bluuebunny/crossref_metadata_2025_split huggingface dataset:
What Serum Lipid Abnormalities Are Associated with Adhesive Capsulitis Accompanied by Diabetes?
Authors: Park Hyung Bin , Gwark Ji-Yong , Jung Jaehoon 
Published: September 2018

Abstract

Background
Adhesive capsulitis is common and can cause stiffness and pain. Diabetes and dyslipidemia are known to be associated with adhesive capsulitis. However, there is no report of any association between serum lipid profiles and adhesive capsulitis accompanied by diabetes.

Question/purpose
Which serum lipid abnormalities are associated with adhesive capsulitis accompanied by diabetes?

Methods
This is a case-control study with two control groups. Our case group included 37 patients with newly diagnosed adhesive capsulitis accompanied by newly diagnosed diabetes who had no other diagnosed systemic diseases or rotator cuff tears. The two control groups each had 111 age- and sex-matched individuals with normal shoulder function (bilaterally pain-free, with full range of motion and no shoulder muscle weakness), no thyroid dysfunction, and no previously diagnosed systemic diseases. Individuals in the first control group had neither adhesive capsulitis nor diabetes. Individuals in the second control group had newly diagnosed diabetes without adhesive capsulitis. We evaluated any association between adhesive capsulitis accompanied by diabetes and serum lipid profile, including total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides, and nonhigh-density lipoprotein (nonHDL). Conditional logistic regression analysis was used to evaluate the strengths of associations between serum lipid levels and adhesive capsulitis accompanied by diabetes, as determined by odds ratios (ORs) and 95% confidence intervals (CIs).

Results
Low-density lipoprotein and nonHDL were associated with adhesive capsulitis accompanied by diabetes. Specifically, patients with adhesive capsulitis and diabetes had greater odds ratios of hyperlow-density lipoproteinemia when compared with individuals with neither adhesive capsulitis nor diabetes (OR, 3.19; 95% CI, 1.21–8.38; p = 0.019) and when compared with individuals without adhesive capsulitis but with newly diagnosed diabetes (OR, 5.76; 95% CI, 1.67–19.83; p = 0.005). Similarly, patients with adhesive capsulitis accompanied by diabetes had greater odds ratios of hypernonhigh-density lipoproteinemia when compared with individuals with neither adhesive capsulitis nor diabetes (OR, 7.39; 95% CI, 2.72–20.09; p < 0.001) and when compared with individuals without adhesive capsulitis but with newly diagnosed diabetes (OR, 3.26; 95% CI, 1.40–7.61; p = 0.006).

Conclusions
Inflammatory lipoproteinemias, particularly hyperlow-density lipoproteinemia and hypernonhigh-density lipoproteinemia, are associated with adhesive capsulitis accompanied by diabetes. Further research is needed to evaluate whether inflammatory lipoproteinemias are a cause, a related cofactor, or an aggravating factor in the development of adhesive capsulitis in people who have diabetes.

Level of Evidence
Level III, prognostic study.
Adipose-derived Human Perivascular Stem Cells May Improve Achilles Tendon Healing in Rats
Authors: Devana Sai K. , Kelley Benjamin V. , McBride Owen J. , Kabir Nima , Jensen Andrew R. , Park Se Jin , Eliasberg Claire D. , Dar Ayelet , Mosich Gina M. , Kowalski Tomasz J. , Péault Bruno , Petrigliano Frank A. , SooHoo Nelson F. 
Published: September 2018

Abstract

Background
Achilles tendon rupture is a common injury and the best treatment option remains uncertain between surgical and nonoperative methods. Biologic approaches using multipotent stem cells such as perivascular stem cells pose a possible treatment option, although there is currently a paucity of evidence regarding their clinical therapeutic use.

Questions/purposes
The purpose of this study was to determine whether injected perivascular stem cells (PSCs) would (1) improve histologic signs of tendon healing (such as percent area of collagen); and (2) improve biomechanical properties (peak load or stiffness) in a rat model of Achilles tendon transection.

