bluuebunny/crossref_metadata_2025_split huggingface dataset:
High-Voltage Electrical Stimulation Versus Ultrasound in the Treatment of Pressure Ulcers
Authors: Bora Karsli Pinar , Gurcay Eda , Karaahmet Ozgur Zeliha , Cakci Aytul 
Published: November 2017

ABSTRACT

OBJECTIVE:
The aim of this study was to assess and compare the efficacy of high-voltage electrical stimulation (HVES) with ultrasound (US) in treating Stage II through Stage IV pressure ulcers (PrUs)* of hospitalized patients.

DESIGN:
This study was designed as a prospective, controlled trial in which patients were randomly assigned to 2 groups.

PARTICIPANTS AND SETTINGS:
A total of 27 patients (22 male, 5 female) hospitalized for neurologic rehabilitation in the Clinic of Physical Medicine and Rehabilitation with Stage II through Stage IV PrUs were included in this study. The patients were randomly assigned to either HVES or US treatment group, and all patients underwent standard wound care. Over 4 to 12 weeks, HVES was applied for 60 minutes 3 times per week, and US was applied 3 times per week.

MAIN OUTCOME MEASURES:
Properties of the PrUs were noted during pre- and posttreatment.

RESULTS:
The PrUs of patients in the HVES and US groups healed at a mean rate of 43% and 63%, respectively. There was no statistically significant intergroup difference in healing found after treatment. Regression analysis was performed for the factors that could influence the wound surface areas, and significant effects were detected among the level of ambulation, pretreatment stage, and smoking.

CONCLUSIONS:
Both HVES and US are promising methods for wound healing, and both electrotherapy modalities have been demonstrated to support the healing of PrUs.
Managing hypertriglyceridemia
Authors: Copple Tina , Ciffone Nicole A. 
Published: November 2017

Abstract:
Cardiovascular (CV) risk remains in some patients who are treated with statins. Evidence supports a role for triglycerides (TGs) in CV disease. TG-lowering agent outcomes studies have been inconsistent, but eicosapentaenoic acid significantly reduced coronary events in hypercholesterolemic patients who were treated with statins. Ongoing outcomes studies will clarify the role of TG-lowering treatments in CV risk reduction.
Drug updates and approvals
Authors: Mospan Geoffrey , Mospan Cortney , Vance Shayna , Bradshaw Alyssa , Meosky Kalyn , Bowles Kirklin 
Published: November 2017

Abstract:
In 2017, the FDA approved several new drugs for use in primary care. This article highlights the following new drugs: brodalumab (Siliq), dapagliflozin and saxagliptin (Qtern), dupilumab (Dupixent), oxymetazoline (Rhofade), safinamide (Xadago), and sarilumab (Kevzara).
Risk Factors for Emergency Department Visits After Hysterectomy for Benign Disease
Authors: Mahnert Nichole , Kamdar Neil , Lim Courtney S. , Skinner Bethany , Hassett Afton , Kocher Keith E. , Morgan Daniel M. , As-Sanie Sawsan 
Published: November 2017

(Abstracted from Obstet Gynecol 2017;130:296–304)
The need for emergency department (ED) visits following hysterectomy for benign indications may reflect quality of care and affect costs of health care. These visits are potentially modifiable and a target for development of interventions to improve care coordination, enhance patient satisfaction, and reduce health care costs.
Clinical Utility of Noninvasive Prenatal Testing in Pregnancies With Ultrasound Anomalies
Authors: Beulen L. , Faas B. H. W. , Feenstra I. , Van Vugt J. M. G. , Bekker M. N. 
Published: November 2017

(Abstracted from Ultrasound Obstet Gynecol 2017;49:721–728)
Following an ultrasound examination indicating an elevated risk of a fetal chromosomal abnormality, pregnant women are offered prenatal genetic testing to more accurately identify the anomalies' etiology and fetal prognosis. Follow-up genetic testing usually includes G-band karyotyping and/or chromosomal microarray analysis (CMA).
24/7 Presence of Medical Staff in the Labor Ward; No Day-Night Differences in Perinatal and Maternal Outcomes
Authors: Tavares Sara , Cavaco-Gomes João , Moucho Marina , Severo Milton , Mateus Mário , Ramalho Carla , Visser Gerard H. A. , Montenegro Nuno 
Published: November 2017

