bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidemiology of Cause of Death in Pediatric Acute Respiratory Distress Syndrome
Authors: Dowell Jasmine C. , Parvathaneni Kaushik , Thomas Neal J. , Khemani Robinder G. , Yehya Nadir 
Published: August 2018

Objectives:
Investigations of acute respiratory distress syndrome in adults suggest hypoxemia is an uncommon cause of death. However, the epidemiology of death in pediatric acute respiratory distress syndrome is not well characterized. We aimed to describe the cause, mode, and timing of death in pediatric acute respiratory distress syndrome nonsurvivors. We hypothesized that most deaths would be due to nonpulmonary factors, rather than hypoxemia.

Design:
Retrospective, decedent-only analysis.

Setting:
Two large, academic PICUs.

Patients:
Nonsurvivors with pediatric acute respiratory distress syndrome.

Interventions:
None.

Measurements and Main Results:
Of 798 subjects with pediatric acute respiratory distress syndrome, there were 153 nonsurvivors (19% mortality). Median time to death was 6 days (interquartile range, 3–13 d) after pediatric acute respiratory distress syndrome onset. Patients dying less than 7 days after pediatric acute respiratory distress syndrome onset had greater illness severity and worse oxygenation. Patients dying less than 7 days were more likely to die of a neurologic cause, including brain death. Patients dying greater than or equal to 7 days after pediatric acute respiratory distress syndrome onset were more commonly immunocompromised. Multisystem organ failure predominated in deaths greater than or equal to 7 days. Withdrawal of therapy was the most common mode of death at all timepoints, accounting for 66% of all deaths. Organ dysfunction was common at time of death, irrespective of cause of death. Refractory hypoxemia accounted for only a minority of pediatric acute respiratory distress syndrome deaths (20%).

Conclusions:
In pediatric acute respiratory distress syndrome, early deaths were due primarily to neurologic failure, whereas later deaths were more commonly due to multisystem organ failure. Deaths from neurologic causes accounted for a substantial portion of nonsurvivors. Refractory hypoxemia accounted for only a minority of deaths. Our study highlights limitations associated with using death as an endpoint in therapeutic pediatric acute respiratory distress syndrome trials.
The role of ultrasound in the evaluation of acute pelvic pain in pregnancy and postpartum period: a review
Authors: Park Sung Bin 
Published: August 2018

Purpose of review
Acute pelvic pain in pregnant and postpartum patients presents diagnostic and therapeutic challenges. Ultrasound remains the primary imaging modality of choice for assessing pregnant and postpartum women. The purpose of this review is to help practitioners ensure a correct diagnosis of acute pelvic pain in pregnancy and the postpartum period.

Recent findings
This review describes the various causes and highlights the sonographic features and characteristics of acute pelvic pain in pregnancy and the postpartum period.

Summary
Evaluation of acute pelvic pain in pregnancy and the postpartum period is challenging. Knowledge of the clinical settings and sonographic features of acute pelvic pain in pregnancy and the postpartum period can lead to accurate diagnosis and appropriate management of the condition.
Development of a New Patient-reported Outcome Measure for Ear Conditions: The EAR-Q
Authors: Klassen Anne F. , Longmire Natasha M. , Bulstrode Neil W. , Fisher David M. , Kasrai Leila , O’Hara Justine , Panchapakesan Vivek , Pusic Andrea L. , Stewart Ken , Tsangaris Elena , Ziolkowski Natalia , Wong Riff Karen W. Y. 
Published: August 2018

Background:
Patient-reported outcome measures are widely used to improve health services and patient outcomes. The aim of our study was to describe the development of 2 ear-specific scales designed to measure outcomes important to children and young adults with ear conditions, such as microtia and prominent ears.

Methods:
We used an interpretive description qualitative approach. Semi-structured qualitative and cognitive interviews were performed with participants with any type of ear condition recruited from plastic surgery clinics in Canada, Australia, United States, and United Kingdom. Participants were interviewed to elicit new concepts. Interviews were audio-recorded, transcribed, and coded using the constant comparison approach. Experts in ear reconstruction were invited to provide input via an online Research Electronic Data Capture survey.

Results:
Participants included 25 patients aged 8–21 years with prominent ears (n = 9), microtia (n = 14), or another condition that affected ear appearance (n = 2). Analysis of participant qualitative data, followed by cognitive interviews and expert input, led to the development and refinement of an 18-item ear appearance scale (eg, size, shape, look up close, look in photographs) and a 12-item adverse effects scale (eg, itchy, painful, numb).

