bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relationship Between Types of Social Support, Coping Strategies, and Psychological Distress in Individuals Living With Congenital Heart Disease
Authors: Kim Mi-Yeon , Johnson Joy L. , Sawatzky Richard 
Published: October 2018

Background:
Many people with congenital heart disease (CHD) experience psychological distress related to medical complications and psychosocial issues related to the disease. Although studies show that social support and coping strategies are closely associated with psychological distress in people struggling with different chronic health challenges, very little is known about whether the same factors hold true for the psychological distress of people living with CHD.

Objective:
The purpose of this study was to examine the relationships between types of social support, coping strategies, and psychological distress for individuals living with CHD.

Design:
A cross-sectional survey design with self-report questionnaires was used.

Method:
A convenience sample of 272 participants was obtained from the Adult Congenital Heart Disease program at a tertiary care hospital in Western Canada. Structural equation modeling was conducted to examine hypothesized relationships among study variables.

Results:
Perceived social support was directly related to both anxiety and depression. Received social support influenced anxiety and depression, but its effect was through perceived social support. Wishful-thinking coping strategies mediated the relationships between perceived social support and both anxiety and depression.

Conclusion:
Individuals with CHD who have low perceived and received social support are vulnerable to experiences of psychological distress. Assessments of social support and facilitation of positive coping strategies are integral to nursing care for adults with CHD.
Development of a Multistep Hypertension Quality Improvement Program in an Academic General Medicine Practice
Authors: Bui-Duy Mai-Khanh , Wong Shirley , Lam Rosemary , Karliner Leah S. 
Published: October 2018

ABSTRACT
Hypertension is a common problem and a major risk factor for cardiovascular disease. It is unclear whether efforts to control blood pressure (BP) known to be effective in integrated healthcare systems can be successfully implemented in an academic setting. We describe our experience implementing a multistep quality improvement program within an academic general medicine practice aimed at improving BP among patients with uncontrolled hypertension. Ensuring medical assistants were correctly measuring BP provided the basis for accurate data entry into the electronic medical record (EMR); our EMR-based registry data allowed us to feedback primary care provider (PCP) level data on BP control for panel management, which resulted in improvements in BP for a substantial proportion of patients, particularly for those with more practice visits. However, due to PCP, patient, and system barriers, our initial attempt to integrate a pharmacist into our team for hypertension management was only successful for a small number of patients who engaged in pharmacist in-person visits. Future improvement efforts will focus on addressing the barriers to more intensive BP management, integrating lessons from this experience. As chronic disease management shifts to a population-based model, team change will be a necessary component for achieving clinical improvement.
Can a Chronic BPPV With a History of Trauma be the Trigger of Symptoms in Vestibular Migraine, Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), and Whiplash Associated Disorders (WAD)? A Retrospective Cohort Study
Authors: Tjell Carsten , Iglebekk Wenche , Borenstein Peter 
Published: October 2018

Background:
In patients with chronic benign paroxysmal positional vertigo (BPPV), i.e., chronic vestibular multicanalicular canalithiasis (CVMCC), abnormal signals are transmitted from diseased labyrinths via the healthy vestibular nuclei complex to their end organs. The vestibulo-thalamo-cortical reflex as proposed in vestibular migraine is just one of these reflexes. In a group of patients diagnosed with CVMCC otolith repositioning maneuvers specific for each semicircular canal (SCC) ameliorated pain and other symptoms in 90%. Increased awareness of CVMCC may reduce suffering and continuous medication.

Objective:
To evaluate if CVMCC can be the trigger of symptoms in vestibular migraine, myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), and whiplash associated disorders (WAD).

Study Design:
Retrospective consecutive observational cohort study.

Setting:
Ambulatory at a private Otoneurology Centre.

Patients:
One hundred sixty-three patients with CVMCC and a history of trauma.

Intervention:
Based on the symptoms (structured symptom questionnaire), the patients are post hoc sub grouped according to the criteria of the different diagnoses.

Main Outcome Measure:
Frequency of patients with CVMCC who fulfill the criteria of the different diagnoses.

Results:
98% of all patients with CVMCC fulfill the Barany Society criteria of a probable vestibular migraine; 17% fulfill the International Classification of Headache Disorders defined vestibular migraine criteria; 63% fulfill the Fukuda criteria of ME/CFS; 100% of the patients with WAD suffer from CVMCC.

