bluuebunny/crossref_metadata_2025_split huggingface dataset:
Radiofrequency Energy and Electrode Proximity Influences Stereoelectroencephalography-Guided Radiofrequency Thermocoagulation Lesion Size: An In Vitro Study with Clinical Correlation
Authors: Staudt Michael D , Maturu Sarita , Miller Jonathan P 
Published: February 2018

Abstract

BACKGROUND
Radiofrequency thermocoagulation of epileptogenic foci via stereoelectroencephalography (SEEG) electrodes has been suggested as a treatment for medically intractable epilepsy, but reported outcomes have been suboptimal, possibly because lesions generated using conventional high-energy radiofrequency parameters are relatively small.

OBJECTIVE
To describe a technique of delivering low energy across separate SEEG electrodes in order to create large confluent radiofrequency lesions.

METHODS
The size and configuration of radiofrequency lesions using different radiofrequency intensity and interelectrode distance was assessed in egg whites. Magnetic resonance images (MRI) from 3 patients who had undergone radiofrequency lesion creation were evaluated to determine the contribution of lesion intensity and electrode separation on lesion size. Electroencephalography, MRI, and clinical data were assessed before and after lesion creation.

RESULTS
Both in Vitro and in Vivo analysis revealed that less energy paradoxically produced larger lesions, with the largest possible lesions produced when radiofrequency power was applied for long duration at less than 3 W. Linear separation of electrodes also contributed to lesion size, with largest lesions produced when electrodes were separated by a linear distance of between 5 and 12 mm. Clinical lesions produced using these parameters were large and resulted in improvement in interictal and ictal activity.

CONCLUSION
Radiofrequency lesions produced using low-energy delivery between SEEG electrodes in close proximity can produce a large lesion. These findings might have advantages for treatment of focal epilepsy.
Patient-Clinician Communication: American Society of Clinical Oncology Consensus Guideline
Authors: Gilligan Timothy , Coyle Nessa , Frankel Richard M. , Berry Donna L. , Bohlke Kari , Epstein Ronald M. , Finlay Esme , Jackson Vicki A. , Lathan Christopher S. , Loprinzi Charles L. , Nguyen Lynne H. , Seigel Carole , Baile Walter F. 
Published: February 2018

(Abstracted from J Clin Oncol 2017;35(31):3618–3632)
Clinicians who treat cancer are faced with many challenges when communicating diagnostic, treatment, and prognostic information to patients and their families. The limited training of many oncologists does not prepare them to deliver effective information.
Understanding the Epidemiology of Pediatric Supracondylar Humeral Fractures in the United States: Identifying Opportunities for Intervention
Authors: Holt Joshua B. , Glass Natalie A. , Shah Apurva S. 
Published: February 2018

Background:
Supracondylar humeral fractures (SCHF) are the most common elbow fractures in children. The epidemiology of these injuries in the United States is described.

Methods:
The Nationwide Emergency Department Sample database was queried for all children (age, below 18 y) with SCHF treated in the emergency department (ED) from 2006 to 2011, and weighted estimates were extracted.

Results:
A total of 63,348 ED visits for SCHF were identified. The weighted estimate of ED visits remained stable over the study period, ranging from 60.3 to 71.8 per 100,000 children annually. There was no significant difference in fracture rate (52% male) by sex. The mean age of closed injury was 5.5±3.1 years, with 53.6% of fractures occurring in children 3 to 6 years. Open injuries accounted for 1.0% of fractures. Children with open injuries were significantly older (mean, 9.1±4.4 y; P<0.0001) and more often male (OR, 1.43; P<0.001). Neurovascular injury occurred in significantly older children (mean, 7.6±3.1 y; P<0.0001) and was documented in 11.4% of open fractures and 3.6% of operative fractures. Although the South had the greatest number of total SCHF-related ED visits, children in the West had significantly more SCHF-related ED visits per 100,000 children annually (77.9) than all other regions (P<0.05). Average fracture rates were approximately 60% higher in April to September than October to March (P<0.001). Mean total charges for patients treated and discharged from the ED were $2965, compared with $17,865 in children admitted for surgery (P<0.05). Mean charges were significantly higher in the West compared with all other regions (P<0.0001).