(Abstracted from Am J Perinatol 2017;34:529–534)
An unavoidable part of every health care professional's life is nighttime shifts that may have negative effects on both the providers themselves and the patients they care for. Absence of experienced staff during the night and exhaustion after long working days could lead to errors and subsequently adverse neonatal and maternal outcomes.
Gender Disparities in Medical Student Research Awards: A 13-Year Study From the Yale School of Medicine
Authors: King Joseph T. , Angoff Nancy R. , Forrest John N. , Justice Amy C. 
Published: November 2017

Purpose
The Liaison Committee on Medical Education mandates instruction in research conduct, and many U.S. medical schools require students to complete a research project. All Yale School of Medicine (YSM) graduating students submit a research thesis, and ~5% are awarded highest honors. Gender disparities exist in areas related to physician research productivity, including academic rank, research funding, and publications. The authors asked whether gender disparities exist for medical student research.

Method
The authors conducted a retrospective review of 1,120 theses submitted by graduating medical students from 2003 to 2015 at YSM and collected data on gender, mentoring, research type, sponsoring department, and other characteristics. Multivariate logistic regression modeling examined gender differences in medical student research awards.

Results
Women authored 50.9% of theses, but earned only 30.9% of highest honors awards (OR 0.41; 95% CI: 0.23, 0.74). Among factors associated with increased receipt of highest honors that differed by gender, men were more likely than women to work with a mentor with a history of three or more thesis honorees, take a fifth year of study, secure competitive research funding, undertake an MD–master of health science degree, and conduct laboratory research (all P < .001). After adjustment for these factors, and for underrepresented in medicine status and sponsoring department, women remained less likely to receive highest honors (OR 0.51; 95% CI: 0.27, 0.98).

Conclusions
Women YSM students were less likely to receive highest honors for medical research. Gender disparities in postgraduate biomedical research success may start during undergraduate medical education.
Recurrent Corneal Erosions Secondary to Use of Sleep Mask
Authors: McGlumphy Elyse J. , Margo Jordan A. , Jeng Bennie H. 
Published: November 2017

Abstract:
A 31-year-old woman with a history of unusual appearing recurrent linear corneal epithelial defects and subepithelial scaring in both eyes underwent 2 years of evaluation and treatment. It was eventually discovered that the patient was using a sleep mask with excessive fabric pilling, which was found to be the source of her chronic epitheliopathy. After discontinuation of the sleep mask, the patient experienced complete resolution of symptoms. When evaluating recurrent corneal epithelial defects, external sources of repeated trauma, including sleepwear, should be investigated.
Sealing of Corneal Lacerations Using Photoactivated Rose Bengal Dye and Amniotic Membrane
Authors: Soeken Timothy A. , Zhu Hong , DeMartelaere Sheri , Davies Brett W. , Kim Mirang , Wang Heuy-Ching , Aden James , Grimm Rose , Alt Clemens , Kochevar Irene E. , Johnson Anthony J. 
Published: November 2017

Purpose:
Watertight closure of perforating corneoscleral lacerations is necessary to prevent epithelial ingrowth, infection, and potential loss of the eye. Complex lacerations can be difficult to treat, and repair with sutures alone is often inadequate. In this study, we evaluated a potentially sutureless technology for sealing complex corneal and scleral lacerations that bonds the amniotic membrane (AM) to the wound using only green light and rose bengal dye.

Methods:
The AM was impregnated with rose bengal and then sealed over lacerations using green light to bond the AM to the deepithelialized corneal surface. This process was compared with suture repair of 3 laceration configurations in New Zealand White rabbits in 3 arms of the study. A fourth study arm assessed the side effect profile including viability of cells in the iris, damage to the blood–retinal barrier, retinal photoreceptors, retinal pigment epithelium, and choriocapillaris in Dutch Belted rabbits.

