bluuebunny/crossref_metadata_2025_split huggingface dataset:
Performance of Electrical Velocimetry for Noninvasive Cardiac Output Measurements in Perioperative Patients After Subarachnoid Hemorrhage
Authors: Mutoh Tatsushi , Sasaki Kazumasu , Yamamoto Shuzo , Yasui Nobuyuki , Ishikawa Tatsuya , Taki Yasuyuki 
Published: June 2018

Background:
Fluid therapy guided by cardiac output measurements is of particular importance for adequate cerebral perfusion and oxygenation in neurosurgical patients. We examined the usefulness of a noninvasive electrical velocimetry (EV) device based on the thoracic bioimpedance method for perioperative hemodynamic monitoring in patients after aneurysmal subarachnoid hemorrhage.

Patients and Methods:
In total, 18 patients who underwent surgical clipping or endovascular coiling for ruptured aneurysms were examined prospectively. Simultaneous cardiac index (CI) measurements obtained with EV (CIEV) and reference transpulmonary thermodilution (CITPTD) were compared. A total of 223 pairs of data were collected.

Results:
A significant correlation was found between CIEV and CITPTD (r=0.86; P<0.001). Bland and Altman analysis revealed a bias between CIEV and CITPTD of −0.06 L/min/m2, with limits of agreement of ±1.14 L/min/m2 and a percentage error of 33%. Although the percentage error for overall data was higher than the acceptable limit of 30%, subgroup analysis during the postoperative phase showed better agreement (23% vs. 42% during the intraprocedure phase). Four-quadrant plot and polar plot analyses showed fair-to-poor trending abilities (concordance rate of 90% to 91%, angular bias of +17 degrees, radial limits of agreement between ±37 and ±40 degrees, and polar concordance rate of 72% to 75%), including the subgroup analysis.

Conclusions:
Absolute CI values obtained from EV and TPTD are not interchangeable with TPTD for perioperative use in subarachnoid hemorrhage patients. However, considering the moderate levels of agreement with marginal trending ability during the early postoperative phase, this user-friendly device can provide an attractive monitoring option during neurocritical care.
Is there a Correlation Between Degree of Radiologic Lumbar Spinal Stenosis and its Clinical Manifestation?
Authors: Andrasinova Tereza , Adamova Blanka , Buskova Jana , Kerkovsky Milos , Jarkovsky Jiri , Bednarik Josef 
Published: June 2018

Study Design:
This was an observational cross-sectional study.

Objective:
The purpose of this study was to evaluate whether the degree of stenosis on magnetic resonance imaging (MRI) relates to the severity of clinical symptoms, disability, or neurological deficit in patients with symptomatic central lumbar spinal stenosis (LSS).

Summary of Background Data:
The relationship between radiologic findings and the clinical manifestations of LSS remains unclear.

Materials and Methods:
A total of 84 patients (42 men, median age 70 y) with neurogenic claudication and central degenerative LSS were included in the study. The MRI parameters describing severity (anteroposterior diameter of dural sac, cross-sectional area of the dural sac, stenosis ratio, and Schizas qualitative morphologic classification were evaluated at maximum stenotic level) and the extent of stenosis (the number of central stenotic levels) were correlated to symptoms (pain intensity, walking capacity), functional disability (measured in terms of the Oswestry Disability Index), and neurological signs of LSS (neurological status was evaluated and scored by Neurological Impairment Score in LSS).

Results:
A statistically significant correlation emerged only between the Neurological Impairment Score in LSS and Schizas morphologic classification (P=0.006). Pain intensity, walking capacity, and functional disability displayed no correlation with the MRI parameters of LSS.

Conclusions:
LSS is a clinicoradiologic syndrome with complex relationships between degree of radiologic stenosis disclosed by MRI and clinical manifestations. Neurological impairment in the lower extremities reflects the degree of morphologic LSS on MRI. This study did not identify any association between the degree of stenosis and functional disability, pain intensity, or walking capacity.

