bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acute Heart Failure at the Time of Transcatheter Aortic Valve Replacement Does not Increase Mortality
Authors: Burke William T. , Trivedi Jaimin R. , Flaherty Michael P. , Grubb Kendra J. 
Published: February 2018

Objective Patients presenting for transcatheter aortic valve replacement are often in acute on chronic heart failure, as indicated by elevated N-terminal pro-B-type natriuretic peptide. Many believe that elevated N-terminal pro-B-type natriuretic peptide is an indication to treat medically, reserving surgery until the patient is medically optimized. Methods A single-center transcatheter aortic valve replacement database was queried from December 2015 to November 2016 to identify patients undergoing transcatheter aortic valve replacement. Patients were divided into two cohorts based on preoperative N-terminal pro-B-type natriuretic peptide level. An analysis was then completed to assess outcomes such as length of intensive care unit stay, total length of stay, discharge to home, major complications, and mortality at 30 days. Results There were 142 patients (median age = 80 years, 44% female) with preoperative N-terminal pro-B-type natriuretic peptide data included (range = 106–73,500 pg/mL). The mean Society of Thoracic Surgeons predicative risk of mortality was 8%, and 46 patients (32%) had N-terminal pro-B-type natriuretic peptide of greater than 3000 pg/mL. N-terminal pro-B-type natriuretic peptide of greater than 3000 pg/mL was associated only with increased intensive care unit length of stay of greater than 24 hours (35% vs 9%, P = 0.0001). There was no statistical difference between cohorts with regard to total length of stay of greater than 3 days (24% vs 15%, P = 0.2), discharge to home (74% vs 83%, P = 0.3), major complication, or mortality at 30 days. Conclusions Transcatheter aortic valve replacement is an appropriate and effective treatment for patients with aortic stenosis presenting with high N-terminal pro-B-type natriuretic peptide and acute on chronic heart failure.
Emphysematous Gastritis Is a Severe Infectious Disease
Authors: Fromentin Melanie , Troche Gilles , Bruneel Fabrice , Mezghani Julien , Samama Charles-Marc , Bedos Jean Pierre 
Published: February 2018

Purpose
Emphysematous gastritis (EG) is a rare form of infectious gastritis reported in many immunocompromised patient with extreme severity and many potential comorbidities. However, despite lots of critically ill case reports, there is a trend towards conservative management. Furthermore, it has never been described in refractory septic intensive care unit patient treated successfully with a sleeve gastrectomy. We wanted to focus on the progress made in diagnosis and treatments since the early 2000s and to report a case.

Methods
We report the case of a critically ill and immunocompromised 45-year-old women, who presented an EG secondary to an ileus due to a high dose of barbiturates for a refractory epilepticus status. Then, we conducted a literature search for reported adult cases of EG since 2000.

Results
Study cohort included 53 new cases of EG since 2000. Mean age was 54, and mean (SD) length of stay was 23 ± 36 days. Diabetes mellitus is still the main predisposing factor identified. Causative pathogen was found in only 40% of the cases, mostly Enterobacteriaceae, Enterococcus spp, and Streptococcus. An emergent surgery was required in only 6 cases of refractory septic shock or gastric necrosis. The global mortality rate reached 34%.

Conclusions
Emphysematous gastritis remains a severe disease, which can evolve quickly in septic shock or in gastric necrosis. Early diagnosis and management are warranted to favor a conservative management, even for severe forms and prevent further complications. Cases refractory to supportive measures can be successfully managed with minimally invasive surgery.
Epidemiology and the Changing Face of HIV Infection in Qatar
Authors: Al Soub Hussam , Al-khal A. Latif , Al Maslamani Muna , Dousa Khalid , Ahmed Abubaker , Fabella Ameera 
Published: February 2018

Background
The aim of the study was to study the demographics, modes of transmission, clinical features, and outcome of human immunodeficiency virus (HIV) infection in Qatar and the change in epidemiology over time before and after 2000.

Method
Review of the records of all cases of HIV infection diagnosed in Qatar between 1984 and October 2014 was conducted.