Conclusion:
This survey supports the hypothesis that CVMCC can be the trigger of symptoms in vestibular migraine, ME/CFS, and WAD. The actual diagnosis the patient receives is often in accordance with the patient's dominant symptom.
A Systematic Review on Factors Associated With Percutaneous Bone Anchored Hearing Implants Loss
Authors: Bezdjian Aren , Smith Rachel Ann , Thomeer Henricus G.X.M. , Willie Bettina M. , Daniel Sam J. 
Published: October 2018

Objective:
To investigate factors associated with percutaneous bone anchored hearing implant (BAHI) loss.

Data Sources:
Africa-Wide, Biosis, Cochrane, Embase, Global Health, LILACs, Medline, Pubmed, and Web of Science electronic databases.

Study Selection:
All studies reporting on adult and/or pediatric patients with a BAHI loss were identified. Retrieved articles were screened using predefined inclusion criteria. Eligible studies underwent critical appraisal for directness of evidence and risk of bias. Studies that successfully passed critical appraisal were included for data extraction.

Data Extraction:
Extracted data included study characteristics (study design, number of total implants and implant losses, follow-up), patient characteristics (sex, age, comorbidities, previous therapies), and information regarding BAHI loss (etiology of loss, timing of occurrence).

Data Synthesis:
From the 5,151 articles identified at the initial search, 847 remained after title and abstract screening. After full text review, 96 articles were eligible. Fifty-one articles passed quality assessment, however, due to overlapping study population, 48 articles reporting on 34 separate populations were chosen for data extraction. Three hundred one implant losses occurred out of 4,116 implants placed, resulting in an overall implant loss occurrence rate of 7.3%. Failed osseointegration was responsible for most implant losses (74.2%), followed by fixture trauma (25.7%). Most losses due to failed osseointegration occurred within 6 months of the implantation. BAHI implant loss occurred more frequently in pediatric patients (p < 0.005).

Conclusion:
The current systematic review identified factors associated with BAHI loss. These factors should be considered when assessing patients’ candidacy and when investigating reasons for impeded implant stability and loss.
Optimizing continuous renal replacement therapy in the ICU: a team strategy
Authors: Joannes-Boyau Olivier , Velly Lionel , Ichai Carole 
Published: October 2018

Purpose of review
The consideration of acute kidney injury, its incidence and its impact on the outcome of patients has grown continuously in recent years, leading to an increase in the use of renal replacement therapy (RRT) techniques. However, the successful conduct of RRT depends on the effectiveness of the entire team, doctors and nurses. It is therefore important to know the essential elements to be implemented in the ICU to ensure optimal RRT.

Recent findings
Recent studies show that the successful conduct of a RRT session requires a good knowledge of the principles of the technique, regular basic training, identification of experts, drafting clear and well followed protocols and good communication between the various stakeholders. In addition, the use of the latest advances, such as regional citrate anticoagulation, allows further optimization of therapy, only if, again, both physicians and nurses are properly trained and highly involved.

Summary
We now have a better understanding of the measures to be deployed to optimize RRT. Organization, training, evaluation and protocols are the key points of the team's efficiency for a safe and effective implementation of RRT.
Comparison Between an Oral Sulfate Solution and a 2 L of Polyethylene Glycol/Ascorbic Acid as a Split Dose Bowel Preparation for Colonoscopy
Authors: Lee Han Hee , Lim Chul-Hyun , Kim Jin Su , Cho Yu Kyung , Lee Bo-In , Cho Young-Seok , Lee In Seok , Choi Myung-Gyu 
Published: October 2018

Background/Aims:
This study aimed to compare the efficacy and tolerability of an oral sulfate solution (OSS) versus 2 L of polyethylene glycol/ascorbic acid (2L-PEG/Asc) for bowel cleansing before colonoscopy.

Methods:
A prospective, single-center, single-blinded, noninferiority, randomized, controlled trial was performed. The primary outcome was the rate of successful bowel cleansing, evaluated using the Boston Bowel Preparation Scale (BBPS). Secondary outcomes were examination time, polyp, and adenoma detection rate (PDR and ADR), tolerability, and safety. Ease of use, palatability, intention to reuse, and satisfaction were evaluated using a questionnaire.