Level of Evidence:
Level II.
Trichoblastic Carcinosarcoma of the Skin: A Case Report and Literature Review
Authors: Okhremchuk Ilona , Nguyen Anh Tuan , Fouet Bernard , Morand Jean-Jacques 
Published: June 2018

Abstract:
An 83-year-old man presented to the dermatology department for an ulcerated skin lesion of the back that had been increasing in size during the past 11 years. The physical examination revealed a well-defined, fleshy, reddish plaque measuring 10 × 20 cm in diameter with erosions and black areas on the surface. The patient underwent surgical excision with margins of 10 mm followed by a skin graft. Histologic section showed a lesion composed of 2 intimately intermingled epithelial and mesenchymal components associated with a basal cell carcinoma (BCC). Immunohistochemical examination showed epithelial cells that were positive for CK AE1/AE3 and p53, whereas stromal cells were positive for vimentin, CD10, and p53. BCC was positive for CD10. On the basis of these findings, a diagnosis of trichoblastic carcinosarcoma associated with BCC was made. Given the scarcity of data available in the literature regarding this diagnosis, no standard of care exists. No adjuvant treatment was provided and after 1 year of follow-up, the patient did not experience recurrence.
Dynamic Hyperinflation Impairs Cardiac Performance During Exercise in COPD
Authors: Frazão Murillo , Silva Paulo Eugênio , Frazão Wanessa , da Silva Vinícius Zacarias Maldaner , Correia Marco Aurélio de Valois , Neto Mansueto Gomes 
Published: June 2018

Purpose:
To investigate the correlation between a plateau in minute ventilation

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E during cardiopulmonary exercise tests (CPETs) and its impact on cardiac performance.

Methods:
This retrospective study analyzed 2575 CPETs of patients with chronic obstructive pulmonary disease. The study randomly selected 10 patients with a plateau in the

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E curve, suggesting dynamic hyperinflation, 10 patients with normal pattern for the

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E curve, and 10 healthy persons. Classic CPET variables, the new ventilation hyperinflation index, and the dynamic cardiac constraint index were analyzed.

Results:
The patients with dynamic hyperinflation presented with lower ventilation at 100% work rate (P < .0001), without significant differences in

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E at 50% and 100% work rate. Patients with dynamic hyperinflation also presented with a lower oxygen pulse (O2 pulse) at 100% (P < .0001), without significant difference in O2 pulse at 50% and 100% work rate. The subjects with dynamic hyperinflation had a higher ventilation hyperinflation index (P < .0001) and dynamic cardiac constraints index (P < .0001). The ventilation hyperinflation index correlated with the dynamic cardiac constraints index (r = 0.81, P < .0001); oxygen pulse variation (r =−0.63, P < .001);

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E/

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co
2 slope (r =−0.57, P < .01); work rate (r =−0.86, P < .0001);

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o
2 (r =−0.80, P < .0001), and

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E (r =−0.83, P < .0001).

Conclusion:
There is a correlation between a plateau in the

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E during CPET, suggesting hyperinflation, and it has an impact on cardiac performance.
Selenium in Graves Hyperthyroidism and Orbitopathy
Authors: Marinò Michele , Menconi Francesca , Rotondo Dottore Giovanna , Leo Marenza , Marcocci Claudio 
Published: June 2018

Purpose:
To review the in vitro and in vivo studies supporting a role of selenium for the treatment of mild Graves orbitopathy.

Methods:
Review of the current literature on the role of selenium in the management of Graves orbitopathy.

Results:
Graves orbitopathy (GO) is a disfiguring and disabling disorder usually observed in patients with Graves hyperthyroidism, and more rarely in patients with hypothyroid autoimmune thyroiditis or in the absence of overt thyroid dysfunction. Noninvasive treatments include intravenous glucocorticoids and orbital radiotherapy and are generally offered to patients with moderately severe GO. In contrast, patients with mild GO are generally treated only with local measures. Thus, the benefits of intravenous glucocorticoids in mild GO are limited and do not justify the risks that the treatment carries. However, a medical treatment for mild GO is heavily wanted, as a relevant proportion of patients have a significant decrease in their quality of life, and GO can progress into more severe forms. Because of the role of oxidative stress in the pathogenesis of GO, an antioxidant approach has been proposed and the antioxidant agent selenium has been shown to be effective for GO.

