bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hematoma and Abscess After Neuraxial Anesthesia: A Review of 647 Cases
Authors: Bos E.M.E. , Haumann J. , de Quelerij M. , Vandertop W.P. , Kalkman C.J. , Hollmann M.W. , Lirk P. 
Published: May 2019

(Br J Anaesth. 2018;120:693–704)
Incidences of spinal hematoma or abscess after central neuraxial block (CNB) are estimated to be low, with the former being 1:154,730 and the latter being so rare, it could not even be calculated in a major 2016 study. Because of the rarity, there is no evidence on which to base recommendations for management strategies. However, these adverse events could result in permanent injury for patients, with the incidence of paraplegia or death being 1.8 per 100,000 patients. Therefore, the authors of the present study reviewed all cases reported regarding spinal hematomas or abscesses after CNB, identified potential factors that may predispose patients to these adverse outcomes, and predicted persistent neurological damage.
Can Oxytocin Augmentation Modify the Risk of Epidural Analgesia by Maternal Age in Cesarean Sections?
Authors: Rossen J. , Klungsøyr K. , Albrechtsen S. , Løkkegård E. , Rasmussen S. , Bergholt T. , Skjeldestad F.E. 
Published: May 2019

(Acta Obstet Gynecol Scand. 2018;97:872–879)
Oxytocin augmentation of labor is often used in the setting of labor dystocia to increase the likelihood of vaginal delivery, and therefore avoid cesarean section. Increasing maternal age is an established risk factor for cesarean section. Oxytocin augmentation has been found to occur more frequently among women receiving epidural analgesia, and the authors of this study proposed associations may exist among epidural analgesia, oxytocin augmentation, and maternal age and the correlation with cesarean section. This study examined the effects and interactions of oxytocin augmentation, epidural analgesia and maternal age on the risk of cesarean section in nulliparous women.
Maternal Body Mass Index and Use of Labor Neuraxial Analgesia: Population-based Retrospective Cohort Study
Authors: Butwick A.J. , Wong C.A. , Guo N. 
Published: May 2019

(Anesthesiology. 2018;129:448–458)
Maternal obesity is a risk factor for many pregnancy and peripartum complications, and affects one in 4 deliveries in the United States. Neuraxial labor analgesia may offer important benefits to obese women, such as attenuate sympathetically mediated cardiovascular responses and optimize maternal respiratory function. However, the extent to which obese women receive neuraxial labor analgesia is unknown. This study hypothesized that, compared with nonobese parturients, maternal obesity was associated with a higher rate of neuraxial labor analgesia, and aimed to estimate the difference in analgesia rates between the 2 groups.
Antidepressant Use During Pregnancy and the Risk of Attention-deficit/Hyperactivity Disorder in the Children: A Meta-Analysis of Cohort Studies
Authors: Jiang H.Y. , Peng C.T. , Zhang X. , Ruan B. 
Published: May 2019

(BJOG. 2018;125(9):1077–1084)
Approximately 10% of pregnant women use antidepressants during pregnancy. Evidence for the relationship between antidepressant use during pregnancy and the risk of attention-deficit/hyperactivity disorder (ADHD) in their offspring is conflicting. ADHD is heritable yet there are environmental factors that may be involved in the development of the disorder. This was a systematic literature review and meta-analysis to assess the association between fetal exposure to antidepressant drugs and the subsequent development of ADHD.
The Incidence, Characteristics, Management, and Outcomes of Anaphylaxis in Pregnancy: A Population-based Descriptive Study
Authors: McCall S.J. , Bunch K.J. , Brocklehurst P. , D’Arcy R. , Hinshaw K. , Kurinczuk J.J. , Lucas D.N. , Stenson B. , Tuffnell D.J. , Knight M. 
Published: May 2019

