bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Intraocular Pressure Changes During the Water Drinking Test Between Different Fluid Volumes in Patients With Primary Open-angle Glaucoma
Authors: Susanna Carolina N. , Susanna Remo , Hatanaka Marcelo , Susanna Bianca N. , Susanna Fernanda N. , De Moraes Carlos G. 
Published: August 2018

Purpose:
The main objective of this study was to compare the intraocular pressure (IOP) response during the water drinking test (WDT) performed with 800 mL, 1000 mL, and 10 mL/kg of body weight and to test its relationship with body mass index (BMI).

Methods:
In this prospective, observer-masked, observational study, patients treated with primary open-angle glaucoma were evaluated. In group I, 29 consecutive patients with body weight ≤60 kg underwent an 800 mL fluid challenge followed by a second WDT session with 10 mL/kg of body weight no longer than 4 months apart. Group II included 30 consecutive patients with body weight >60 kg who underwent a 1000 mL fluid challenge followed by an 800 mL test no longer than 4 months apart. IOP was measured before (baseline) and after water ingestion every 15 minutes for 45 minutes.

Results:
In group I, there was no significant difference in baseline or peak IOP between 800 mL and 10 mL/kg of body weight tests (P=0.12 and 0.56, respectively). However, 10 mL/kg tended to lead to consistently lower IOP values and a biased response in eyes with higher IOP. In group II, there was also no significant difference in baseline or peak IOP between 800 and 1000 mL tests (P=0.26 and 0.72, respectively). No biased response was observed in this group. There was no significant association between IOP peak and BMI with 800 mL (P=0.18), 10 mL/kg (P=0.29), or 1000 mL (P=0.34).

Conclusions:
There was overall good agreement between WDT results with different fluid volumes. The response to the volume loads tested in this study was not influenced by the BMI.
Decreased Prevalence of Rheumatic Heart Disease Confirmed Among HIV-positive Youth
Authors: Hovis Ian W. , Namuyonga Judith , Kisitu Grace P. , Ndagire Emma , Okello Emmy , Longenecker Chris T. , Sanyahumbi Amy , Sable Craig A. , Penny Daniel J. , Lwabi Peter , Kekitiinwa Adeodata R. , Beaton Andrea 
Published: August 2018

Background:
There is geographical overlap between areas endemic for rheumatic heart disease (RHD) and those endemic for HIV. A recent pilot study demonstrated that children living with HIV might be at less risk for RHD development; however, the sample size was too small to make definitive conclusions. Our objective was to determine the prevalence of RHD among HIV-positive children in Uganda.

Methods:
We conducted a prospective, cross-sectional study of HIV-positive children (5–15 years of age) receiving care at the Baylor Uganda HIV Clinic, Kampala, Uganda. A focused echocardiogram and chart review was performed. A sample size of 988 children was needed to provide 80% power to detect a difference in population prevalence between HIV-positive children and the general population, 2.97% [95% confidence interval (CI): 2.70–3.24%], based on previous reports.

Results:
Screening echocardiography of 993 HIV-positive children found 15 individuals (1.5%; 95% CI: 0.88%–2.54%) with RHD. Of these 15, 2 were classified as definite RHD and 13 as borderline RHD. The majority of children had isolated mitral valve disease (93%). Children found to have RHD were older than those without RHD, 12 versus 10 years of age (P = 0.004). When separated based on geographic location, the prevalence of RHD among HIV-positive children from Kampala was 1.28% (95% CI: 0.63%–2.51%) compared with 2.1% (95% CI: 0.89%–4.89%) in those from outside Kampala.

Conclusions:
Children living with HIV have a lower prevalence of RHD than the general pediatric population. Further studies are needed to explore this protective association.
Perceived Social Support in Persons With Heart Failure Living With an Implantable Cardioverter Defibrillator
Authors: Allemann Hanna , Strömberg Anna , Thylén Ingela 
Published: August 2018

Background:
The links between chronic illness, psychological well-being, and social support have previously been established. Social isolation and loneliness have shown an increased mortality risk for those with heart failure (HF). Increasingly more people with HF are living with an implantable cardioverter defibrillator (ICD), but only a few small-scale studies have focused on social support in this population.