Methods
Two subtypes of PSCs were derived from human adipose tissue: pericytes (CD146+CD34-CD45-CD31-) and adventitial cells (CD146-CD34+CD45-CD31-). Thirty-two athymic rats underwent right Achilles transection and were randomized to receive injection with saline (eight tendons), hydrogel (four tendons), pericytes in hydrogel (four tendons), or adventitial cells in hydrogel (eight tendons) 3 days postoperatively with the left serving as an uninjured control. Additionally, a subset of pericytes was labeled with CM-diI to track cell viability and localization. At 3 weeks, the rats were euthanized, and investigators blinded to treatment group allocation evaluated tendon healing by peak load and stiffness using biomechanical testing and percent area of collagen using histologic analysis with picrosirius red staining.

Results
Histologic analysis showed a higher mean percent area collagen for pericytes (30%) and adventitial cells (28%) than hydrogel (21%) or saline (26%). However, a nonparametric statistical analysis yielded no statistical difference. Mechanical testing demonstrated that the pericyte group had a higher peak load than the saline group (41 ± 7 N versus 26 ± 9 N; mean difference 15 N; 95% confidence interval [CI], 4-27 N; p = 0.003) and a higher peak load than the hydrogel group (41 ± 7 N versus 25 ± 3 N; mean difference 16; 95% CI, 8-24 N; p = 0.001). The pericyte group demonstrated higher stiffness than the hydrogel group (36 ± 12 N/mm versus 17 ± 6 N/mm; mean difference 19 N/mm; 95% CI, 5-34 N/mm; p = 0.005).

Conclusions
Our results suggest that injection of PSCs improves mechanical but not the histologic properties of early Achilles tendon healing.

Clinical Relevance
This is a preliminary study that provides more insight into the use of adipose-derived PSCs as a percutaneous therapy in the setting of Achilles tendon rupture. Further experiments to characterize the function of these cells may serve as a pathway to development of minimally invasive intervention aimed at improving nonoperative management while avoiding the complications associated with surgical treatment down the line.
Guidelines for the evaluation and treatment of perimenopausal depression: summary and recommendations
Authors: Maki Pauline M. , Kornstein Susan G. , Joffe Hadine , Bromberger Joyce T. , Freeman Ellen W. , Athappilly Geena , Bobo William V. , Rubin Leah H. , Koleva Hristina K. , Cohen Lee S. , Soares Claudio N. 
Published: September 2018

Abstract
There is a new appreciation of the perimenopause – defined as the early and late menopause transition stages as well as the early postmenopause - as a window of vulnerability for the development of both depressive symptoms and major depressive episodes. However, clinical recommendations on how to identify, characterize and treat clinical depression are lacking. To address this gap, an expert panel was convened to systematically review the published literature and develop guidelines on the evaluation and management of perimenopausal depression. The areas addressed included: 1) epidemiology; 2) clinical presentation; 3) therapeutic effects of antidepressants; 4) effects of hormone therapy; and 5) efficacy of other therapies (eg, psychotherapy, exercise, and natural health products). Overall, evidence generally suggests that most midlife women who experience a major depressive episode during the perimenopause have experienced a prior episode of depression. Midlife depression presents with classic depressive symptoms commonly in combination with menopause symptoms (ie, vasomotor symptoms, sleep disturbance), and psychosocial challenges. Menopause symptoms complicate, co-occur, and overlap with the presentation of depression. Diagnosis involves identification of menopausal stage, assessment of co-occurring psychiatric and menopause symptoms, appreciation of the psychosocial factors common in midlife, differential diagnoses, and the use of validated screening instruments. Proven therapeutic options for depression (ie, antidepressants, psychotherapy) are the front-line treatments for perimenopausal depression. Although estrogen therapy is not approved to treat perimenopausal depression, there is evidence that it has antidepressant effects in perimenopausal women, particularly those with concomitant vasomotor symptoms. Data on estrogen plus progestin are sparse and inconclusive.
CHANGES IN OPTICAL COHERENCE TOMOGRAPHY FINDINGS IN PATIENTS WITH CHRONIC RENAL FAILURE UNDERGOING DIALYSIS FOR THE FIRST TIME
Authors: Hwang Hyeseong , Chae Ju Byung , Kim Jin Young , Moon Byung Gil , Kim Dong Yoon 
Published: September 2018

Purpose:
To investigate the spectral domain optical coherence tomography findings before and after dialysis in patients with diabetic end-stage renal disease undergoing dialysis for the first time.