Results:
A total of 187 participants were randomized to receive either OSS (n=93) or 2L-PEG/Asc (n=94). Successful bowel cleansing was achieved in 86.0% (80/93) of the OSS group, which was noninferior to the 2L-PEG/Asc group (88.3%, 83/94), with a difference of −2.3% by ITT analysis [95% confidence interval (CI) −12.0 to +7.4]. The withdrawal time of the OSS group was significantly shorter than that of the 2L-PEG/Asc group (11.8±5.2 vs. 14.3±8.5; P=0.016). Ease of use, palatability, intention to reuse, and satisfaction were similar between the 2 groups. Adverse events were also similar between the 2 groups. Mucosal erythema (4.3%) and aphthous lesions (2.1%) were found only in the 2L-PEG/Asc group.

Conclusions:
OSS was as effective as 2L-PEG/Asc for successful bowel cleansing and had acceptable tolerability. OSS is a promising and safe low-volume preparation alternative for colonoscopy. (Clinical trial registration number: NCT02761213.)
Association between AGTR1 A1166C polymorphism and the susceptibility to diabetic nephropathy
Authors: Zhuang Yan , Niu Fukun , Liu Defeng , Sun Juanjuan , Zhang Xiaowei , Zhang Jian , Guo Shuxia 
Published: October 2018

Abstract

Background:
Diabetic nephropathy (DN) is a common complication in patients with diabetic mellitus (DM). Growing evidences have demonstrated that the polymorphisms of angiotensin II receptor type 1 (AGTR1) showed significant association with DN onset, but no consensus has been achieved yet. Therefore, we performed this meta-analysis to combine the findings of previous researches for a more comprehensive conclusion.

Methods:
Eligible publications were identified through electronic databases. The intensity of the correlation between AGTR1 A1166C polymorphism and DN susceptibility was evaluated through calculating pooled odds ratios (ORs) with their 95% confidence intervals (95% CIs). Heterogeneity among included studies was examined with Q test. When P-value less than .05, significant heterogeneity presented, random-effects model was used to calculate the pooled ORs, otherwise, the fixed-effects model was used. Stratification analyses were also performed based on ethnicity and the type of DM.

Results:
Seventeen eligible articles were finally included in the present meta-analysis. The analysis results showed that AGTR1 A1166C polymorphism was significantly related to increased risk of DN under CC versus AA (OR = 1.723, 95% CI = 1.123–2.644), CC + AC versus AA (OR = 1.179, 95% CI = 1.004–1.383), CC versus AA + AC (OR = 1.662, 95% CI = 1.112–2.486), and C versus A (OR = 1.208, 95% CI = 1.044–1.397) genetic models. Additionally, a similar result was also found in Asian and T2DM (type 2 diabetic mellitus) groups after subgroup analyses of ethnicity and DM type.

Conclusion:

AGTR1 A1166C polymorphism may increase the susceptibility to DN, especially in Asians and T2DM population.
Risk factors for procedure-related complications after endoscopic resection of colorectal laterally spreading tumors
Authors: Hong Ji-Yun , Kweon Sun-Seog , Lee Jun , Kim Sang-Wook , Seo Geom-Seog , Kim Hyun-Soo , Joo Young-Eun 
Published: October 2018

Abstract
Colorectal laterally spreading tumors (LSTs) are large and flat elevated neoplasms with diameters of at least 10 mm. Endoscopic resection of LSTs, with their large size and broad base, is difficult and dangerous compared with the resection of polypoid neoplasms. This study aimed to determine the risk factors for procedure-related complications including bleeding and perforation after endoscopic resection of LSTs.
Patients with colorectal LST undergoing endoscopic resection at 5 university hospitals in Honam Province of South Korea were enrolled, and their records about patients, lesions, and procedure parameters associated with the occurrence of complications were reviewed retrospectively. Logistic regression analysis was performed to identify risk factors for complications.
The frequency of comorbidities in bleeding group was significantly higher than in the no bleeding group. The frequency of bleeding was significantly higher in lesions with adenocarcinoma than in lesions with low or high-grade dysplasia. The frequency of bleeding was significantly higher in piecemeal resection than in en bloc resection. The frequency of perforation was significantly higher in endoscopic mucosal resection-precutting (EMR-P) than in endoscopic mucosal resection (EMR) or endoscopic submucosal dissection. The mean procedure duration was significantly longer in the perforation group than in the no perforation group. On multivariate analysis, patient comorbidity and histologic grade of the lesion were significant independent risk factors for bleeding, whereas EMR-P was a significant independent risk factor for perforation after endoscopic resection.
This study demonstrated that patient comorbidity and histologic grade of lesion were significant independent risk factors for bleeding, and EMR-P was a significant independent risk factor for perforation after endoscopic resection of colorectal LSTs.
An electrical scalpel conization versus Shimodaira-Taniguchi conization procedure for cervical intraepithelial neoplasia
Authors: Kigure Keiko , Nakamura Kazuto , Kitahara Yoshikazu , Nakao Kohshiro , Hirakawa Takashi , Rokukawa Shunichi , Ito Masahiro , Nishimura Toshio , Ito Ikuro , Kagami Issei , Itoga Shunichi 
Published: October 2018

