bluuebunny/crossref_metadata_2025_split huggingface dataset:
Posterolateral Versus Posterior Interbody Fusion in Lumbar Degenerative Spondylolisthesis
Authors: Urquhart Jennifer C. , Alnaghmoosh Nabeel , Gurr Kevin R. , Bailey Stewart I. , Tallon Corinne , Dehens Shauna , Rosas Arellano M. Patricia , Bailey Christopher S. 
Published: August 2018

Study Design:
This was a retrospective study of 2 different fusion techniques for the treatment of lumbar degenerative spondylolisthesis.

Objective:
To determine whether posterior lumbar interbody fusion (IF) is associated with improved patient-rated satisfaction and functional outcome when compared with posterolateral fusion (PLF).

Summary of Background Data:
IF and PLF are widely used surgical approaches in the treatment of spondylolisthesis. Numerous studies have compared IF and PLF techniques, but inconsistent results, heterogeneous cohorts, and conflicting scientific evidence have made it difficult to reach a consensus on the optimal fusion technique.

Materials and Methods:
A consecutive cohort of 87 patients who had single-level degenerative spondylolisthesis and either PLF or IF were identified from a prospectively maintained database. Short Form-36 physical and mental component score, Oswestry Disability Index, back and leg pain, and complication rate were assessed to 24 months postoperatively. Patient characteristics, clinical outcome, and complications were compared between groups.

Results:
Of the 87 patients identified, 29 patients (33%) had PLF and 58 patients (67%) had IF. Patient follow-up was ≥85%. Foraminal stenosis (PLF, 13.8% vs. IF, 34.5%; P=0.046) was more common among the participants in the IF group. Intraoperative and postoperative complications were not different between groups (P>0.05). The reoperation rate was 3.4% in the PLF group and 10.3% in the IF group (P=0.416). Patients in the PLF group experienced similar gains in improvement in all outcome measures as those in the IF group (P>0.05). Four patients in the IF group and 3 in the PLF group were lacking evidence of radiographic fusion. These patients did have increased moderate back pain compared with patients demonstrating radiographic fusion but did not differ in any other postoperative outcomes measures.

Conclusions:
Type of fusion, IF or PLF, does not affect patient outcome or postoperative complication rates.

Level of Evidence
Level IV.
Changes in Temperature Management of Cardiac Arrest Patients Following Publication of the Target Temperature Management Trial*
Authors: Salter Ryan , Bailey Michael , Bellomo Rinaldo , Eastwood Glenn , Goodwin Andrew , Nielsen Niklas , Pilcher David , Nichol Alistair , Saxena Manoj , Shehabi Yahya , Young Paul 
Published: August 2018

Objectives:
To evaluate knowledge translation after publication of the target temperature management 33°C versus 36°C after out-of-hospital cardiac arrest trial and associated patient outcomes. Our primary hypothesis was that target temperature management at 36°C was rapidly adopted in Australian and New Zealand ICUs. Secondary hypotheses were that temporal reductions in mortality would be seen and would have accelerated after publication of the target temperature management trial.

Design:
Retrospective cohort study (January 2005 to December 2016).

Setting:
The Australian and New Zealand Intensive Care Society Centre for Outcome and Resource Evaluation adult patient database containing greater than 2 million admission episodes from 186 Australian and New Zealand ICUs.

Patients:
Sixteen-thousand two-hundred fifty-two adults from 140 hospitals admitted to ICU after out-of-hospital cardiac arrest.

Interventions:
The primary exposure of interest was admission before versus after publication of the target temperature management trial.

Measurements and Main Results:
The primary outcome variable to evaluate changes in temperature management was lowest temperature in the first 24 hours in ICU. The primary clinical outcome variable of interest was inhospital mortality. Secondary outcomes included proportion of patients with fever in the first 24 hours in ICU. Mean ± sd lowest temperature in the first 24 hours in ICU in pre- and posttarget temperature management trial patients was 33.80 ± 1.71°C and 34.70 ± 1.39°C, respectively (absolute difference, 0.98°C [99% CI, 0.89–1.06°C]). Inhospital mortality rate decreased by 1.3 (99% CI, –1.8 to –0.9) percentage points per year from January 2005 until December 2013 and increased by 0.6 (99% CI, –1.4 to 2.6) percentage points per year from January 2014 until December 2016 (change in slope 1.9 percentage points per year [99% CI, –0.6 to 4.4]). Fever occurred in 568 (12.8%) of 4,450 pretarget temperature management trial patients and 853 (16.5%) of 5,184 posttarget temperature management trial patients (odds ratio, 1.35 [99% CI, 1.16–1.57]).