Conclusion:
Studies have shown that a 6-month course of sodium selenite can improve the course of mild GO and prevent deterioration when compared with placebo.
Screening of hepatitis C virus infection in adult general population in Spain
Authors: Viejo Laura Gómez-Escolar , Herola Antonio García , Lloret Isabel Sáez , Ruano Fernando Sánchez , Paulino Inmaculada Clemente , Ivorra Cristina Quílez , Saavedra Isabel Almenta , Pérez David Martínez , de la Osa Jaime Valverde 
Published: June 2018

Purpose
The aim was to estimate seroprevalence and prevalence of hepatitis C virus (HCV) infection in a small health area of the Valencian Community, Spain.

Patients and methods
This is a descriptive cross-sectional study aimed at estimation of HCV infection prevalence in the whole adult population (25–70 years old), that is, a pilot study for an eventual population-based screening program.

Results
A total of 5849 participants aged 25–70 years (51% male) were invited to participate by regular mail. Overall, 143 letters were returned owing to errors in the addresses. Of 5706 participants, 2637 (46.2%) participated in the study. Rapid test of anti-HCV antibody detection was positive in 30 cases (HCV seroprevalence 1.14%, 95% confidence intervals: 0.73–1.55%). Of those, seven were not aware of their condition. Participants who had a positive result in the rapid test of anti-HCV detection were given a confirmatory test by enzyme immune assay, and all had a positive result. RNA-HCV determination by quantitative PCR in positive anti-HCV patients showed positive viremia in 13 (43.3%) cases, of which five were not aware of the disease. Of the 17 patients who had negative viremia, two were unaware of their HCV status, one was a carrier of anti-HCV and was already aware of his condition, and 14 had been previously treated with satisfactory results. Regarding fibrosis, of the seven patients who were unaware of HCV infection, none of them had significant fibrosis. Moreover, 26 (86.7%) anti-HCV positive patients were reported to have one or more risk factors for HCV infection.

Conclusion
HCV screening strategies applied to the general population are good means to diagnose and treat patients who are not aware of their infection, avoiding new transmissions as well as disease progression.
Quality-adjusted Life Years (QALY) for 15 Chronic Conditions and Combinations of Conditions Among US Adults Aged 65 and Older
Authors: Jia Haomiao , Lubetkin Erica I. , Barile John P. , Horner-Johnson Willi , DeMichele Kimberly , Stark Debra S. , Zack Matthew M. , Thompson William W. 
Published: June 2018

Background:
Although the life expectancy for the US population has increased, a high proportion of this population has lived with ≥1 chronic conditions. We have quantified the burden of disease associated with 15 chronic conditions and combinations of conditions by estimating quality-adjusted life years (QALYs) for older US adults.

Research Design:
Data were from the Medicare Health Outcomes Survey Cohort 15 (baseline survey in 2012, follow-up survey 2014, with mortality follow-up through January 31, 2015). We included individuals aged 65 years and older (n=96,481). We estimated mean QALY throughout the remainder of the lifetime according to the occurrence of these conditions.

Results:
The age-adjusted QALY was 5.8 years for men and 7.8 years for women. Over 90% respondents reported at least 1 condition and 72% reported multiple conditions. Respondents with depression and congestive heart failure had the lowest age-adjusted QALY (1.1–1.5 y for men and 1.5–2.2 y for women), whereas those with hypertension, arthritis, and sciatica had higher QALY (4.2–5.4 and 6.4–7.2 y, respectively). Having either depression or congestive heart failure and any 1 or 2 of the other 13 conditions was associated with the lowest QALY among the possible dyads and triads of chronic conditions. Dyads and triads with hypertension or arthritis were more prevalent, but had higher QALY.