Methods:
A retrospective medical review of patients with diabetic end-stage renal disease who recently started dialysis was conducted. Spectral domain optical coherence tomography findings before and after initiation of dialysis were analyzed. Systemic blood pressure, body weight, estimated glomerular filtration rate, and serum levels of blood urea nitrogen, creatinine (Cr), albumin, hemoglobin (Hb), and total CO2 were measured before and 1 month after starting dialysis. The correlations between the changes in these variables and the degree of decrease of the central subfield thickness after initiation of dialysis were analyzed.

Results:
A total 26 eyes from 15 patients were included. Among them, 14 started hemodialysis, and 1 started peritoneal dialysis. After initiation of dialysis, the incidence of any macular edema significantly decreased from 69.2% (18/26) to 26.9% (7/26) (P = 0.001). The central subfield thickness (317.92 ± 91.41 vs. 287.77 ± 57.55 μm, P = 0.006) and subfoveal choroidal thickness (313.31 ± 85.89 vs. 288.81 ± 92.02; P = 0.024) also significantly decreased. Improvement in blood urea nitrogen, Cr, Hb, and total CO2 levels in serum and estimated glomerular filtration rate was observed. A significant positive correlation between the amount of central subfield thickness decrease and the decrease in serum blood urea nitrogen was found (Pearson correlation coefficient: 0.481, P = 0.013).

Conclusion:
Macular edema and central subfield thickness significantly decreased after initiation of dialysis in patients with diabetic chronic renal failure without any ocular treatment. This may be related to the improvement in uremia and volume overload after the initiation of dialysis.
Comparative Outcomes of Boston Keratoprosthesis Type 1 Implantation Based on Vision in the Contralateral Eye
Authors: Shanbhag Swapna S. , Saeed Hajirah N. , Colby Kathryn A. , Chodosh James 
Published: September 2018

Purpose:
To compare the outcomes of Boston keratoprosthesis type 1 implantation after failed keratoplasty in patients who are blind or sighted in the contralateral eye.

Methods:
Retrospective comparative case series of Boston keratoprosthesis type I recipients performed for failed keratoplasty, between January 1, 2008, and June 30, 2016, at a single center. Patients were divided based on the best-corrected visual acuity in the contralateral eye at the time of surgery: group I, ≤20/200, and Group II, >20/200. Preoperative diagnoses, postoperative visual acuity, device retention, and postoperative complications were compared.

Results:
Group I (37 eyes) and group II (36 eyes) had similar demographics, median preoperative best-corrected visual acuity (count fingers) in the operated eye, and median duration of postoperative follow-up (37.4 vs. 45.2 months, respectively). Keratoprosthesis retention after the first year postimplantation was significantly better in group I versus group II (P = 0.038). Sterile vitritis and sterile keratolysis occurred more frequently in group II compared with group I (P = 0.013 and P = 0.056, respectively). At final examination, visual outcomes were not significantly different between the 2 groups.

Conclusions:
Most patients with failed keratoplasty who were implanted with a Boston keratoprosthesis type I experienced improved vision, and visual acuity of the contralateral eye did not seem to influence the visual outcome of surgery. However, patients with good vision in the contralateral eye were more likely to experience complications, possibly because of reduced vigilance when the other eye has ambulatory vision.
Comparison of masseter muscle referred sensations after mechanical and glutamate stimulation: a randomized, double-blind, controlled, cross-over study
Authors: Exposto Fernando G. , Udagawa Gen , Naganawa Takuya , Svensson Peter 
Published: September 2018