(BJOG. 2018;125:965–971)
Anaphylaxis in pregnancy is characterized by life-threatening breathing, circulatory or airway problems stemming from a systemic hypersensitivity reaction, often caused by exposure to allergens including antibiotics or latex. The incidence of anaphylaxis in pregnancy is unknown but thought to be rising. There is a lack of guidelines for the management of anaphylaxis in pregnancy. This study aimed to describe the incidence, characteristics, management and outcomes of anaphylaxis in pregnancy in the United Kingdom.
Trends in Practice and Safety Measures of Epidural Analgesia: Report of a National Survey
Authors: Bos E.M.E. , Schut M.E. , de Quelerij M. , Kalkman C.J. , Hollmann M.W. , Lirk P. 
Published: May 2019

(Acta Anaesthesiol Scand. 2018;62:1466–1472)
There is a trend to move away from neuraxial blocks in favor of truncal blocks, peripheral nerve blocks, and local anesthetic wound infiltration in the Netherlands. Furthermore, recent epidural “alert systems” have been introduced, meant to aid in the early detection of spinal hematoma or abscess after neuraxial anesthesia. However, these changes have not been investigated on a national level. The authors of the present study thus quantified trends in the practice of epidural analgesia and assessed the extent to which these epidural alert systems have been introduced in clinical practice.
Trainability of Cricoid Pressure Force Application: A Simulation-based Study
Authors: Noll E. , Shodhan S. , Varshney A. , Gallagher C. , Diemunsch P. , Florence F.B. , Romeiser J. , Bennett-Guerrero E. 
Published: May 2019

(Anesth Analg. 2019;128:109–116)
Cricoid pressure (CP) force has been suggested as a protective means of preventing aspiration of gastric contents during anesthesia. It is widely used for rapid sequence intubation (RSI). Current national guidelines recommend the use of 10 N when the patient is awake, increasing to 30 N once the patient loses consciousness (LOC). However, studies have shown that few clinicians are proficient at achieving such targets, and individual learning curves during simulation training have not been studied. In the present study, the authors determined the extent to which experienced clinicians accurately apply force targets and established individual learning curves during training on a CP simulator.
Vitamin D and Risk of Pregnancy-related Hypertensive Disorders: Mendelian Randomization Study
Authors: Magnus M.C. , Miliku K. , Bauer A. , Engel S.M. , Felix J.F. , Jaddoe V.W.V. , Lawlor D.A. , London S.J. , Magnus P. , McGinnis R. , Nystad W. , Page C.M. , Rivadeneira F. , Stene L.C. , Tapia G. , Williams N. , Bonilla C. , Fraser A. 
Published: May 2019

(BMJ. 2018;361:k2477)
Pregnant women commonly have low vitamin D levels, and this might be a causal factor in the development of gestational hypertension and preeclampsia. Previous meta-analyses have suggested an association between a low 25-hydroxyvitamin D concentration and an increased risk of preeclampsia, but these results may be biased. One recent meta-analysis did not find strong evidence that vitamin D supplementation during pregnancy had a protective effect in preventing preeclampsia or gestational hypertension. This current study used mendelian randomization to triangulate findings from studies varying in design and investigate the causal effect of 25-hydroxyvitamin D levels on pregnancy-related hypertensive disorders.
Subsequent Reproductive Outcome Among Women With Peripartum Cardiomyopathy: A Nationwide Study
Authors: Guldbrandt Hauge M. , Johansen M. , Vejlstrup N. , Gustafsson F. , Damm P. , Ersbøll A.S. 
Published: May 2019

(BJOG. 2018;125:1018–1025)
Peripartum cardiomyopathy (PPCM) is a condition characterized by idiopathic heart failure late in pregnancy or within 6 months postpartum. It is diagnosed when no other identifiable cause of heart failture is identified and left ventricular systolic function is impaired with left ventricular ejection fraction (LVEF) of 45% of lower. Women who have developed PPCM must receive counseling on potential risks in subsequent pregnancies, but there are not clear guidelines or literature on reproductive outcomes after PPCM. Previous studies reported increased relapse rates if LVEF was still impaired. This study used a Danish cohort of women to investigate perinatal outcomes in women with prior PPCM.
Cesarean Scar Pregnancy, Incidence, and Recurrence: Five-Year Experience at a Single Tertiary Care Referral Center
Authors: Grechukhina O. , Deshmukh U. , Fan L. , Kohari K. , Abdel-Razeq S. , Bahtiyar M.O. , Sfakianaki A.K. 
Published: May 2019

