bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Nordic Obstetric Surveillance Study: A Study of Complete Uterine Rupture, Abnormally Invasive Placenta, Peripartum Hysterectomy, and Severe Blood Loss at Delivery
Authors: Colmorn L.B. , Petersen K.B. , Jakobsson M. , Lindqvist P.G. , Klungsoyr K. , Källen K. , Bjarnadottir R.I. , Tapper A.M. , Børdahl P.E. , Gottvall K. , Thurn L. , Gissler M. , Krebs L. , Langhoff-Roos J. 
Published: May 2016

(Acta Obstet Gynecol Scand. 2015;94:734–744)
There is a lack of reliable research regarding severe complications at delivery, which is most likely due to the rarity of such complications. There is also the issue of interactions between different severe complications, questionable reporting, and the absence of precise terminology. The Nordic Obstetric Surveillance Study (NOSS) evaluated the rate of uterine rupture, placenta accreta, peripartum hysterectomy, and severe blood loss during delivery in Nordic countries as well as the characteristics of the women who suffered these complications. The aim was to provide valuable information that might help guide the management of obstetric emergencies.
The Consistency of Experts’ Evaluation of Obstetric Claims for Compensation
Authors: Andreasen S. , Backe B. , Lydersen S. , Øvrebø K. , Øian P. 
Published: May 2016

(BJOG. 2015;122(7):948–953)
In Norway, patients who believe they have been injured by the health care system may apply for compensation to the Norwegian System of Compensation to Patients (NPE), a no-blame system which can dispense compensation without anyone being proven guilty of negligence.
The Effect of Co-administration of Intravenous Calcium Chloride and Oxytocin on Maternal Hemodynamics and Uterine Tone Following Cesarean Delivery: A Double-blinded, Randomized, Placebo-controlled Trial
Authors: Farber M.K. , Schultz R. , Lugo L. , Liu X. , Huang C. , Tsen L.C. 
Published: May 2016

(Int J Obstet Anesth. 2015;24:217–224)
Oxytocin administration following cesarean delivery may be associated with significant adverse effects, such as cardiovascular instability (hypotension, tachycardia, myocardial ischemia). Intravenous (IV) calcium chloride (CaCl2) has been shown to increase mean arterial pressure (MAP) and cardiac contractility in patients undergoing anesthesia. Consequently, the authors of the present study hypothesized that IV co-administration of CaCl2 with oxytocin 5 U IV bolus would reduce the risk of hypotension and improve uterine tone in women undergoing elective cesarean delivery under spinal anesthesia. The primary outcome studied was blood pressure change after study drug administration. Secondary outcomes included the effect of CaCl2 on heart rate, uterine tone, need for additional uterotonic agent, vasopressor use, and blood loss.
Ondansetron Does Not Attenuate Hemodynamic Changes in Patients Undergoing Elective Cesarean Delivery Using Subarachnoid Anesthesia
Authors: Terkawi A.S. , Tiouririne M. , Mehta S.H. , Hackworth J.M. , Tsang S. , Durieux M.E. 
Published: May 2016

(Reg Anesth Pain Med. 2015;40:344–348)
The most common side effect of subarachnoid (SA) anesthesia for cesarean delivery (CD) is hypotension, and the use of serotonin receptor-blocking drugs has been suggested as a possible treatment for this. One receptor antagonist that has been proposed for this use in both obstetric and nonobstetric settings is ondansetron. However, current studies regarding the use of ondansetron are either underpowered or have reported conflicting results. The purpose of this study was to determine how useful ondansetron actually is in the prevention of hypotension, particularly when it is administered intravenously and prophylactically to women undergoing elective CD.
Multidisciplinary Team Training Reduces the Decisions-to-delivery Interval for Emergency Cesarean Section
Authors: Fuhrmann L. , Pedersen T.H. , Atke A. , Møller A.M. , Østergaard D. 
Published: May 2016

