bluuebunny/crossref_metadata_2025_split huggingface dataset:
A randomized trial to assess the immediate impact of acupuncture on quantitative sensory testing, pain, and functional status
Authors: Chen Lucy , Deng Hao , Houle Timothy , Zhang Yi , Ahmed Shihab , Zhang Vivian , Sullivan Shelly , Opalaze Arissa , Roth Sarah , Falacova Jen , St Clair Kristan , Vo Tran , Malarick Charline , Kim Hyangin , You Zerong , Shen Shiqian , Mao Jianren 
Published: July 2019

Abstract
In this randomized clinical trial, we examined whether the effect of true acupuncture can be differentiated from sham acupuncture (pain and functionality) by analyzing quantitative sensory testing (QST) profiles in chronic pain participants. We recruited 254 healthy or chronic back and neck pain participants. Healthy subjects were included to control for a possible effect of acupuncture on baseline QST changes. Study participants received 6 sessions (twice weekly) of true acupuncture, sham acupuncture, or no acupuncture treatment (routine care). Quantitative sensory testing profiles, pain scores, and functionality profile were obtained at baseline (visit 1) and after 3 (visit 4) or 6 sessions (visit 7). A total of 204 participants were analyzed. We found no QST profile changes among 3 groups (P = 0.533 and P = 0.549, likelihood ratio tests) in either healthy or chronic pain participants. In chronic back and neck pain participants, true acupuncture reduced pain (visit 4: difference in mean [DIM] = −0.8, 95% confidence interval [CI]: −1.4 to −0.1, adjusted P = 0.168; visit 7: DIM = −1.0, 95% CI: −1.7 to −0.3, adjusted P = 0.021) and improved functional status including physical functioning (DIM = 14.21, 95% CI: 5.84-22.58, adjusted P = 0.003) and energy/fatigue (DIM = 12.28, 95% CI: 3.46-21.11, adjusted P = 0.021) as compared to routine care. Our results indicate that QST was not helpful to differentiate between true acupuncture and sham acupuncture (primary outcome) in this study, although true acupuncture reduced pain and improved functionality (secondary outcomes) when compared with routine care.
Understanding the High Frequency Use of the Emergency Department for Patients With Chronic Pain: A Mixed-Methods Study
Authors: Glynn Brittany A. , Brulé Madeleine , Kenny Samantha L. , Khoo Eve-Ling , Shergill Yaadwinder , Smyth Catherine E. , Poulin Patricia A. 
Published: July 2019

ABSTRACT

Introduction:
Chronic pain (CP) is a common driver of emergency department (ED) visits despite the ED not being the ideal setting for CP because of increased risk of adverse events and high costs.

Purpose:
The purpose of this study is to understand factors contributing to CP-related ED visits, patients' care experiences, and patients' perspectives on alternatives to the ED.

Methods:
We used a mixed-methods design combining semi-structured interviews and questionnaires with 12 patients with CP who had 12 or more ED visits over 1 year. We analyzed test scores using descriptive statistics and interviews using applied thematic analysis.

Results:
Four themes emerged. Factors contributing to ED visits included the following: fear (e.g., pain and its impact); inability to cope with pain; family suggestions to go to the ED; and access to other services and resources. Patients had validating and invalidating experiences in the ED: needs were met or not met; and feeling acknowledged or unacknowledged. Patients' experiences with their family physician included feeling supported or unsupported. Alternatives to the ED included working with an interdisciplinary team, developing personalized care plans, and increased community-based resources.

Conclusions:
Patients with CP and frequent ED use present with complex pain and care experiences, requiring careful attention to management strategies and the patient–provider relationship.
The Effects of Aromatherapy on Postpartum Women: A Systematic Review
Authors: TSAI Shuo-Shin , WANG Hsiu-Hung , CHOU Fan-Hao 
Published: July 2019

ABSTRACT

Background
The postpartum period is the most crucial but also the most fragile stage of most pregnancies. The health benefits of aromatherapy have recently become more widely accepted among medical experts. Although a number of studies have examined these health benefits, no systematic reviews have been conducted to assess the effects of aromatherapy on the psycho-physiological health of postpartum women.

Purpose
This systematic review was conducted to evaluate the effectiveness of aromatherapy interventions on the psycho-physiological health of postpartum women, to determine the methods that were used to measure intervention effectiveness, and to identify the types of interventions that were used.