Abstract
The incidence of cervical intraepithelial neoplasia(CIN) among reproductive-aged women has increased in Japan. Cervical conization is commonly applied for local cervical treatment to preserve fertility. The Shimodaira-Taniguchi (S-T) conization procedure is widely used in Japan. S-T conization uses a high-frequency current and a triangular probe with a linear excision electrode to remove cervical tissue as a single informative specimen. However, alternative of an electrosurgical scalpel (ES) has the advantage of adjusting the surgical margin to the transformation zone in order to preserve the maximum amount of healthy cervical tissue with good hemostasis. The aim of this study is to retrospectively analyze data regarding surgical margin status, perioperative adverse events, cervical stenosis, and preterm birth between S-T and ES.
Between January 2009 and December 2014, the medical records of 1166 patients who were diagnosed as CIN II, III, or stage 1a1 cervical cancer and who were treated with conization in 7 hospitals in Gunma Prefecture, Japan were enrolled for this retrospective study. The clinicopathological data was analyzed to statistically compare outcome between S-T and ES conization.
There was no difference for age or post-operative follow-up period between ES and S-T treatments. However, positive surgical margins were significantly less frequent in patients who were treated with S-T than in those treated with ES, resulting in a reduced incidence of re-treatment for S-T in comparison with ES patients. In perioperative adverse events, S-T had more patients who were administered antibiotics. The incidence of preterm delivery and cervical stenosis did not differ significantly between the groups.
We demonstrate here that S-T is an alternative procedure for cervical conization with a low risk of recurrence and acceptably low rate of adverse events such as cervical stenosis and preterm delivery. The results of this study can provide useful information for future management of patient with cervical intraepithelial neoplasia.
Impact of diet restriction on bowel preparation for colonoscopy
Authors: Nam Seung-Joo , Kim Young Jin , Keum Bora , Lee Jae Min , Kim Seung Han , Choi Hyuk Soon , Kim Eun Sun , Seo Yeon Seok , Jeen Yoon Tae , Lee Hong Sik , Chun Hoon Jai , Um Soon Ho , Kim Chang Duck 
Published: October 2018

Abstract
Diet restriction is one of the difficult parts of bowel preparation for colonoscopy, and many patients do not follow instructions properly. Few studies have evaluated the impact of dietary restriction in real clinical setting. The aim of this study was to study the effect of diet control on bowel preparation with detailed investigation of unacceptable food list in order to reveal what kind of foods are most problematic in clinical practice.
Prospective observational study was carried out at a university-affiliated hospital. Around 4 L polyethylene glycol solution was used for bowel preparation on the day of colonoscopy. Patients were allowed to have regular diet until lunch the day before colonoscopy and educated to control diet from 3 days before colonoscopy with information regarding an unacceptable foods list. Factors associated with inadequate bowel preparation were analyzed using univariate statistics and multivariate logistic regression analysis.
Of the 245 patients included in the study, 68 patients (27.8%) followed the diet instructions. Fiber-rich vegetables were the most commonly taken unacceptable foods (N = 143, 58.4%). Inadequate bowel preparation (fair and poor by Aronchick scale) was 47.3%. In multivariate analysis, diabetes [odds ratio (OR) 2.878, 95% confidence interval (CI) 1.242–6.671], preparation to colonoscopy interval (OR 1.003, 95% CI 1.000–1.005) and consumption of foods disturbing bowel preparation (OR 2.142, 95% CI 1.108–4.140) were independent predictors of inadequate bowel preparation.
We could identify substantially low compliance to diet instructions in real clinical practice. Consumption of any foods disturbing bowel preparation was significant factor predicting inadequate bowel preparation, even though we could not select specific food list compromising preparation significantly. Favorable bowel preparation was achieved in the subgroup compliant to diet restriction, suggesting that regular diet avoiding specific kinds of foods can be possible option for diet restriction before colonoscopy.
Esmolol does not improve quality of postsurgical recovery after ambulatory hysteroscopy
Authors: De Oliveira Gildasio S. , Kendall Mark C. , McCarthy Robert J. 
Published: October 2018

Abstract

Introduction:
Intraoperative systemic esmolol has been shown to reduce postsurgical pain. Nonetheless, it is unknown whether the use of intraoperative systemic esmolol can improve patient-reported postsurgical quality of recovery. The main objective of the current investigation was to evaluate the effect of intraoperative esmolol on postsurgical quality of recovery. We hypothesized that patients receiving intraoperative esmolol would report better quality of postsurgical recovery than the ones receiving saline.