Conclusions:
The incidence of pediatric SCHF-related ED visits remained stable from 2006 to 2011 and occurred most frequently in children aged 3 to 6 years. Open injuries are rare and are more likely to occur in older boys. There are significant differences in the injury rates and charges across geographic regions, identifying opportunities for injury prevention, cost reduction, and value improvement. The indications for operative management should be clearly delineated given the high cost of surgical treatment.

Level of Evidence:
Therapeutic Level IV.
Patterns of menopausal hormone therapy use and hyperkyphosis in older women
Authors: Woods Gina N. , Huang Mei-Hua , Cawthon Peggy M. , McDaniels-Davidson Corinne , Fink Howard A. , Kado Deborah M. 
Published: February 2018

Abstract

Objective:
Hyperkyphosis, an exaggerated anterior curvature of the thoracic spine, is associated with poor physical function, falls, fractures, and earlier mortality. Low bone mineral density, bone loss, and vertebral fractures are strong risk factors for hyperkyphosis. Menopausal hormone therapy (HT) reverses bone loss, prevents vertebral fractures, and, therefore, we hypothesize, may reduce the risk for developing hyperkyphosis.

Methods:
We evaluated the cross-sectional association between Cobb angle of kyphosis from lateral spine radiographs and pattern of self-reported HT use during the prior 15-year period in 1,063 women from the Study of Osteoporotic Fractures.

Results:
Participants had a mean age of 83.7 ± 3.3 years and a mean Cobb angle of 51.3 ± 14.6°. Forty-six per cent of women were characterized as never-users of HT, 24% as remote past users, 17% as intermittent users, and 12% as continuous users. In minimally adjusted models, the mean Cobb angle was 4.0° less in continuous HT users compared with never-users (P = 0.01); however, in fully adjusted models, this association was attenuated to 2.8° (P = 0.06). Remote past HT users had 3.0° less kyphosis compared with never-users in minimally adjusted models (P = 0.01), attenuated to 2.8° less in fully adjusted models (P = 0.02). Intermittent users did not differ from never-users in degree of kyphosis.

Conclusions:
Women reporting continuous or remote past HT use had less pronounced kyphosis than never-users by their mid-eighties, suggesting a possible role for HT in the prevention of age-related hyperkyphosis.
Technology's Role in Quality Improvement and Operational Efficiency
Authors: Blauwet Judy , Bell Mandy 
Published: February 2018

SUMMARY
Technology for technology's sake is never a good idea. There must be a purpose behind it. It must help us do our jobs better. Technology allows healthcare to remain affordable and, as such, accessible. Technology must increase access to care, improve safety, make test results more reliable, and help teams communicate better for a seamless care experience.
Avera Health, a health system based in Sioux Falls, South Dakota, comprises 330 facilities in 100 communities in five states. Sponsored by the Benedictine and Presentation Sisters, Avera is a healthcare ministry whose employees deliver high-quality care with compassion. We have been early innovators in using technology to deliver a high standard of service.
Avera has been nationally recognized for its innovation. For 18 of the past 19 years, the system has been named to Hospitals & Health Networks magazine's list of Health Care's Most Wired and has been designated as “advanced” for reasons that include the development of the most extensive telehealth network serving rural healthcare facilities. Avera also won the Most Wired Innovator Award in 2011 and 2012. Avera's flagship 545-bed tertiary facility, Avera McKennan Hospital & University Health Center, has received Stage 7 recognition from HIMSS Analytics.
Avera leaders have developed a spirit of inquiry and a culture of innovation. We have fostered change by aligning our care into service lines that help ensure that wherever people walk in our doors, they will receive the same quality care. In several cases, we have innovated through strategic partnerships. In this article, we describe how technology helps sustain our culture of innovation.
Reliability of Blotting Techniques to Assess Contact Lens Water Content
Authors: Cañadas Pilar , López-Miguel Alberto , Gómez Alba , López-de la Rosa Alberto , Fernández Itziar , González-García María J. 
Published: February 2018