Methods
We searched for studies that evaluated the effects of aromatherapy on postpartum women published in the Chinese or English languages before March 2018. We used online databases such as the Taiwan Journal Index, Centre for European Policy Studies, Cumulative Index for Nursing and Allied Health Literature, Cochrane Library, PubMed, and Social Sciences Citation Index. The search keywords used were “women,” AND “postpartum,” OR “postnatal” AND “aromatherapy,” OR “aroma,” OR “essential oils.” Only randomized controlled trials including humans as study participants were included. The methodological quality of the trials was assessed using the modified Jadad scale. The quality of the full-text studies was assessed by three reviewers.

Results
The 15 studies that were included in this systematic review were performed in Iran, England, and the United States and included 2,131 participants in total. The numbers of participants in each study ranged between 35 and 635. The review found that the effective duration of aromatherapy varied according to the essential oils that were selected. The visual analog scale was the most frequently used measure of postpartum pain. Most of the studies found that the aromatherapy intervention improved postpartum physiological and psychological health, with positive effects shown on anxiety, depression, distress, fatigue, mood, nipple fissure pain, physical pain, post-cesarean-delivery pain, post-cesarean-delivery nausea, postepisiotomy pain, postepisiotomy recovery, sleep quality, and stress. Most of the studies reported no serious intervention-related side effects.

Conclusions
This systematic review may serve as a reference for healthcare workers in caring for postpartum women. Aromatherapy may be applied as a noninvasive complementary intervention to promote physio-psychological comfort in postpartum women.
Sarcopenia assessed using bioimpedance analysis is associated independently with significant liver fibrosis in patients with chronic liver diseases
Authors: Hyun Kim Kyung , Kyung Kim Beom , Yong Park Jun , Young Kim Do , Hoon Ahn Sang , Han Kwang-Hyub , Kim Seung Up 
Published: July 2019

Aim
Sarcopenia is common in patients with advanced fibrosis or cirrhosis. We investigated the correlation between sarcopenia and other clinical variables, in particular, significant liver fibrosis in patients with chronic liver diseases (CLDs).

Patients and methods
Patients with CLDs who underwent transient elastography (TE) and bioelectrical impedance analysis between 2015 and 2017 were retrospectively recruited. The sarcopenia index (SI) was calculated as follows: SI = total appendicular skeletal muscle mass (kg)/ body mass index (BMI) (kg/m2). Sarcopenia was defined as SI less than 0.789 for men and less than 0.521 for women. Significant liver fibrosis and fatty liver were defined using TE liver stiffness value more than 7 kPa and controlled attenuation parameter more than 250 dB/m, respectively.

Results
Of 2168 patients recruited, 218 (10.1%) had sarcopenia. Age, BMI, diabetes, hypertension, fasting glucose, aspartate aminotransferase, and liver stiffness value were correlated positively with sarcopenia (all P < 0.05), whereas male sex, viral etiology, obesity (BMI > 25 kg/m2), total bilirubin, and serum albumin were correlated negatively with sarcopenia (all P < 0.05). On multivariate analysis, TE-defined significant liver fibrosis was associated independently with sarcopenia (odds ratio = 1.597; 95% confidence interval: 1.174–2.172; P = 0.003), together with age, male sex, viral etiology, and TE-defined fatty liver (all P < 0.05). Among the subgroups with ultrasonography-defined nonalcoholic fatty liver disease (n = 957), sarcopenia was also associated independently with TE-defined significant liver fibrosis (odds ratio = 1.887; 95% confidence interval: 1.261–2.823; P < 0.001).

Conclusion
Sarcopenia is associated independently with significant liver fibrosis in patients with CLDs. Further studies are required to determine whether interventions to improve muscle mass can improve liver fibrosis.
Coping Strategies for Self-perceived Burden Among Advanced Cancer Patients
Authors: Oeki Miki , Takase Miyuki 
Published: July 2019

Background
Self-perceived burden (SPB) causes stress and negatively impacts the quality of life and mental health of patients. It is important to identify effective coping methods to reduce SPB when supporting advanced cancer patients.

Objective
To qualitatively elucidate advanced cancer patients’ strategies for coping with SPB.

Methods
Eleven participants with advanced cancer were recruited from 2 palliative care units. The data were collected through semistructured interviews and analyzed by content analysis.

Results
One of the coping strategies that advanced cancer patients used to reduce their SPB was “making individual efforts to deal with their own circumstances.” This category included subcategories: “making proactive action,” “expressing their gratitude verbally,” “suppressing their feelings,” “searching for positive meanings,” and “avoiding thinking about the burden on their families.” Another coping strategy used was “exploring the solutions with their family,” which consisted of one subcategory and indicated an open dialogue between patients and their families to reach acceptable and mutual decisions about patient care.

