bluuebunny/crossref_metadata_2025_split huggingface dataset:
Modifications in Presurgical Nasoalveolar Molding Treatment of Bilateral Cleft Lip and Palate Patients With Severely Malpositioned Premaxillae
Authors: Titiz Serap , Aras Isil 
Published: March 2018

Objective: The aim of this study was to evaluate a modified presurgical nasoalveolar molding (PNAM) treatment for patients with bilateral cleft lip and palate (BCLP) with severely malpositioned premaxillae. Setting: This study was conducted at the Faculty of Dentistry, Department of Orthodontics, Ege University, Bornova, Izmir, Turkey. Method: Retention arms were manufactured using a mold that we developed, and prefabricated retraction apparatuses were applied to the plaster model obtained from the patient. During the acrylic curing process, the flanges of the appliances were elongated into the sulcus without including the premaxilla. The premaxilla was aligned with the midline with an elastic band system, and the lip hanger was constructed with 0.023-in stainless steel wire. Elastic bands were stretched between the retraction apparatuses and the lip hanger based on the desired force. Nasal stents were added to the retention arms when the cleft width was reduced to less than 6 mm. Conclusion: The modified PNAM treatment enabled faster derotation of the premaxilla and earlier initiation of retraction. The prefabricated retraction apparatus and retention arm provided efficient PNAM for patients with BCLP.
Decreasing dialysis catheter rates by creating a multidisciplinary dialysis access program
Authors: Rosenberry Patricia M , Niederhaus Silke V , Schweitzer Eugene J , Leeser David B 
Published: March 2018

Introduction: Centers for Medicare and Medicaid Services have determined that chronic dialysis units should have <12% of their patients utilizing central venous catheters for hemodialysis treatments. On the Eastern Shore of Maryland, the central venous catheter rates in the dialysis units averaged >45%. A multidisciplinary program was established with goals of decreasing catheter rates in order to decrease central line–associated bloodstream infections, decrease mortality associated with central line–associated bloodstream infection, decrease hospital days, and provide savings to the healthcare system. Methods: We collected the catheter rates within three dialysis centers served over a 5-year period. Using published data surrounding the incidence and related costs of central line–associated bloodstream infection and mortality per catheter day, the number of central line–associated bloodstream infection events, the costs, and the related mortality could be determined prior to and after the initiation of the dialysis access program. Results: An organized dialysis access program resulted in a 82% decrease in the number of central venous catheter days which lead to a concurrent reduction in central line–associated bloodstream infection and deaths. As a result of creating an access program, central venous catheter rates decreased from an average rate of 45% to 8%. The cost savings related to the program was calculated to be over US$5 million. The decrease in the number of mortalities is estimated to be between 13 and 27 patients. Conclusion: We conclude that a formalized access program decreases catheter rates, central line–associated bloodstream infection, and the resultant hospitalizations, mortality, and costs. Areas with high hemodialysis catheter rates should develop access programs to better serve their patient population.
Mitigating noise-induced hearing loss after blast injury
Authors: Muzaffar SJ , Orr L , Rickard RF , Coulson CJ , Irving RM 
Published: March 2018