Conclusions:
The average lowest temperature of postcardiac arrest patients in the first 24 hours in ICU rose after publication of the target temperature management trial. This change was associated with an increased frequency of fever not seen in the target temperature management trial.
Plexiform Xanthomatous Tumor, Variety of Xanthoma or Subtype of Fibrohistiocytic Tumors?
Authors: Illán-Gambín Francisco José , Encabo-Durán Belén , Romero-Pérez David , Álvarez-Chinchilla Pedro , Niveiro-de Jaime María 
Published: August 2018

Abstract:
Plexiform xanthomatous tumor was proposed as an independent neoplasm within fibrohistiocytic tumor group a few years ago. The arguments were based on their different clinical features as well as their own morphological and immunohistochemical findings. Nevertheless, it has not been widely studied yet, and there are few reports about this entity. Regarding a case, we reviewed the diagnostic characteristics of this underdiagnosed tumor.
The Effect of Electrical Load Shedding on Pediatric Hospital Admissions in South Africa
Authors: Gehringer Christian , Rode Heinz , Schomaker Michael 
Published: August 2018

Background:
South Africa faced repeated episodes of temporary power shutdowns, or load shedding, in 2014/2015. The effect of load shedding on children’s health is unknown.

Methods:
We determined periods of load shedding using Twitter, Facebook, and data from the City of Cape Town. We obtained the number of unscheduled hospital admissions between June 2014 and May 2015 from Red Cross Children’s Hospital, Cape Town, and weather data from the South African Weather Service. We used quasi-Poisson regression models to explore the relationship between number of hospital admissions and load shedding, adjusted for season, weather, and past admissions. Based on assumptions about the causal process leading to hospital admissions, we estimated the average treatment effect, that is, the difference in expected number of admissions per day had there been load shedding each day or on any of the preceding 2 days compared with if there had not been any load shedding.

Results:
We found a 10% increase (95% confidence interval: 4%, 15%) in hospital admissions for days where load shedding was experienced on the same day, or no more than 2 days prior, compared with when there was no load shedding in the past 2 days. The increase was more pronounced during weekdays (12% [7%, 18%] vs. 1% [−9%, 11%]), and for specific diagnoses (e.g., respiratory system: 14% [2%, 26%]). The average treatment effect was estimated as 6.50 (5.12, 7.87) highlighting that about 6 additional admissions a day could be attributed to load shedding.

Conclusions:
The association we measured is consistent with our hypothesis that failures of the power infrastructure increase risk to children’s health. See video abstract at, http://links.lww.com/EDE/B409.
EPIRETINAL MEMBRANE REMOVAL WITH FOVEAL-SPARING INTERNAL LIMITING MEMBRANE PEELING
Authors: Russo Andrea , Morescalchi Francesco , Gambicorti Elena , Cancarini Anna , Costagliola Ciro , Semeraro Francesco 
Published: August 2018

Purpose:
To compare the retinal sensitivity after complete internal limiting membrane (ILM) peeling with that after foveal-sparing ILM peeling during vitrectomy for Type I epiretinal membrane.

Methods:
This was a prospective, randomized, comparative study. Thirty-eight eyes were randomized to undergo complete peeling of the ILM (CP group) or peeling with foveal sparing (FS group). The main outcome measures were foveal and perifoveal retinal sensitivity, visual acuity, and central retinal thickness.

Results:
Foveal retinal sensitivity showed a significant improvement in the FS group (2.82 ± 0.85 dB, P = 0.037) versus a slight drop in the CP group (−0.66 ± 0.48 dB, P = 1). Perifoveal retinal sensitivity slightly improved in both groups (0.47 ± 0.37 dB, P = 1 in the CP group and 0.79 ± 0.42 dB, P = 0.77 in the FS group), showing a similar trend without significant differences. Significant improvements were observed in both visual acuity and central retinal thickness in both groups. However, three cases in the FS group showed epiretinal membrane recurrence and required revision surgery with complete ILM removal.

