bluuebunny/crossref_metadata_2025_split huggingface dataset:
Negative-pressure pulmonary edema after laparoscopic appendectomy
Authors: Chang Wei Chao 
Published: July 2019

ABSTRACT
Negative-pressure pulmonary edema (NPPE) is acute-onset bilateral pulmonary interstitial edema. This condition can be caused by significant negative intrathoracic pressure generated by large inspiratory effort against acute upper airway obstruction. Postoperative NPPE is rare but potentially life-threatening if not recognized and treated promptly. This article describes a patient who developed postoperative NPPE following a laparoscopic appendectomy.
Broadening Medical Students’ Exposure to the Range of Illness Experiences: A Pilot Curriculum Focused on Depression Education
Authors: Pandhi Nancy , Gaines Martha , Deci David , Schlesinger Mark , Culp Cecilia , Karp Zaher , Legler Christie , Grob Rachel 
Published: July 2019

Problem
Exposing medical students to a broad range of illness experiences is crucial for teaching them to practice patient-centered care, but students often have limited interaction with patients with diverse illness presentations.

Approach
The authors developed, implemented, and evaluated a self-directed online curriculum followed by a small-group discussion focused on depression education. The curriculum was based on a module created using the Database of Individual Patients’ Experiences methodology. Findings from 40 interviews with young adults across the United States about their diverse experiences with depression were summarized online, and the summaries were illustrated by video, audio, and text clips. From August 2016 to April 2017, third-year students completed either this online curriculum and the usual clerkship curriculum or just the usual clerkship curriculum. These intervention and control groups completed pre- and postsurveys.

Outcomes
Students in the intervention group reported that the online curriculum influenced their thinking about depression (51/56) nearly as often as they reported that seeing patients in clinic did (53/56). They also reported greater decreases in personal stigmatizing attitudes toward depression than did students in the control group as measured by the Depression Stigma Scale (5.75–4.02, intervention; 6.50–5.65, control; P = .004). In open-ended responses, students in the intervention group were 13 times more likely to describe key lessons from the curriculum that reflected patient heterogeneity.

Next Steps
Future collaborations include implementing and evaluating this curriculum at other medical schools and developing additional versions based on other illness experiences.
Uniplanar Osteotomy for Multiplanar Femoral Deformity Correction
Authors: Medda Suman , Jinnah Alexander H. , Marquez-Lara Alejandro , Araiza Edgar T. , Carroll Eben A. 
Published: July 2019

Summary:
Long-bone deformity may be significantly symptomatic. A uniplanar corrective osteotomy uses a single cut to correct coronal, sagittal, and axial plane deformity simultaneously. Careful preoperative planning is required in addition to a comprehensive understanding of the magnitude and plane of the true deformity of the bone. With precise operative technique and intraoperative assessment of correction, good results can be achieved.

Video available at:
http://links.lww.com/JOT/A800
Open Reduction Internal Fixation of a Medial Epicondyle Avulsion Fracture With Incarcerated Fragment
Authors: Ostrander James D. , O'Connell Megan , Dolch Henry J. 
Published: July 2019

Purpose:
The purpose of this video is to present a technique for open reduction and internal fixation of a displaced unstable medial epicondyle avulsion fracture.

Method:
A 13-year-old boy presented 2 days after injury at our institution after sustaining a medial epicondyle avulsion fracture with incarcerated fragment and posterolateral dislocation of the elbow after a fall off a fence. He described paresthesia in the ulnar nerve distribution and demonstrated slight weakness to intrinsic hand strength on examination. He was urgently reduced under sedation in the emergency department using the Roberts maneuver, a technique consisting of a valgus stress with forearm supination with finger and wrist extension that uses muscle forces to extract the fragment. Successful reduction of the ulna-humeral joint and extraction of the incarcerated medial epicondyle was demonstrated on CT. The patient was then taken in a nonurgent fashion to the operating room for open reduction and internal fixation of the displaced medial epicondyle fracture. Intraoperative examination after fixation demonstrated a congruent and stable elbow. A long-arm cast was then applied.

Results:
The video is 7-minute, 38-second duration in time and 461 MB in size.

Conclusions:
Although fixation of medial epicondyle avulsion fractures may be controversial, there are some indications for ORIF including incarcerated epicondylar fragment, suspected entrapment and dysfunction of the ulnar nerve, marked instability of the elbow, and open fracture. Presented in this video is a safe technique for ORIF of the displaced and unstable medial epicondyle avulsion fracture.