Introduction Whilst hearing injuries are not life threatening they may have a profound impact on the victim’s ability to understand and interact with the world around them. Noise-induced hearing loss is a common occupational injury and hearing impairment as a consequence of noise and blast exposure remains the most common injury in both war and peace for military personnel. Health and Safety legislation has made an impact and in the future innovative approaches to mitigate against acoustic injury sustained in the work place will be fundamental. For the Armed Forces, noise exposure during conflict is unpredictable. Furthermore, recent events in the UK and elsewhere have highlighted the potential civilian impact of blast injuries on hearing in the acute setting. No well-established protocol for the management of acute, blast-induced hearing injury currently exists. Methods Narrative review is supported by electronic literature searches of PubMed, Embase and the Cochrane Library. Synthesis of published literature and production of flow charts for the acute setting are part of the Emergency Preparedness, Resilience and Response programme. Results Whilst there is a lack of high-quality randomised controlled trials, there are a number of studies that may inform our choice of acute management. Animal studies of acute acoustic trauma have shown the potential protective effects of corticosteroids. Human data may be extrapolated from sudden onset sensorineural hearing loss where again there is evidence for the use of corticosteroids. Less certainty exists around the use of other treatments including antioxidants. Intratympanic administration of corticosteroids may be superior to oral administration, particularly in the salvage setting. No evidence exists specifically pertaining to the paediatric population. Conclusion Prompt identification of any hearing deficit followed by administration of glucocorticoids either orally or via intratympanic preparations is the mainstay of management. Further research is needed to identify the optimum acute management.
African-American caregivers’ perspectives on aggressive behaviors in dementia
Authors: Hansen Bryan R , Hodgson Nancy A , Gitlin Laura N 
Published: March 2018

Purpose Although African-American dementia caregivers report less upset and more confidence managing aggressive behaviors when compared to whites, their contextual experience remains unclear and this study explores that context. Methods Semi-structured interviews with 13 African-American family caregivers were analyzed using content analysis. Results Two themes emerged, “It’s the disease…not the person” and “You got to pick your battles.” “It’s the disease…not the person,” reframing aggressive behavior, included three sub-themes. Sometimes the person with dementia seemed like a stranger but caregivers remembered “In there somewhere is that person.” Aggressive behavior made this perspective difficult as they reported, “Sometimes it’s hard not to take it personal.” Premorbid dyadic conflict made caregiving difficult but caregivers remembered they were “Not who they were then.” “You got to pick your battles,” reflecting cognitive and behavioral strategies, also included three sub-themes. Participants prioritized caregiving over other commitments by reminding themselves “I got to do what I gotta do.” Preventing aggressive behaviors was most successful when “We didn’t argue…we didn’t insist” and caregivers remembered “Don’t put her in a position to fail” when involving the person with dementia in activities. Implications African-American caregivers described substantial challenges when confronted by aggressive behaviors. Strategies employed by caregivers enabled them to maintain a caring perspective and the person with dementia to maintain calm. Interventions that help caregivers manage aggressive behaviors may benefit by considering the challenges, cultural values, and effective strategies used by African-Americans.
Reliability and Validity Testing of the Quality of Life in Late-Stage Dementia Scale
Authors: Resnick Barbara , Galik Elizabeth , Kolanowski Ann , Van Haitsma Kimberly , Boltz Marie , Ellis Jeanette , Behrens Liza , Flanagan Nina M. 
Published: March 2018

Background/rationale: This study tested the psychometric properties of the Quality of Life in Late-Stage Dementia (QUALID) Scale using Rasch analysis. The QUALID includes 11 items with a 5-point response scale. Scores range from 11 to 55, and lower scores indicate higher quality of life (QoL). Methods: Baseline data from a randomized clinical trial including 137 residents from 14 nursing homes were used. Psychometric testing included item mapping, evaluation of response categories, item reliability, construct validity based on INFIT and OUTFIT statistics, and convergent validity based on correlations between QoL and pain, agitation, depression, and function. Results: The Cronbach α was .89. All the items except “appears physically uncomfortable” fit the model. There was a significant relationship between QoL and depressive symptoms ( r = .71, P = .001), pain ( r = .26, P = .01), physical function ( r = −.19, P = .03), and agitation ( r = .56, P = .001). The categories were appropriately used. Item mapping suggested a need for easier items.
The Evaluation of Aortic Diameter Changes During Long-Term Follow-Up After Endovascular Treatment of Acute Blunt Traumatic Thoracic Aortic Injuries
Authors: Fontana Federico , Macchi Edoardo , Piacentino Filippo , Cardim Larissa Nocchi , Marchi Giuseppe De , Barbosa Fabiane , Piffaretti Gabriele , Novario Raffaele , Rampoldi Antonio Gaetano , Fugazzola Carlo 
Published: March 2018