Results
During the study period, 306 cases of HIV infection were diagnosed in Qatar. Files were available for review for only 148 patients. Males were more than females with a ratio of 2.5:1. The male to female ratio in those diagnosed after 2000 (group 2) was significantly more than in those diagnosed before 2000 (group 1). Almost half of the cases were Qatari. The most common mode of transmission was sexual (72%); however, in a significant proportion (43%) of those in group 1, the mode of transmission was blood transfusion. Fifty-four percent of patients had a late presentation with an acquired immunodeficiency syndrome defining condition or with CD+4 less than 350 cells/mm3. The mean CD+4 cell count at presentation was 359 cells/mm3, and there was no significant difference between the two groups. Evidence of previous infection with hepatitis B virus, hepatitis C virus, syphilis, and toxoplasmosis was low (10%, 4%, 2.5%, and 11%, respectively); however, the difference between the two groups was significant only for HCV infection. One hundred four patients (70%) are still alive despite some of them were diagnosed early in HIV epidemic.

Conclusions
Qatar remains a low prevalence country for HIV infection. The disease affects mainly young male adults with many of them presenting late in the disease. The epidemiology of HIV infection in Qatar has changed over time with infection being mostly sexually transmitted in later years. More non-Qataris are being diagnosed compared with earlier years, and this reflects the change in population that occurred in Qatar in recent years. More efforts are needed to educate the public especially the young in prevention measures and to improve early diagnosis.
Participants’ Experiences of a Sexual Counseling Intervention During Cardiac Rehabilitation
Authors: D’Eath Maureen , Byrne Molly , Murphy Patrick , Jaarsma Tiny , McSharry Jenny , Murphy Andrew W. , Doherty Sally , Noone Chris , Casey Dympna 
Published: February 2018

Background:
International guidelines recommend sexual assessment and counseling be offered to all patients with cardiovascular disease during cardiac rehabilitation. However, sexual problems are infrequently addressed. The Cardiac Health and Relationship Management and Sexuality (CHARMS) intervention is a complex, multilevel intervention designed to increase the provision of sexual counseling in cardiac rehabilitation. It was piloted in 2 cardiac rehabilitation centers to assess the acceptability and feasibility of the intervention and to inform and refine a definitive cluster randomized controlled trial protocol.

Objectives:
The aim of this study was to explore the experiences, perceptions, and opinions of patients, partners, and cardiac rehabilitation staff who participated in the CHARMS staff-led patient education class.

Methods:
A qualitative, descriptive study using semistructured interviews to collect the data. Cardiac rehabilitation staff (n = 8) were interviewed when the intervention commenced in their center and 3 months later (n = 6). Patients (n = 19) and partners (n = 2) were interviewed after delivery of the class; 7 were interviewed again 3 months postintervention to explore temporal changes in opinions.

Results:
Most cardiac rehabilitation staff were comfortable delivering the CHARMS intervention but would prefer a less structured format. Some staff perceived discomfort among patients. Few patients reported discomfort. Most patients and partners considered that the intervention was a welcome and acceptable part of a cardiac rehabilitation program.

Conclusion:
Incorporating sexual counseling into cardiac rehabilitation programs is feasible. Although the views of the patients and staff diverged on a number of issues including the perceived comfort of patients, its inclusion was welcomed by patients and was acceptable overall to both staff and patients.
Agreement Between Automated and Human Measurements of Heart Rate in Patients With Atrial Fibrillation
Authors: Lin Ting-Tse , Wang Chia-Ling , Liao Min-Tsun , Lai Chao-Lun 
Published: February 2018

Background:
The accuracy of heart rate (HR) measurement by automated blood pressure monitors in patients with atrial fibrillation (AF) remains unclear. The authors investigate the agreement between HR measurements by 2 automated devices and human counting in patients with AF.

Methods:
In 47 patients with persistent AF, HR was recorded using 2 automated blood pressure monitors: Omron M5-I and Microlife BPA100 Plus. Human counting of HR by a stethoscope was used as the reference. For each method, 3 readings were made and the mean was calculated for comparison. In addition to Wilcoxon signed rank test, the correlation between HR measurements by automated devices and human counting was determined using Spearman's rank correlation coefficient (r), and the agreement between HR measurements by both devices and human counting was validated by the Bland-Altman plot and intraclass correlation coefficient (ICC).

Results:
Overall, we found no significant difference in HR measurements between devices and human counting (Omron vs human counting, 81.1 ± 11.1 vs 80.2 ± 10.8 beats per minute [bpm]; P = .21, r = 0.911; ICC, 0.954; Microlife vs human counting, 81.3 ± 10.8 vs 80.2 ± 10.8 bpm; P = .22, r = 0.842; ICC, 0.912). However, in patients with HR greater than 80 bpm, the HR measured by the Microlife device was significantly higher than that measured by human counting (91.1 ± 5.2 vs 87.1 ± 8.6 bpm, P = .034).