Conclusions:
The EAR-Q in currently being field-tested internationally. Once finalized, we anticipate the EAR-Q will be used in clinical practice and research to understand the patient’s perspective of outcomes following ear surgery.
Current Challenges of Plastic Surgical Care in Sub-Saharan Africa (Maputo, Mozambique)
Authors: Guzman Kevin J. , Gemo Natacha , Martins Deborah B. , Santos Pedro , DeUgarte Daniel A. , Ademo Fatima , Kulber David , Issufo Celma 
Published: August 2018

Background:
Limited data exist on plastic surgery practices in Sub-Saharan Africa. The aim of this study was to characterize the spectrum of disease and operative procedures at a teaching hospital in Maputo, Mozambique to help understand the challenges of providing care for the local providers and to provide contextual relevance for training through partnerships.

Methods:
A mixed-methods approach was utilized to perform an ongoing needs assessment. A retrospective review was performed of plastic surgery operative records, ward admissions records, and death records in a tertiary-care hospital in Maputo, Mozambique for the period January 2015 to December 2015.

Results:
Limited resources (equipment, block-time, personnel, and perioperative services) were observed. The most common diagnoses for the 455 patients evaluated were burns (44%) and neoplasms (17%). Congenital abnormalities accounted for only 1% of the patient diagnoses. Of the 408 procedures performed, the majority were skin grafts (43%) and skin excisions (31%). Sepsis from burns accounted for 70% of documented deaths (14/20). The mean number of days to skin grafting for inpatients was 53 days.

Conclusion:
We observed a large burden of burns and skin graft procedures at a public referral teaching hospital in Mozambique. Our findings provide contextual relevance to help focus public health efforts and improve plastic surgery training and practices.
INTRAOCULAR JARISCH–HERXHEIMER REACTION IN LEMIERRE SYNDROME
Authors: Ramtohul Prithvi , Boulicot-Seguin Céline , Marc Caroline 
Published: August 2018

Purpose:
To report an intraocular Jarisch–Herxheimer reaction induced by Lemierre syndrome antibiotherapy.

Methods:
Case report.

Results:
A 43-year-old-man presented with an acute onset of bilateral blurred vision few days after intravenous antibiotic administration for Lemierre syndrome. Best-corrected visual acuity was 20/32 in both eyes. Examination revealed bilateral cystoid macular edema and peripheral retinal vasculitis, persisting despite Lemierre syndrome recovery with antibiotics. Intravitreal injection of ranibizumab 0.5 mg (0.05 mL) was performed in both eyes. After 1 month, cystoid macular edema and retinal vasculitis were totally resolved, and best-corrected visual acuity increased to 20/20 in both eyes. The paradoxical worsening of the patient's best-corrected visual acuity after initiating antibiotherapy evokes a Jarisch–Herxheimer reaction. The result of this single intravitreal injection of ranibizumab was sustained; best-corrected visual acuity remained unchanged (20/20 in both eyes), and no recurrence of cystoid macular edema or retinal vasculitis was found after 4-year follow-up.

Conclusion:
To the best of our knowledge, this is the first reported case of an isolated intraocular Jarisch–Herxheimer reaction induced by Lemierre syndrome antibiotherapy and successfully treated with a single intravitreal injection of ranibizumab.
LIPEMIA RETINALIS DURING CHEMOTHERAPY WITH ADJUNCTIVE GLUCOCORTICOID TREATMENT IN A PATIENT WITH COLON CARCINOMA
Authors: Wetzel Barbara , Mylonas Georgios , Puntus Thomas , Prager Franz , Bernhart Clemens , Amon Michael 
Published: August 2018

Purpose:
The purpose of this report is to describe a case of lipemia retinalis due to decompensating hyperlipidemia that occurred during chemotherapy in a patient with metastatic colon carcinoma.

Methods:
Retrospective case report.

Results:
A 55-year-old non–insulin-dependent diabetic man with well-controlled hyperlipidemia presented himself with temporarily blurred vision in both eyes occurring during chemotherapy. He was found to have lipemia retinalis in his both eyes. Blood tests revealed elevated cholesterol and triglyceride levels exceeding 8,200 mg/dL. He received six cycles of FOLFIRI/bevacizumab and accompanying dexamethasone because of colon cancer with pulmonary metastases. Lipemia retinalis had resolved after a 6-week follow-up when chemotherapy was finished, and the patients' triglyceride and glucose levels decreased to normal values.

