bluuebunny/crossref_metadata_2025_split huggingface dataset:
Positive precepting: Identifying NP student learning levels and needs
Authors: Pearson Tamera , Hensley Tonya 
Published: November 2018

ABSTRACT

Background and Purpose:
Clinical preceptors are vital partners in the education of nurse practitioner (NP) students. This article describes NP student learning stages and proposes strategies preceptors can use to facilitate precepting NP students who enter clinical rotations at varied learner levels.

Methods:
Searches were conducted in the Cumulative Index to Nursing and Allied Health Literature and PubMed and EBSCOhost interfaces to MEDLINE using terms related to NPs, students, higher education, and preceptorship. Because only 10 publications met the inclusion criteria focusing on precepting NP students at different levels, literature from related health fields are included in the discussion.

Conclusions:
Benner's Novice to Expert Model is applied to NP education in primary care settings to describe the clinical levels of learning. Clinical teaching methods that focus on either preceptor- or student-led communication are described, followed by a discussion of the association between methods and levels of learners.

Implications for Practice:
Nurse practitioners who precept NP students at various levels of their clinical learning can apply specific teaching methods that are delineated in this article. By recognizing the unique needs of NP students at different levels, preceptors can help facilitate their experiential learning.
Surgery for Chronic Otitis Media Causes Greater Taste Disturbance Than Surgery for Otosclerosis
Authors: Berling Holm Katarina , Bornefalk-Hermansson Anna , Knutsson Johan , von Unge Magnus 
Published: November 2018

Objectives:
Patients with otosclerosis more often complain about postoperative taste disturbance than patients with chronic otitis media, which seems paradoxical. We aim to investigate if and potentially why this seems to be the case, since the chorda tympani nerve (CTN) is thought to be severely traumatized less frequently during surgery in the former than in the latter.

Study Design:
Prospective cohort study.

Setting:
Department of Otorhinolaryngology at Hospital of Vastmanland, Vasteras, Sweden.

Patients:
Sixty-five adults undergoing primary middle ear surgery were included. Thirty-seven were operated on for chronic suppurative otitis media with or without cholesteatoma (CSOM) and 28 for otosclerosis.

Interventions:
Middle ear surgery due to otosclerosis or CSOM. Subjective and objective taste measurements and quality of life (QoL) questionnaire.

Main Outcome Measures:
Taste was assessed using electrogustometry (EGM) and the filter paper disc (FPD) method before and up to 1 year after surgery. Questionnaires on taste disturbance, including a visual analogue scale (VAS), and QoL were completed before and up to 1 year after surgery.

Results:
Subjective taste disturbance anytime during the 1-year follow-up were reported by 62 and 46%, respectively. The difference in EGM 1 week after surgery compared with preoperative EGM was significantly greater among CSOM patients than otosclerosis. One year postoperatively, the difference is non-significant.

Conclusion:
Surgery for CSOM causes greater initial and more long-lasting taste disturbances as compared with surgery for otosclerosis. One-year postoperative taste normalizes for both CSOM and otosclerosis patients according to VAS and EGM measurements. No real change in QoL was seen 1-year postoperatively.

Level of evidence:
Level 2 evidence is prospective observational research with an experimental design.
Assessing the methodological and reporting quality of network meta-analyses in Chinese medicine
Authors: Yang Fengwen , Wang Hucheng , Zou Jiahan , Li Xuemei , Jin Xinyao , Cao Yawen , Tian Jinhui , Ge Long , Lee Myeong Soo , Zhang Junhua 
Published: November 2018

Abstract

Background
An increasing number of network meta-analyses (NMAs) in traditional Chinese medicine (TCM) have been published recently, but the quality of them was lack of assessment. This study aims to evaluate the methodological and reporting quality of NMAs in TCM.

Methods
Six electronic databases, including PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL), Embase, China National Knowledge Infrastructure (CNKI), Wanfang and Chinese Biomedical Literature Database (CBM) from inception to January 2018, were searched. NMAs of TCM were included. A measurement tool to assess the methodological quality of systematic reviews (AMSTAR) and the PRISMA Extension Statement for Reporting of Systematic Reviews Incorporating Network Meta-analyses of Health Care Interventions (PRISMA-NMA) were used to assess the methodological and reporting quality of the included NMAs.

