bluuebunny/crossref_metadata_2025_split huggingface dataset:
Integrative Therapies for Women with a High Risk Pregnancy During Antepartum Hospitalization
Authors: Schlegel Merry L. , Whalen Jeanne L. , Williamsen Pilar M. 
Published: August 2016

Abstract

Background:
High-risk pregnancies that require lengthy hospitalization can cause anxiety and stress for pregnant women. Integrative medicine therapies may be beneficial for this population, but have not been widely studied.

Purpose:
The purpose of this study was to evaluate potential effects of acupuncture, guided imagery, Healing Touch, massage therapy, and reflexology on pain and anxiety of hospitalized pregnant women.

Methods:
A retrospective analysis of the effects of integrative medicine therapies was conducted; N = 554 individual therapies were provided to hospitalized women with high-risk pregnancies. They included acupuncture (n = 83), guided imagery (n = 71), Healing Touch (n = 119), massage therapy (n = 196), and reflexology (n = 85) over an 18-month period. Pain and anxiety were measured pre- and posttherapy using a scale of 0 to 10, where 0 means no pain or no anxiety and 10 means high pain or high anxiety.

Results:
Analysis of mean scores of pre- and posttherapies for pain and anxiety found a decrease of pain and anxiety after all of the therapies, ranging from an 84.5% to 61.4% decrease for pain (p < .0001) and a 91% to 70. 9% decrease for anxiety (p < .0001). Overall, patients rated their anxiety higher than pain prior to each therapy.

Clinical Implications:
Hospitalized pregnant women responded favorably to the therapies. There were no adverse reactions reported. Results suggest potential benefits of integrative medicine therapies for this group of inpatients. Anxiety was more prevalent than pain among hospitalized pregnant women who received integrative medicine therapy.
Profiles of Depression Help Seeking Among Black Americans
Authors: Hays Krystal , Gilreath Tamika 
Published: August 2016

Abstract
Although Black Americans have lower prevalence of depression compared to non-Hispanic Whites (10% vs. 17%), they are nearly twice as likely to have worse outcomes. One contributor to poor depression outcomes involves the ways in which Black Americans seek help for depression. However, little is known about depression help-seeking behavior, and the use of multiple sources of help, among Black Americans. This study used latent class analysis to identify unique constellations of depression help seeking, from multiple sources, among African American and Black Caribbeans. Results indicated four profiles of depression help seeking including Informal/Primary Care Utilizers (41.4%), Formal Mental Health Utilizers (40.6%), All Support Utilizers (9.8%), and Mixed Source Utilizers (8.2%). The constellation of each profile and demographic differences in class assignment are discussed. Results have implications for tailored depression interventions for Black Americans including community-based psychoeducation and cultural competence training for mental health providers.
Vision Therapy for Post-Concussion Vision Disorders
Authors: Gallaway Michael , Scheiman Mitchell , Mitchell G. Lynn 
Published: August 2016

ABSTRACT

Purpose
To determine the frequency and types of vision disorders associated with concussion, and to determine the success rate of vision therapy for these conditions in two private practice settings.

Methods
All records over an 18-month period of patients referred for post-concussion vision problems were reviewed from two private practices. Diagnoses of vergence, accommodative, or eye movement disorders were based on pre-established, clinical criteria. Vision therapy was recommended based on clinical findings and symptoms.

Results
Two hundred eighteen patient records were found with a diagnosis of concussion. Fifty-six percent of the concussions were related to sports, 20% to automobile accidents, and 24% to school, work, or home-related incidents. The mean age was 20.5 years and 58% were female. Eighty-two percent of the patients had a diagnosis of an oculomotor problem [binocular problems (62%), accommodative problems (54%), eye movement problems (21%)]. The most prevalent diagnoses were convergence insufficiency (CI, 47%) and accommodative insufficiency (AI, 42%). Vision therapy was recommended for 80% of the patients. Forty-six per cent (80/175) either did not pursue treatment or did not complete treatment. Of the 54% (95/175) who completed therapy, 85% of patients with CI were successful and 15% were improved, and with AI, 33% were successful and 67% improved. Clinically and statistically significant changes were measured in symptoms, near point of convergence, positive fusional vergence, and accommodative amplitude.