Conclusion:
There was a high agreement between HR measurements by 2 automated devices and human counting, but the Microlife device may overestimate HR in AF patients with HR greater than 80 bpm.
Design and Construction of a New Partial Foot Prosthesis Based on High-Pressure Points in a Patient with Diabetes with Transmetatarsal Amputation: A Technical Note
Authors: Zarezadeh Fatemeh , Arazpour Mokhtar , Bahramizadeh Mahmood , Mardani Mohammad Ali , Head John 
Published: February 2018

ABSTRACT

INTRODUCTION
Diabetic foot ulcers are significant complications of diabetes that can lead to amputation. Partial foot prostheses can be used to redistribute the plantar pressure on the residual limb to alleviate local pressures. The aim of this study was to describe the fabrication of an original silicone foot prosthesis that provided an improved functional outcome for a patient with a transmetatarsal amputation due to diabetes.

METHODS
High-pressure areas on the foot were identified using Force-Sensing Resistor sensors. During prosthetic fabrication, silicone with low shore was injected in these areas. Different silicone stiffness was used to reduce pressure accordingly. The silicone injection was achieved in two stages, using cast formers and wax.

DISCUSSION
The bespoke method of fabrication used in this study and the use of various levels of silicone stiffness provided a highly cosmetic prosthesis that offered improved pressure distribution.
Anticoagulant therapy for venous thromboembolism in patients with inflammatory bowel disease
Authors: Lobo Jose L. , Garcia-Fuertes Julia A. , Trujillo-Santos Javier , Merah Adel , Blanco-Molina María Á. , Casado Ignacio , Hirmerova Jana , De Miguel Javier , Salgado Estuardo , Monreal Manuel 
Published: February 2018

Background
There is lack of evidence to guide the type, intensity, and the duration of anticoagulation following venous thromboembolism (VTE) in patients with inflammatory bowel disease (IBD).

Patients and methods
Registro Informatizado Enfermedad Trombo Embólica (RIETE) is an ongoing, multicenter, observational registry of consecutive patients with symptomatic, objectively confirmed, acute VTE. We used the RIETE database to compare the rate of VTE recurrences and major bleeding during the course of anticoagulation in noncancer patients with or without IBD.

Results
As of October 2014, 41 927 patients without active cancer have been recruited in RIETE. Of these, 265 (0.63%) had IBD and 85 (32%) had the VTE during an acute flare. The duration of anticoagulation was similar in patients with VTE during an acute flare (8.3±8.8 months), in remission (9.4±11.5 months), or without IBD (10.0±12.8 months). The rate of VTE recurrences [7.25, 95% confidence interval (CI): 1.46–21.2; 8.84, 95% CI: 3.23–19.2; and 5.85, 95% CI: 5.46–6.26 per 100 patient-years, respectively] and major bleeding (7.25, 95% CI: 1.46–21.2; 2.95, 95% CI: 0.33–10.6; and 4.79, 95% CI: 4.44–5.15, respectively) were similar in all three subgroups. Propensity score matching analysis confirmed the absence of differences in the rate of VTE recurrences (rate ratio: 1.16, 95% CI: 0.54–2.47) or major bleeding (rate ratio: 0.84, 95% CI: 0.31–2.23) between patients with or without IBD.

Conclusion
Therapeutic anticoagulation for patients with IBD and VTE is as safe and effective as for those with VTE without IBD.
Patient tolerance and acceptance of different colonic imaging modalities: an observational cohort study
Authors: Ojidu Hannah , Palmer Hansa , Lewandowski Jakub , Hampton James , Blakeborough Tony , Epstein Owen , McAlindon Mark E. 
Published: February 2018

