bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Experience of Acute Mechanical Ventilation From the Patient's Perspective
Authors: Roberts Melanie , Bortolotto Shannon Johnson , Weyant Ruth A. , Jock Leighann , LaLonde Trent , Henderson Ann 
Published: May 2019

Background
The Pain, Agitation, and Delirium guidelines influenced practice to support targeted, light sedation for the mechanically ventilated patient. This practice is associated with improved clinical outcomes, but it remains unclear how it impacts the patient experience.

Objective
The objective was to determine the pervasive patient experience components and how the experience may have been influenced by targeted, light sedation practices.

Methods
A prospective observational study using mixed methodology and a convenience sample was conducted after institutional review board approval was obtained. Inclusion criteria were the following: acute mechanical ventilation of less than 14 days, 18 years or older and able to provide consent, English speaking, and delirium-free. Exclusion criteria were the presence of delirium or intravenous opioids/sedatives within 24 hours prior to the interview. The quantitative component included simple yes or no questions and identification of quantitative adjectives describing the mechanical ventilation experience. Every 10th patient was invited to participate in an expanded qualitative interview.

Results
Data were collected for 12 months with a total sample size of 130 patients participating in the quantitative component and a subset of 15 patients also participating in the qualitative interview. Sixty percent of the total sample consisted of cardiothoracic surgery patients, and 40% were mixed intensive care unit patient populations. Descriptive statistics include the following averaged values: Richmond Agitation Sedation Scale scores −1.7 throughout mechanical ventilation, aged 59.9 years, days mechanically ventilated 1.4, intensive care unit length of stay 4.6 days, and Acute Physiology and Chronic Health Evaluation II score 16.1. The most significant finding was that 56.2% of patients who could not communicate reported feeling afraid, whereas 32.5% of those who could communicate reported feeling afraid (P < .027). The themes identified in the qualitative component of the study reinforced these quantitative findings; 10 of the 15 patients interviewed reported experiencing fear, and all of the patients reported issues with communication.

Discussion
The clinical implications of this research study primarily affect critical care nursing. Changes in nursing practice can address these findings to improve and more effectively acknowledge the patient experience.
Cognitive behavior therapy for menopausal symptoms (CBT-Meno): a randomized controlled trial
Authors: Green Sheryl M. , Donegan Eleanor , Frey Benicio N. , Fedorkow Donna M. , Key Brenda L. , Streiner David L. , McCabe Randi E. 
Published: May 2019

Abstract

Objective:
To evaluate the effectiveness of cognitive behavioral therapy for menopausal symptoms (CBT-Meno) compared with a waitlist condition (no active intervention). A randomized controlled trial was conducted with 71 perimenopausal or postmenopausal women who were seeking treatment for menopausal symptoms.

Methods:
Blind assessments were conducted at baseline, 12 weeks postbaseline, and 3 months post-treatment. An intention-to-treat analysis was conducted. CBT-Meno sessions included psychoeducation, and cognitive and behavioral strategies for vasomotor and depressive symptoms, anxiety, sleep difficulties, and sexual concerns. Primary outcomes were scores on the Hot Flash Related Daily Interference Scale (HFRDIS) and Beck Depression Inventory (BDI-II). Secondary outcomes were scores assessing vasomotor and sexual concerns on the Greene Climacteric Scale (GCS-vm, GCS-sex), the Montgomery-Åsberg Depression Rating Scale (MADRS), Hamilton Anxiety Rating Scale (HAM-A), Pittsburgh Sleep Quality Index (PSQI), and the Female Sexual Function Index (FSFI).

Results:
There were significantly greater improvements in CBT-Meno compared with waitlist in vasomotor symptom interference (HFRDIS; P < 0.001, η2

P
= 0.21) and “bothersomeness” (GCS-vm; P = 0.04, η2

P
= 0.06), depressive symptoms (BDI-II; P = 0.001, η2

P
= 0.15), sleep difficulties (PSQI; P = 0.001, η2

P
= 0.17), and sexual concerns (GCS-sex; P = 0.03, η2

P
= 0.07). These results were found even when controlling for menopausal staging and medication use. Gains were maintained at 3 months post-treatment.

Conclusions:
CBT-Meno was particularly effective in improving self-reported vasomotor symptoms, depressive symptoms, sleep difficulties, and sexual concerns. Although future studies will be needed to confirm the impact of CBT-Meno on anxiety symptoms, these results suggest that this protocol is effective in targeting commonly reported menopausal symptoms.