Video available at:
http://links.lww.com/JOT/A790
Novel 3-Dimensional Imaging Analysis of the Ryan Procedure for Inframammary Fold Elevation in the Reconstruction of the Revised Breast
Authors: Kraft Casey T. , Rendon Juan L. , Koutz Cynthia A. , Miller Michael J. 
Published: July 2019

Summary:
The inframammary fold (IMF) can be challenging to reconstruct after disruption during mastectomy or breast reconstruction. The Ryan procedure is a previously described technique with little long-term analysis. Our goal is to analyze the long-term results of the Ryan procedure using 3-dimensional (3D) technology, with the hypothesis that 3D measurements will provide quantitative outcomes that add to the qualitative assessment of the reconstruction. We retrospectively reviewed consecutive breast reconstruction patients by a single surgeon from January 1, 2012 to January 31, 2015 to identify patients who underwent the Ryan procedure. Previously obtained 3D photographs were then analyzed to compare breast base diameter, breast projection, and inter-IMF distance pre- and postoperatively. A survey was then given to 15 health professionals in our department to assess the IMF and symmetry pre- and postoperatively. Eight patients were eligible for inclusion. Four patients were unilateral reconstruction and 4 were bilateral. The Ryan procedure resulted in an inter-IMF discrepancy reduction of 39% and a breast projection increase of 18%. Average length of follow-up was 2.82 ± 0.75 years. One patient required a secondary IMF revision. The majority of survey respondents felt that the IMF and IMF symmetry were improved or stable postoperatively. The Ryan procedure seems to be a reliable and durable technique for IMF reconstruction with increased projection, decreased IMF discrepancy, and increased symmetry. Additionally, 3D imaging provides a useful approach in the assessment of breast reconstruction outcomes, adding quantitative outcomes measures to its evaluation.
A Completely Unique Branching Pattern of the Facial Artery
Authors: Nakamura Kanae , Umezawa Hiroki , Yokoshima Kazuhiko , Nakamizo Munenaga , Ogawa Rei 
Published: July 2019

Summary:
This case report describes a recent case where a patient with hypopharyngeal cancer underwent resection and reconstruction with a free jejunum flap and the surgeons found a rare variation in the branching pattern of the common carotid artery. Specifically, the left facial artery arose directly from the common carotid artery, whereas the left superior thyroid artery arose from the facial artery. This branching pattern has not been reported previously. Although this is a hitherto unique case, head and neck and reconstructive surgeons should be aware of the possibility that this branching pattern may be present because it could complicate the outcomes of both neck dissection and reconstruction by free tissue transfer.
Evaluation of Tissue-engineered Skin on Base of Human Amniotic Membrane for Wound Healing
Authors: John Samuel , Kesting Marco Rainer , Stoeckelhuber Mechthild , von Bomhard Achim 
Published: July 2019

Background:
Human amniotic membranes (hAMs) have shown promising results in recent studies aimed at improving wound healing through several mechanisms. We wanted to investigate its properties as a scaffold by adding autologous cells to treat full-thickness skin defects and hypothesized that recultivated hAM would show an even improved wound healing by accelerating the epidermal closure of the wound.

Methods:
In an air–liquid cell culture, we cultivated autologous keratinocytes and fibroblasts on the hAM until a mostly keratinized surface was achieved. These hAM, de-epithelialized hAM, native hAM with remaining allogenous cells, and negative controls were compared in the treatment of circular 30 × 30 mm2 full-thickness skin defects in 4 groups of 6 rats with one wound each. We evaluated the wound contraction every 10 days until wound closure, the macroscopic scar appearance on the Vancouver Scar Scale and the qualitative histological properties of the scar regarding morphology and continuity of the basement membrane.

Results:
Rats treated with de-epithelialized hAM showed more extent wound contraction (P < 0.001) than the other 3 groups, which did not differ significantly compared with the control group (P > 0.05). Vancouver Scar Scale showed no significantly statistical differences between the 4 groups (P = 0.46). The scar structure of all rats showed similar morphologies, the only difference being the absence of a basement membrane in the negative controls compared with the groups treated with hAM.