Results
A total of 40 NMAs, including 2535 randomized controlled trials (RCTs), were included. They were published between December 2012 and November 2017. The median score and interquartile range of methodological and reporting quality was 7 (6–8) and 22 (19.1–27.1). Serious methodological flaws existed in the following aspects: the status of publication (22.5%), a list of studies provided (0%), assessment of publication bias (37.5%), and conflicts of interest (12.5%). Several items need to be improved in reporting, especially for Protocol and registration (2.5%), Data items (22.5%), Risk of bias across studies (Methods section) (37.5%), Results of individual studies (27.5%), Risk of bias across studies (Results section) (40%), Results of additional analyses (35%), and Funding (15%).

Conclusions
The methodological and reporting quality of NMAs in TCM is moderate. Identified shortcomings of published NMAs should be taken into consideration in further trainings of authors and editors of NMAs in TCM. Future researchers should be encouraged to apply PRISMA-NMA, and a recognized tool for the assessment of NMA methodology was wanted.
The association between statin use and endometrial cancer survival outcome
Authors: Li Jia , Liu Ruijuan , Sun Zhengdi , Tang Shifeng , Wang Lu , Liu Cun , Zhao Wenge , Yao Yan , Sun Changgang 
Published: November 2018

Abstract

Background:
Previous studies on the association between statin use and survival outcomes in gynecologic cancers have presented conflicting results. No independent studies to elucidate the association between statin use and survival outcomes of endometrial cancer (EC) have been conducted.

Methods:
To gather updated evidence, we carried out an extensive literature search on Medline (PubMed and OvidSP), Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), wanfang data, and Vip network to identify all potential studies on the effect of statins on the prognosis of endometrial carcinoma. The design and quality of all studies were evaluated, and a fixed-effects model was used to calculate pooled hazard ratios (HRs) for overall survival (OS) and disease-specific survival (DSS).

Results:
Of the 219 articles screened, 9 articles were eligible, including 8 articles and 1 abstract. A total of 5923 patients with endometrial cancer who used statins were identified. Statin use was related to increased overall survival (HR, 0.80; 95% confidence interval [CI], 0.66–0.95, without significant heterogeneity, I
2 = 52%, P = .080). Statin users also had increased disease-specific survival (HR, 0.69; 95% CI, 0.61–0.79, I
2 = 0.0%).

Conclusion:
Statins are beneficial to the survival outcome of patients with endometrial cancer. The selection of statins as a 1st-line agent seems justified for endometrial carcinoma.
Management of disseminated intravascular coagulation in a patient with hepatic angiosarcoma
Authors: Rosen Emily A. , Vallurupalli Mounica , Choy Edwin , Lennerz Jochen K. , Kuter David J. 
Published: November 2018

Abstract

Rationale:
Hepatic angiosarcoma is a rare endothelial cell tumor that may lead to concurrent consumptive coagulopathies including disseminated intravascular coagulation (DIC). This report details a multifaceted approach to managing DIC in a patient with advanced-stage hepatic angiosarcoma, which continued to progress after a brief response to taxane-based chemotherapy.

Patient concerns:
A 55-year-old man with a recent history of hemorrhoids and hemarthroses presented with acute rectal bleeding. He was found to have concurrent hepatomegaly, abnormal liver function tests, anemia, thrombocytopenia, and coagulopathy.

Diagnoses:
DIC in the setting of hepatic angiosarcoma.

Interventions:
The patient's acute bleeding in the setting of DIC was controlled with a combination of antifibrinolytic agents to prevent clot breakdown, heparin products to prevent deposition of new clot, and romiplostim to increase platelet production. His angiosarcoma was treated with various combinations of chemotherapy, including taxane-based chemotherapy, doxorubicin, and pazopanib.

Outcomes:
The patient's DIC and acute bleeding on initial presentation improved following treatment with unfractionated heparin and low-molecular weight heparin maintenance therapy. It is unclear if the chemotherapy to treat the hepatic angiosarcoma played a significant role in the improvement of DIC.