Video Summary: Supplemental Digiatl Content 1, http://links.lww.com/MENO/A416
Techniques, Principles and Benchmarks in Asian Blepharoplasty
Authors: Chen William P. D. 
Published: May 2019

Background:
Asian blepharoplasty is a deceptively simple procedure where the goal is to create an upper lid crease. The author presents a retrospective self-analysis of 362 cases performed over the past 12 years.

Methods:
362 cases that fits the inclusion criteria were tabulated into spreadsheet data format. Recorded were age, gender, date of service and follow-ups, whether the AB performed was for primary or revisional purpose; the preoperative lid crease status, the patient-chosen crease height as well as shape preferred. Intraoperative observation included presence or absence of preaponeurotic fat, whether partially resected, or reposited were noted.

Results:
Of 362 patients (724 upper lids), primary AB constituted 81% (295) and revisional AB contributed 19% (67). The gender distribution was 87% female (315) and 13% male (47). The age distribution ranged from 12 to 75 years. The crease height selected ranged from 6.0 to 8.0 mm, with the median being 7.0 mm. Of the crease shape chosen, parallel shape was 65% (236) and nasally-joining crease shape was 35% (126).

Conclusions:
Asian blepharoplasty via trapezoidal debulking of preaponeurotic platform is a safe, effective and anatomically-based technique that does not involve the use of permanent buried sutures. The article discussed the 5 essential factors (aponeurotic attachment, selective block clearance of preaponeurotic space, precise positioning of the crease formation loci, detection of latent droopy eyelids and avoidance of Faden-like suture effect) and the author’s benchmarks to achieve a better success rate. Results for primary and revisional Asian blepharoplasty, strategies and potential pitfalls are presented. (

JOURNAL/prcsgo/04.03/01720096-201905000-00006/inline-graphic1/v/2023-08-02T002938Z/r/image-tiff

http://links.lww.com/PRSGO/B141)
LAMELLAR MACULAR HOLES IN THE PRESENCE OF AGE-RELATED MACULAR DEGENERATION
Authors: Francone Anibal , Yun Lisa , Kothari Nikisha , Cheng Iris , Farajzadeh Matthew , Govetto Andrea , Hubschman Jean-Pierre 
Published: May 2019

Purpose:
To investigate whether age-related macular degeneration (AMD) has an influence on the prevalence and anatomical characteristics of lamellar macular holes (LMHs).

Methods:
Clinical records and spectral-domain optical coherence tomography images of 756 eyes of 423 consecutive patients diagnosed with AMD were reviewed and analyzed. Spectral-domain optical coherence tomography was used to identify degenerative or tractional LMH subtypes and assess their morphology. The clinical and optical coherence tomography findings of AMD eyes with LMH were compared with those of a control group of eyes with LMH without AMD from a previously published report.

Results:
Lamellar macular holes were identified in 25 eyes of 23 patients (3.3%; 25 of 756). Seventeen of 25 eyes (68%) presented with degenerative LMH and underlying late neovascular AMD. Mean best-corrected visual acuity was worse in eyes with AMD and LMH eyes than in those with AMD and no LMH (20/230 vs. 20/98; P = 0.02). The mean outer diameter was greater in the group with degenerative LMH with concomitant AMD than in the control group of degenerative LMH without AMD (1,323.9 ± 999.1 µm vs. 905.9 ± 356.8 µm, respectively; P = 0.01).

Conclusion:
The incidence of degenerative LMH increased in advanced forms of AMD, whereas the presence of tractional LMH subtype may be unrelated to AMD evolution.
PHARMACOKINETIC STUDY OF INTRAVITREAL AFLIBERCEPT IN HUMANS WITH NEOVASCULAR AGE-RELATED MACULAR DEGENERATION
Authors: Do Diana V. , Rhoades William , Nguyen Quan Dong 
Published: May 2019

Purpose:
To investigate the half-life of aflibercept in aqueous humor after a single intravitreal injection in patients with neovascular age-related macular degeneration.