Conclusion:
The rats treated with hAM showed no improved wound healing but a tendency toward a more prominent basement membrane in the resulting scar.
Fat Grafting and Breast Augmentation: A Systematic Review of Primary Composite Augmentation
Authors: Salibian Ara A. , Frey Jordan D. , Bekisz Jonathan M. , Choi Mihye , Karp Nolan S. 
Published: July 2019

Background:
Fat grafting during primary breast augmentation has the ability to address the limitations of soft tissue coverage of breast implants. The purpose of this study was to evaluate the current evidence on patient selection, surgical techniques, and assessment of outcomes with composite breast augmentation.

Methods:
A systematic review of the literature was performed for studies reporting on primary composite breast augmentation. Studies were analyzed for level of evidence, surgical techniques for implant placement and fat grafting, postoperative complications, and assessment of additional outcomes.

Results:
Five studies (4 case series and 1 retrospective cohort study) were identified for review with a pooled total of 382 patients. Implants were most commonly placed in the subfascial plane (156 patients, 54.1%) followed by dual-plane placement (51 patients, 17.6%). Round (220 patients, 57.6%) and textured (314 patients, 82.2%) implants were utilized in the majority of cases. The average amount of fat grafted among all 5 studies was 109.2 ml per breast (range 55–134 ml). The most common fat grafting location was in the subcutaneous plane and over the medial breast/cleavage (80% of studies). Overall complication rates were low. The pooled reoperation rate was 3.7% with repeat fat grafting as the most common reason for reoperation (9 cases, 2.4%).

Conclusions:
Primary composite breast augmentation is a safe procedure with a trend toward subfascial implant placement and low fat grafting volumes focused on the medial breast borders. Long-term studies with analysis of additional outcome measures including patient-reported outcomes will further bolster the current evidence.
Hypocalcemia in cancer patients: An exploratory study
Authors: Ferraz Gonçalves José António , Costa Telma , Rema Joana , Pinto Cristina , Magalhães Miguel , Esperança Ana , Sousa Luciana 
Published: July 2019

Abstract

Introduction:
Calcium has several physiological functions and when it registers abnormal serum levels those functions may be impacted with potentially severe consequences. There is much research on hypercalcemia in cancer patients, but there are no recent studies on the prevalence of hypocalcemia in those patients. However, there has been an evolution in oncology, namely, new drugs that may directly or indirectly result in hypocalcemia. The primary aim was to explore the association of hypocalcemia with the diverse types of cancer. The secondary aim was to study the influence that hypocalcemia might have on survival.

Methods:
Review of the records of patients ≥18 years old, with total calcium <2.0 mmol/L measured in 2013 in a cancer center.

Results:
Eight hundred twenty-nine patients were included. Four hundred thirty-nine (53%) were male. The median age was 63 years. The most frequent cancer diagnoses were hematological 196 (24%) and colorectal 111 (13%). Six hundred thirty-eight patients had measured serum albumin, with a median of 25.5 g/L (14–47). When corrected for albumin level, calcium was in the normal range in 210 (33%) cases. The median survival of patients with corrected calcium lower than normal was 479 days (95% confidence interval [CI]: 309–649) and that of patients with normal corrected calcium was 62 days (95% CI: 33–91), P < .001. In a multivariate analysis, age, primary cancer, and albumin were significantly associated with survival.

Conclusion:
Hypocalcemia is associated with several types of cancer. A low calcium level is not by itself a factor of a poor prognosis since other factors seem to be more important.
Understanding nurse practitioner scope of practice: Regulatory, practice, and employment perspectives now and for the future
Authors: Hudspeth Randall S. , Klein Tracy A. 
Published: July 2019

ABSTRACT
The nurse practitioner (NP) role has existed for 50 years. During the past 10 years, a national effort to use NPs to the full extent of their education based on the 2008 Consensus Model for Advanced Practice Registered Nurse Regulation and the 2010 Institute of Medicine Report on the Future of Nursing continues to result in variable scopes of practice (SOP) between states. Subsequently, NPs have a lack of clarity on SOP because it relates to population foci and practice setting. Review and analysis of state-based statutes and rules with the current literature focused on NP SOP, including documents by the National Council of State Boards of Nursing, was conducted. Clarification and understanding of SOP is essential for safe practice and optimum access to care. Inconsistent SOP regulation continues to exist between states, and NPs can be in employment situations that place them in a position to possibly breech their SOP. Although practice is not setting specific, NP licensure is based on NP education and certification that is competency based within population foci, and credentialing by employers should align with these parameters. Continuing to work toward a more common NP SOP between states and achievement of full practice authority means periodic reassessment of NP education and practice models. Practice mobility is essential for continued advancement of the NP profession and increased access to care by the public.
Answering the question: Is the Doctor of Philosophy or Doctor of Nursing Practice right for me?
Authors: Hartjes Tonja M. , Lester Donna , Arasi-Ruddock Lisa , McFadden Bradley Sharon , Munro Shannon , Cowan Linda 
Published: July 2019