Conclusion:
Lipemia retinalis associated with visual impairment may occur during chemotherapy under accompanying treatment with dexamethasone. Even if patients with hyperlipidemia are metabolically well-controlled with oral medication, treatment with dexamethasone can potentially lead to decompensation of hyperlipidemia causing secondary lipemia retinalis.
Successfully Improving Visual Acuity in Keratitis–Ichthyosis–Deafness Syndrome Utilizing Gas-Permeable Lenses: A Case Report
Authors: Strul Sasha , Straughn Penny 
Published: August 2018

Abstract:
There is currently no well-defined guideline for treatment and management of patients with keratitis–ichthyosis–deafness (KID) syndrome, and most patients will face disabling vision loss due to corneal neovascularization and cicatrization. We offer this case as an example of how we can improve visual acuity (VA) and quality of life even in advanced cases of corneal neovascularization. We showcase the use of gas-permeable (GP) contact lenses to provide useful, functional VA in a patient with long-standing visual impairment secondary to corneal neovascularization and irregularity due to KID syndrome. The patient's VA improved from 20/200 both eyes (OU) to 20/40 OU with successful fitting of GP lenses, which additionally relieved the patient's otherwise intractable monocular diplopia.
Prognosis of Biliary Atresia After 2‐year Survival With Native Liver
Authors: Witt Mauri , van Wessel Daan B.E. , de Kleine Ruben H.J. , Bruggink Janneke L.M. , Hulscher Jan B.F. , Verkade Henkjan J. ,   NeSBAR (Netherlands Study group on Biliary Atresia Registry)
Published: August 2018

ABSTRACTObjectives:The aim of the study is to determine the prognosis of patients with biliary atresia after 2 years of native liver survival (NLS) and to identify prognostic factors for continued NLS after 2 years of age.Methods:We retrospectively analyzed perioperative, laboratory, and outcome parameters of all biliary atresia patients in The Netherlands between January 1987 and June 2015 with NLS of at least 2 years. We compared parameters between patients who continued to have their native liver (NLS+) to those who did not, either by transplant or death (NLS−).Results:We included 100 patients. Upon a median follow‐up of 16.4 years, NLS ended in 37% by liver transplantation (LTx) and in 6% by (pre‐transplant) mortality. NLS rates at 5, 10, 15, 18 years of age were 89%, 72%, 60%, 54%, respectively. Corresponding overall survival rates were 98%, 90%, 87%, 87%, respectively. Six months post‐Kasai, NLS+ patients had higher clearance of jaundice (COJ) rate, significantly lower total and direct serum bilirubin, aspartate‐aminotransferase and alkaline phosphatase levels, compared with NLS− patients (each P < 0.05). Cox regression could only assess a significant effect of COJ on continued NLS. Main indications for LTx after the age of 2 were irreversible jaundice and portal hypertension.Conclusions:Eighty‐seven percent of patients with 2‐year NLS reach adult age and more than 50% with their native liver. A pre‐transplant mortality of 6%, however, exists among patients who reach the age of 2 years with their native livers. Early life parameters, other than COJ, did not have a significant effect on continued NLS after 2 years of age.
Randomized Study of Early Continuous Positive Airways Pressure in Acute Respiratory Failure in Children With Impaired Immunity (SCARF) ISRCTN82853500*
Authors: Peters Mark J. , Agbeko Rachel , Davis Peter , Klein Nigel , Zenasni Zohra , Jones Amy , Mackerness Christine , George Susan , Veys Paul , Ray Samiran , Mouncey Paul R. , Harrison David A. , Rowan Kathy 
Published: August 2018

Objectives:
Previous trials in adults with impaired immunity and respiratory failure suggest that early noninvasive ventilation avoids endotracheal intubation and improves survival. No randomized clinical trials have addressed this question in children.

Design:
We undertook an open, parallel-group randomized trial in three pediatric hospitals.

Subjects:
Children with impaired immunity and acute respiratory failure defined as tachypnoea (> 90th centile); a new requirement for supplemental oxygen; and new chest radiograph infiltrates.

Interventions:
Children were randomly assigned to early PICU admission for continuous positive airways pressure (early continuous positive airways pressure) or to standard care. The primary outcome was endotracheal intubation by 30 days.