Methods:
Prospective, noncomparative, interventional case series of five eyes with neovascular age-related macular degeneration naive to anti–vascular endothelial growth factor therapy were enrolled and treated with intravitreal aflibercept. At baseline, best-corrected visual acuity, optical coherence tomography imaging, and aqueous humor (treatment eye) and blood/plasma samples were taken. Patients underwent best-corrected visual acuity, optical coherence tomography imaging, and sampling of aqueous humor from the eye and blood/plasma at six additional post-treatment time points of 4 hours and Days 1, 3, 7, 14, and 28. Concentrations of aflibercept were quantified using an enzyme-linked immunosorbent assay.

Results:
Median peak concentration (Cmax) of free aflibercept in the aqueous was 122 mg/L. The median half-life of free aflibercept was 11 days in the eye. In plasma, the concentrations of free aflibercept were low and transient, reaching undetectable levels during the first week after injection, and undetectable in all patients at time points beyond 7 days.

Conclusion:
The pharmacokinetic profile in the aqueous humor described here together with the previously reported affinity of aflibercept for vascular endothelial growth factor is consistent with and adds to our understanding for the duration of its clinical efficacy.
The efficacy of Chinese patent medicine combined with entecavir for the treatment of chronic HBV-related liver fibrosis or cirrhosis
Authors: Song Yudi , Zhao Junkai , Wang Sudan , Huang Haoming , Hong Junwei , Zuo Junling , Huo Shaochuan 
Published: May 2019

AbstractBackground:There are currently no FDA-approved biological or chemical drugs for the treatment of HBV-related liver fibrosis or cirrhosis. Some Chinese patent medicines have proven to be effective in this area.Objective:The network meta-analysis (NMA) is to evaluate whether entecavir combined with Chinese patent medicine, such as “fuzhenghuayu capsules,” “anluohuaxian pills,” “fufangbiejiaruangan tablets,” shows superior efficiency compared with entecavir alone for the treatment of chronic HBV-related liver fibrosis or cirrhosis. To evaluate which Chinese patent medicine is the most effective at improving liver fibrosis or cirrhosis in chronic hepatitis B-infected patients?Methods:Registration of protocol: the protocol was published in the PROSPERO database (identification number: CRD42018112547). We will search PubMed, EMbase, Medline, Cochrane, China Network Knowledge Infrastructure (CNKI), and Wanfang for randomized controlled trials (RCTs) or “prospective cohort studies” of “fuzhenghuayu capsules,” “anluohuaxian pills,” ”fufangbiejiaruangan tablets” respectively combined with entecavir in the treatment of chronic HBV-related liver fibrosis or cirrhosis from their inception to September 30, 2018. R 3.3.3 and GeMTC 0.14.3 software will be used for data analysis.
Penetrating neck trauma with common carotid artery injury caused by a percussive drill
Authors: Wang Dong , Zhao Yi , Cha Bingshan , Fang Ping , Liu Yehai 
Published: May 2019

Abstract

Rationale:
Penetrating neck traumas are dangerous and have a high mortality rate, particularly in patients with common carotid artery injuries. Advances in diagnostic imaging technology have shifted management of penetrating neck injuries from mandatory exploration to selective management. The question is now regarding optimal selection of auxiliary examinations to assess “stability” rapidly and guide clinics in managing such patients.

Patient concerns:
A 56-year-old man suffered neck trauma with the right common carotid artery caused by a percussive drill. The carotid artery could not be clearly displayed in computed tomography (CT) angiography imaging.

Diagnoses:
Penetrating neck trauma due to percussive drill bit with common carotid artery injury.

Interventions:
X-ray and bedside duplex ultrasound with color Doppler flow imaging were used to assess the state of trauma and the foreign body was removed under general anesthesia.

Outcomes:
The patient was discharged at postoperative day 10 with no complication. The patient had no sequelae from this injury at 6-month follow up.

Lessons:
X-ray provides a comprehensive assessment of damage, and can efficiently detect foreign bodies in the skull and cervical vertebrae. Duplex ultrasound to be a viable method to exclude macrovascular injury in unstable patients who are not eligible for computed tomography angiography (CTA) or catheter angiography imaging. Widely available duplex ultrasound and x-ray should be considered in emergency situations.
Herbal medicine Banha-sasim-tang for the treatment of functional dyspepsia protocol for a systematic review of randomized controlled trials
Authors: Ko Seok-Jae , Cho Soo-ho , Kim Keum-Ji , Kim Jin-sung , Ha Na-yeon , Park Jae-Woo 
Published: May 2019

Abstract

Background:
Functional dyspepsia (FD) has a high prevalence rate. The dyspeptic symptoms are not easily cured despite the availability of various conventional Western medical treatments. Banha-sasim-tang (BST) is a traditional herbal medicine that has long been used for treating FD.