Conclusions:
Understanding the burden of disease for common chronic conditions and for combinations of these conditions is useful for delivering high-quality primary care that could be tailored for individuals with combinations of chronic conditions.
Development of a Prehabilitation Multimodal Supportive Care Interventions for Men and Their Partners Before Radical Prostatectomy for Localized Prostate Cancer
Authors: Paterson Catherine , Primeau Charlotte , Pullar Irene , Nabi Ghulam 
Published: June 2018

Background
An important question revolves around when the most opportune time is to introduce recovery-optimizing behaviors for men opting for radical prostatectomy (RP) for localized prostate cancer (PCa). An emerging field of research describes the role of preoperative strategies to improve treatment tolerance and overall physical and psychological recovery.

Objective
The aim of this study was to explore the perceptions of a multimodal prehabilitation intervention for men and their partners before RP for localized PCa.

Methods
Thirty-four patients who opted for RP for localized PCa and their partners (19) were identified and recruited into the study. The multimodal intervention was composed of educational materials, physiotherapy instruction, and a self-management group-based seminar.

Results
The multimodal prehabilitation intervention was perceived as overall helpful with demonstrated acceptability (91.9%). Beneficial themes related to the quality of the information provided to support self-management, open forum questions with multidisciplinary healthcare professionals, and increased knowledge among partners to help with their understanding of how to look after their partners.

Conclusion
The intervention was feasible and beneficial for the PCa dyad. A future pilot randomized controlled trial study is needed to provide sufficient evidence on the long-term physical and psychological outcomes and cost-effectiveness.

Implications for Practice
Oncology nurses play a key role in the development of prehabilitation care delivery. Prehabilitation interventions can have a positive effect on improving health outcomes for cancer patients and their partners after surgery and into survivorship.
Managing Cancer Experiences
Authors: Haase Kristen R. , Gifford Wendy , Holtslander Lorraine , Thomas Roanne 
Published: June 2018

Background
People with cancer increasingly use the Internet to find information about their illness. However, little is known regarding people’s use of cancer-related Internet information (CRII) to manage their patient experience, defined as patients’ cumulative perceptions of interactions with the healthcare system during their illness.

Objective
The purpose of this study was to create an understanding of CRII use by people newly diagnosed with cancer and how it shapes their patient experience and informs their interactions with healthcare professionals and healthcare services.

Methods
An embedded mixed design guided this study. Nineteen people with cancer were interviewed twice and completed a survey about CRII use. Qualitative data were analyzed using thematic analysis. Descriptive statistics summarized the quantitative findings.

Results
Participants of all ages and educational levels reported using CRII as a pivotal resource, across the cancer trajectory. Cancer-related Internet information played a central role in how patients understood their illness and when they sought and used healthcare services. Two themes emerged based on patient interviews: (1) person in context and (2) management of information.

Conclusion
Cancer-related Internet information plays a crucial role in how people manage their illness and take control of their patient experience. Participants used CRII to learn about their illness, support their efforts to self-manage, and complement information from professionals.

Implications for Practice
Individuals and institutions can promote and encourage tailored CRII use by engaging patients and suggesting websites based on their needs. Doing so may create efficiencies in service use and empower patients to be more involved in their own care.
Preterm Premature Rupture of Membranes: A Review of 3 National Guidelines
Authors: Tsakiridis Ioannis , Mamopoulos Apostolos , Chalkia-Prapa Eleni-Markella , Athanasiadis Apostolos , Dagklis Themistoklis 
Published: June 2018

Importance
Preterm premature rupture of membranes (PPROM) is a major cause of perinatal mortality and morbidity.

Objective
The aim of this study was to compare recommendations from published national guidelines for pregnancies complicated with PPROM.