Objective:
The aim of this study was to explore factors related to perceived social support in a large cohort of individuals with HF living with an ICD.

Methods:
All eligible adult ICD recipients in the Swedish ICD registry were invited to participate in this cross-sectional study. For this analysis, those with HF and complete data on perceived social support were included (N = 1550; age, 67.3 (SD, 9.8) years; 19.5% female).

Results:
Most reported a high level of social support, but 18% did not. In logistic regression, living alone was the greatest predictor of low/medium support. Lower social support for those living alone was associated with poorer perceived health status, having symptoms of depression, and experiencing low perceived control. For those living with someone, lower support was associated with female gender, symptoms of depression and anxiety, and less control. Heart failure status and perceived symptom severity were not related to the outcome.

Conclusion:
One in five participants reported low/medium social support. Our study underlines the complex relationships between perceived social support, psychological well-being and perceived control over the heart condition. Multiple aspects need to be taken into account when developing interventions to provide psychosocial support and optimize outcomes in this patient group.
Reduced Levels of Aligned Fibrillar Structure Are Not Associated With Achilles and Patellar Tendon Symptoms
Authors: Docking Sean I. , Girdwood Michael A. , Cook Jill , Fortington Lauren V. , Rio Ebonie 
Published: August 2018

Objective:
To investigate whether the mean cross-sectional area (mCSA) of aligned fibrillar structure (AFS) was associated with the presence and severity of symptoms.

Design:
Prospective cohort study.

Participants:
One hundred seventy-five elite male Australian football players completed monthly Oslo Sports Trauma Research Center overuse injury questionnaires for both the Achilles and patellar tendon over the season to ascertain the presence and severity of symptoms. At the start of the preseason, participants underwent ultrasound tissue characterization (UTC) imaging of the Achilles and patellar tendon.

Main Outcome Measures:
Images were classified as normal or abnormal based on gray-scale ultrasound. Based on UTC quantification, the mCSA of AFS was compared between those with and without current symptoms.

Results:
No difference in the mCSA of AFS was observed between those with or without tendon symptoms (P < 0.05). Similar to previous findings, 80% to 92% of abnormal tendons had similar amounts of mCSA of AFS compared with normal tendon. If reduced mCSA of AFS was present, it was not associated with the presence or severity of symptoms.

Conclusions:
The prevalence, development, or severity of symptoms was not associated with decreased levels of AFS in the Achilles or patellar tendon. This suggests that a lack of structural integrity is not linked to symptoms and questions the rationale behind regenerative medicine. Most tendons are able to compensate for areas of disorganization and maintain tissue homeostasis.
Understanding patient-important outcomes after critical illness: a synthesis of recent qualitative, empirical, and consensus-related studies
Authors: Dinglas Victor D. , Faraone Leeza N. , Needham Dale M. 
Published: August 2018

Purpose of review
Patients surviving critical illness frequently experience long-lasting morbidities. Consequently, researchers and clinicians are increasingly focused on evaluating and improving survivors’ outcomes after hospital discharge. This review synthesizes recent research aimed at understanding the postdischarge outcomes that patients consider important (i.e., patient-important outcomes) for the purpose of advancing future clinical research in the field.

Recent findings
Across multiple types of studies, patients, family members, researchers, and clinicians have consistently endorsed physical function, cognition, and mental health as important outcomes to evaluate in future research. Aspects of social health, such as return to work and changes in interpersonal relationships, also were noted in some research publications. Informed by these recent studies, an international Delphi consensus process (including patient and caregiver representatives) recommended the following core set of outcomes for use in all studies evaluating acute respiratory failure survivors after hospital discharge: survival, physical function (including muscle/nerve function and pulmonary function), cognition, mental health, health-related quality of life, and pain. The Delphi panel also reached consensus on recommended measurement instruments for some of these core outcomes.