Results:
Analyses of the first 3 arms revealed a clinically insignificant increase in polymorphonuclear inflammation. In the fourth arm, iris cells appeared unaffected and no evidence of breakdown of the blood–retinal barrier was detected. The retina from green light laser-treated eyes showed normal retinal pigment epithelium, intact outer segments, and normal outer nuclear layer thickness.

Conclusions:
The results of these studies established that a light-activated method to cross-link AM to the cornea can be used for sealing complex penetrating wounds in the cornea and sclera with minimal inflammation or secondary effects.
T-SPOT.TB Performance in Routine Pediatric Practice in a Low TB Burden Setting
Authors: Mandalakas Anna M. , Highsmith Heather Y. , Harris Nadine M. , Pawlicka Anna , Kirchner H. Lester 
Published: November 2017

Background:
The T-SPOT.TB, an interferon-gamma release assay, is an indirect test of Mycobacterium tuberculosis infection. Due to sparse and conflicting evidence, the use of interferon-gamma release assay is limited in young and HIV-infected children. We determined the prevalence of invalid, borderline, positive and negative results and associations with key demographic variables during routine pediatric use in a low tuberculosis burden setting.

Methods:
For pediatric samples received at Oxford Diagnostic Laboratories between 2010 and 2015, the associations between initial test outcome and demographics were estimated by bivariate analysis and logistic regression.

Results:
A total of 44,289 samples (median age 12.5 years; interquartile range 7.7–15.5), including 5057 samples (11.6%) from children under 5 years old, were received from 46 U.S. states, Washington, DC and Puerto Rico. A total of 592 samples (1.3%) could not be tested. T-SPOT.TB positivity was strongly correlated (r = 0.60; P < 0.0001) with state TB incidence. Compared with negative results, positive results were more likely in samples from older children (P < 0.0001), public health clinics (P < 0.0001) and rural locations (P = 0.005). Although infrequent (0.6%), invalid results were more common in samples collected at HIV clinics (odds ratio = 2.5, 95% confidence interval: 1.3–4.9) and from younger children (P = 0.03). These invalid results were more likely due to a robust nil (negative) control response rather than a weak mitogen (positive) control response.

Conclusions:
The T-SPOT.TB test correlated strongly with well-recognized risk factors for tuberculosis infection and provided evaluable results in 98% of children. To optimize the impact of testing on clinical decision making and patient outcomes, local epidemiology and individual patient risk should be considered when incorporating IGRAs into pediatric guidelines.
Immunity After Childhood Vaccinations in Perinatally HIV-exposed Children With and Without HIV Infection in Latin America
Authors: Succi Regina C. M. , Krauss Margot R. , Harris D. Robert , Machado Daisy M. , de Moraes-Pinto Maria I. , Mussi-Pinhata Marisa M. , Pavia Ruz Noris , Pierre Russell B. , Kolevic Roca Lenka A. , Joao Esaú , Foradori Irene , Scotta Marcelo C. , Hazra Rohan , Siberry George K. ,   for the NISDI Pediatric Study Group 2012
Published: November 2017

Background:
Perinatally HIV-infected (PHIV) children are at risk for under-vaccination and poor vaccine response at 4 years of age. Childhood vaccine coverage and immune response were compared between PHIV and HIV-exposed uninfected (HEU) children in Latin America and the Caribbean.

Methods:
PHIV and HEU children were enrolled prospectively at 15 sites from 2002 to 2009. Full vaccination by age 4 years was defined as: 3 hepatitis B virus vaccine doses; 4 tetanus toxoid–containing vaccine doses; 3 doses of Haemophilus influenzae type b vaccine by age 12 months or ≥1 dose given after age 12 months; one measles-containing vaccine dose; one rubella-containing vaccine dose. Immunity was defined by serum antibody titer. Fisher exact test (for categorical measures) and t test (for continuous measures) were used for comparisons.