Conclusion
Nurses should not only support patients’ efforts to tackle the situation by themselves, but also help the family as a whole to tackle problems together. By facilitating meaningful dialogue between family members, patients’ feelings of SPB can be alleviated.

Implications for Practice
Nurses should facilitate dialogue between patients and their family members in order to help them discover solutions to reduce their SPB and to find positive meanings in the caregiving-receiving situation.
Burden Among Parents of Children With Cancer in Jordan: Prevalence and Predictors
Authors: Al Qadire Mohammad , Aloush Sami , Alkhalaileh Murad , Qandeel Haitham , Al-Sabbah Ashraf 
Published: July 2019

Background
A diagnosis of cancer in children affects the children themselves and their entire family. Cancer treatment places parents under continuous stress and increases their life burdens.

Objective
The aim of this study was to assess the burden level and predictors as perceived by Jordanian parents of children with cancer.

Methods
A cross-sectional survey design was used to conduct the study in 2 hospitals. A sample of 264 parents of children with cancer was recruited. Data were collected using 2 instruments: the Zarit Burden Interview and the Hospital Anxiety and Depression Scale.

Results
The mean burden score was 38.1 (SD, 16.6), and 75.4% of parents experienced mild to severe levels of burden. Having a chronic disease, financial constraints, high levels of anxiety and depression, a child with advanced cancer, and a child experiencing pain, nausea, and vomiting predicted higher levels of burden.

Conclusions
Characteristics of both parents and children affect perceived levels of burden, and thus both should be taken into consideration by healthcare providers, and nurses in particular. Various interventions can be suggested to reduce the parents’ burden, including financial support, psychiatric care, and focused management of symptoms.

Implications for Practice
Powered by Editorial Manager and ProduXion Manager from Aries Systems Corporation, assessment of burden and screening for at-risk parents is of high importance and could be conducted briefly at admission and repeated thereafter. Healthcare institutions may need to offer various types of interventions for parents who are at high risk of burden to improve their quality of life and reduce their suffering.
Suspected Radial Head Subluxation in Infants
Authors: Hanes Lauren , McLaughlin Robyn , Ornstein Amy E. 
Published: July 2019

Abstract
Radial head subluxation (“pulled elbow” or “nursemaid's elbow”) is a common pediatric condition in children aged 1 to 4 years, although it is an uncommon finding in nonambulatory infants. It is a clinical diagnosis, and further investigations such as x-ray are not routinely done. We present a case series of 2 nonambulatory infants with forearm fractures that were initially diagnosed as radial head subluxation. Current literature supports the use of x-ray in children with atypical or unclear history prior to an attempted pulled elbow reduction. We suggest that this recommendation should be extended to all nonambulatory infants, given the unlikely diagnosis of radial head subluxation, and the necessity for early recognition of injuries that may be indicators of abuse.
Abdominal Tuberculosis in an Infant Presenting With a Small Bowel Obstruction
Authors: Matettore Adela , Rajaprakash Meghna , Bennett Mary , Skarsgard Erik D. , Goldman Ran D. 
Published: July 2019

Abstract
Abdominal tuberculosis (TB) is rare in children and usually spread in the peritoneum or gastrointestinal tract. Symptoms tend to be vague and nonspecific, with no extra-abdominal involvement, presenting a challenge for clinicians and delayed diagnosis. Postnatally acquired abdominal TB is most commonly transmitted through inhalation or ingestion of respiratory droplets with Mycobacterium tuberculosis from the mother.
Abdominal TB in infants is rare. We present a case of a 2-month-old infant presenting with an acute bowel obstruction secondary to abdominal TB acquired through contact with maternal TB mastitis. This unique case emphasizes the importance of considering abdominal TB in the differential for at-risk infants presenting with small bowel obstruction.
Clinical Utility of Different Approaches for Detection of Late Pseudoprogression in Glioblastoma With O-(2-[18F]Fluoroethyl)-l-Tyrosine PET
Authors: Kertels Olivia , Mihovilovic Milena I. , Linsenmann Thomas , Kessler Almuth F. , Tran-Gia Johannes , Kircher Malte , Brumberg Joachim , Monoranu Camelia Maria , Samnick Samuel , Ernestus Ralf-Ingo , Löhr Mario , Meyer Philipp T. , Lapa Constantin 
Published: July 2019

Purpose
PET/CT using O-(2-[18F]fluoroethyl)-l-tyrosine (18F-FET) has proven valuable in differentiating tumor recurrence and progression from therapy-induced changes. This study aimed to investigate the diagnostic performance of several analytic approaches in the setting of suspected late pseudoprogression (PsP) in glioblastoma multiforme (GBM).