Conclusion:
Internal limiting membrane peeling may reduce retinal sensitivity and significantly increase the incidence of microscotomas. However, the higher epiretinal membrane recurrence rate after the foveal-sparing technique limits the effectiveness of this procedure. Further studies must be conducted to determine if it is safe to leave a portion of the ILM in front of the fovea.
ADALIMUMAB THERAPY FOR REFRACTORY BIRDSHOT CHORIORETINOPATHY
Authors: Huis in het Veld Paulien I. , van Asten Freekje , Kuijpers Robert W.A.M. , Rothova Aniki , de Jong Eiko K. , Hoyng Carel B. 
Published: August 2018

Purpose:
To report the outcome of using adalimumab to treat birdshot chorioretinopathy.

Methods:
Retrospective case series of 19 patients (38 eyes) with HLA-A29–positive birdshot chorioretinopathy who received adalimumab treatment. Patients had been refractory to previous standard systemic immunomodulatory therapy. They received biweekly subcutaneous injections of 40 mg of adalimumab. Outcome measures were change in visual acuity, fluorescein angiography, and optical coherence tomography features, the concomitant use of immunosuppressive drugs, and the occurrence of adverse effects between 1 year before, at baseline, and after 1 year of adalimumab treatment.

Results:
Mean Snellen visual acuity at 1-year follow-up was 20/28, an improvement from 20/43 at the start of the treatment (P = 0.011) and equal to the visual acuity 1 year before the treatment (20/29). Only 2 of the 9 patients who had complete fluorescein angiography and optical coherence tomography results after the 1 year of treatment were completely free of inflammation signs at the end of the follow-up. Half (53%) of 17 patients were receiving adalimumab monotherapy after 1 year of treatment, an increase from 21% at the start of treatment (P = 0.047). Three of the 19 patients reported possible side effects; 2 discontinued treatment within 1 year.

Conclusion:
The results suggest that adalimumab is effective at improving visual acuity and at tapering concomitant immunomodulatory therapy, in patients with refractory birdshot chorioretinopathy. However, complete remission is rarely achieved.
CENTRAL SEROUS CHORIORETINOPATHY ASSOCIATED WITH STEROID ENEMA
Authors: Peiris Timothy J. , El Rami Hala E. , Sun Jennifer K. 
Published: August 2018

Background/Purpose:
To report a case of acute recurrent central serous chorioretinopathy that developed after a regimen of corticosteroid enemas and suppositories.

Methods:
Observational case report. Fluorescein angiography and spectral domain optical coherence tomography.

Results:
A 47-year-old male patient with ulcerative colitis managed through hydrocortisone enemas presented to clinic with a 1-day history of blurry vision of his left eye. Posterior segment examination revealed subretinal fluid in the superotemporal macula of the left eye extending centrally. After diagnosis of acute central serous chorioretinopathy, the patient was advised to taper steroid enemas and his visual symptoms and subretinal fluid resolved within the month. Seven years later, several months after using steroid suppositories for the first time since the original central serous chorioretinopathy episode, asymptomatic subretinal fluid accumulation with foveal sparing was found on routine ophthalmic examination. Three months later, most of this fluid had resolved with minimal residual subretinal fluid on clinical examination.

Conclusion:
Acute central serous chorioretinopathy may develop after corticosteroid enema or suppository use, a route of administration that has not been previously reported in association with the disease.
BRANCH RETINAL ARTERY WALL RUPTURE AND SUBSEQUENT OCCLUSION DURING PARS PLANA VITRECTOMY WITH MEMBRANE PEEL
Authors: Garrity Sean T. , Govetto Andrea , Hubschman Jean Pierre 
Published: August 2018

Purpose:
To report a case of branch retinal artery wall rupture and subsequent branch retinal artery occlusion occurring during a routine pars plana vitrectomy with epiretinal membrane and internal limiting membrane peeling.

Methods:
Case report. Multimodal imaging including fluorescein angiography, spectral domain optical coherence tomography (OCT), en face OCT, and OCT angiography were performed.