Summary
Recent studies have made major advances in understanding patient-important outcomes to help guide future clinical research aimed at improving ICU survivors’ recovery.
Risk stratification and treatment of ICU-acquired pneumonia caused by multidrug- resistant/extensively drug-resistant/pandrug-resistant bacteria
Authors: Bassetti Matteo , Righi Elda , Vena Antonio , Graziano Elena , Russo Alessandro , Peghin Maddalena 
Published: August 2018

Purpose of review
Describe the risk factors and discuss the management of multidrug-resistant (MDR) bacteria responsible for pneumonia among critically ill patients, including methicillin-resistant Staphylococcus aureus, extended spectrum beta-lactamase-producing Enterobactericeae, carbapenem-resistant Enterobactericeae, multidrug resistant Pseudomonas aeruginosa, and Acinetobacter baumannii.

Recent findings
Multiple factors have been associated with infections because of MDR bacteria, including prolonged hospital stay, presence of invasive devices, mechanical ventilation, colonization with resistant pathogens, and use of broad-spectrum antibiotics. Management of these infections includes the prompt use of appropriate antimicrobial therapy, implementation of antimicrobial stewardship protocols, and targeted active microbiology surveillance. Combination therapy and novel molecules have been used for the treatment of severe infections caused by resistant bacteria.

Summary
The exponential increase of antimicrobial resistance among virulent pathogens currently represents one of the main challenges for clinicians in the intensive care unit. Knowledge of the local epidemiology, patient risk stratification, and infection-control policies remain key elements for the management of MDR infections. Results from clinical trials on new molecules are largely awaited.
Pathophysiological relevance of deiodinase polymorphism
Authors: Bianco Antonio C. , Kim Brian S. 
Published: August 2018

Purpose of review
To assess new findings and clinical implications of deiodinase gene polymorphism. Deiodinases are enzymes that can activate or inactivate thyroid hormone molecules. Whereas the types 1 and 2 deiodinase (D1 and D2) activate thyroxine (T4) to 3,5,3′-triiodothyronine (T3) via deiodination of T4's outer ring, D1 and D3 inactivate both T4 and T3 and terminate thyroid hormone action via deiodination of T4's inner molecular ring. A number of polymorphisms have been identified in the three deiodinase genes; the most investigated and likely to have clinical relevance is the Thr92 substitution for Ala substitution in DIO2 (Thr92Ala-DIO2). There are a number of reports describing the association between the Thr92Ala-DIO2 polymorphism and clinical syndromes that include hypertension, type 2 diabetes, mental disorders, lung injury, bone turnover, and autoimmune thyroid disease; but these associations have not been reproduced in all population studies.

Recent findings
A new report indicates that carriers of the Thr92Ala-DIO2 polymorphism exhibit lower D2 catalytic activity and localized/systemic hypothyroidism. This could explain why certain groups of levothyroxine-treated hypothyroid patients have improved quality of life when also treated with liothyronine (LT3). Furthermore, Ala92-D2 was abnormally found in the Golgi apparatus, what could constitute a disease mechanism independent of T3 signaling. Indeed, brain samples of Thr92Ala-DIO2 carriers exhibit gene profiles suggestive of brain degenerative disease. In addition, African American carriers of Thr92Ala-DIO2 exhibit an about 30% higher risk of developing Alzheimer's disease.

Summary
The finding of deiodinase polymorphisms that can diminish thyroid hormone signaling and/or disrupt normal cellular function opens the door to customized treatment of hypothyroidism. Future studies should explore how the racial background modulates the clinical relevance of the Thr92Ala-DIO2 gene polymorphism.
New insights into cardiovascular disease in patients with Kawasaki disease
Authors: Burns Jane C. , Matsubara Tomoyo 
Published: August 2018

Purpose of review
Kawasaki disease presents many challenges to the diverse group of physicians who care for these patients including infectious disease specialists, rheumatologists, and cardiologists. Here we review some of the progress being made toward improved understanding of disease pathogenesis, treatment, and long-term outcomes.

Recent findings
Epidemiologic studies in different populations documented increasing numbers of cases in countries with high physician awareness of the disease. These data suggest true increases in patient numbers rather than increases because of increased case ascertainment. Adequately powered clinical trials for adjunctive therapies continue to be an unmet need. Long-term consequences of damage to the arterial wall and myocardium are beginning to emerge and systematic, longitudinal observational studies are needed to better define outcomes.