Methods:
The following databases will be searched from inception to January 2019: Medline via PubMed, the Cochrane Central Register of Controlled Trials, EMBASE, Allied and Complementary Medicine Database, National Digital Science Library, Korean Medical Database (KoreaMed), Oriental Medicine Advanced Searching Integrated System, Korean Studies Information Service System, China National Knowledge Infrastructure Database, and Citation Information by Nii. Randomized controlled trials (RCTs) that used BST or herbs-added BST for treating FD will be included in the systematic review. Control groups in these RCTs will be the placebo, no-treatment, and conventional Western medicine groups. RCTs that compared BST and Western medicine combination therapy with the conventional Western medicine will also be included in the systematic review to investigate the synergistic effect of BST and Western medicine. Data extraction and evaluation of risk of bias will be performed by 2 independent investigators. The primary outcome will be the total clinical effective rate and secondary outcomes will include gastrointestinal symptom scale, visual analog scale, FD-related quality of life, electrogastrography, plasma motilin, dyspepsia-related symptom score, gastric emptying, and adverse events. RevMan version 5.3 will be used for data integration and analysis.

Results:
This systematic review will provide a high-quality integration of current evidence of BST for treating FD from several aspects including total clinical effective rate, dyspepsia-related symptoms, quality of life, and adverse events.

Conclusions:
This systematic review will provide evidence of the effectiveness and safety of BST on FD.

Ethics and dissemination:
Identifying information of the participants will not be revealed; hence, this protocol does not need ethical approval. The systematic review will be published in a peer-reviewed journal and disseminated electronically.

Trial registration number:
PROSPERO CRD42019123285.
The diagnostic performance of serum LIM homeobox transcription factor 1 alpha in patients with gastric cancer
Authors: Li Dinuo , Li Chen 
Published: May 2019

Abstract
The study was conducted to investigate the diagnostic performance of serum LIM homeobox transcription factor 1 alpha (LMX1A) in patients with gastric cancer (GC).
The serum level of LMX1A in GC, benign, and healthy groups was measured using quantitative real time PCR (qRT-PCR) and compared with the student t test. The associations of serum LMX1A levels with clinical parameters were analyzed with chi-square test. The diagnostic value of serum LMX1A in GC was evaluated by receiver operating characteristic (ROC) curve.
The level of serum LMX1A in GC group (1.309 ± 0.553) was significantly lower than that in the benign group (2.174 ± 0.676) and healthy group (2.598 ± 0.826) (P < .01 for both). The decreased level of LMX1A was associated with large tumor size (P = .009), positive lymph node metastasis (P = .027), and advanced TNM stages (P = .002). Receiver operating characteristic (ROC) analysis demonstrated that serum LMX1A could discriminate GC patients from the healthy individuals, with the area under the curve (AUC) of 0.889 (95% confidence interval [CI] = 0.838–0.938) combining with the sensitivity and specificity of 82.68% and 82.61%. Additionally, serum LMX1A also exhibited high accuracy in discriminating between GC patients and benign gastric disease cases (AUC = 0.842, 95% CI = 0.782–0.901), with the sensitivity of 81.89% and specificity of 72.41%.
Serum LMX1A may be an effective biomarker for early detection of GC.
Comparison of 2-point and 3-point point-of-care ultrasound techniques for deep vein thrombosis at the emergency department
Authors: Lee Ju Hyung , Lee Sun Hwa , Yun Seong Jong 
Published: May 2019

Abstract

Background:
To our knowledge, so far, no studies have comprehensively examined the performance of 2-point and 3-point point-of-care compression ultrasound (POCUS) in the diagnosis of lower extremity deep vein thrombosis (DVT). The aim of this meta-analysis was to compare the performance of 2-point and 3-point POCUS techniques for the diagnosis of DVT and evaluate the false-negative rate of each POCUS method.

Methods:
A computerized search of the PubMed, EMBASE, and Cochrane library databases was performed to identify relevant original articles. Bivariate modeling and hierarchical summary receiver operating characteristic modeling were performed to compare the diagnostic performance of 2-point and 3-point POCUS. The pooled proportions of the false-negative rate for each POCUS method were assessed using a DerSimonian–Laird random-effects model. Meta-regression analyses were performed according to the patient and study characteristics.