Conclusions
In this case series, post-concussion vision problems were prevalent and CI and AI were the most common diagnoses. Vision therapy had a successful or improved outcome in the vast majority of cases that completed treatment. Evaluation of patients with a history of concussion should include testing of vergence, accommodative, and eye movement function. Prospective clinical trials are necessary to assess the natural history of concussion-related vision disorders and treatment effectiveness.
Regressive Retinal Flecks in CRX-Mutated Early-Onset Retinal Dystrophy
Authors: Cicinelli Maria Vittoria , Manitto Maria Pia , Parodi Maurizio Battaglia , Bandello Francesco 
Published: August 2016

ABSTRACT

Purpose
To describe a peculiar flecked-retina phenotype in a young female affected by early-onset retinal dystrophy due to a heterozygous mutation in the cone-rod transcription factor CRX gene.

Case Report
A 5-year-old girl presented with poor vision and nystagmus from the first month after birth. Opththalmologic examination at baseline revealed an altered foveal reflex, epiretinal membrane, and yellow fleck-like retinal deposits in the mid- and extreme periphery bilaterally that disappeared after 3 years of follow-up. Electoretinogram was non-recordable in both rods and cones components bilaterally. Genomic sequencing identified a heterozygous missense mutation −c.425A > G (Tyr142Cys) in CRX.

Conclusions
We identified a novel early-onset retinal dystrophy-related heterozygous CRX mutation associated with early and severe rod and cone dysfunction and regressive flecked-retina appearance on ophthalmoscopy.
Visual Acuity and Self-Reported Visual Function among Migrant Farmworkers
Authors: Quandt Sara A. , Schulz Mark R. , Chen Haiying , Arcury Thomas A. 
Published: August 2016

ABSTRACT

Purpose
Visual impairment presents significant risks for occupational injuries among farmworkers, a vulnerable population with limited access to vision care. Although previous research has noted farmworkers’ low lifetime experience with vision screening and high rates of complaints of eye ailments and poor vision, there have been few screening data collected to evaluate these self-reports. The objectives of this analysis are to (1) describe farmworker visual health using standardized visual acuity screening data and self-reported visual function, and (2) to compare the screening and self-report data.

Methods
Data are from a cross-sectional study of eye health among Latino migrant farmworkers in North Carolina with uncorrected vision (n = 289). Workers were recruited using methods to achieve a representative sample of a hard-to-reach population. Visual acuity data were collected using Snellen Tumbling E charts for nearsightedness and farsightedness. Binocular data are reported here. Interviews were conducted to obtain personal characteristics and self-assessed visual function.

Results
About 75% of farmworkers reported never having had a vision screening. Based on binocular screening, 1.7% (distance vision) and 6.9% (near vision) had moderate to severe visual impairment (>20/40). Farmworkers self-reported poorer visual function, compared with screening results; only 36.4% reported good or very good vision. Sensitivity of distance and near vision self-reports were 60 and 20%, respectively, but specificity was high.

Conclusions
This study confirms past reports of little vision screening among farmworkers. Visual impairment for distance is comparable to other studies of Latinos in the US, though these studies have not reported near vision. Self-reports of vision problems are not a sensitive measure of visual acuity among farmworkers. Screening is needed to identify visual impairment that can create occupational safety risks in this health disparate population.
Holographic Refraction and the Measurement of Spherical Ametropia
Authors: Nguyen Nicholas Hoai Nam 
Published: August 2016

ABSTRACT

Purpose
To evaluate the performance of a holographic logMAR chart for the subjective spherical refraction of the human eye.

Methods
Bland-Altman analysis was used to assess the level of agreement between subjective spherical refraction using the holographic logMAR chart and conventional autorefraction and subjective spherical refraction.

Results
The 95% limits of agreement (LoA) were calculated between holographic refraction and the two standard methods (subjective and autorefraction). Holographic refraction has a lower mean spherical refraction when compared to conventional refraction (LoA 0.11 ± 0.65 D) and when compared to autorefraction (LoA 0.36 ± 0.77 D). After correcting for systemic bias, this is comparable between autorefraction and conventional subjective refraction (LoA 0.45 ± 0.79 D). After correcting for differences in vergence distance and chromatic aberration between holographic and conventional refraction, approximately 65% (group 1) of measurements between holography and conventional subjective refraction were similar (MD = 0.13 D, SD = 0.00 D). The remaining 35% (group 2) had a mean difference of 0.45 D (SD = 0.12 D) between the two subjective methods. Descriptive statistics showed group 2’s mean age (21 years, SD = 13 years) was considerably lower than group 1’s mean age (41 years, SD = 17), suggesting accommodation may have a role in the greater mean difference of group 2.