(Obstet Gynecol. 2018;132:1285–1295)
Cesarean scar pregnancy, in which a gestational sac implants on the site of a previous hysterotomy, is associated with life-threatening complications. Although numerous treatment modalities have been described (expectant management, methotrexate, intrauterine balloon compression, resection, and more), data on optimal treatment modalities, pregnancy outcomes, treatment decisions, and patient counseling are limited. In order to add to the available literature, the authors of the present study described the treatment and follow-up of women with cesarean scar pregnancy at Yale-New Haven Hospital, a tertiary care center, from 2013 to 2018.
Anesthetic Management for Caesarean Delivery in Patient With Uncorrected Pulmonary Atresia, Ventricular Septal Defect, and Major Aortopulmonary Collateral Arteries
Authors: Gang S.P. , Fang K.Y. , Ma Y. , Zhang F.X. , Xiang D.K. , Liu X.L. , Wang R.P. , Chen D.D. , Ma X.W. 
Published: May 2019

(Int J Obstet Anesth. 2018;36:125–129)
Pulmonary atresia with ventricular septal defect and major aortopulmonary arteries (PA/VSD/MAPCAs) is a rare cyanotic cardiac malformation that is associated with a high mortality rate. In this condition, there is no pulmonary valve, and the pulmonary vascular bed is supplied by aortopulmonary collateral arteries. The management of anesthesia for cesarean delivery in a woman with this uncorrected congenital heart defect is challenging. It is essential that a management plan is developed before the patient presenting in labor. This report detailed the anesthetic management of a 24-year-old primigravid woman with PA/VSD/MAPCAs.
Quantification of Postoperative Posterior Malleolar Fragment Reduction Using 3-Dimensional Computed Tomography (Q3DCT) Determines Outcome in a Prospective Pilot Study of Patients With Rotational Type Ankle Fractures
Authors: Meijer Diederik T. , de Muinck Keizer Robert-Jan O. , Stufkens Sjoerd A. S. , Schepers Tim , Sierevelt Inger N. , Kerkhoffs Gino M. M. J. , Goslings J. Carel , Doornberg Job N. 
Published: May 2019

Objective:
To correlate Q3DCT measurements of residual step-off, gap, and 3D multidirectional displacement of postoperative posterior malleolar fracture fragment reduction in patients with rotational type ankle fractures, with patients' clinical outcome using standardized patient- and physician-based outcome measures.

Design:
Prospective cohort study.

Setting:
Level-I Trauma Center.

Patients:
Thirty-one patients with ankle fractures including a posterior malleolar fracture (OTA/AO type 44) were included.

Intervention:
All patients underwent open reduction internal fixation of their ankle fracture, of which 18 patients (58%) had direct fixation of the posterior malleolar fragment. Decision of (direct) fixation of the posterior malleolar fragment was not standardized and guided by surgeons' preference.

Main Outcome Measurements:
Quality of postoperative reduction was quantified using Q3DCT: posterior fragment size (% of joint surface), residual step-off (mm), postoperative gaps (mm2), and overall multidirectional displacement were quantified. Foot and Ankle Outcome Score pain and symptoms subscales and quality of life (Short Form-36) at 1 year postoperatively were included as the main outcome measures.

Results:
Step-off (mean 0.6 mm, range 0.0–2.7, SD 0.8) showed a significant correlation with worse Foot and Ankle Outcome Score pain and symptoms subscales. Residual fracture gap (mean 12.6 mm2, range 0.0–68.8, SD 19.5) and 3D multidirectional displacement (mean 0.96 mm, range 0.0–2.8, SD 0.8) showed no correlation.

Conclusions:
In patients with rotational type ankle fractures involving a posterior malleolar fracture, contemporary Q3DCT measurements of posterior fragment size and residual intra-articular step-off—but not gap—show significant correlation with patient-reported pain and symptoms.

Level of Evidence:
Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
Life cycle assessment as decision support tool for environmental management in hospitals: A literature review
Authors: Seifert Christin , Koep Lisa , Wolf Patrick , Guenther Edeltraud 
Published: May 2019

Background
Life cycle assessment (LCA) is an environmental accounting tool aimed at determining environmental impacts of products, processes, or organizational activities over the entire life cycle. Although this technique already provides decision-makers in other sectors with valuable information, its application in the health care setting has not yet been examined.