Results:
Among 519 children seen at age 4 years, 191 had serum specimens available (137 PHIV, 54 HEU). Among those with specimens available, 29.3% initiated combination antiretroviral therapy (cART) <12 months of age, 30.9% initiated at ≥12 months of age, and 39.8% had not received cART by the time they were seen at 4 years of age. At 4 years of age, 59.9% were on PI-containing cART (cART/PI), and 20.4% were on no ART. PHIV children were less likely than HEU children to be fully vaccinated for tetanus (55.5% vs. 77.8%, P = 0.005) and measles and rubella (both 70.1% vs. 94.4%, P < 0.001). Among those fully vaccinated, immunity was significantly lower among PHIV than HEU for all vaccines examined: 20.9% versus 37.8% for hepatitis B virus (P = 0.04), 72.0% versus 90.5% for tetanus (P = 0.02), 51.4% versus 68.8% for H. influenzae type b (P = 0.05), 80.2% versus 100% for measles (P < 0.001) and 72.9% versus 98.0% for rubella (P < 0.001) vaccine, respectively.

Conclusions:
Compared with HEU, PHIV children were significantly less likely to be immune to vaccine-preventable diseases when fully vaccinated. Strategies to increase immunity against vaccine-preventable diseases among PHIV require further study.
Baccalaureate Nursing Students’ Perceptions Regarding Autopsy Experiences
Authors: Cannon Emily J. , Bauer Renee N. 
Published: November 2017

ABSTRACT

Purpose
Since 2012, a medical–surgical nursing course at a midsized state university has provided the opportunity for students to view autopsies with a board-certified forensic pathologist. The autopsies are performed at a midsized hospital relatively close to the campus. The purpose of this study was to discover nursing students’ perceptions that emerged during the autopsy experience.

Methods
A convenience sample of 23 baccalaureate nursing students took part in the autopsy experience over a 4-month period. Archival data from an online, anonymous questionnaire, completed after the experience, were reviewed and subjected to qualitative analysis. This study was approved by the university’s institutional review board.

Results
Rich data emerged regarding the students’ experiences, including emotional, psychological, and knowledge-based perceptions.

Conclusion
Autopsies are important learning tools for nursing students, especially those who go into advanced practice nursing and forensic nursing. Anatomy, physiology, and pathophysiology are essential for students to understand as they learn about medical–surgical nursing concepts. Unique emotional characteristics of the students and cause of death of the deceased influenced how some students viewed the autopsy experience. Students reported that processing and debriefing activities were important after viewing autopsies and should be encouraged.
Evolving paradigms for new agent development in pediatric oncology
Authors: Flynn Andrea , Fox Elizabeth 
Published: November 2017

Purpose of review
To discuss considerations of new paradigms for clinical drug development in pediatric oncology that incorporate our expanding knowledge and complexity of molecular alterations associated with cancer; advances in cancer immunology and cellular therapy; the increasing number of new anticancer drugs, therapeutic approaches, and potential combinations; and recent initiatives by regulatory agencies to improve access to safe and effective therapies.

Recent findings
Cancer in children and adolescents is a rare event with significant long-term impact on individuals and society. Using multimodality therapy, stratified by patient and disease characteristics, the cure rate for childhood cancer exceeds 80%. Cancer genomics has transformed anticancer drug development. Understanding the genetic basis of pediatric cancers and the use of genomics for risk stratification has changed the focus of drug development from cytotoxic drugs to targeted therapeutic approaches. Advances in cancer immunology, immune checkpoint blockade, and cellular therapy offer novel approaches to harness T cells to treat cancer. To improve the outcome for children and adolescents with cancer and accelerate drug development, understanding drug and target interactions in preclinical models of pediatric cancer should be coupled with efficient clinical trial designs that incorporate biomarker selection, assessment of toxicity and drug exposure, and improved measures of response.