Methods
Retrospective analysis of tumor recurrence was performed in 36 patients with histopathologically confirmed GBM and suspicion of recurrence/disease progression more than 12 weeks from cessation of irradiation based on MRI and Response Assessment in Neuro-Oncology working group criteria. For differentiation of late PsP from true tumor recurrence, images were analyzed semiquantitatively employing tumor-to-brain ratios using 5 different approaches for tumor and normal brain reference region definition, respectively. Histopathology and/or clinical and imaging follow-up served as reference. Respective areas under the receiver operating characteristic curve were compared.

Results

18F-FET PET was able to reliably differentiate PsP from true tumor progression with areas under the receiver operating characteristic curve ranging from 0.80 to 0.88 (all P < 0.01). Irrespective of the approach chosen, the classification differences between the applied methods were not significant (all P > 0.05), albeit approaches focusing on voxels with the highest uptake tended to perform superior.

Conclusions
Irrespective of the analytical approach, 18F-FET PET is a robust tool for detection of late PsP with only minor differences between different analytical approaches. However, methodological standardization and harmonization are needed to ensure comparability between different centers.
18F-FDG PET/MR in an Atypical Pediatric Solid Pseudopapillary Pancreatic Tumor
Authors: Cavaliere Annachiara , Giraudo Chiara , Zuliani Monica , Cecchin Diego , Quaia Emilio 
Published: July 2019

Abstract
MR and 18F-FDG PET/MR images of a 15-year-old boy with recurrent mild abdominal pain and hyperamylasemia demonstrating a pancreatic head lesion hypointense on the T1-weighted and slightly hyperintense on the T2-weighted images, with very small pseudocystic areas, restricted diffusion on the apparent diffusion coefficient map, and focal FDG uptake. No other pathologic findings such as enlarged lymph nodes, vascular invasion, metastases, dilatation of the main pancreatic duct, or pathologic uptake of the parotid glands were detected. The MR features, even if atypical, together with the focal uptake, allowed the diagnosis of pediatric solid pseudopapillary pancreatic tumor, which was then confirmed by histology.
18F-FDG PET/CT in Lymphomatoid Papulosis Mimicking Primary Cutaneous Anaplastic Large Cell Lymphoma
Authors: Senthil Raja , Gangadharan V. P. , Visakh R. Arun , Mahadevan Pushpa , Pratap Thara , Jayasree M. G. 
Published: July 2019

Abstract
Lymphomatoid papulosis is a benign self-healing condition, presenting as papulonodular skin eruptions and mimicking malignant cutaneous lymphomas histopathologically. 18F-FDG PET/CT findings in this benign condition have not been described in detail in the literature. We present a case of lymphomatoid papulosis mimicking primary cutaneous anaplastic large cell lymphoma histopathologically and demonstrating intensely FDG-avid cutaneous lesions on 18F-FDG PET/CT, which disappear spontaneously in the follow-up scan.
Low 68Ga–PSMA PET/CT Uptake in Chronic Intramuscular Nodular Fasciitis
Authors: Plouznikoff Nicolas , Artigas Carlos , Karfis Ioannis , Flamen Patrick 
Published: July 2019

Abstract
Nodular fasciitis is an uncommon benign mass-forming myofibroblastic proliferation, most frequently found in the upper limbs, with only rare intramuscular cases. We describe herein a case of chronic nodular fasciitis of the left triceps muscle with a low 68Ga-labeled prostate-specific membrane antigen (PSMA) ligand uptake on PET/CT. 68Ga-PSMA ligands bind to PSMA-expressing prostate cancer cells, but uptake has also been demonstrated in other solid neoplasms and various benign lesions. Nodular fasciitis should be included in the differential diagnosis of soft tissue lesions with variable 68Ga-PSMA uptake.
Multiple Solitary Plasmacytomas With Multifocal Bone Involvement Diagnosed With 68Ga–Prostate-Specific Membrane Antigen PET/CT
Authors: Alabed Yazan Z. 
Published: July 2019

Abstract
A 63-year-old man with elevated prostate-specific antigen serum levels and enlarged prostate gland underwent ultrasound-guided transrectal biopsy, which did not reveal any evidence of malignancy. In order to help guidance of repeat biopsy, 68Ga–prostate-specific membrane antigen–targeted ligand PET (PSMA PET/CT) was ordered. PET/CT scan showed no abnormal PSMA expression within the prostate gland. There were, however, multiple PSMA-expressing osteolytic lesions throughout the axial skeleton. Bone lesion biopsy obtained for final workup revealed multiple solitary plasmacytomas with multifocal bone involvement. This rare case highlights the utility of PSMA PET/CT in diagnosing nonprostate malignancies.
Ileal Neuroendocrine Tumor With Bilateral Breast and Ovarian Metastases
Authors: Tripathy Sarthak , Naswa Niraj , Jha Pragati , Reddy Sreenivasa , Parida Girish Kumar 
Published: July 2019