Evidence Acquisition
A descriptive review of 3 national guidelines on PPROM was performed: the Royal College of Obstetricians and Gynaecologists on “Preterm Prelabour Rupture of Membranes,” the American College of Obstetricians and Gynecologists on “Premature Rupture of Membranes,” and the Society of Obstetricians and Gynaecologists of Canada on “Antibiotic Therapy in Preterm Premature Rupture of the Membranes.” Guidelines were compared in the diagnosis and management of PPROM. Recommendations and strength of evidence were reviewed based on each guideline's method of reporting. The references were compared with regard to their total number, total number of randomized controlled trials, Cochrane reviews, and systematic reviews/meta-analyses cited.

Results
The variations stated on the guidelines reflect the heterogeneity of the literature contributing to the guidelines and challenges of diagnosing and managing cases of PPROM.

Conclusions
An improved international guideline may improve safety and outcomes in pregnant women with PPROM.

Target Audience
Obstetricians and gynecologists, family physicians.

Learning Objectives
After completing this activity, the learner should be better able to assess the aspects on diagnosis of preterm premature rupture of membranes, analyze the available regimens for the management of cases with preterm premature rupture of membranes, and identify the appropriate time of delivery in cases of preterm premature rupture of membranes.
Parity Associated With Telomere Length Among US Reproductive Age Women
Authors: Pollack A. Z. , Rivers K. , Ahrens K. A. 
Published: June 2018

(Abstracted from Human Reprod 2018;33:736–744)
Shorter telomeres have been associated with aging, parity, and multiple chronic diseases. A number of studies have reported that women with shorter telomeres are at increased risk of breast, ovarian, and uterine cancer; type 2 diabetes; cardiovascular disease; and atherosclerosis, as well as socio-environmental characteristics and stress.
Within Country Inequalities in Cesarean Section Rates: Observational Study of 72 Low and Middle Income Countries
Authors: Boatin Adeline Adwoa , Schlotheuber Anne , Betran Ana Pilar , Moller Ann-Beth , Barros Aluisio J. D. , Boerma Ties , Torloni Maria Regina , Victora Cesar G. , Hosseinpoor Ahmad Reza 
Published: June 2018

(Abstracted from BMJ 2018;360:k55)
Access to cesarean delivery is an essential procedure for population-level obstetrical care. However, excessively high levels of cesarean often represent non–medically-indicated use, which may result in adverse events and exceed the risk of vaginal deliveries.
Risk of Stillbirth, Preterm Delivery, and Fetal Growth Restriction Following Exposure in a Previous Birth: Systematic Review and Meta-analysis
Authors: Malacova E. , Regan A. , Nassar N. , Raynes-Greenow C. , Leonard H. , Srinivasjois R. , Shand A. W. , Lavin T. , Pereira G. 
Published: June 2018

(Abstracted from BJOG 2018;125:183–192)
The leading cause of infant morbidity and mortality are stillbirth, preterm birth (PTB), and small for gestational age (SGA), which can occur as a result of fetal growth restriction (FGR). Contemporary literature shows a significant increase in the risk of stillbirth, PTB, or SGA after its presentation in a prior pregnancy.
Paroxysmal Sympathetic Hyperactivity and Clinical Considerations for Patients With Acquired Brain Injuries
Authors: Thomas Alphonsa , Greenwald Brian D. 
Published: June 2018

Abstract
The term “storming” has often been used colloquially to characterize patients with brain injury who showed signs and symptoms of elevated heart rate, blood pressure, respiratory rate, temperature, and motor posturing. Recently, the term paroxysmal sympathetic hyperactivity has been used as the unifying term to describe these acute episodes of elevated sympathetic hyperactivity. Various pharmaceutical and management options are available, but no single drug or protocol has been deemed superior to the others. Data on prognosis and recovery in relation to paroxysmal sympathetic hyperactivity are limited but point toward poorer functional outcome and increased mortality. Overall, the phenomenon of paroxysmal sympathetic hyperactivity requires further research to aid rehabilitative efforts so that patients can effectively participate in therapy. A review of the literature has revealed sparse information on the management of sympathetic storming within rehabilitation facilities. This narrative review seeks to provide an up-to-date synopsis and recommendations on the management of rehabilitation inpatients with paroxysmal sympathetic hyperactivity.