Purpose: To evaluate the variations in aortic diameters and long-term results in patients who underwent thoracic endovascular aortic repair (TEVAR) for acute blunt traumatic thoracic aortic injuries (BTTAIs). Materials and Methods: We retrospectively evaluated 23 patients with a mean age of 39 years (range: 17-74 years) who underwent TEVAR for BTTAI between October 2000 and November 2014. All of the patients underwent computed tomography angiography (CTA) before hospital discharge as a baseline imaging for the subsequent follow-up examinations. The technical success, overall survival, and complications were evaluated. Furthermore, the aortic diameters outside of the stent-graft (1 cm proximal and 1 cm distal to the stent-graft) and the aortic diameters within the stent-graft (2 cm distal to the proximal end and 2 cm proximal to the distal end) were assessed. The diameters at baseline on CTA were compared with those of the latest available follow-up examination. Results: Technical success was 100% with a mean follow-up of 65.4 months (range: 12-171 months). No death was registered, and 2 (8.7%) of 23 endograft-related complications (1 stent-graft distal infolding and 1 endoleak 2 and 4 months after the procedure, respectively) were observed. An increase in aortic diameter either proximal or distal to the stent-graft (mean value 0.7 and 0.5 mm, respectively) or within the stent-graft (mean value of 0.5 mm for both proximal and distal diameters) was registered (mean follow-up at 65.4 months, range: 12-171 months). Conclusion: Aortic dilatation following TEVAR for BTTAI is minimal during long-term follow-up. Endovascular treatment represents a durable and safe option in acute BTTAIs.
The Effect of Testosterone Replacement Therapy on Penile Hemodynamics in Hypogonadal Men With Erectile Dysfunction, Having Veno-Occlusive Dysfunction
Authors: Efesoy Ozan , Çayan Selahittin , Akbay Erdem 
Published: March 2018

Hypogonadism may cause veno-occlusive dysfunction (VOD) by structural and biochemical alterations in the cavernosal tissue. The aim of the study was to investigate the effect of testosterone replacement therapy (TRT) on penile hemodynamics in hypogonadal men with erectile dysfunction and VOD. The study included 32 hypogonadal men with erectile dysfunction, having VOD. All patients underwent penile color Doppler ultrasonography (PCDU) at the beginning and 6 months after the initial evaluation. Erectile function was evaluated with the 5-item version of the International Index of Erectile Function (IIEF-5); hypogonadism was evaluated by testosterone measurement and the Aging Male Symptoms (AMS) scale. All patients received transdermal testosterone 50 mg/day for 6 months. Clinical and radiological findings were compared before and 6 months after the TRT. The mean age was 58.81 ± 4.56 (52–69) years. Mean total testosterone levels were 181.06 ± 39.84 ng/dL and 509.00 ± 105.57 ng/dL before and after the therapy, respectively ( p < .001). While all patients had physiological serum testosterone levels (>320 ng/dL) after the therapy, three cases (9.3%) had no clinical improvement of hypogonadism symptoms. Cavernosal artery peak systolic velocity (PSV) and resistive index (RI) significantly increased, and end diastolic velocity (EDV) significantly decreased after TRT. VOD no longer existed in 21 (65.6%) of the cases. This study demonstrated that TRT may restore penile hemodynamics in hypogonadal men with VOD.
Fractures of the Lateral Process of the Talus With Associated Ankle Instability: A Report of 2 Cases
Authors: Killen Maire-Clare , Karpe Prasad , Limaye Rajiv 
Published: March 2018