Results:
An 86-year-old woman presented with a symptomatic epiretinal membrane in the right eye. Pars plana vitrectomy with epiretinal membrane and internal limiting membrane peel was performed. During the peel, spontaneous preretinal and intraretinal hemorrhage emanating from an adjacent branch retinal artery developed. At postoperative Week 1, OCT showed retinal thinning and hyperreflectivity suggestive of vascular accident. At postoperative Year 1, OCT imaging revealed retinal atrophy while fluorescein angiography demonstrated the arterial occlusion, and OCT angiography illustrated reduction in retinal perfusion in the region of the branch retinal artery occlusion.

Conclusion:
The authors report an unusual case of retinal arterial wall rupture and hemorrhaging during routine pars plana vitrectomy with membrane peel resulting in a branch retinal artery occlusion and subsequent retinal atrophy. Surgeons must limit stress on the underlying retina during membrane peel to avoid this surgical complication.
RETINAL DYSTROPHY IN A PATIENT WITH McARDLE DISEASE
Authors: Alsberge Joseph B. , Chen Judy J. , Zaidi Ali A. , Fu Arthur D. 
Published: August 2018

Purpose:
To report a case of pattern dystrophy in a patient with McArdle disease, a rare autosomal recessive disorder of glycogen metabolism.

Methods:
Case report.

Results:
A 29-year-old woman with a history of muscle biopsy–confirmed McArdle disease presented with fundus findings consistent with pattern dystrophy. Multimodal imaging, including optical coherence tomography and fundus autofluorescence, was performed.

Conclusion:
To our knowledge, this is the third reported case of pattern dystrophy in a patient with McArdle disease.
PHENOTYPIC HETEROGENEITY IN A FAMILY WITH X-LINKED FAMILIAL EXUDATIVE VITREORETINOPATHY WITH PREVENTION OF VISUAL LOSS IN AN AFFECTED MALE CHILD WITH LASER TREATMENT IN INFANCY
Authors: Flores Pimentel Mariana A. , De la Huerta Irina , Duncan Jacque L. , Slavotinek Anne M. , Moore Anthony T. , de Alba Campomanes Alejandra G. 
Published: August 2018

Purpose:
To present the scope of prenatal diagnosis and early treatment of patients with clinically heterogeneous phenotypic retinal dysplasia associated with NDP gene variants.

Methods:
Retrospective. Review of electronic medical records.

Results:
Twenty-nine–year-old woman known to carry a NDP gene variant presented to the eye clinic for consultation and risk assessment at her second pregnancy. Her 11-year-old son had bilateral retinal detachment, despite surgical treatment. The family declined prenatal testing. The patient was born full term, was examined, and underwent genetic testing after birth. He was found to have bilateral retinal avascular periphery abnormalities and preretinal hemorrhages on the left eye. The patient received bilateral laser treatment at 2 months of age. He was found to be doing well at 16 months after treatment with adequate visual acuity and flat maculae. The asymptomatic mother and maternal grandfather of the proband were found to have retinal periphery abnormalities with unremarkable posterior pole and excellent visual acuity.

Conclusion:
NDP gene variants associated with X-linked familial exudative vitreoretinopathy phenotype benefit from early treatment. Providers who take care of these patients need to monitor closely the pregnancy and delivery of a male child born to a female carrier to offer appropriate and timely treatment.
Metastatic Salivary Ductal Carcinoma to the Mastoid Segment of the Facial Nerve
Authors: Fabie Joshua E. , Hatch Jonathan L. , Cross Ashley W. , Oyer Samuel L. , Neskey David M. , McRackan Theodore R. 
Published: August 2018

Objective:
To describe salivary ductal carcinoma (SDC) presenting as an isolated lesion of the mastoid segment of the facial nerve

Patients:
A 70-year-old man presenting with weakness of his right lower lip that progressed to complete facial paralysis over a span of 2 weeks.

Main Outcome Measures:
Clinical case records, immunohistochemical analyses, and radiological analyses including magnetic resonance imaging and positron emission tomography-computed tomography.

Results:
Nodular enhancement along the mastoid segment of the facial nerve was identified without any mass within the parotid on magnetic resonance imaging or regional/distant disease on positron emission tomography-computed tomography. Pathologic analysis of tissue obtained from a right parotidectomy, neck dissection, and transmastoid resection of the vertical segment of the facial nerve revealed a benign parotid gland with malignant glands identified intra- and perineurally within the central aspect of the gland.