Summary
Clinical trials for children and adolescents with cancer evaluate cytotoxic drugs, molecularly target drugs, immunotherapy as well as combination therapies. The framework for oncology clinical trials will continually adapt to improve efficiency of trials and evaluate new therapeutic approaches.
Management of Menopausal Symptoms in Women With Gynecologic Cancers
Authors: del Carmen Marcela G. , Rice Laurel W. 
Published: November 2017

(Abstracted from Gynecol Oncol 2017;146:427–435)
Treatment of gynecologic cancers usually involves surgery, systemic chemotherapy, and/or radiation therapy, which often result in loss of ovarian function. Many of these women will be cured or become long-term cancer survivors and will become postmenopausal.
Effectiveness of Vaccination During Pregnancy to Prevent Infant Pertussis
Authors: Baxter Roger , Bartlett Joan , Fireman Bruce , Lewis Edwin , Klein Nicola P. 
Published: November 2017

(Abstracted from Pediatrics 2017;139(5):e20164091)
Pertussis is a virulent and life-threatening respiratory infection, particularly in infants, caused by the bacteria Bordetella pertussis. Tetanus toxoid, reduced diphtheria toxoid, acellular pertussis (TDaP) vaccination during pregnancy is recommended to protect newborns against pertussis.
Unusual Suicide by a Speargun Shot Through the Mouth
Authors: Nouma Youssef , Krimi Sami , Regaieg Karama 
Published: November 2017

Abstract
We report an unusual case of suicide committed with a speargun shot through the mouth, causing a penetrating brain injury. The special features of the present case are not only related to the method chosen for the purpose but also to the difficulties encountered in confirming the diagnosis. Although this type of suicide has been previously reported, this case is particularly interesting in terms of the shooting mechanism and manner of death. Because of the length of the weapon, which was apparently used and found at the scene, a suicidal manner of death first seemed unlikely and the possibility of a simulated suicide was raised. It seemed impossible for the decedent to have shot himself without a mechanism to launch the shaft through the mouth. However, a complete forensic approach eventually allowed for a plausible mechanism of self-infliction, confirming the suicide diagnosis.
A Rare Case of Hemopericardium From a Ruptured Dissecting Pulmonary Artery Aneurysm
Authors: Tse Rexson , Garland Jack , Triggs Yvonne , Stables Simon 
Published: November 2017

Abstract
Nontraumatic hemopericardium is a potentially fatal pathology that is most commonly caused by myocardial wall rupture, ruptured aortic dissection, aortic aneurysm rupture, or a neoplastic process. A rare potential cause of hemopericardium is pulmonary artery dissection, with less than 100 reported cases in the literature. Pulmonary artery dissection is associated with pulmonary artery aneurysm, pulmonary artery hypertension, and congenital heart disease. We report a fatal case of nontraumatic hemopericardium caused by a ruptured dissecting pulmonary artery aneurysm in a 16-year-old girl with patent ductus arteriosus. The unenhanced postmortem computed tomography performed before autopsy was able to identify a large hemopericardium with a pulmonary artery aneurysm and lifting of mural calcification suggestive of a dissecting aneurysm. This enabled the pathologist to locate the exact rupture site that caused the hemopericardium.
State-of-the-Art Techniques in Treating Peripheral Nerve Injury
Authors: Kubiak Carrie A. , Kung Theodore A. , Brown David L. , Cederna Paul S. , Kemp Stephen W. P. 
Published: November 2017

Background:
Peripheral nerve injuries remain a major clinical concern, as they often lead to chronic disability and significant health care expenditures. Despite advancements in microsurgical techniques to enhance nerve repair, biological approaches are needed to augment nerve regeneration and improve functional outcomes after injury.

Methods:
Presented herein is a review of the current literature on state-of-the-art techniques to enhance functional recovery for patients with nerve injury. Four categories are considered: (1) electroceuticals, (2) nerve guidance conduits, (3) fat grafting, and (4) optogenetics. Significant study results are highlighted, focusing on histologic and functional outcome measures.

Results:
This review documents the current state of the literature. Advancements in neuronal stimulation, tissue engineering, and cell-based therapies demonstrate promise with regard to augmenting nerve regeneration and appropriate rehabilitation.

Conclusions:
The future of treating peripheral nerve injury will include multimodality use of electroconductive conduits, fat grafting, neuronal stimulation, and optogenetics. Further clinical investigation is needed to confirm the efficacy of these technologies on peripheral nerve recovery in humans, and how best to implement this treatment for a diverse population of nerve-injured patients.