Abstract
Referred sensations (RS) are commonly found in various musculoskeletal pain conditions. Experimental studies have shown that RS can be elicited through glutamate injection and mechanical stimulation. Despite this, differences and similarities between these modalities in RS outcomes remain unclear. The aim of this study was to assess differences between mechanical-induced and glutamate injection–induced RS in the trigeminal region. The present randomized, double-blind, controlled, cross-over study recruited 60 healthy participants who were assessed in 2 different sessions. In both sessions, pressure was applied to the masseter muscle with 4 different forces (0.5, 1, 2, and 4 kg), and glutamate (1 mol/L or 0.25 mol/L) was injected into the same area. Participants rated their perceived masseter sensations and rated and drew any RS they experienced. No difference was found in number of participants reporting RS after glutamate injection compared with mechanical stimulation. More participants reported RS when the stimulus was painful compared with a nonpainful stimulus. Furthermore, it was shown that the more intense the stimulus, the higher the frequency of RS. Finally, RS centre-of-gravity location was similar between the 2 sessions. In summary, RS was elicited in healthy individuals through both modalities, and no differences in frequency of RS were observed in the orofacial region. Hence, RS does not seem to be modality-dependent, and only the painfulness of the stimulus caused an increase in frequency of RS. Finally, RS location for each participant was similar in both sessions possibly indicating a preferred location of referral. These findings may have implications for our understanding of RS in craniofacial pain conditions.
Opioid Overdose and Naloxone Kit Distribution
Authors: Lockett Tiffany L. , Hickman Kim L. , Fils-Guerrier Bernoune J. , Lomonaco Michael , Maye John P. , Rossiter Alicia Gill 
Published: September 2018

Abstract

Problem:
In 2014, there were approximately 200,000 incidents of an unintentional opioid overdose nationwide. The 2016 Centers for Disease Control and Prevention opioid prescription guidelines identified a knowledge deficit regarding opioid prescribing among primary care providers as a contributing factor to this epidemic.

Purpose:
The purpose of this quality assurance project was to provide education on opioid overdose and distribution of naloxone kits through a presentation to primary care providers at Veterans Administration facilities in the southeast region of the United States.

Methods:
A convenience sampling strategy was utilized for this project. Primary care providers who prescribe opioids or care for patients at risk of an opioid-related event or death were invited to participate. A Likert scale survey was used to determine the effectiveness of the presentation.

Results:
The results of the survey showed a potential for improving medical providers’ perceptions and comfort with prescribing naloxone kits. The mean score at pretest was 32 of 50 (64%) in contrast to 42 of 50 (84%) after attending the presentation. Attending this quality assurance presentation was related to an increased awareness of naloxone kit availability and Centers for Disease Control and Prevention recommendations regarding the safe administration of opioids.

Conclusion:
This educational presentation can assist providers in identifying patients who are prescribed opioids and at risk for accidental overdose and death.
Evaluating Emergency Department Opioid Prescribing Behaviors After Education About Mandated Use of the Pennsylvania Prescription Drug Monitoring Program
Authors: Martello Jennifer , Cassidy Brenda , Mitchell Ann 
Published: September 2018

Abstract

Introduction:
Prescription drug monitoring programs (PDMPs) are among the most promising state-level interventions to improve opioid prescribing, inform clinical practice, and protect patients at risk for prescription drug misuse, overdose, and death. In 2016, Pennsylvania launched an initiative mandating all prescribers to search the PDMP for each patient when the patient is prescribed controlled substances.

Objectives:
The primary aim of this project was to support the Pennsylvania PDMP mandate by educating emergency department (ED) providers regarding the opioid epidemic and use of the PDMP and measure opioid prescriptions posteducation. Secondary aims were to evaluate provider knowledge and identify barriers to PDMP use.

Methods:
This quality improvement project was conducted through a retrospective chart review of patients 18–85 years old discharged from the ED with a chief complaint of pain. A pretest and a posttest measured provider knowledge change after an education program and assessed barriers to PDMP use. Numbers of opioid prescriptions written at discharge were examined.

Results:
Provider knowledge scores increased significantly (p = .000). Barriers to PDMP use focused on access and process issues. A statistically significant decrease was observed in opioid prescriptions written (p = .002) during the project.