BackgroundLess invasive alternatives to optical colonoscopy (OC) may improve patient compliance with investigation, but study of patient preference is limited.ObjectivesThe aims of this study were to determine patient tolerance and acceptability of OC, computed tomography colonography (CTC) and colon capsule endoscopy (CCE) and also to determine the choice of investigation made by fully informed members of the lay public.Patients and methodsPatients assigned a Gloucester Comfort Score (GCS, 1–5; as did endoscopists), an overall test experience score (visual analogue scale, 0–10) and completed a ‘Friends and Family Test’ following OC, CTC or CCE. In the second part of the study, members of the public were given information detailing the nature, tolerance, acceptability, risks and outcomes and invited to choose which test they would prefer in the event that one was needed.ResultsAssessed by endoscopist and patient, respectively, 24.2 and 49.3% (P<0.005) of symptomatic and 27.3 and 22.1% (P=0.4) of Bowel Cancer Screening Programme patients suffered moderate to severe discomfort (GCS: 4–5) [GCS (mean±SEM): 3.32±0.085, 1.96±0.083 and 1.30±0.088 (P<0.001); overall experience: 5.43, 2.35 and 3.80 (P<0.001)]. In all, 93.6, 96.1 and 85.7% of OC, CTC and CCE patients, respectively, were willing to undergo the same test under the same circumstances. The lay public (n=100) chose a noninvasive test (CTC or CCE) in 55% of the cases to investigate symptoms and chose a Bowel Cancer Screening Programme test in 29% of the cases (P<0.001).ConclusionPatient tolerance and experience favours CTC and CCE over OC and informed about all aspects of each procedure; a noninvasive option is commonly chosen by the lay public.
Medicare Advantage Penetration and Hospital Costs Before and After the Affordable Care Act
Authors: Henke Rachel Mosher , Karaca Zeynal , Gibson Teresa B. , Cutler Eli , White Chapin , Wong Herbert S. 
Published: February 2018

Background:
Research has suggested that growth in the Medicare Advantage (MA) program indirectly benefits the entire 65+-year-old population by reducing overall expenditures and creating spillover effects of patient care practices. Medicare programs and innovations initiated by the Affordable Care Act (ACA) have encouraged practices to adopt models applying to all patient populations, which may influence the continued benefits of MA program growth.

Objective:
This study investigated the relationship between MA program growth and inpatient hospital costs and utilization before and after the ACA.

Methods:
Primary data sources were 2005–2014 Health Care Cost and Utilization Project hospital data and 2004–2013 Centers for Medicare & Medicaid Services enrollment data. County-year-level regression analysis with fixed effects examined the relationship between Medicare managed care penetration and hospital cost per enrollee. We decomposed results into changes in utilization, severity, and severity-adjusted inpatient resource use. Analyses were stratified by whether the admission was urgent or nonurgent.

Principal Findings:
A 10% increase in MA penetration was associated with a 3-percentage point decrease in inpatient cost per Medicare enrollee before the ACA. This effect was more prominent in nonurgent admissions and diminished after the ACA.

Conclusions:
Results suggest that MA enrollment growth is associated with diminished spillover reductions in hospital admission costs after the ACA. We did not observe a strong relationship between MA enrollment and inpatient days per enrollee. Future research should examine whether spillover effects still are observed in outpatient settings.
Developing competent videofluoroscopic swallowing study analysts
Authors: Edwards Ann , Froude Elspeth , Sharpe Gabriella 
Published: February 2018

Purpose of review
This review examines the recent literature concerning the development of VFSS analysts.

Recent findings
Face-to-face and blended methods of training improve reliability and accuracy of VFSS analysis. However, with the exception of the literature describing the MBSImP training, most studies investigate relatively brief training for specific VFSS rating tools. The influence of training mode and trainee factors has received limited attention.

Summary
There is a lack of controlled studies investigating the influences of training methods for VFSS analysis. Pilot data is emerging concerning VFSS analysis training ‘packages’ but without information about the relative influence of training mode, it is difficult to determine the most efficient and cost-effective way of training VFSS analysts. Future research should investigate the contribution of trainee-related factors to succeed in VFSS analysis training, and the relative benefits and disadvantages of online, peer, independent, and blended modes of training.
Evidence supporting laparoscopic hernia repair in children
Authors: Jessula Samuel , Davies Dafydd A. 
Published: February 2018

Purpose of review
Pediatric inguinal hernias are a commonly performed surgical procedure. Currently, they can be approached via open or laparoscopic surgery. We summarize the current evidence for laparoscopic inguinal hernia repairs in children.

Recent findings
Laparoscopic and open inguinal hernia repair in children are associated with similar operative times for unilateral hernia, as well as similar cosmesis, complication rates and recurrence rates. Bilateral hernia repair has been shown to be faster through a laparoscopic approach. The laparoscopic approach is associated with decreased pain scores and earlier recovery, although only in the initial postoperative period. Laparoscopy allows for easy evaluation of the patency of contralateral processus vaginalis, although the clinical significance of and need for repair of an identified defect is unclear.