Lessons:
Laboratory measurement of prothrombin fragment 1.2, a byproduct of prothrombin conversion to thrombin, proved to be a useful way to monitor this patient's DIC over time.
Exploring the use of single-port surgery in the conservative management of hepatic portal vein gas
Authors: Taniguchi Kohei , Asakuma Mitsuhiro , Nagayabu Kazuya , Takashima Syogo , Iida Ryo , Hirokawa Fumitoshi , Umegaki Osamu , Neo Masashi , Takasu Akira , Uchiyama Kazuhisa 
Published: November 2018

Abstract

Rationale:
Hepatic portal vein gas (HPVG) is known as a sign of a lethal condition resulting from bowel necrosis. Recently, the detection rate of non-life-threatening cases of HPVG has increased due to the technological development of imaging, i.e., computed tomography (CT). However, it is difficult to determine accurately whether surgical treatment is necessary because of its lethal potential.

Patient concerns:
A 74-year-old woman suddenly complained about lower abdominal pain and vomiting after an operation for cervical spondylosis myelopathy. Her vital signs were slightly unstable and she was perspiring and exhibited pallor. Muscular defense was not clear, though her abdomen was tender and slightly distended.

Diagnosis:
CT results showed massive HPVG. However, laboratory investigation did not clearly indicate bowel necrosis. Also, a contrast-CT scan was not performed due to her chronic renal dysfunction and asthma.

Intervention:
Exploration was performed by single-port surgery (SPS) instead of exploratory laparotomy.

Outcome:
This approach showed no ischemic bowel and so conservative therapies were undertaken with confidence. The HPVG disappeared 2 days later, and she recover completely from the illness.

Lessons:
HPVG requires immediate and reliable decision for management. However, unnecessary exploratory laparotomy should be avoided. Hence, a novel strategy should be considered in light of innovative surgical procedures. Our experience suggested that SPS was useful as an exploratory tool for the management of HPVG.
Septic arthritis of the pediatric hip: update on diagnosis and treatment
Authors: Mooney James F. , Murphy Robert F. 
Published: November 2018

Purpose of review
To review the clinical diagnosis, management and natural history of septic arthritis of the hip (SAH) in the pediatric patient, and to highlight new information that may improve the management of these patients.

Recent findings
The basics of management of possible pediatric SAH have remained largely unchanged for generations. New questions have been raised regarding the role and timing of advanced imaging (MRI) in the evaluation of patients with possible SAH. Published criteria have been derived to guide the need for MRI studies in these patients. Validation of these guidelines continues. Recent reviews have highlighted the possibility of Lyme disease as a potential cause of monoarticular pediatric hip pain. The role of PCR technology in the diagnosis and management of SAH remains unclear at this time.

Summary
The child with a limp remains a common and urgent clinical concern. There may be expanded roles for MRI and PCR to better diagnose and treat the involved joint itself, as well as any associated nonarticular area of infection. Lyme disease should remain on the list of possible differential diagnoses in this population, particularly in geographic areas where the disease vector is known to be endemic.
Biochemical Differences Between Vitreous Humor and Cerebral Spinal Fluid in a Death From Diabetic Ketoacidosis
Authors: Garland Jack , Philcox Winston , Kesha Kilak , McCarthy Sinead , Lam Leo , Palmiere Cristian , O'Regan Toni , Stables Simon , Tse Rexson 
Published: November 2018

Abstract
Biochemical analysis of cerebrospinal fluid (CSF) and vitreous humor (VH) forms an important diagnostic ancillary test at autopsy. Cerebrospinal fluid can be sampled from the ventricular system (VA) and from lumbar puncture (LP), whereas VH can be sampled from the orbits. Biochemical electrolytes seem to vary between VH and CSF collected from different sites, but whether there is any difference in glucose and β-hydroxybutyrate is unclear. We present a case report of a 21-year-old man who died of diabetic ketoacidosis confirmed at autopsy. Ventricular system, LP, and VH were biochemically analyzed and showed that glucose was highest in VH (41 mmol/L) and was 6 and 8 mmol/L higher than CSF in the LP and VA, respectively. β-Hydroxybutyrate was also highest in VH (20 mmol/L) and was 5 and 6 mmol/L higher than LP and VA, respectively. Our findings suggest that postmortem CSF glucose and β-hydroxybutyrate may not truly reflect that of VH and vary between CSF sampling sites.
Chest Radiograph Alone Is Sufficient as the Foreign Body Survey for Children Presenting With Coin Ingestion
Authors: Shatani Naoya , Alshaibani Sara , Potts James , Phillips Bruce , Bray Heather 
Published: November 2018