Summary
The unknown cause, lack of a specific diagnostic test, and uncertain future for patients who develop permanent cardiovascular damage all require further study.
Endoscopy in Pediatric Inflammatory Bowel Disease
Authors: Oliva Salvatore , Thomson Mike , de Ridder Lissy , Martín‐de‐Carpi Javier , Van Biervliet Stephanie , Braegger Christian , Dias Jorge Amil , Kolacek Sanja , Miele Erasmo , Buderus Stephan , Bronsky Jiri , Winter Harland , Navas‐López Víctor Manuel , Assa Amit , Chong Sonny K.F. , Afzal Nadeem Ahmad , Smets Francoise , Shaoul Ron , Hussey Séamus , Turner Dan , Cucchiara Salvatore 
Published: August 2018

ABSTRACTEndoscopy is a central tool for the evaluation and management of inflammatory bowel disease (IBD). In the last few decades, gastrointestinal (GI) endoscopy has undergone significant technological developments including availability of pediatric‐size equipment, enabling comprehensive investigation of the GI tract in children. Simultaneously, professional organization of GI experts have developed guidelines and training programs in pediatric GI endoscopy. This prompted the Porto Group on Pediatric IBD of the European Society for Pediatric Gastroenterology, Hepatology and Nutrition to develop updated guidelines on the role of GI endoscopy in pediatric IBD, specifically taking into considerations of recent advances in the diagnosis, disease stratification, and novel therapeutic targets in these patients.
Nutritional Comparison of Raw, Holder Pasteurized, and Shelf‐stable Human Milk Products
Authors: Lima Hope , Vogel Kenneth , Wagner‐Gillespie Montana , Wimer Courtney , Dean Lisa , Fogleman April 
Published: August 2018

ABSTRACTObjective:We aim to assess the nutritional composition of shelf‐stable (SS) human milk and compare the nutritional profile to Holder pasteurized (HP) and raw human milk from the same pool.Methods:Milk samples from 60 mothers were pooled. From this pool, 36 samples were taken; 12 samples were kept raw, 12 samples were HP, and 12 samples were retort processed to create an SS product. Samples were analyzed for percent fat, percent solids, total protein, lactose, amino acids, and thiamine.Results:Percent fat, percent solids, and lactose were similar between raw, HP, and SS samples. Total protein was statistically increased in SS samples when compared to raw (P = 0.005) and HP (P < 0.001) samples, but protein differences were not clinically relevant (raw = 15.1 mg/mL, HP = 14.8 mg/mL, and SS = 15.8 mg/mL). Lysine was the only amino acid impacted by processing, and its destruction increased as heat increased (raw = 0.85 mg/100 mL, HP = 0.77 mg/100 mL, SS = 0.68 mg/100 mL). Total thiamine was significantly decreased in SS samples (0.14 mg/L; P < 0.01) when compared with raw samples (0.24 mg/L) and HP samples (0.26 mg/L).Conclusions:Macronutrient content is relatively unaffected by processing; Holder pasteurization and retort processing maintain similar fat, lactose, and total protein levels. Lysine and thiamine were significantly decreased by retort processing, but not by Holder pasteurization. Thiamine losses are clinically significant, and fortification may be necessary if SS donor milk is a long‐term feeding choice.
Recent Prescription Patterns for Children With Acute Infectious Diarrhea
Authors: Okubo Yusuke , Miyairi Isao , Michihata Nobuaki , Morisaki Naho , Kinoshita Noriko , Urayama Kevin Y. , Yasunaga Hideo 
Published: August 2018

ABSTRACTBackground:This study investigated recent trends in antibiotic use and factors associated with antibiotic use among children with acute infectious diarrhea. We obtained records of outpatients aged under 18 years diagnosed with acute infectious diarrhea from the Japan Medical Data Center database during 2012–2015.Objective:We investigated prescription patterns of antibiotics at their initial visit and evaluated factors associated with antibiotic usage using multivariable log‐binomial regression models.Results:Overall, we identified 4493 patients diagnosed with acute infectious diarrhea; 29.6% received antibiotics. The most commonly prescribed antibiotic is fosfomycin (20.3%). In multivariable log‐binomial regression analysis, out‐of‐hour visits, clinical diagnoses of suspected bacterial enterocolitis, private outpatient clinics, and pediatric departments are significantly associated with higher prevalence of antibiotic use.Conclusions:Antibiotics are over‐prescribed for children with acute infectious diarrhea. Our investigation provides important information to promote education of physicians and of health policy considerations for appropriate antibiotic prescription practices.
Is the Scout Out? The Utility of Scout Radiographs in the Pediatric Upper Gastrointestinal Examination
Authors: Abdullah Selwan , Shet Narendra , Watkins Runa , Kim Jane S. 
Published: August 2018