Conclusion:
An education program increased ED providers’ knowledge of the opioid epidemic and the Pennsylvania PDMP mandate and identified barriers to use. A decrease in opioid prescriptions written may have been associated with improved knowledge and suggests that providers can change prescribing behaviors. More research is needed in this area, and future projects may want to focus on prescriber attitudes toward PDMP usefulness.
Caught in the Crossfire of the Syndemic
Authors: Dobbs Gina , Fogger Susanne A. 
Published: September 2018

Abstract
The worsening opioid epidemic ignites infectious disease development and transmission as opioids abused by insufflation and/or injection establish a pathway for infection to the user and propagate vulnerability to diseases. The phenomenon of the synergistic collision of epidemics intensifying the load of disease constitutes a syndemic. Merrill Signer (1994) voiced the term “syndemic” to characterize the complex nexus of politics, economics, psychosocial/environmental factors, and health disparities resulting in the inner-city AIDS crisis of the 1990s. Today, the surge of opioid use puts individuals at risk for disease transmission and living the catastrophic clash wrought by the epidemics. By following a case study caught in the crossfire of epidemics, this article prompts to underscore recognition of the at-risk patient for HIV infection and to embolden care integration of prevention and treatment strategies nurses are qualified to execute.
Preference for Human Papillomavirus Self-Collection and Papanicolaou: Survey of Underscreened Women in North Carolina
Authors: Kilfoyle Kimberly A. , Des Marais Andrea C. , Ngo Mai Anh , Romocki LaHoma , Richman Alice R. , Barclay Lynn , Brewer Noel T. , Rahangdale Lisa , Smith Jennifer S. 
Published: September 2018

Objectives
Self-collection of samples for human papillomavirus (HPV) testing (self-collection) has the potential to increase cervical cancer screening among underscreened women. We assessed attitudes toward at-home HPV self-collection compared with clinic-based Pap testing in this higher-risk population.

Materials and Methods
Participants were low-income women in North Carolina overdue for cervical cancer screening. Women self-collected samples at home, returned samples by mail for HPV testing, and completed phone questionnaires about at-home HPV self-collection. Participants were referred to clinic-based Pap testing and invited to complete a second questionnaire about Pap testing. A cross-sectional questionnaire compared attitudes, experiences, and preferences for self-collection versus Pap testing and assessed predictors of preference for HPV self-collection.

Results
Half (51%) of 221 women reported a preference for HPV self-collection, 19% preferred Pap testing, and 27% reported no preference. More women reported difficulty finding time to do the Pap test (31%) than the self-test (13%, p = .003) and being afraid of the self-test results (50%) than the Pap test results (36%, p = .02). There were relatively fewer reports of physical discomfort and pain from self-collection than Pap testing (discomfort: 18% self; 48% Pap; pain: 8% self; 30% Pap, p = .001). No differences were found in positive versus negative thoughts about the tests, trust in the tests' safety and accuracy, or willingness to do tests again.

Conclusions
Overall positive attitudes toward HPV self-collection compared with Pap testing among underscreened women suggest that self-collection is a promising option to increase cervical cancer screening in this high-risk population.
Trend analysis of emergency department malpractice claims in the Netherlands: a retrospective cohort analysis
Authors: Wansink Luuk , Kuypers Maybritt I. , Boeije Tom , van den brand Crispijn L. , de Waal Manon , Holkenborg Joris , Ter Avest Ewoud 
Published: September 2018

BackgroundOver the past two decades, several quality improvement projects have been implemented in emergency departments (EDs) in the Netherlands, one of these being the training and deployment of emergency physicians. In this study we aim to perform a trend analysis of ED quality of care in Dutch hospitals, as measured by the incidence of medical malpractice claims.Patients and methodsWe performed a multicentre retrospective cohort study of malpractice claims in five Dutch EDs over the period 1998–2014. Incidence risk ratios were calculated to demonstrate any relation of specific quality improvement initiatives with the primary outcome, defined as the number of claims per 10 000 ED visits per year.ResultsDuring the study period, the cumulative number of ED visits increased significantly from 99 145 in 1998 to 162 490 in 2014 (P< 0.01). In total, 228 of 2 348 417 ED visits (0.97 per 10 000) resulted in a malpractice claim. At the same time, the yearly number of ED claims filed decreased with 0.07 (0.03–0.10) per 10 000 each year. The claim rate was higher in the period before emergency physicians were employed in the ED [1.18 (0.98–1.41) claims per 10 000 visits] compared with the period after they were employed [0.81 (0.67–0.97), incidence risk ratio 0.69 (0.53–0.89),P< 0.01].ConclusionEven though the number of ED visits increased significantly over the past two decades, the number of malpractice claims filed after an ED visit decreased. Various quality improvement initiatives, including the training and employment of emergency physicians, may have contributed to the observed decrease in claims.