Results:
Seventeen studies from 16 original articles were included (2-point, 1337 patients in 9 studies; 3-point, 1035 patients in 8 studies). Overall, 2-point POCUS had similar pooled sensitivity [0.91; 95% confidence interval (95% CI), 0.68–0.98; P = .86) and specificity (0.98; 95% CI, 0.96–0.99; P = .60) as 3-point POCUS (sensitivity, 0.90; 95% CI, 0.83–0.95 and specificity, 0.95; 95% CI, 0.83–0.99). The false-negative rates of 2-point (4.0%) and 3-point POCUS (4.1%) were almost similar. Meta-regression analysis showed that high sensitivity and specificity tended to be associated with an initial POCUS performer (including attending emergency physician > only resident) and separate POCUS training for DVT (trained > not reported), respectively.

Conclusion:
Both 2-point and 3-point POCUS techniques showed excellent performance for the diagnosis of DVT. We recommend that POCUS-trained attending emergency physicians perform the initial 2-point POCUS to effectively and accurately diagnose DVT.
A case of Kawasaki disease presenting with parotitis
Authors: Li Yanchun , Yang Qingran , Yu Xiuhua , Qiao Hongmei 
Published: May 2019

Abstract

Rationale:
Kawasaki disease affects multiple organ systems. Its typical symptoms include fever, rash, oropharyngeal mucosal erythema, bilateral non-exudative conjunctivitis, cervical lymphadenopathy, extremity changes, and membranous desquamation of the fingers and toes. In severe cases, cardiovascular, respiratory, musculoskeletal, gastrointestinal, neurological, and genitourinary complications may occur. In the early stage, Kawasaki disease is often manifested by uncommon symptoms, such as pyuria, meningitis, shock, and retropharyngeal or parapharyngeal abscess, which may delay diagnosis and treatment. We have reported a case of Kawasaki disease presenting with mumps and reviewed the clinical features of 14 other similar cases, in order to facilitate the early diagnosis and treatment of this unusual presentation of Kawasaki disease.

Patient concerns:
A 10-year-old boy presented with persistent fever and parotitis and was diagnosed with suppurative parotitis. After antibiotic therapy, the parotid swelling reduced, but the fever persisted and other typical symptoms of Kawasaki disease appeared, including bilateral conjunctival hyperaemia, cervical lymphadenopathy, oropharyngeal mucosal erythema, membranous desquamation of the fingers, and left coronary artery widening.

Diagnoses:
The patient was diagnosed with Kawasaki disease 12 days after the onset of fever.

Interventions:
The patient was administered γ-globulin 1.0 g/kg·d for 2 consecutive days and oral aspirin 5 mg/kg·d.

Outcomes:
The left coronary artery returned to a width of 3.8 mm after 1 month and of 3.1 mm after 3 months. The dose of aspirin was reduced to 3 mg/kg·d after 2 months and to 1.5 mg/kg·d after 3 months.

Lessons:
Physicians should be aware that Kawasaki disease may develop after parotitis.
Fatty liver increases gallstone disease risk in younger Chinese patients
Authors: Li Xu , Gao Pujun 
Published: May 2019

Abstract
We investigated possible associations between fatty liver and gallstone disease (GD) in a Chinese population.
This cross-sectional study included 897 people who visited the clinical center and underwent ultrasonography at The First Hospital of Jilin University between January 2018 and June 2018.
The overall prevalence of GD was 8.8%; the between-sex difference (9.3% in men, 8.4% in women) was not statistically significant. The risk of GD was similar for men and women across all age groups. GD prevalence increased steadily with increasing age, from 2.1% in patients ≤30 years of age to 15.4% in those >70 years of age. Older age (≥50 years) and fatty liver were associated with GD development. Diabetes mellitus (adjusted odds ratio [AOR]: 3.066; 95% confidence interval [CI]: 1.563–6.013) was associated with GD in female but not in male subjects. In younger patients (<50 years), fatty liver (AOR: 5.268; 95% CI: 1.832–15.147) was associated with GD development.
The factors older age and fatty liver predicted GD risk in Chinese individuals. Further studies are required to explore differences in lithogenesis according to sex.