Conclusions
Overall, holographic refraction has good agreement with conventional refraction and is a viable alternative for spherical subjective refraction. A larger bias between holographic and conventional refraction was found in younger subjects than older subjects, suggesting an association between accommodation and myopic over-correction during holographic refraction.
A Fatal Case of a Ruptured Cerebral Aneurysm Detected by Postmortem Computed Tomography Angiography Using a New Contrast-Medium Solution
Authors: Stamou Stamatios , Gascho Dominic , Eggert Sebastian , Berger Florian , Thali Michael J. , Flach Patricia M. 
Published: August 2016

Abstract
Forensic autopsy is still the criterion standard in legal investigations. Currently, notable transformation is occurring because postmortem imaging is being increasingly endorsed. This article highlights the effectiveness of postmortem computed tomography angiography by using a new contrast medium mixture as a solitary tool to define the cause and manner of death in a ruptured cerebral aneurysm case. Based on the imaging results, autopsy was not mandated and the case was closed.
Chronic Heart Failure
Authors: Hoffman Timothy M. 
Published: August 2016

Objectives:
The objectives of this review are to discuss the paradigms used to stage heart failure in children, the classification and physiologic profile of cardiomyopathies, and the acute and chronic pharmacologic management of heart failure.

Data Source:
MEDLINE, PubMed.

Conclusion:
The etiology of chronic heart failure in pediatrics is vast. The paradigm of extrapolating adult clinical trials and technological advancements to treat heart failure in children has become a nonsustainable model. The field of pediatric heart failure continues to advance with more robust guideline-directed care and the imminent creation of a dynamic, contemporary international database. As the field involves a markedly heterogeneous patient population, it is imperative to use pediatric specific descriptors of disease impact. The fields of pediatric heart failure and critical care medicine will continue to evolve together as childhood specific registries, quality improvement guidelines, and research will lead to practice models eliciting optimal therapy for patients with heart failure in the intensive care setting.
Intensive Care in the Adult With Congenital Heart Disease
Authors: Redington Andrew 
Published: August 2016

Objectives:
The purpose of this review is to discuss current outcomes for patients with adult congenital heart disease, assess the level of knowledge regarding the impact of comorbidities, and discuss the various models of care with a view to establish the optimal environment for the care of these patients in the future.

Data Source:
MEDLINE and PubMed.

Conclusion:
There is an increasingly large population of adults with previously operated congenital heart disease. Consequently, there are increasing numbers of adults requiring intensive care support after re-do surgery, or as a consequence of medical complications of their underlying cardiac disease. There is relatively little data specific to this population to guide optimal disposition and care models.
Shunt Lesions Part I: Patent Ductus Arteriosus, Atrial Septal Defect, Ventricular Septal Defect, and Atrioventricular Septal Defect
Authors: Backer Carl L. , Eltayeb Osama , Mongé Michael C. , Mazwi Mjaye L. , Costello John M. 
Published: August 2016

Objectives:
This review summarizes the current understanding of the pathophysiology and perioperative management of patent ductus arteriosus, atrial septal defect, ventricular septal defect, and atrioventricular septal defect.

Data Source:
MEDLINE and PubMed.

Conclusions:
The four congenital cardiac lesions that are the subject of this review, patent ductus arteriosus, atrial septal defect, ventricular septal defect, and atrioventricular septal defect, are the most commonly found defects causing a left-to-right shunt. These defects frequently warrant transcatheter or surgical intervention. Although the perioperative care is relatively straightforward for many of these patients, there are a number of management strategies and complications associated with each intervention. The treatment outcomes for all of these lesions are very good in the current era.
Right Ventricular Outflow Tract Obstruction: Pulmonary Atresia With Intact Ventricular Septum, Pulmonary Stenosis, and Ebstein’s Malformation
Authors: Kwiatkowski David M. , Hanley Frank L. , Krawczeski Catherine D. 
Published: August 2016

Objectives:
The objectives of this review are to discuss the anatomy, pathophysiology, clinical course, and current treatment strategies for pulmonary atresia with intact ventricular septum, pulmonary stenosis, and Ebstein’s anomaly.