Objectives:To determine the reliability of wet and modified dry blotting techniques used in the gravimetric method to assess contact lens (CL) water content (WC), the accuracy of both techniques in comparison with the nominal WC, and also their agreement.Methods:We evaluated hydrated and dry CL mass values and WC using the gravimetric method in 440 daily disposable CLs. Samples assessed corresponded to Dailies Total 1, Dailies AquaComfort Plus, 1-Day Acuvue TruEye, and Biotrue ONEday. Back vertex power ranged from +3.00 diopters (D) to −6.00 D. Within-subject coefficient of variation (CVw) and intraclass correlation coefficients were calculated. Bland-Altman analysis was also performed.Results:The modified dry blotting technique yielded significantly (P≤0.0001) higher hydrated CL mass values. The wet blotting technique provided significantly (P≤0.04) better consistency than the modified dry one. Values of CVw for wet and modified dry blotting techniques ranged from 1.2% to 2.1% and from 3.7% to 5.4%, respectively. As for dry CL mass values, CVw values were not significantly different (P≥0.05) between wet (range: 1.1%–1.9%) and dry (range: 1.0%–5.1%) blotting techniques, except for Dailies AquaComfort Plus (P=0.03). Bland-Altman analysis showed poor agreement between the techniques. The wet blotting technique yielded WC values close (around 1%) to nominal ones, in contrast to modified dry blotting technique (≥2.5%).Conclusions:The wet blotting technique is not only more reliable than the modified dry one when obtaining hydrated CL mass but also provides more accurate nominal WC measurements. Agreement between the techniques was poor.
Extravaginal Gardnerella vaginalis Infection—An Uncommon Variable
Authors: Booher Katelyn J. , Czachor John S. 
Published: February 2018

Abstract
Extravaginal infections due to Gardnerella vaginalis are rare and likely underappreciated. We present a case of G. vaginalis pyelonephritis and bacteremia due to an obstructing nephrolith. It is important for healthcare providers to be aware of such infections, including genitourinary or bloodstream infections, which may follow local anatomic disruption.
Kawasaki Disease After Streptococcal Pneumonia
Authors: Argyri Ioanna , Soldatou Alexandra , Grigoriadou Georgia , Vougiouka Olga , Tsolia Maria 
Published: February 2018

Abstract
A 4.5-year-old girl presented to the emergency department with a 5-day history of high fever, fatigue, and rash. Because of pneumonia with pleural empyema and sepsis caused by Streptococcus pyogenes, she was admitted to the pediatric intensive care unit. After initial improvement and on the eighth day, she became febrile again and also developed conjunctivitis, rash, cervical lymphadenopathy, periungual desquamation, and elevated inflammatory markers. A cardiac echo revealed a limited dilatation of the left main coronary artery. Because of suspicion of secondary Kawasaki disease, she received intravenous immunoglobulin and acetylsalicylic acid. There was an immediate clinical response with improvement of all clinical manifestations and laboratory findings. During follow-up examination 1 month later, the diameter of the left main coronary artery was within normal limits. A high index of suspicion of Kawasaki disease in children is required upon development of fever and compatible signs and symptoms in patients with serious streptococcal disease.
Long-Term Safety of Tedizolid in a Patient With Spondilodiscitis After Switch From Linezolid Due to Toxicity
Authors: Martínez Álvarez Rosa Maria , Navarro Pardo Irene , Moreno García Estela , Huarte Lacunza Rafael 
Published: February 2018

Abstract
The patient is a 57-year-old man with liver cirrhosis, Bricker anastomosis after a radical cystoprostatectomy and, a history of bacteremias caused by extended-spectrum β-lactamase–positive Escherichia coli, Enterococcus faecium, and Candida albicans. He presented with persistent low back pain and was diagnosed with vertebral osteomyelitis, for which he received ertapenem-linezolid treatment. However, after 20 days, linezolid had to be discontinued because of myelotoxicity and metabolic acidosis. The patient was switched to tedizolid, which, in combination with ertapenem, was successfully given for 114 days until biopsy showed no growth of gram-positive cocci. We conclude that tedizolid can be an alternative to linezolid in case of toxicity, especially in long-term treatments.
Retracting Locking-Pin Mechanism That Allows Partial Prosthetic Socket Doffing during Sitting
Authors: Goldstein Mark D. , Cagle John C. , Hafner Brian J. , Allyn Katheryn J. , Sanders Joan E. 
Published: February 2018

ABSTRACT

Introduction
The purpose of this research was to develop a retractable tethered pin system to facilitate partial doffing and redonning of prosthetic sockets with locking-pin suspension.

Materials and Methods
The system included a tethered cord that extended from a retracting mechanism on the pylon through the shuttle lock to a clip at the bottom of the locking pin. The mechanism operated similarly to a seatbelt retractor, applying low-level tension unless the user made a rapid pull on the tether to lock the mechanism.