Measurements and Main Results:
One-hundred fourteen children met inclusion criteria of whom 42 were randomized between January 2013 and January 2016. There was no significant difference in endotracheal intubation by 30 days with early continuous positive airways pressure (10/21; 48%) compared with standard care (5/21; 24%), odds ratio 2.9 (0.8–10.9), p value equals to 0.11. However, 30-day mortality was significantly higher with early continuous positive airways pressure (7/21; 33%) compared with standard care (1/21; 5%), odds ratio 10.0 (1.1–90.6), p value equals to 0.041. Mortality at 90 days was early continuous positive airways pressure (11/21; 52%) versus standard care (4/21; 19%), odds ratio 4.7 (1.2–18.6), p value equals to 0.029, whereas mortality at 1 year was similar early continuous positive airways pressure (13/21; 61.9%) versus standard care (9/21; 42.7%), odds ratio 2.2 (0.6–7.4), p value equals to 0.22. There were two serious adverse events: early continuous positive airways pressure (pneumothorax) and standard care (hemothorax).

Conclusions:
This study provided no evidence to support early PICU admission for continuous positive airways pressure in children with acute respiratory failure and impaired immunity. There was a trend toward increased endotracheal intubation and a higher early mortality in the early continuous positive airways pressure group.
Congenital Chagas disease: current diagnostics, limitations and future perspectives
Authors: Messenger Louisa A. , Bern Caryn 
Published: August 2018

Purpose of review
Congenital transmission is an important route of Trypanosoma cruzi infection, both in Latin America and internationally, with considerable populations of infected women of child-bearing age residing in the United States and Europe. This review examines recent literature on congenital Chagas disease, with a focus on the changing clinical spectrum and potential new diagnostic tools.

Recent findings
Vertical transmission occurs in approximately 5–10% of births from T. cruzi-infected mothers. Historically, congenital Chagas disease was associated with high levels of neonatal morbidity and mortality. Bolivian birth cohort data from the early 1990s to the present indicate that the incidence of symptomatic neonatal disease has declined. Treatment with trypanocides is greater than 90% effective and well tolerated in infants. Current programs face challenges from the multistep screening algorithm, low sensitivity of microscopy and high loss to follow-up.

Summary
Congenital Chagas disease remains an important contributor to the global disease burden because of T. cruzi. PCR and related molecular techniques represent the most sensitive diagnostic modalities for early detection but require further optimization for resource-limited settings. Several novel diagnostic tests show promise for the future but further validation and adaptation to field settings are needed.
Updates on the management of neurocysticercosis
Authors: White A. Clinton , Garcia Hector H. 
Published: August 2018

Purpose of review
The goal of this review is highlight recent developments regarding neurocysticercosis, including recently developed guidelines.

Recent findings
Recent diagnostic criteria highlight the importance of neuroimaging in establishing a diagnosis. Monoclonal antibody-based antigen detection and the enzyme-linked immunotransfer blot can be confirmatory. Management should be guided by the form of disease. Single enhancing lesions and one to two viable parenchymal cysticerci can be treated with short courses of albendazole and corticosteroid. Multiple parenchymal lesions should be treated with the combination of corticosteroids, albendazole, and praziquantel. Ventricular cysticerci should be removed when possible, often by minimally invasive surgery. Subarachnoid cysticercosis often requires prolonged courses of antiparasitic and anti-inflammatory treatment.

Summary
Neurocysticerocis represents a spectrum of disease that is a common cause of neurologic disease worldwide. Management needs to be guided by the number and location of the parasites and the host response.
A Nurse’s Perspective on Visual Rehabilitation of Outpatients With Low Vision in China
Authors: Ni Lingzhi , Li Keke , Jiang Longfei , Chen Jie , Chen Yanyan , Li Xiaoman , Lin Na , Thorn Frank , Deng Ruzhi 
Published: August 2018

Abstract

Purpose
The purposes of the study were to analyze patient use and satisfaction with low vision aids (LVAs) at the Wenzhou Medical University Low Vision and Rehabilitation Center and to assess the promotion of visual rehabilitation services as a new responsibility for nurses in China.

Methods
Records of 178 patients with low vision (LV) from the Low Vision and Rehabilitation Center examined between October 2015 and October 2016 included basic patient information (e.g., age, diagnosis, visual acuity, educational level) and use of LVAs (patients’ own aids, daily duration of LVA use, or refusal to use aids).