ABSTRACTObjective:The aim of the study is to demonstrate the scout radiograph does not change patient management, alter planning, or contribute to interpretation of the outpatient pediatric upper gastrointestinal fluoroscopic examination (UGI).Methods:We retrospectively reviewed 197 outpatient pediatric UGIs performed over a 2‐year period. We performed a chart review on all patients to evaluate for potentially clinically significant findings on the scout radiograph. Scout findings were categorized into 4 groups: no new clinically significant findings (group 1), potentially clinically significant findings that were not directly addressed in the electronic medical record (group 2), incidental non‐gastrointestinal (GI) findings that necessitated further workup, however, were later deemed insignificant (group 3), and clinically significant findings that changed patient GI management, altered the planning of the procedure, or contributed to the interpretation of the fluoroscopic study (group 4).Results:A total of 197 UGIs were analyzed. A significant majority of cases (97.0%) were classified into group 1. Three cases (1.5%) were classified into group 2 with findings not addressed in the medical record. Two cases (1.0%) were classified into group 3, which, after further workup, were deemed not clinically significant. One case (0.5%) was classified into group 4, which resulted in a change in patient GI management.Conclusions:In our review, there was only 1 case in which the scout radiograph changed patient GI management, with moderate stool burden leading to a miralax cleanout, although there were no cases, which altered the planning of the procedure or contributed to the interpretation of the study. The scout radiograph can be omitted and/or substituted with the last image hold function to decrease radiation exposure.
Evaluating the Usability of a Second-Generation Virtual Reality Game for Refreshing Sterile Urinary Catheterization Skills
Authors: Kardong-Edgren Suzan , Breitkreuz Karen , Werb Michael , Foreman Stephen , Ellertson Anthony 
Published: August 2018

Background
Virtual reality (VR) allows risk- and anxiety-free practice, mediated by consistent objective feedback.

Purpose
This study evaluated the usability of a VR game system for sterile catheterization practice. Participant enjoyment, engagement, likelihood to practice, and comfort using VR are reported.

Methods
Thirty-one students and faculty tested a VR game using Oculus Rift devised to allow practice of placing a urinary catheter in a virtual patient. Data were collected via an electronic survey using the System Usability Survey (SUS) and a User Reaction Survey (URS).

Results
The SUS score was 64.03. Seventy-five percent of participants rated the game as positive overall on the URS. Left-handed players had more difficulty playing the game. Players with prescription glasses could not comfortably place the Oculus Rift over their glasses to play.

Conclusions
The VR game shows promise for refreshing sterile catheterization skills.
Benefits of Peer Mentoring in Prelicensure Nursing Education
Authors: Miller Hailey , Bosselait Lauren , Venturato Linda , Irion Kendall , Schmidt Nicole , DiGeronimo Jaclyn , Pritchard Tracy 
Published: August 2018

Background
College retention rates continue to be a national issue in the United States. Solutions to decrease attrition have not been adequately tested in the nursing student population.

Purpose
The purpose of this study was to investigate the benefits of a peer-mentoring program in a baccalaureate nursing program from the perspectives of both the mentor and mentee.

Methods
Electronic surveys were used to evaluate the impact of a peer-mentoring program.

Results
Responses showed the peer-mentoring program to be beneficial academically, personally, and professionally. A large majority (89%-96%) of mentees agreed or strongly agreed with the positive effects of the peer-mentoring program, whereas all of the mentors agreed or strongly agreed with the positive effects.

Conclusions
Peer mentoring was found to be advantageous for both the mentees and mentors.