ABSTRACT
Over the past decade, leading health care organizations have recommended doubling the number of doctorally prepared nurses to meet the future demands of health care. In 2018, the National Organization of Nurse Practitioner Faculties committed to move all nurse practitioner degree programs to the Doctor of Nursing Practice degree by 2025. As more and more doctorally prepared nurses enter the workforce, other nurses are considering returning to school for a terminal degree. This column will review options for doctoral education in nursing and the strength, focus, and program requirements for PhD and DNP degrees.
Evaluation of PTEN and CD4+FOXP3+ T cell expressions as diagnostic and predictive factors in endometrial cancer
Authors: Xi Zeng , Jing Li , Le-Ni Kang , Zhu Lan , Ze-Wen Deng , Hui Ye , Ming-Rong Xi , Guang-Dong Liao 
Published: July 2019

Abstract
To evaluate the potential role of Pten and CD4+FOXP3+ T cells in prognosis from endometrial cancer.
Tissue samples and clinical data were collected from 200 patients with endometrial cancer and 100 control patients with benign uterine diseases. The expressions of Pten and CD4+FOXP3+ T cells were quantified by immunohistochemistry and immunofluorescence. After surgery, all patients were followed up for an average of 56.3 months. Surgical effects were evaluated based on the patients’ symptoms and signs. A two-sided P value < .05 was considered significant.
Pten diminished and CD4+FOXP3+ T cells significantly accumulated with the progression of endometial cancer, in comparison to the controls. Moreover, Pten expression was negatively correlated with the count of CD4+FOXP3+ T cells. Pten and CD4+FOXP3+ T cells were correlated with clinical characteristics, including tumor stage, differentiation and associated with patients’ disease-free survival.
Limited data were available between the expressions of Pten and CD4+FOXP3+ T cells in patients with endometrial cancer. Our study findings suggested that the expressions of Pten and CD4+FOXP3+ T cells might become possible biomarkers for the diagnosis and prediction in endometrial cancer.
Evaluation of β-endorphin concentration, mood, and pain intensity in men with idiopathic hip osteoarthritis treated with variable magnetic field
Authors: Koczy Bogdan , Stołtny Tomasz , Pasek Jarosław , Leksowska–Pawliczek Maria , Czech Szymon , Ostałowska Alina , Kasperczyk Sławomir , Białkowska Monika , Cieślar Grzegorz 
Published: July 2019

Abstract
Osteoarthritis is the most frequently diagnosed disease of the musculoskeletal system. Growing number of patients waiting for surgical treatment and the possible negative consequences resulting from long-term pharmacological therapy lead to the search for non-pharmacological methods aimed at alleviating pain and reducing doses of analgesics, among them physical therapy with use of magnetic fields.
The study involved 30 men aged 49 to 76 (mean age, 61.7 years) treated for idiopathic osteoarthritis of the hip joint. The subjects were divided into 2 groups (15 patients each) and underwent a cycle of magnetostimulation and magnetoledtherapy procedures, respectively. During the exposure cycle concentrations of β-endorphin were assessed 3 times and the mood was assessed 2 times. In addition, the assessment of pain intensity and the dose of analgesic drugs was performed before and after the end of therapy.
Statistically significant increase in plasma β-endorphins concentration was observed in both groups of patients (magnetostimulation—P < .01 vs magnetoledtherapy—P < .001). In the assessment of mood of respondents, no statistically significant differences were found. Significant reduction in intensity of perceived pain was observed in both groups of patients (P < .05). In the group of patients who underwent magnetoledtherapy cycle, the analgesic drug use was significantly lower by 13% (P < .05) as compared with initial values, which was not noted in group of patients who underwent magnetostimulation procedures.
The use of magnetic field therapy in the treatment of men with idiopathic osteoarthritis of hip joints causes a statistically significant increase in the concentration of plasma β-endorphins resulting in statistically significant analgesic effect in both magnetostimulation and magnetoledtherapy treated groups of patients, with accompanying decrease of need for analgetic drugs in magnetoledtherapy group, but without any significant changes regarding the patient's mood.
Analysis of the long non-coding RNA LINC01614 in non-small cell lung cancer
Authors: Sun Yan , Ling Chunhua 
Published: July 2019