Fractures of the lateral process of the talus are uncommon, but often overlooked. They can result in significant functional deficit with residual nonunion and arthritis if not recognized and treated appropriately. We describe 2 cases of such injuries, one with acute recognition and management, and one with delayed diagnosis and nonunion. In both cases, pain from the fracture was accompanied by symptoms of instability requiring simultaneous lateral ligament reconstruction along with fracture fixation. Evaluation of patients with lateral process fractures should include assessment of the lateral ligaments; ankle instability may need to be surgically addressed along with intervention for fracture fixation. Levels of Evidence: Level IV: Case report
Spontaneously reported adverse drug events related to tapentadol and oxycodone/naloxone in Australia
Authors: Abeyaratne Carmen , Lalic Samanta , Bell J. Simon , Ilomäki Jenni 
Published: March 2018

Background: The rapid increase in prescribing and use of opioids for noncancer pain has coincided with an increase in opioid-related adverse drug events (ADEs). The objective of our study was to describe ADEs related to tapentadol and oxycodone/naloxone spontaneously reported to the Australian Therapeutic Goods Administration (TGA). Methods: Public case detail reports for tapentadol (September 2013–March 2017) and oxycodone/naloxone (April 2011–March 2017) were sourced from the TGA. The total number of public case detail reports for tapentadol were 104 and 249 for oxycodone/naloxone. Demographic characteristics of patients, concomitant medications, causality assessment and outcome were described for each opioid according to the Medical Dictionary for Regulatory Activities (MedDRA) system organ class. Results: The most prevalent ADEs for tapentadol were nervous system disorders ( n = 52, 50%), psychiatric ( n = 34, 32.7%), gastrointestinal ( n = 18, 17.3%), and general disorders and administration site conditions ( n = 21, 20.2%). Sixteen (23.2%) of 69 nervous system disorders reaction terms were consistent with serotonin syndrome of which 14 (87.5%) involved documented coadministration with another serotonergic medication. The most prevalent ADEs for oxycodone/naloxone were psychiatric disorders ( n = 78, 31.3%), gastrointestinal ( n = 73, 29.3%), general disorders and administration site conditions ( n = 87, 35%), and nervous system disorders ( n = 62, 24.9%). There were 40 (16%) public case detail reports for oxycodone/naloxone with the MedDRA reaction terms ‘drug withdrawal syndrome’ and ‘withdrawal syndrome’. Conclusion: The profiles of spontaneous ADE reports for tapentadol and oxycodone/naloxone are largely consistent with their premarketing randomized controlled studies and profiles of opioids in general. Further research into the risk of serotonin syndrome with tapentadol use is warranted. The ADEs suggest clinicians should be cautious when switching patients to oxycodone/naloxone from other opioids.
The willingness and attitude of patients towards self-administration of medication in hospital
Authors: Vanwesemael Toke , Boussery Koen , van den Bemt Patricia , Dilles Tinne 
Published: March 2018

Background: Literature suggests a positive impact of self-administration of medication during hospitalization on medication adherence and safety, and on patient satisfaction. However, self-administration is not a common practice in Belgian hospitals. The aim of this study was to describe patients’ willingness towards self-administration of medication while in hospital. Methods: A cross-sectional observational study was conducted in three Belgian hospitals in November and December 2015. All patients of 14 randomly selected wards were asked to participate. The structured questionnaire comprised patient characteristics, their willingness and attitude towards self-administration of medication, perceived ability to self-administer during hospitalization, and prerequisites and perceived consequences. Results: In total, 124 patients participated (36% of all eligible patients). The main reasons not to participate were the patients’ physical and mental condition (30%) and the absence of patients during the time of data collection (23%). The majority of the 124 participating patients had a positive attitude towards the implementation of self-administration; 83.9% were willing to self-administer their medication while in hospital. Most important prerequisites were self-administration at home before and after hospitalization, patients’ motivation, and a regular evaluation of the patients’ competences. Patients acknowledged benefits such as an increase in autonomy, independence and medication knowledge. Patients did not expect self-administration would cause important safety issues. Conclusion: The majority of patients, capable of participating in the study, would want to self-administer medication during hospitalization. They had a positive attitude towards self-administration of medication. Nevertheless, patients stated important conditions which need to be considered in order to implement self-administration.
The Positive Benefits of Negative Movement Patterns Following Total Knee Arthroplasty
Authors: Christensen Jesse C. , Foreman K. Bo , LaStayo Paul C. 
Published: March 2018