Summary
Laparoscopic surgery for pediatric inguinal hernias offers some advantages over open repair with most outcomes being equal. It should be considered a safe alternative to open repair to children and their caregivers.
Intrahepatic Cholestasis of Pregnancy: A Review of Diagnosis and Management
Authors: Wood Amber M. , Livingston Elizabeth G. , Hughes Brenna L. , Kuller Jeffrey A. 
Published: February 2018

Importance
Intrahepatic cholestasis of pregnancy (ICP) complicates approximately 0.2% to 2% of pregnancies and can lead to increased fetal risks in pregnancy.

Objective
This review aims to increase the knowledge of women's health care providers regarding the diagnosis, management, and fetal risks associated with ICP.

Results
The diagnosis of ICP is based on symptoms of pruritus that typically include the palms and soles, as well as elevated bile acid levels. Other liver function tests such as alanine aminotransferase and aspartate aminotransferase are also frequently elevated, and other causes of liver dysfunction should be ruled out. Fetal risks of ICP include increased risk of preterm birth, meconium-stained amniotic fluid, respiratory distress syndrome, or stillbirth. There is evidence that as bile acid levels increase, so does the risk of adverse neonatal outcomes. Ursodeoxycholic acid treatment has been shown to improve maternal pruritus symptoms, as well as biochemical tests, but no treatment has been shown to definitively improve fetal outcomes.

Conclusions and Relevance
Providers should be aware of the signs and symptoms of ICP and provide accurate diagnosis and management of affected women. Women with a diagnosis of ICP should be treated with ursodeoxycholic acid to improve maternal symptoms. Given the increased risk of stillbirth in the setting of ICP, delivery may be considered at 37 weeks' gestation.

Target Audience
Obstetricians and gynecologists, family physicians.

Learning Objectives
After completing this activity, the learner should be better able to identify symptoms of and diagnose ICP, counsel patients on neonatal risks associated with the diagnosis of ICP, and provide treatment for women with a diagnosis of ICP.
Improving Shoulder Dystocia Management and Outcomes With a Targeted Quality Assurance Program
Authors: Gurewitsch Allen Edith D. , Brown Will Susan E. , Allen Robert H. , Satin Andrew J. 
Published: February 2018

(Abstracted from Am J Perinatol 2017;34:1088–1096)
Simulation-based training has been shown by several investigators to help obstetric trainees in mastering shoulder dystocia management skills and in reducing rates of brachial plexus injury. However, the comparative effectiveness of specific simulation schemes is still debatable.
Repeatability of Monocular Acuity Testing in Adults with and without Down Syndrome
Authors: Ravikumar Ayeswarya , Benoit Julia S. , Morrison Kelsie B. , Marsack Jason D. , Anderson Heather A. 
Published: February 2018

PURPOSEIndividuals with Down syndrome may experience greater difficulty reliably performing visual acuity (VA) tests because of intellectual disability and limitations in visual quality. This study evaluated the repeatability of acuity (Bailey-Lovie [BL] and HOTV) in subjects with and without Down syndrome.METHODSHigh-contrast VA was measured in both eyes of 30 subjects with Down syndrome (mean, 30 years; range, 18 to 50 years) and 24 control subjects without Down syndrome (mean, 29 years; range, 18 to 50 years). In the Down syndrome group, 23 subjects performed BL, and 7 subjects performed HOTV. All control subjects performed both BL and HOTV, but for HOTV analysis, only seven age-matched control subjects were included. For each eye, subjects performed VA three times on different charts (computer controlled, single-line display) until five total letters were missed on each chart. A repeated-measure ANOVA was used to compare the acuity measures between groups.RESULTSThe average logMAR VA for subjects with Down syndrome was approximately six lines worse than the control subjects (BL: Down syndrome = right eye: 0.51 ± 0.16, left eye: 0.53 ± 0.18; control = right eye: −0.06 ± 0.06, left eye: −0.06 ± 0.08,P< .0001; HOTV: Down syndrome = right eye: 0.47 ± 0.19, left eye: 0.46 ± 0.16; control: right eye = −0.11 ± 0.09, left eye: −0.07 ± 0.07,P< .001). Bailey-Lovie VA repeatability (1.96 *Sw* √2) was 0.13 logMAR (6.5 letters) for Down syndrome and 0.09 logMAR (4.5 letters) for control subjects. HOTV VA repeatability was 0.16 logMAR (eight letters) for both Down syndrome and control subjects.CONCLUSIONSDespite poorer acuity in individuals with Down syndrome, repeatability of VA measurements was comparable to control subjects for both BL and HOTV techniques.