Early Recovery
Authors: Vincent Heather K. , Hagen Jennifer E. , Zdziarski-Horodyski Laura A. , Patrick Matthew , Sadasivan Kalia K. , Guenther Robert , Vasilopoulos Terrie , Sharififar Sharareh , Horodyski MaryBeth 
Published: August 2018

Objectives:
This study explored the relationships between negative affective states (depression and anxiety), physical/functional status, and emotional well-being during early treatment and later in recovery after orthopaedic trauma injury.

Design:
This was a secondary observational analysis from a randomized controlled study performed at a Level-1 trauma center.

Patients:
Patients with orthopaedic trauma (N = 101; 43.5 ± 16.4 years, 40.6% women) were followed from acute care to week 12 postdischarge.

Main Outcome Measures:
Patient-reported outcomes measurement information system measures of Physical Function, Psychosocial Illness Impact—Positive and Satisfaction with Social Roles and Activities and the Beck Depression Inventory-II and the State-Trait Anxiety Inventory were administered during acute care and at weeks 2, 6, and 12. Secondary measures included hospital length of stay, adverse readmissions, injury severity, and surgery number.

Results:
At week 12, 20.9% and 35.3% of patients reported moderate-to-severe depression (Beck Depression Inventory-II score ≥20 points) and anxiety (State-Anxiety score ≥40 points), respectively. Depressed patients had greater length of stay, complex injuries, and more readmissions than those without. The study sample improved patient-reported outcomes measurement information system T-scores for Physical Function and Satisfaction with Social Roles and Activities by 40% and 22.8%, respectively (P < 0.0001), by week 12. Anxiety attenuated improvements in physical function. Both anxiety and depression were associated with lower Psychosocial Illness Impact—Positive scores by week 12.

Conclusions:
Although significant improvements in patient-reported physical function and satisfaction scores occurred in all patients, patients with depression or anxiety likely require additional psychosocial support and resources during acute care to improve overall physical and emotional recovery after trauma.

Level of Evidence:
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Improvements in Depressive Symptoms and Affect During Cardiac Rehabilitation
Authors: Gathright Emily C. , Busch Andrew M. , Buckley Maria L. , Stabile Loren , DeAngelis Julianne , Whited Matthew C. , Wu Wen‑Chih 
Published: August 2018

Purpose:
Depression is indicative of poor prognosis in cardiac patients. Reductions in depression have been observed following cardiac rehabilitation (CR). Whether similar improvements in positive and negative affect occur is unknown. Greater understanding of depressive symptom and affect change is needed to enhance facilitators of emotional improvement after a cardiac event.

Methods:
Cardiac rehabilitation attendees (n = 637) completed measures of depressive symptoms, affect, health status, and social support at CR intake and discharge. Body mass index, metabolic equivalents, and blood pressure were also measured. Relationships between changes in psychosocial and physical health indicators and depressive symptoms, positive affect, and negative affect were examined.

Results:
From intake to discharge, depressive symptoms (d = 0.40, P < .001) and negative affect (d = 0.26, P < .001) decreased. Positive affect increased (d = 0.34, P < .001). In multivariate regression, predictors of depressive symptom reduction were increased vitality (β = −.26) and decreased bodily pain (β = −.08). Predictors of positive affect increase were increased vitality (β = .25), social support (β = .16), and physical role functioning (β = .09). Predictors of negative affect reduction were increased vitality (β = −.23) and social support (β = −.10). Changes in indicators of physical health were not related to depressive symptom or affect change.

Conclusions:
Depressive symptom and affect improvements following CR were observed and most strongly associated with improvements in vitality and social support. Future research should explore how enhancement of these mechanisms may further improve depressive symptom and affect during CR.
PRESUMED FOVEAL BACILLARY LAYER DETACHMENT IN A PATIENT WITH TOXOPLASMOSIS CHORIORETINITIS AND PACHYCHOROID DISEASE
Authors: Mehta Nitish , Chong Jillian , Tsui Edmund , Duncan Jacque L. , Curcio Christine A. , Freund K. Bailey , Modi Yasha 
Published: August 2018

Purpose:
To report a detachment that apparently separated photoreceptor inner segment myoids from inner segment ellipsoids as a manifestation of toxoplasmosis chorioretinitis in a patient with pachychoroid spectrum disease.