Conclusions:
SDC is one of the most aggressive salivary malignancies and typically presents as a rapidly enlarging mass in the involved gland. Although SDC's clinical course is characterized by early metastasis, isolated neural invasion has not been reported in the absence of an identifiable primary tumor within the gland of origin. The present case illustrates the clinical history and treatment of the first case of a SDC presenting as an isolated facial nerve lesion from perineural spread.
Pediatric free flap reconstruction for head and neck defects
Authors: Roasa Francis V. , Castañeda Samantha S. , Mendoza Daniel Jose C. 
Published: August 2018

Purpose of review
The aim of this study was to review recent literature on the use of pediatric free flap reconstruction for head and neck defects with focus on skull base, congenital deformities, mandibular reconstruction and operative considerations.

Recent findings
Reconstruction of the skull base depends on the defect size, location, bony involvement, and pedicle length with a variety of flaps to choose from. Free flaps may be used to correct congenital anomalies due to facial clefts and syndromic causes requiring bony and tissue bulk. Preservation of the condyle together with free flap mandibular reconstruction has better growth potential. Delayed repair of mandibular defects may be an option especially for patients with malignancy. Chemotherapy and radiation therapy may inhibit the growth potential of the mandible. The use of running or coupled arterial anastomosis is associated with an increased immediate complication.

Summary
Pediatric free flap reconstruction is a reasonable option for various head and neck defects such as skull base, congenital, and mandibular defects.
Exploration of Relationships Between Postoperative Pain and Subsyndromal Delirium in Older Adults
Authors: Denny Dawn L. , Such Tami L. 
Published: August 2018

Background
Subsyndromal delirium is associated with serious adverse outcomes of longer lengths of stay, increased long-term care admissions, and higher 6-month mortality rates. Postoperative pain is a risk factor for delirium, but the relationship between pain and the severity of subclinical delirium symptoms is unclear. A better understanding will inform nursing interventions to reduce adverse outcomes associated with delirium symptoms.

Objectives
The purpose of this correlational study was to determine the relationship between pain and subsyndromal delirium in older adults following joint replacement surgery.

Methods
Delirium assessments were completed on postoperative Days 1, 2, and 3 for 49 adults of ages 65 years or older following joint replacement surgery. Multiple linear regression was used to analyze data for relationships between postoperative pain and subsyndromal delirium and, secondarily, postoperative opioid intake and subsyndromal delirium while accounting for known preoperative risk factors.

Results
Increased age, cognitive impairment, current smoking, and higher levels of self-reported pain were significantly related to subsyndromal delirium (p < .001). After accounting for preoperative risk factors of age, cognitive status, smoking status, and opioid intake, pain was significantly related to subsyndromal delirium (β = .28, p < .05); however, opioid intake did not contribute to subsyndromal delirium.

Discussion
Higher pain levels were significantly related to subsyndromal delirium when age, cognitive status, smoking status, and opioid intake were accounted for (p < .05), although opioid intake was not significantly related to subsyndromal delirium after accounting for age, cognitive status, smoking status, and pain. Nurses caring for older adults who undergo joint replacement surgery are encouraged to ensure effective pain management to reduce onset and severity of delirium symptoms.
Using Reflexive Thinking to Establish Rigor in Qualitative Research
Authors: Rettke Horst , Pretto Manuela , Spichiger Elisabeth , Frei Irena Anna , Spirig Rebecca 
Published: August 2018

Background
Reflexivity can be helpful in developing the methodological rigor necessary to attaining trustworthy qualitative study results.

Objectives
The aim of this study was to evaluate strategies of critical reflexive thinking during a qualitative enquiry rooted in a mixed-methods study.

Methods
Guided by the questions of Rolfe and colleagues from 2001 (“what,” “so what,” and “now what”), we applied reflexive thinking to all aspects of the investigation.

Results
Critical reflexive thinking strongly supported our efforts to establish methodological rigor and helped reveal shortcomings.

Discussion
Effective strategical use of reflexive thinking takes concerted effort. Both time and space are essential to applying reflexive thinking throughout the qualitative research process.