Data Source:
MEDLINE and PubMed.

Conclusions:
Considerable advances have been made in management strategies for these complex congenital heart lesions, which have led to improved outcomes.
Comorbid Conditions in Neonates With Congenital Heart Disease
Authors: Krishnamurthy Ganga , Ratner Veniamin , Bacha Emile , Aspelund Gudrun 
Published: August 2016

Objectives:
The objectives of this review are to discuss the pathophysiology, clinical impact and treatment of major noncardiac anomalies, and prematurity in infants with congenital heart disease.

Data Source:
MEDLINE and PubMed.

Conclusion:
Mortality risk is significantly higher in patients with congenital heart disease and associated anomalies compared with those in whom the heart defect occurs in isolation. Although most noncardiac structural anomalies do not require surgery in the neonatal period, several require surgery for survival. Management of such infants poses multiple challenges. Premature infants with congenital heart disease face challenges imposed by their immature organ systems, which are susceptible to injury or altered function by congenital heart disease and abnormal circulatory physiology independent of congenital heart disease. For optimal outcomes in premature infants or in infants with multiple congenital anomalies, a collaborative interdisciplinary approach is necessary.
Multisite Tissue Oxygenation Monitoring Indicates Organ-Specific Flow Distribution and Oxygen Delivery Related to Low Cardiac Output in Preterm Infants With Clinical Sepsis
Authors: van der Laan Michelle E. , Roofthooft Marcus T. R. , Fries Marian W. A. , Schat Trijntje E. , Bos Arend F. , Berger Rolf M. F. , Kooi Elisabeth M. W. 
Published: August 2016

Objectives:
Cardiac output may be compromised in preterm infants with sepsis. Whether low cardiac output is associated with low tissue oxygen supply in these patients is unclear. The aim of the current study was to assess the association between cardiac output, assessed by echocardiography, and tissue oxygenation, measured with multisite near-infrared spectroscopy, in a cohort of preterm infants with clinical sepsis.

Design:
Prospective observational cohort study.

Setting:
Level III neonatal ICU.

Patients:
Twenty-four preterm infants (gestational age < 32 wk) with clinical sepsis.

Interventions:
None.

Measurements and Main Results:
Clinical and echocardiographic assessment of hemodynamics was performed within 48 hours of sepsis workup and repeated at least 24 hours later. We measured cerebral, renal, and intestinal tissue oxygen saturation using near-infrared spectroscopy during an hour of stable measurements directly preceding or following echocardiography and calculated fractional tissue oxygen extraction in each tissue. We determined Spearman correlation coefficients between fractional tissue oxygen extraction and right ventricular output corrected for patent foramen ovale flow, left ventricular output corrected for ductus arteriosus flow, and superior vena cava flow. Right ventricular output corrected for patent foramen ovale and left ventricular output corrected for ductus arteriosus flow both correlated significantly with intestinal fractional tissue oxygen extraction (ρ, –0.700; p = 0.036 and ρ, –0.604; p = 0.029, respectively). In contrast, no significant correlations were found between cardiac output measurements and cerebral and renal fractional tissue oxygen extraction, respectively. Changes in cardiac output measurements were not associated with observed changes in fractional tissue oxygen extraction values.

Conclusions:
Right ventricular output corrected for patent foramen ovale and left ventricular output corrected for ductus arteriosus flow, indicators of systemic blood flow in preterm infants with shunts, were negatively associated with intestinal fractional tissue oxygen extraction, but not with renal and cerebral fractional tissue oxygen extraction. These findings suggest that during low output states due to clinical sepsis intestinal perfusion is most at risk.
The Current State of the Diagnosis and Management of Acute Kidney Injury by Pediatric Critical Care Physicians*
Authors: Hassinger Amanda B. , Garimella Sudha , Wrotniak Brian H. , Freudenheim Jo L. 
Published: August 2016

Objectives:
Increasingly prevalent in pediatric intensive care, acute kidney injury imparts significant short- and long-term consequences. Despite advances in acute kidney injury research, clinical outcomes are worsening. We surveyed pediatric critical care physicians to describe the current state of acute kidney injury diagnosis and management in critically ill children.