Introduction: Eccentric (negative) resistance exercise of the legs using specialized machines has been reported to be useful and often superior to standard exercise following total knee arthroplasty (TKA). Movements that utilize body mass and gravity as a mode of eccentric resistance exercise in a more pragmatic rehabilitation paradigm may also be useful in reversing chronic muscle impairments observed years following surgery. This study explores whether an eccentrically biased, body mass resistance exercise induces greater magnitude of sagittal plane extensor angular impulse of the support torque and individual net joint torque contributions during both squatting and lunging movement patterns 6 weeks following TKA. Methods: Cross-sectional laboratory-based study design including 10 patients following primary unilateral TKA (6.5 ± 0.8 weeks.). All patients completed 3 trials of the squat and lunge movement pattern under both a concentric and an eccentric condition. Extensor angular impulse of the support torque and net joint torque contributions were calculated by integrating the joint torque versus time curves. A Two-way analysis of covariance was conducted and contracts of clinical interest were computed using Wald posttest. P Values for all pairwise comparisons were adjusted for multiplicity using Bonferroni multiple comparison procedure. Results: The eccentric condition, compared to the concentric condition, displayed larger magnitude of extensor angular impulse during both the squat ( P < .001) and lunge ( P < .001) movement patterns for the support torques. Similarly, the eccentric condition, compared to the concentric condition, displayed larger magnitude of extensor angular impulse of the hip, knee, and ankle ( P < .001) during both movement patterns. Conclusion: Eccentrically biased, body mass movement exercises can produce higher levels of extensor angular impulse on the surgical limb in patients early after TKA. Patients in this study were able to tolerate the higher extensor angular impulse demands and performed the eccentrically biased conditions (without specialized machines) that could be beneficial in postoperative rehabilitation.
Relationship Between Pitching a Complete Game and Spending Time on the Disabled List for Major League Baseball Pitchers
Authors: Erickson Brandon J. , Chalmers Peter N. , Romeo Anthony A. , Ahmad Christopher S. 
Published: March 2018

Background: Injury rates among Major League Baseball pitchers have been increasing over the past several years. It is currently unknown whether pitching a complete game (CG) is a risk factor for spending time on the disabled list (DL). Purpose/Hypothesis: The purpose of this study was to determine the relationship between pitching a CG and time on the DL. We hypothesized that pitchers who threw a CG (1) would be at increased risk for spending time on the DL, which would be earlier in the season and for a longer period, than those who did not and (2) would be at further increased risk for spending time on the DL during subsequent seasons than matched controls. Study Design: Descriptive epidemiology study. Methods: Pitchers who threw a CG between 2010 and 2016 at the major league level and were placed on the DL during the same season were included. Timing and length of period on the DL were determined, as well as placement on the DL during subsequent seasons. Matched controls who did not throw a CG were assessed for time spent on the DL during that season and subsequent seasons. Results: Overall, 246 individual pitchers (501 pitcher-seasons) threw at least 1 CG between 2010 and 2016. Of the pitcher-seasons, 370 (73.9%) included a period on the DL, as compared with only 20% of controls. There were no differences in length of time on the DL ( P = .928) or days from season start to time on the DL ( P = .861) between pitchers who threw a CG and controls. Pitchers who threw a CG were significantly more likely than controls to spend subsequent seasons on the DL (1.9 ± 1.1 vs 0.5 ± 0.9, P < .001). Conclusion: Overall, 74% of pitchers who threw a CG spent time on the DL, as compared with 20% of controls. Pitchers who threw a CG during the study period spent more time in subsequent seasons on the DL than did matched controls who did not throw a CG.