Methods:
Multimodal imaging including fundus photography, spectral domain and enhanced-depth imaging optical coherence tomography (OCT), indocyanine green angiography, and OCT angiography.

Results:
A 33-year-old man with a history of toxoplasmosis chorioretinitis reported 1 week of decreased vision to 20/200 in his right eye. Examination of the right eye demonstrated mild vitritis with recurrent chorioretinitis inferior to the fovea and adjacent to a chorioretinal scar. A dome-shaped, foveal photoreceptor layer-splitting detachment was noted on OCT. Because degenerating cone photoreceptors are capable of shedding their inner segments, we inferred the location of the detachment at the level of the inner segment myoid and provided a histological example of such from an unrelated donor case. In addition, multimodal imaging revealed dilated choroidal veins (pachyvessels) with attenuation of the inner choroid in both eyes and asymptomatic findings of central serous chorioretinopathy in the left eye. After 1 month of antibiotic and steroid therapy, the chorioretinitis resolved, as did the detachment. Hyperreflective foci on the vitreoretinal interface were appreciated with en face OCT that appeared to aggregate throughout the course of therapy, induce inner retinal striae, and resolve without inducing epiretinal membrane formation.

Conclusion:
Patients with preexisting pachychoroid spectrum disease may manifest a more significant retinal fluid accumulation in the setting of superimposed chorioretinal inflammation. In this case of macular toxoplasmosis chorioretinitis, inflammation manifested as a retinal detachment at the level of photoreceptor inner segment myoids that we named as a bacillary layer detachment. In this case, inflammatory sequelae of toxoplasmosis reactivation responded well to oral and intravitreal therapy.
Intravenous Acetaminophen Improves Outcomes after Transapical Transcatheter Aortic Valve Replacement
Authors: Allen Keith B. , Michael Borkon A. , Cohen David J. , Chhatriwalla Adnan K. , Aggarwal Sanjeev , Saxon John , Russell Davis J. , Kennedy Kevin F. 
Published: August 2018

Objective Complications with opioid-based postoperative pain management have led to guideline recommendations for a multimodal analgesia strategy incorporating nonopioid agents. We evaluated the opioid-sparing effect of intravenous acetaminophen in patients undergoing transapical transcatheter aortic valve replacement. Methods A multimodal pain management strategy that incorporated intravenous acetaminophen was retrospectively evaluated in 43 patients undergoing transapical transcatheter aortic valve replacement between November 2012 and March 2014. Before intravenous acetaminophen formulary availability, 23 patients received standard postoperative pain management interventions including intravenous narcotics and oral narcotics/acetaminophen. After intravenous acetaminophen availability, 20 patients received intravenous acetaminophen (4 g/d, ≥4 doses) and supplemental intravenous and nonacetaminophen oral narcotics. Daily narcotic dose (standardized to morphine equivalents), drug cost, and hospital length of stay were compared between groups. Results Baseline characteristics were similar between intravenous acetaminophen (n = 20) and nonintravenous acetaminophen (n = 23) patients including the Society of Thoracic Surgery mortality risk (10.5% vs 9.0%, P = 0.3). The median number of intravenous acetaminophen doses was 6.5 (interquartile range = 4.0–18.5), with a median cost per patient of US $221 (interquartile range = $136–$629). Patients who received intravenous acetaminophen used significantly fewer morphine equivalents on postoperative day 0 compared with patients not receiving intravenous acetaminophen (22.5 vs 45.0 morphine equivalents, P = 0.03) and had a shorter median length of stay (5.0 vs 7.0 days, P = 0.007). After adjusting for the Society of Thoracic Surgery risk, intravenous acetaminophen continued to be associated with a reduction in median postoperative length of stay [−1.9 days (95% confidence interval = −0.9 to −8.2 days), P = 0.049]. Conclusions In patients undergoing transapical transcatheter aortic valve replacement, a multimodal pain management strategy incorporating intravenous acetaminophen was associated with reductions in narcotic use on the day of surgery and overall length of stay.
Effectiveness of Initiating Deep Vein Thrombosis Prophylaxis in Patients With Stroke: An Integrative Review
Authors: Dizon Mark Angel M. , De Leon Josephine M. 
Published: August 2018