Results
Evaluation tests on four people with limb loss demonstrated that users liked the retracting mechanism and its capability to facilitate partial doffing and redonning. However, participants reported that the clip used to connect the mechanism to the locking pin worsened initial donning and final doffing of the socket.

Conclusions
Modifications to the retractable tethered pin system design may overcome limitations and result in an easy and effective accommodation technology for people with transtibial amputation.
From dysmotility to virulent pathogens: implications of opioid use in the ICU
Authors: Chapple Lee-anne , Deane Adam 
Published: February 2018

Purpose of review
Gastrointestinal dysmotility occurs frequently in the critically ill. Although the causes underlying dysmotility are multifactorial, both pain and its treatment with exogenous opioids are likely causative factors. The purpose of this review is to describe the effects of pain and opioids on gastrointestinal motility; outline the rationale for and evidence supporting the administration of opioid antagonists to improve dysmotility; and describe the potential influence opioids drugs have on the intestinal microbiome and infectious complications.

Recent findings
Opioid drugs are frequently prescribed in the critically ill to alleviate pain. In health, opioids cause gastric dysmotility, yet the evidence for this in critical illness is inconsistent and limited to observational studies. Administration of opioid antagonists may improve gastrointestinal motility, but data are sparse, and these agents cannot be recommended outside of clinical trials. Although critical illness is associated with alterations in the microbiome, the extent to which opioid administration influences these changes, and the subsequent development of infection, remains uncertain.

Summary
Replication of clinical studies from ambulant populations in critical care is required to ascertain the independent influence of opioid administration on gastrointestinal motility and infectious complications.
Lessons Learned From Domestic and International Human Papillomavirus Vaccination Programs: A Review
Authors: Miller Kathryn , Dilley Sarah E. , Huh Warner K. 
Published: February 2018

(Abstracted from Am J Obstet Gynecol 2017; http://dx.doi.org/10.1016/j.ajog.2017.08.109)
Persistent infection with oncogenic human papillomavirus (HPV) leads to the development of many cervical cancers, as well as cancers of other anatomic locations. Among the more than 150 types of HPV, 13 have been identified as carcinogenic; types 16 and 18 are responsible for 70% of invasive cervical cancer.
Surgeons' Views on Sling Tensioning During Surgery for Female Stress Urinary Incontinence
Authors: Borazjani Ali , Pizarro-Berdichevsky Javier , Li Jianbo , Goldman Howard B. 
Published: February 2018

(Abstracted from Int Urogynecol J 2017;28:1489–1495)
Over the past 2 decades, synthetic midurethral slings (MUSs) have become the criterion standard treatment for female stress urinary incontinence (SUI). Rates of MUS far exceed those of other operations for female incontinence.
Nutrient Deficiency and Obstetrical Outcomes in Pregnant Women Following Roux-en-Y Gastric Bypass: A Retrospective Danish Cohort Study With a Matched Comparison Group
Authors: Hammeken Lianna Hede , Betsagoo Ramsina , Jensen Ann Nygaard , Sørensen Anne Nødgaard , Overgaard Charlotte 
Published: February 2018

(Abstracted from Eur J Obstet Gynecol Reprod Biol 2017;216:56–60)
Roux-en-Y gastric bypass (RYGB) is among the most common types of bariatric surgery for inducing weight loss by restricting the gastric volume and promoting malabsorption of nutrients. Often RYGB is performed in women of childbearing potential.
Pelvic Packing for Intractable Obstetric Hemorrhage After Emergency Peripartum Hysterectomy: A Review
Authors: Touhami Omar , Bouzid Arij , Ben Marzouk Sofiene , Kehila Mahdi , Channoufi Mohamed Badis , El Magherbi Hayen 
Published: February 2018

Importance
Postpartum hemorrhage (PPH) is the leading cause of maternal mortality worldwide. Even after emergency peripartum hysterectomy (EPH), bleeding may occur in the setting of acquired coagulopathy. This type of bleeding resistant to clipping, ligating, or suturing could be successfully controlled with a pelvic packing.

Objective
This review provides an overview of the different pelvic packing techniques used after the failure of an EPH to control severe PPH. It aims to highlight the outcome of patients after packing, the morbidity and complications of packing, the timing and indications of packing, and finally the optimal duration of packing.

Evidence Acquisition
Literature relating to pelvic packing after EPH in a PPH setting was reviewed.