Design:
Anonymous electronic questionnaire.

Participants:
Pediatric critical care physicians from academic centers, the Pediatric Acute Lung Injury and Sepsis Investigators network, and/or the pediatric branch of Society of Critical Care Medicine.

Interventions:
None.

Measurements and Main Results:
Of 201 surveys initiated, 170 surveys were more than 50% completed and included in our results. The majority of physicians (74%) diagnosed acute kidney injury using serum creatinine and urine output. Acute kidney injury guidelines or criteria were used routinely by 54% of physicians; Risk, Injury, Failure, Loss, and End stage criteria were the most commonly used. Awareness of any acute kidney injury guideline or definition was associated with five-fold higher odds of using any guideline (odds ratio, 5.22; 95% CI, 1.84–14.83) and four-fold higher odds of being dissatisfied with available acute kidney injury biomarkers (odds ratio, 4.88; 95% CI, 1.58–15.05). Less than half of respondents recognized the limitations of serum creatinine. Physicians unaware of the limitations of serum creatinine had two-fold higher odds of being unaware of newer biomarker availability (odds ratio, 2.34; 95% CI, 1.14–4.79). Novel biomarkers were available to 37.6% of physicians for routine use. Physicians with access to novel biomarkers more often practiced in larger (odds ratio, 3.09; 95% CI, 1.18–8.12) and Midwestern (odds ratio, 3.38; 95% CI, 1.47–7.78) institutions. More physicians with access to a novel biomarker reported satisfaction with current acute kidney injury diagnostics (66%) than physicians without access (48%); this finding approached significance (p = 0.07).

Conclusions:
Half of PICU attending physicians surveyed are not using recent acute kidney injury guidelines or diagnostic criteria in their practice. There is a positive association between awareness and clinical use of acute kidney injury guidelines. Serum creatinine and urine output are still the primary diagnostics; novel biomarkers are frequently unavailable.
Inotropic Therapy in Newborns, A Population-Based National Registry Study*
Authors: Burns Margrete Larsen , Stensvold Hans Jørgen , Risnes Kari , Guthe Hans Jørgen , Astrup Henriette , Nordhov S. Marianne , Selberg Terje Reidar , Rønnestad Arild , Lang Astri Maria 
Published: August 2016

Objective:
To describe the use of inotropic drugs and the characteristics of neonates receiving such treatment in a national cohort of patients admitted to neonatal ICUs in Norway.

Design:
A national registry study of patients included in the Norwegian Neonatal Network database 2009–2014. Demographic and treatment data, including the use of inotropic drugs (dopamine, dobutamine, epinephrine, norepinephrine, milrinone, and levosimendan) and outcomes, were retrieved and analyzed.

Setting:
Neonatal ICUs in Norway.

Patients:
All patients admitted to Norwegian neonatal ICUs 2009–2014 with a postmenstrual age of less than 310 days at admission, corresponding to a postnatal age of less than 28 days for a child born at term (n = 36 397).

Interventions:
None.

Measurements and Main Results:
Inotropic drugs were administered to 974 of 361,803 live born infants (0.27%) in the study period, representing 2.7% of the neonatal ICU patient population. The relative proportion of neonatal ICU patients receiving inotropes decreased with increasing gestational age, yet 41% of the patients receiving inotropes were born at term. Of note, 89.8% of treated patients received dopamine. Use of inotropes was particularly prevalent in patients with necrotizing enterocolitis (72.4%) and pulmonary hypertension (42.1%) and in patients with gestational age less than 28 weeks (28.2%). Inotropic treatment initiated in the first week of life (84.2%) was associated with birth asphyxia and pulmonary hypertension, whereas treatment initiated after the first week of life was associated with extremely preterm birth, neonatal surgery, neonatal sepsis, cardiac disease, and necrotizing enterocolitis.

Conclusions:
This comprehensive epidemiologic study indicates that less than 0.3% of newborns receive inotropic support in the neonatal period. Dopamine was the most commonly used drug. Relating inotrope use to clinical condition, gestational age, and postnatal age may be useful for clinicians and helpful in delineating relevant patient populations for future clinical trials.