ABSTRACT
Venous thromboembolism (VTE) is a frequent and potentially fatal complication of immobility caused by cerebrovascular disease. This review examines the efficiency of deep vein thrombosis (DVT) prophylaxis methods. Patients with stroke initiated on DVT prophylaxis were compared with those who did not have any prophylaxis. Integrative review research design was used and included articles from 2010 to 2016. Search terms such as “DVT prophylaxis” and “stroke” were used to identify scientific publications. Of 173 studies identified, 12 articles were included and rated using the Canadian Medical Association and Center for Evidence-Based Medicine Level of Evidence ranking system. Of DVT prophylaxis methods identified, intermittent pneumatic compression device was superior to antiembolic stockings. Current data showed that the stockings were insufficient in preventing VTE. Heparin and low–molecular-weight heparin were efficient chemoprophylaxis in reducing the incidence of VTE. The combination of chemical and mechanical DVT prevention is recommended.
Factors Affecting the Adherence to Disease-Modifying Therapy in Patients With Multiple Sclerosis
Authors: Erbay Öznur , Usta Yeşilbalkan Öznur , Yüceyar Nur 
Published: August 2018

ABSTRACT

Background: Adherence to medication treatment in patients with multiple sclerosis (MS) is important to increase its effectiveness, reduce patient disability, prevent attacks, and increase the quality of life. Aim: This study investigated factors that influence adherence to disease-modifying therapy in patients with MS. Methods: This descriptive study was conducted with 198 patients with MS who met the inclusion criteria and agreed to participate between July 2016 and February 2017. Data were collected using an Individual Identification Form that included sociodemographic characteristics, the Multiple Sclerosis Treatment Adherence Questionnaire, the Fatigue Severity Scale, the Self-Efficacy Scale, and the Brief COPE. Results: We found that 59.6% of the patients were adherent to therapy. Patients were significantly more adherent to Avonex than other treatments, and “memory problems” was the most common reason for missing or forgetting medication in nonadherent patients. There was a significant difference between medication adherence and some sociodemographic characteristics and disease characteristics (P < .05). There was no significant difference between coping attitudes, fatigue, and self-efficacy level and medication adherence (P > .05). Conclusion: Patients’ adherence to medication treatment was low and may be associated with social, physical, and cognitive measures.
Effect of Educational Intervention on Self-Sampling Acceptability and Follow-Up Paps in Border Dwelling Hispanic Females
Authors: Molokwu Jennifer C. , Penaranda Eribeth , Dwivedi Alok , Mallawaarachchi Indika , Shokar Navkiran 
Published: August 2018

Objective
The aims of the study were to evaluate the effect of a community outreach worker (promotora)-led high-intensity educational intervention compared with control without promotora-led intervention on cervical cancer screening preference (Pap smear vs self-sampling) and to determine the effect of this preference on subsequent screening completion.

Materials and Methods
This randomized controlled trial compared the effect of educational intervention on women's preferences for self-sampling for human papillomavirus. Inclusion criteria were women aged 30 to 65 years and no cervical cancer screening in 3 years or more. Community-based study with intervention group receiving culturally tailored education by promotora vs control group who received written education pamphlet. We evaluated participants' test preference, knowledge, and Pap completion at 12-months postintervention.

Results
Two hundred one predominantly Hispanic women were randomly assigned to high-intensity (n = 100) education vs low-intensity education (n = 101). The mean age was 46.4 years (SD = 8.2 years). There was no difference in test preference between high- and low-intensity groups (49% vs 41%, both tests equally; 28.6% vs 35.1%, self-sampling; and 22% vs 23%, Pap, p = .536). High-intensity intervention resulted in a significantly higher self-sampling acceptability score (25.02 vs 24.06, p = .039).Testing preference did not significantly affect Pap completion (Pap vs self-sampling vs unsure/both equally, 60.0% vs 43.6% vs 48.9%, p = 0.24). Human papillomavirus knowledge was found to be significantly associated with completion of Pap at 12 months. Human papillomavirus–positive result on self-sampling trended toward increased likelihood of screening completion (16.3% vs 7.8%, p = .058).

Conclusions
We found a high level of acceptability of self-sampling regardless of intensity of education in a largely Hispanic female population living on the US-Mexico border and a trend toward increased Pap smear follow-up in participants who tested positive.