Results
Packing techniques can be divided into 2 types: pads or roller gauze and balloon pack. The overall success rate was as high as 78.8% with a mortality rate of 12.5%. No major morbidity related to the pelvic packing was documented. The optimal duration of packing is in the range of 36 to 72 hours.

Conclusions
Pelvic packing should be part of the armamentarium available to the obstetrician whenever intractable pelvic hemorrhage is encountered. It is quite simple and quick to perform and requires no special medical materials, the rate of complications is very low, and the success rate is high.

Relevance
The pelvic packing should be particularly useful in developing countries where more advanced technologies such as selective arterial embolization are not always available. In developed countries, the pelvic packing may be a valuable temporary measure pending transport to a tertiary care facility.

Target Audience
Obstetricians and gynecologists, family physicians.

Learning Objectives
After completing this activity, the learner should be better able to identify the situations were pelvic packing could be used as a lifesaving procedure; compare the different techniques of pelvic packing, highlighting the potential advantages and disadvantages of each technique; and evaluate the success rate of the procedure and the potential morbidity.
Prescription of Preexposure Prophylaxis to Men Who Have Sex With Men Diagnosed and Reported With Gonorrhea, STD Surveillance Network, 2016
Authors: Ramirez Viani , Han Emily , Stoltey Julie , Nguyen Trang Q. , Pathela Preeti , Tourdot Laura , Walters Jaime , Bell Teal , Torrone Elizabeth , Stenger Mark 
Published: February 2018

Abstract
Using a representative sample of gonorrhea cases in select jurisdictions, we estimated the proportion of eligible men who have sex with men reporting being prescribed preexposure prophylaxis (PrEP) to prevent HIV infection. In 2016, half (51.3%) of the estimated 33,165 eligible men who have sex with men reported being prescribed PrEP by their health care provider.
Brimonidine Ophthalmic Solution 0.025% for Reduction of Ocular Redness: A Randomized Clinical Trial
Authors: McLaurin Eugene , Cavet Megan E. , Gomes Paul J. , Ciolino Joseph B. 
Published: February 2018

SIGNIFICANCE
The α2-adrenergic receptor agonist brimonidine has been reported to induce conjunctival blanching in cataract, strabismus, laser refractive, and filtration procedures. Clinicians are often faced with red eyes with no apparent underlying pathology. Low-dose brimonidine reduced ocular redness in such subjects with efficacy maintained over 1 month and negligible rebound redness.

PURPOSE
The aim of this study was to evaluate the safety and efficacy of brimonidine tartrate ophthalmic solution 0.025% for the treatment of ocular redness.

METHODS
In this single-center, double-masked, phase 3 clinical trial, adult subjects with baseline redness of more than 1 unit in both eyes (0- to 4-unit scale) were randomized 2:1 to brimonidine 0.025% or vehicle. A single dose was administered in-office (day 1); thereafter subjects instilled treatment four times a day for 4 weeks, with clinic visits on days 15, 29, and 36 (7 days post-treatment). Efficacy end points included investigator-evaluated redness 5 to 240 minutes post-instillation on day 1 (primary); investigator-evaluated change from baseline 1, 360, and 480 minutes post-instillation on day 1, and 1 and 5 minutes post-instillation on days 15 and 29; total clearance of redness, and subject-assessed redness. Safety/tolerability measures included adverse events, rebound redness, and drop comfort.

RESULTS
Sixty subjects were randomized (n = 40 brimonidine, n = 20 vehicle). Investigator-assessed redness was lower with brimonidine versus vehicle over the 5- to 240-minute post-instillation period (mean [SE], 0.62 [0.076] vs. 1.49 [0.108]; P < .0001) and at each time point within that period (P < .0001). At 1, 360, and 480 minutes post-instillation, respectively, the mean differences (95% confidence interval) between treatments were −0.73 (−1.05 to −0.41), −0.57 (−0.84 to −0.29), and −0.39 (−0.67 to −0.10), respectively. No tachyphylaxis was evident with brimonidine on days 15 and 29, and minimal rebound redness was observed following discontinuation. Adverse events were infrequent, and brimonidine was rated as very comfortable.

CONCLUSIONS
Brimonidine 0.025% appeared safe and effective for reduction of ocular redness, with an 8-hour duration of action, no evidence of tachyphylaxis, and negligible rebound redness.