Methods:
The study was a prospective randomized double-blinded, placebo-controlled, clinical trial. Healthy female subjects undergoing outpatient hysteroscopic surgery under general anesthesia were randomized to receive intravenous esmolol administered at a rate of 0.5 mg/kg bolus followed by an infusion of 5 to 15 μg/kg/min or the same volume of saline. The primary outcome was the Quality of Recovery 40 (QOR-40) questionnaire at 24 hours after surgery. Other data collected included postoperative opioid consumption and pain scores. Data were analyzed using group t tests and the Wilcoxon exact test.

Results:
Seventy subjects were randomized and 58 completed the study. There was not a clinically significant difference in the global QoR-40 scores between the esmolol and saline groups at 24 hours, median (interquartile range) of 179 (171–190) and 182 (173–189), respectively, P = .82. In addition, immediate post-surgical data in the post-anesthesia care unit did not show a benefit of using esmolol compared to saline in regard to pain scores, morphine consumption, and postoperative nausea and vomiting.

Conclusions:
Despite current evidence in the literature that intraoperative esmolol improves postsurgical pain, we did not detect a beneficial effect of intraoperative esmolol on patient-reported quality of recovery after ambulatory surgery. Our results confirm the concept that the use of patient-centered outcomes rather than commonly used outcomes (e.g., pain scores and opioid consumption) can change the practice of perioperative medicine.
Risk of regorafenib-induced cardiovascular events in patients with solid tumors
Authors: Chen Jianxin , Wang Junhui 
Published: October 2018

Abstract

Background:
The present comparative meta-analysis was conducted to evaluate the cardiovascular events of regorafenib in patients with solid tumors.

Methods:
Eligible studies from MEDLINE, Google Scholar, Cochrane Library, Clinical key, EBSCO publishing and Ovid, which had reported cardiovascular adverse events potentially caused by regorafenib were absorbed. Data of clinical characteristics and cardiovascular events including hypertension, hemorrhage, thrombosis, and heart failure were extracted from selected literatures for the final analysis. Pooled analysis of cardiovascular adverse events was developed by relative risks (RRs) and corresponding 95% confidence intervals (CIs) with software STATA 13.0 and RevMan 5.3.

Results:
Thirty studies including 3813 patients were fit into analysis. The incidences of cardiovascular events of all-grade were: hypertension, 36.8% (95% CI, 29.8%–43.8%), hemorrhage, 8.6% (95% CI, 3.2%–14%), thrombosis, 1.4% (95% CI, 0.1%–2.8%), and heart failure, 2.9% (95% CI, 0.3%–5.6%). The incidences of cardiovascular events of high-grade were: hypertension, 9.9% (95% CI, 7.4%–12.4%), hemorrhage, 1.2% (95% CI, 0.3%–2.2%), thrombosis, 1.6% (95% CI, 0.2%–3.4%), and heart failure, 2.9% (95% CI, 0.3%–5.6%). The RRs and their 95% CIs of all-grade cardiovascular events among patients treated with regorafenib were: hypertension, 4.10 (95% CI, 3.07–5.46; P < .00001), hemorrhage, 2.71 (95% CI, 1.45–5.08; P = .002), thrombosis, 1.27 (95% CI, 0.49–3.27; P = .62), and heart failure, 0.79 (95% CI, 0.16–3.94; P = .77). The RRs and their 95% CIs of high-grade cardiovascular events among patients treated with regorafenib were: hypertension, 5.82 (95% CI, 3.46–9.78; P < .00001), hemorrhage, 0.90 (95% CI, 0.50–1.61; P = .72), thrombosis, 1.28 (95% CI, 0.48–3.41; P = .62), and heart failure, 1.15 (95% CI, 0.23–5.69; P = .86), respectively.

Conclusion:
The present meta-analysis has demonstrated that regorafenib is associated with an increasing risk of hypertension at all-grade and high-grade, as well as hemorrhage at all-grade. Adequate awareness of cardiovascular adverse events of regorafenib should be established for clinicians.