Abstract
Metastasis to the breast is a rare occurrence and constitutes less than 2% of all breast tumors. Similarly, ovarian metastases from neuroendocrine tumors are also uncommon, and if the adnexal masses are bilateral, then the chances of it being metastatic rather than being primary range from 88% to 94%. We present a case of 61-year-old woman who in the course of workup for abdominal pain and diarrhea was eventually diagnosed as ileal neuroendocrine tumor with breast, ovarian, and lymph nodal metastases on 68Ga-DOTANOC PET/CT scan.
A Stepwise Approach to Identify the Clinical Role of 18F-FDG PET/CT in Patients With Suspicious Bone Metastasis From an Unknown Primary Site
Authors: Chowdhury Md. Sunny Anam , Jeon Subin , Bom Hee-Seung , Min Jung-Joon , Kwon Seong Young 
Published: July 2019

Abstract
In patients with suspicious bone metastasis, the clinical impact of PET/CT for differential diagnosis and primary lesion identification could differ according to 18F-FDG uptake patterns. We report the findings in patients with suspicious bone metastasis who underwent PET/CT for the evaluation of the primary lesion site and were classified in a stepwise manner, first based on the multiplicity of positive bone uptake and then the presence of extraskeletal uptake.
High-Resolution PET Cisternography With 64Cu-DOTA for CSF Leak Detection
Authors: Freesmeyer Martin , Schwab Matthias , Besteher Bianca , Gröber Sebastian , Waschke Albrecht , Drescher Robert 
Published: July 2019

Abstract
Intracranial hypotension may lead to chronic, debilitating symptoms, and severe complications. The underlying CSF leak may be difficult to localize. To establish a new diagnostic option for the detection of CSF leaks, 64Cu-DOTA was developed as a tracer for PET imaging. PET/CT imaging was possible with high resolution and without complications. In one patient, the exact site of a dural tear was identified, enabling successful surgical treatment. PET cisternography with 64Cu-DOTA appears to be safe and able to locate a CSF leak. It has the potential to be a problem-solving modality in cases with inconclusive CT, MR, and/or scintigraphic findings.
Implementation of a Modified Enhanced Recovery Protocol in Cleft Palate Repairs
Authors: Hush Stefanie E. , Chen Jenny T. , Brady Colin M. , Soldanska Magdalena , Nusz David J. , Rhinehart Darren L. , Heiss Kurt , Crowley Connor , Williams Joseph K. 
Published: July 2019

Aims:
Enhanced Recovery after Surgery (ERAS) protocols have been shown to improve patient outcomes in numerous adult surgical populations, but there are few known standards for their use in pediatric patients. To assess the effectiveness in pediatric craniofacial surgery, we present our results following the application of a modified ERAS protocol for patients undergoing primary palatoplasty.

Methods:
A modified ERAS program was developed and implemented in a multidisciplinary manner. The primary components of the protocol included: (1) administration of gabapentinoids, (2) minimal perioperative narcotic use, and (3) post-operative pain control using nonnarcotic first-line agents. Fifty patients were collected prospectively, assigned to the modified ERAS protocol and compared to historic controls. We reviewed patient demographics, narcotic use, length of stay (LOS), oral intake, and complication rates.

Results:
Between April 2017 and June 2018, 50 patients underwent palatoplasty under the modified ERAS protocol. The mean age (control: 9.7 ± 2.3 months; ERAS: 9.9 ± 1.6 months), weight (8.8 ± 1.3 kg; 8.6 ± 1.3 kg), and comorbidities did not vary between the groups. ERAS patients evidenced an increase in oral intake normalized per LOS (22.3 mL/h vs 15.4 mL/h). Total narcotic usage (morphine equivalents) during each phase of care was greater in the controls compared with ERAS (Intraop: 3.71 mg vs 0.12 mg; PACU: 0.51 mg vs 0.05 mg; Postop: 2.6 mg vs 0.07 mg). The implementation of this protocol led to a 36.6% decrease in LOS (1.83 days vs 1.16 days) without an increase in perioperative complications.

Conclusions:
Implementation of a modified ERAS protocol provided effective perioperative pain control allowing narcotic minimization, increased post-operative oral intake, and a shorter LOS without an increased complication rate.