Purpose
The aim of this study was to provide a comprehensive overview of scientific research on the application of LCA in hospitals and its contribution to management decision-making.

Method
We perform a systematic literature review by searching a range of databases with synonyms of “LCA” in combination with the term “hospital” in order to identify peer-reviewed studies. The final sample of 43 studies were then subjected to a content analysis.

Results
We categorize existing research and show that single and multi-indicator LCA approaches are used to examine several products and processes in hospitals. The various approaches are favored by different scientific communities. Whereas researchers from environmental sciences perform complex multi-indicator LCA studies, researchers from health care sciences focus on footprints. The studies compare alternatives and identify environmental impacts and harmful hotspots.

Practice Implications
LCA results can support health care managers’ traditional decision-making by providing environmental information. With this additional information regarding the environmental impacts of products and processes, managers can implement organizational changes to improve their environmental performance. Furthermore, they can influence upstream and downstream activities. However, we recommend more transdisciplinary cooperation for LCA studies and to place more focus on actionable recommendations when publishing the results.
Transposition Upper Blepharoplasty With Orbital Retaining Ligament Release
Authors: Huggins Alison , Somogyi Marie , Nakra Tanuj 
Published: May 2019

Purpose:
Volume restoration is an important component of aesthetic facial rejuvenation, particularly in the brow and upper eyelid regions. In this study, the authors describe transposition of the central, preaponeurotic fat pad in the sub-brow preperiosteal plane with full release of the brow during upper blepharoplasty.

Methods:
A retrospective review including all patients who underwent transposition of the upper eyelid central, preaponeurotic fat pad at the time of upper blepharoplasty. Patients with simultaneous brow lifting surgeries were excluded. The surgical technique involved placement of the preaponeurotic fat pad pedicle in the sub-brow space after full brow release for augmentation of sub-brow volume after performing upper blepharoplasty.

Results:
Nineteen patients (n = 36 eyelids) were identified who underwent this transposition upper blepharoplasty technique. No complications or adverse events related to this procedure were observed. All patients were satisfied with their outcome.

Conclusions:
Transposition upper blepharoplasty with complete brow release is a safe, effective adjunct to blepharoplasty for upper eyelid and periorbital rejuvenation.
Gender differences in nurse practitioners: job satisfaction and patterns of care
Authors: Bumbach Michael D. , Harman Jeffrey S. , Lucero Robert , Cimiotti Jeannie P. , Felber Neff Donna 
Published: May 2019

ABSTRACT

Background:
Although workforce diversity has been cited as an important workforce issue, the contemporary U.S. nurse practitioner (NP) workforce is dominated by females. Provider diversity, specifically gender, has been found to directly influence patient preference. However, lack of gender diversity in the NP workforce has never been specifically evaluated in terms of job satisfaction and patterns of care.

Purpose:
The purpose of this study was to assess and evaluate NP gender, job satisfaction and practice patterns of care for U.S. clinical NPs.

Methods:
This study used the 2012 National Sample Survey of Nurse Practitioners (NSSNP). Participants meeting inclusion criteria totaled 8,978 NPs, of which 92.8% were female.

Results:
Although overall job satisfaction was not shown to be significantly different between genders, several patterns of care were found to be significant. Of the 11 measured patterns of care in the NSSNP, six were significantly different between genders, with a female majority indicating that they performed these services most often. In only one rendered service, performed medical procedures, did male NPs indicate that they did more than females.

Implications for practice:
This study suggests the importance of a gender-diversified U.S. nurse practitioner workforce. This is indicated by differences highlighted in patterns of care by NP gender, which has been postulated to influence patient outcomes, including perceived quality of care and engagement in the health care process. Patient preferences for same-gender NPs, particularly patients with privacy issues, warrant further exploration.
Venoarterial extracorporeal membrane oxygenation in cardiogenic shock: indications, mode of operation, and current evidence
Authors: Pineton de Chambrun Marc , Bréchot Nicolas , Combes Alain 
Published: May 2019

Purpose of review
Temporary circulatory support (TCS) with venoarterial extracorporeal membrane oxygenation (VA-ECMO) is increasingly used as a salvage therapy for patients with refractory cardiogenic shock. This article provides an overview of VA-ECMO principles, indications, management, complications, and discusses the results of recent case series and trials.