Objectives
Radiographic survey of the entire aerodigestive tract (nares to anus) is common practice in children presenting to the emergency department following coin ingestion. The purpose of our study was to determine the optimal protocol for radiographic survey post–coin ingestion. We hypothesized that for children presenting with a clear history of coin ingestion a frontal chest radiograph including the entire esophagus is adequate to guide treatment.

Methods
We reviewed the clinical history and radiographic surveys of 134 patients presenting with suspected or witnessed coin ingestion to the emergency department of a tertiary care pediatric hospital between January 2012 and June 2016. Patient demographics, presenting symptoms, anatomic coverage of survey, type, number and location of radiopaque foreign bodies, intervention, and follow-up were recorded.

Results
Coins were identified on radiographic surveys in 109 of 134 patients; 25 of 134 patients had no coin. Of those with coins, none of 109 had coin(s) in the airway, 42 of 109 had coin(s) in the esophagus, and 67 of 109 had coin(s) distal to the esophagus. Of those with esophageal coins, 35 of 42 reported symptoms, 7 of 42 were asymptomatic, 40 of 42 underwent endoscopic coin removal, and 2 of 42 had no intervention. Of 92 of 134 surveyed patients with no coin or coin distal to the esophagus, 30 of 92 reported symptoms, 62 of 92 were asymptomatic, 90 of 92 had no further intervention, and 2 of 92 eventually underwent endoscopic coin removal for specific indications (abdominal pain, delayed passage). When there was no coin found in the esophagus, the negative predictive value for intervention was 97.8%.

Conclusions
Following a clear history of coin ingestion, a frontal chest radiograph including the entire length of the esophagus provides sufficient information to direct patient management.
Florid Scurvy in an Autistic Child on a Ketogenic Diet
Authors: Ahmad Syed Amir , Al Thobiti Tariq A. , El Toum Manal , Al Harbi Fahad 
Published: November 2018

Abstract
Ketogenic diets used for treating various neurological disorders can have potentially serious adverse effects. Among these is scurvy, a rarely reported, yet potentially fatal adverse effect of the ketogenic diet caused by vitamin C deficiency. We report a case of a 5-year-old patient with autism, who presented with scurvy secondary to the dietary restrictions of a ketogenic diet. Our review of the literature showed a single previously reported case of vitamin C deficiency in a patient on ketogenic diet. We have also reviewed the clinical indications and adverse effects of ketogenic diets with special reference to scurvy. This case emphasizes the importance of vitamin supplements in patients consuming a special diet.
Nursing Interventions Improve Continuous Positive Airway Pressure Adherence in Obstructive Sleep Apnea With Excessive Daytime Sleepiness: A Systematic Review
Authors: López-López Laura , Torres-Sánchez Irene , Cabrera-Martos Irene , Ortíz-Rubio Araceli , Granados-Santiago Maria , Valenza Marie Carmen 
Published: November 2018

Abstract

Purpose
The purpose of this systematic review was to summarize the effectiveness of interventions in the literature to improve adherence to continuous positive airway pressure (CPAP) treatment in patients with excessive daytime sleepiness.

Methods
In this review, we considered only randomized controlled trials that included interventions to improve CPAP adherence in adult obstructive sleep apnea (OSA) patients with high daytime sleepiness.

Findings
Eight trials were included in this review. The types of interventions to improve adherence to CPAP can be grouped into educational, technological, pharmacological, and multidimensional interventions.