Abstract
The aim of this study was toexplore the long non-coding RNA (lncRNA) expression pattern of non-small cell lung cancer (NSCLC) on a genome-wide scale and investigate their potential biological function in NSCLC.
LncRNAs were investigated in 6 pairs of NSCLC and matched adjacent non-tumor lung tissues (NTL) by microarray. A validation cohort was obtained from The Cancer Genome Atlas (TCGA) database and the effect of LINC01614 on diagnosis and prognosis in NSCLC was analyzed. Gene set enrichment analysis (GSEA) was used to predict the potential molecular mechanism of LINC01614, one identified lncRNA.
A total of 1392 differentially expressed lncRNAs were identified. LINC01614 was the most aberrantly expressed lncRNA in NSCLC compared with NTL. We confirmed the significantly upregulated LINC01614 in NSCLC patients from TCGA database. Furthermore, in TCGA database, LINC01614 was significantly upregulated in both adenocarcinoma and squamous cell carcinoma. And high expression of LINC01614 indicated poor overall survival of NSCLC patients. A sensitivity of 93% was calculated conditional on a high specificity of 95% for the discrimination of NSCLC tissues from normal tissues. Furthermore, the expression levels of LINC01614 were associated with the stage of tumor, but had no relationship with age and sex. Additionally, GSEA found that LINC01614 might be involved in TGF-β-, P53-, IGF-IR-mediated, Wnt and RTK/Ras/MAPK signaling pathways.
lncRNAs may play key roles in the development of NSCLC. LINC01614 is the most aberrantly expressed lncRNA in NSCLC tissues in our experiment and is also significantly differentially expressed in NSCLC patients from TCGA database. LINC01614 could be a prognostic indicator and has the potential to be a diagnostic biomarker of NSCLC.
The overall safety evaluation of programmed cell death/programmed cell death ligand 1 (PD-1/PD-L1) treatment for lung cancer patients
Authors: Shang Heli , Zhang Zewen , Feng Alei , Yang Xiaowei , Zhang Shuisheng , Zhao Yi , Zhu Qingshan , Mao Yantao , Liu Kun , Tian Yuan 
Published: July 2019

Abstract

Background:
We performed the meta-analysis to evaluate the overall safety of programmed cell death-1 (PD-1) or ligand 1 (PD-L1) inhibitor treatment for lung cancer patients.

Method:
Randomized controlled trials were collected according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Risk ratio (RR) of PD-1/PD-L1 inhibitor treatment-related death, treatment-related adverse events, any serious events, and any events leading to discontinuation were all taken into account for the final evaluation.

Results:
Fourteen studies were collected for the meta-analysis. The RR of treatment-related death for PD-1/PD-L1 was significantly lower than that of the control group (RR = 0.37, 95% confidence interval, CI: [0.21, 0.66]). Similar analysis results could also be seen for the RR of treatment-related adverse events and adverse events leading to discontinuation. When PD-1/PD-L1 was combined with chemotherapy, it increased the RR of adverse events leading to discontinuation (RR = 1.68, 95% CI: [1.22, 3.32]). The RR of overall treatment-related adverse events was lower in nivolumab (PD-1) than that of the control group (nivolumab + ipilimumab) (RR = 0.77, 95% CI: [0.65, 0.90]). Similar analysis results could also be seen in the RR of treatment-related adverse events for grade 3 to 5 and adverse events leading to discontinuation.

Conclusion:
Compared with chemotherapy, RR of the treatment-related deaths associated with PD-1/PD-L1 inhibitor was significantly lower than that of the chemotherapy group, while it did not increase the RR when they were combined with chemotherapy or other drugs. When PD-1/PD-L1 was combined with chemotherapy, it increased the RR of adverse events leading to discontinuation.