Recent findings
VA-ECMO is utilized as a bridge to ‘decision’ that includes weaning after cardiac function recovery, transplantation, long-term mechanical circulatory support, and withdrawal in case of futility. VA-ECMO is considered the first-line TCS as it allows rapid improvement in oxygenation, is less expensive, and is also suitable for patients with biventricular failure. Combining Impella (Abiomed, Danvers, MA, USA) or intra-aortic balloon pump support with VA-ECMO might decrease left ventricular pressure and improve outcomes. Massive pulmonary embolism, sepsis-associated cardiomyopathy, and refractory cardiac arrest are among emerging indications for TCS.

Summary
TCS have become the cornerstone of the management of patients with cardiogenic shock, although the evidence supporting their efficacy is limited. VA-ECMO is considered the first-line option, with a growing number of accepted and emerging indications. Randomized clinical trials are now needed to determine the place VA-ECMO in cardiogenic shock treatment strategies.
Why do parents present to the Paediatric Emergency Department with conditions suitable for management in less acute settings? A qualitative study
Authors: McLauchlan Kirsty , Ramlakhan Shammi , Irving Andy 
Published: May 2019

Objective:
To determine the factors influencing attendance at a Paediatric Emergency Department with conditions suitable for management in less acute settings.

Methods:
Semi-structured interviews exploring parental decision-making processes surrounding care-seeking behaviours in urgent situations were undertaken with parents of children allocated to the two lowest triage categories at a type-1 urban Paediatric Emergency Department over two 2-week periods.

Results:
All parents expressed a desire to access care from the most appropriate service for their child in unscheduled situations. A number of factors influenced parental perceptions of appropriateness: (1) perceptions concerning the urgency or severity of a condition; (2) uncertainty regarding their assessment of the severity or urgency of a problem; (3) the possibility that a condition may require resources available solely at the Paediatric Emergency Department; and (4) awareness of alternative services. Parents reported that previous utilisation of alternative services, which lead to them being referred onwards to the Paediatric Emergency Department, influenced their decision to attend the Paediatric Emergency Department on this occasion.

Conclusion:
Parental uncertainty and a low tolerance of risk among parents and healthcare professionals increases the likelihood of emergency department attendance. Parents are likely to continue to utilise the Paediatric Emergency Department for minor conditions. Future strategies should focus on improving outcomes for children with non-urgent problems who access care at the emergency department rather than discouraging utilisation.
Clostridioides difficile in transplant patients: early diagnosis, treatment, and prevention
Authors: Revolinski Sara L. , Munoz-Price L. Silva 
Published: May 2019

Purpose of review

Clostridioides difficile infection is common in solid organ transplant and hematopoietic stem-cell transplant recipients and is associated with significant morbidity and mortality. These populations are also underrepresented in clinical trials, making optimal management difficult. Because of this, management of these populations follows national guideline recommendations. This review aims to summarize the recent relevant literature pertaining to the clinical management of C. difficile infection in transplant patients, with a particular focus on diagnosis, treatment, and prevention.

Recent findings
Early diagnosis of C. difficile colonization may mitigate both horizontal and vertical transmission (progression from colonization to colitis) of infection. Once diagnosed, recent literature suggests antibiotic treatment should align with that recommended by national guidelines. Fecal microbiota transplant is an emerging therapy for recurrent C. difficile infection, and recent data have demonstrated safety and efficacy. Prevention strategies including antimicrobial stewardship, probiotic administration, antibiotic administration, and bezlotoxumab may be beneficial in transplant populations, but more data are needed to confirm recent findings.

Summary
Studies evaluating C. difficile infection in transplant patients are only recently starting to emerge. Further research is needed to identify optimal treatment and prevention strategies, and to examine novel strategies such as microbiome manipulation.