Conclusions and Clinical Relevance
Educational programs can increase CPAP adherence in OSA patients. As nurses are the main clinicians responsible for device use for patients, the therapeutic strategies to improve CPAP adherence are important in their clinical setting. Therefore, the nursing work related to the use of CPAP has a great impact on the quality of life and mortality of patients with OSA.
Two-Team Surgical Approach to Improve Retroperitoneal Nerve Identification in the Treatment of Groin Pain
Authors: George Taylor , Williams Eric H. , Franklin Richard , Lee Dellon A. 
Published: November 2018

Background
An estimated 700,000 groin hernia repairs are performed in the United States each year. Studies have shown that up to 50% of patients who undergo groin hernia repair are affected by persistent pain beyond the first few days after surgery. At 2 to 5 years after either open or laparoscopic, mesh or without mesh, 10% to 12% of these patients will have persistent and disabling pain. If the ilioinguinal, iliohypogastric, or genitofemoral nerves are injured below the transversalis muscle layer, the traditional external, open approach to nerve resection will not help these patients. The traditional internal, laparoscopic, approach to the retroperitoneum can be used for nerve resection, but identification of the correct nerve is difficult. Therefore, we have developed a 2-team, dual approach, combining open and endoscopic approaches to solve this problem.

Methods
A retrospective review of the electronic medical records was performed to identify all patients who underwent a dual approach for groin denervation after persistent postherniorraphy pain. This dual approach included an external incision paired with a laparoscopic, retroperitoneal approach to identify and/or transect the ilioinguinal, iliohypogastic, lateral femoral cutaneous, and genital branch of the genitofemoral nerve. Inclusion criteria are persistent groin pain with alleviation after preoperative nerve block and either a failed attempt at an external approach groin denervation or pain after a primary laparotomy/laparoscopy procedure.

Results
Thirteen patients met the inclusion criteria. All patients underwent a dual approach, and nerves were identified and confirmed in both the external groin and laparoscopic approaches. When placed on a scale from excellent/good to fair/poor relief of pain, 10 patients (77%) described excellent/good relief and 3 (23%) continued to have persistent pain.

Conclusions
A combined open surgical procedure, to identify the lateral femoral cutaneous nerve, and a laparoscopic procedure in the retroperitoneum have demonstrated the feasibility of this approach to identify correctly the nerve to be resected to relieve disabling groin pain.
Application of Computer-Assisted Navigation System in Acute Zygomatic Fractures
Authors: Yang Cristhiam , Lee Min-Chao , Pan Chun-Hao , Chen Chih-hao , Chen Chien-Tzung 
Published: November 2018

Objective
To compare the surgical results of early treatment of zygomatic fractures with and without the use of the computer-assisted navigation system.

Methods
All patients with unilateral traumatic zygomatic fractures treated within 30 days after the injury at a single center between June 2012 and May 2017 were studied retrospectively. Primary outcome was defined by the displacement at 5 junctional sutures of zygomatic bone, the change at each point before and after the reconstruction, and the patient's subjective scoring of their appearance. Secondary outcome included the length of the operation and hospital stay, the number of incisional approaches, the fixation points, the maximal mouth opening, and the sequelae upon follow-up.

Results
Twenty-eight patients were enrolled in this study. Fourteen of them received surgery with the help of a computer-assisted navigation system (navigation group), and 14 patients were treated without its assistance (control group). Before the surgery, the mean displacement of each junctional suture and the mean total displacement between both groups were comparable. Postoperative computed tomography showed that the mean total displacement was significantly less for the navigation group than the control group (0.53 vs 2.93 mm, P = 0.001), and the displacement of zygomaticosphenoid suture was smaller (0 vs 0.9 mm, P = 0.009). Patients in the navigation group underwent surgery via the single buccal-gingival approach without the need for longer operation time. There were no significant differences in the length of hospital stay, maximal mouth opening, or cheek numbness. All patients recovered without major complications and were comparatively satisfied with their final appearance.

Conclusions
The navigation system has been demonstrated to be a useful tool for improving the symmetry in delayed or secondary reconstruction of zygomatic fractures. This study showed its effectiveness and safety in cases of early treatment as well, achieving a more accurate correction in a less invasive manner.