Results
Sixty percent owned LVAs. Of these, 66% were obtained from a hospital, 26% were obtained from commercial stores, and others were obtained from government or gifts. Patients reported that use of LVAs was reduced because of visual fatigue (39%), inconvenience (22%), and lack of benefit (12%). Reasons for the 40% who had never used visual rehabilitation were nonreferral by doctors (76%), refusal because of inconvenience, discomfort and cosmetics (20%), or a preference for other treatments (4%).

Conclusions
Greater awareness of LV rehabilitation by nurses, ophthalmologists, patients, and the public is necessary. Additional government support for LV rehabilitation is also required.
National Longitudinal Comparison of Patients Undergoing Surgical Management of Craniosynostosis
Authors: Wu Robin T. , Shultz Blake N. , Gabrick Kyle S. , Abraham Paul F. , Cabrejo Raysa , Persing John A. , Alperovich Michael 
Published: August 2018

Purpose:
Limited cross-institutional studies compare strip craniectomy versus cranial vault remodeling (CVR) for craniosynostosis management. Given competing surgical preferences, the authors conducted a large-scale analysis of socioeconomic differences, costs, and complications between treatment options.

Methods:
Nonsyndromic craniosynostosis patients receiving strip craniectomies or CVR were identified in the Kids’ Inpatient Database for years 2000 to 2009. Demographics, socioeconomic background, hospital characteristics, charge, and outcomes were tabulated. Univariate and multivariate analyses were performed for comparison.

Results:
Two hundred fifty-one strip craniectomies and 1811 CVR patients were captured. Significantly more strip craniectomy patients were White while more CVR patients were Hispanic or Black (P < 0.0001). Strip craniectomy patients more often had private insurance and CVR patients had Medicaid (P < 0.0001). Over time, CVR trended toward treating a higher proportion of Hispanic and Medicaid patients (P = 0.036). Peri-operative charges associated with CVR were $27,962 more than strip craniectomies, and $11,001 after controlling for patient payer, income, bedsize, and length of stay (P < 0.0001). Strip craniectomies were performed more frequently in the West and Midwest, while CVR were more common in the South (P = 0.001). Length of stay was not significant. Postsurgical complications were largely equivocal; CVR was associated with increased accidental puncture (P = 0.025) and serum transfusion (P = 0.002).

Conclusion:
Our national longitudinal comparison demonstrates widening socioeconomic disparities between strip craniectomy and CVR patients. Cranial vault remodeling is more commonly performed in underrepresented minorities and patients with Medicaid, while strip craniectomy is common in the White population and patients with private insurance. While hospital charges and complications were higher among CVR, differences were smaller than expected.
Cost-effectiveness of Randomized Study of Laparoscopic Versus Open Bilateral Inguinal Hernia Repair
Authors: Ielpo Benedetto , Nuñez-Alfonsel Javier , Duran Hipolito , Diaz Eduardo , Fabra Isabel , Caruso Riccardo , Malavé Luis , Ferri Valentina , Barzola Ernesto , Quijano Yolanda , Vicente Emilio 
Published: August 2018

Objective:
The aim of this study is to compare the clinical and cost-effective outcomes of the open Lichtenstein repair (OL) and laparoscopic trans-abdominal preperitoneal (TAPP) repair for bilateral inguinal hernias.

Summary Background Data:
A cost-effective analysis of laparoscopic versus open inguinal hernia repair is still not well addressed, especially regarding bilateral hernia.

Methods:
This is a clinical and cost-effectiveness analysis within a randomized prospective study conducted at Sanchinarro University Hospital.
Cases of primary, reducible bilateral inguinal hernia were included and randomized using a simple randomization program.
The outcome parameters included surgical and postoperative costs, quality adjusted life years (QALY), and incremental cost per QALY gained or the incremental cost effectiveness ratio.

Results:
Between March 2013 and January 2017, 165 patients were enrolled in this study (81 of them underwent TAPP and 84 OL).
The TAPP procedure had less early postoperative pain (P = 0.037), a shorter length of stay (P = 0.001), and fewer postoperative complications (P = 0.002) when compared with the OL approach. The overall cost of TAPP procedure was higher compared with the OL cost (1,683.93€ vs 1192.83€, P = 0.027). The mean QALYs at 1 year for TAPP (0.8094) was higher than that associated with OL (0.6765) (P = 0.018). At a willingness-to-pay threshold of 20,000 € and 30,000 €, there was a 95.38% and 97.96% probability that TAPP was more cost-effective relative to OL.

Conclusions:
The TAPP procedure for bilateral inguinal hernia appears to be more cost-effective compared with OL.