(Acta Anaesthesiol Scand. 2015;59(10):1287–1295)
A 30-minute period is a common practice benchmark for the decision-to-delivery interval (DDI) for emergency cesarean section (ECS) when the life of the mother or fetus is at risk. In Denmark, there is a national standard recommending that 95% of ECSs be performed within this 30-minute interval. A shorter, 15-minute goal is used when there is an immediate maternal or fetal threat, and a 60-minute goal for cases in which there is a need for an earlier-than-planned delivery, but no maternal or fetal compromise. Danish obstetrical results reported to a national database showed that only 34.4% of the ECSs performed at the study hospital in 2011 achieved the desired goal, indicating the need for improvement. This study implemented a simulation-based multidisciplinary team-training program and examined its effect on the DDI in a before-after study.
Cardiovascular Disease Risk is Only Elevated in Hypertensive, Formerly Preeclamptic Women
Authors: Breetveld N.M. , Ghossein-Doha C. , van Kuijk S. , van Dijk A.P. , van der Vlugt M.J. , Heidema W.M. , Scholten R.R. , Spaanderman M.E. 
Published: May 2016

(BJOG. 2015;122(8):1092–1100)
Preeclampsia (PE) complicates 5% to 8% of all pregnancies and is associated with an increased risk for premature cardiovascular disease (CVD) later in life. Patients with a history of PE have a 2-fold to 7-fold risk of developing ischemic cardiac disease compared with healthy controls, depending on gestational age at delivery, and about a 4-fold risk of developing chronic hypertension within 15 years after pregnancy. Although it is unknown whether PE itself increases the risk of CVD independently or through risk factors associated with both PE and CVD, patients with a history of PE tend to exhibit components of the metabolic syndrome compared with patients with a history of uncomplicated pregnancy. Quantifying person-specific CVD risk could be useful in counseling these patients.
The Effect of Patient Warming During Cesarean Delivery on Maternal and Neonatal Outcomes: A Meta-Analysis
Authors: Sultan P. , Habib A. , Cho Y. , Carvalho B. 
Published: May 2016

(Br J Anaesth. 2015;115(4):500–510)
The use of periperative warming is recommended for surgery under anesthesia, as it can help lower the risk of postoperative wound infection, myocardial ischemia, perioperative coagulopathy, blood loss, and transfusion requirements. However, there are currently no European or American national recommendations on the use of warming prior to and during cesarean delivery and it is not widely practiced. This study looked at the effect of active warming for elective cesarean deliveries on maternal temperature and comfort, neonatal temperature, umbilical cord pH, and Apgar scores.
The Effect of Adding a Background Infusion to Patient-Controlled Epidural Labor Analgesia on Labor, Maternal, and Neonatal Outcomes: A Systematic Review and Meta-Analysis
Authors: Heesen Michael , Böhmer Johannes , Klöhr Sven , Hofmann Thomas , Rossaint Rolf , Straube Sebastian 
Published: May 2016

(Anesth Analg. 2015;121:149–158)
Epidural analgesia during labor can either be administered by means of a continuous infusion, bolus technique, or patient-controlled epidural analgesia (PCEA). PCEA gives patients the ability to administer a bolus themselves, which shortens the duration between the onset of patient discomfort and the administration of additional analgesia. This technique has been associated with less motor block, a reduced need for local anesthetic, and fewer physician-administered boluses compared with continuous infusion. Some clinicians prefer to combine a continuous infusion with a bolus technique even though it is uncertain if there are any real benefits to this method. The purpose of this review was to provide a meta-analysis that would hopefully guide clinical practice with respect to this combined method.
Pencil-point Needle Bevel Direction Influences ED50 of Isobaric Ropivacaine With Fentanyl in Spinal Anesthesia for Cesarean Delivery: A Prospective, Double-blind Sequential Allocation Study
Authors: Stroumpoulis K. , Stamatakis E. , Koutroumanis P. , Loukeri A. , Valsamidis D. 
Published: May 2016

(Int J Obstet Anesth. 2015;24:225–229)
The authors of this study reported that their clinical experiences suggested that a cephalad orientation of the bevel of a Whitacre spinal needle decreased the amount of local anesthetic required for effective spinal anesthesia during cesarean delivery. To provide evidence supporting their anecdotal experience, they conducted a prospective, double-blind, sequential allocation study, in which they evaluated if the mean effective dose (ED50) of intrathecal isobaric 0.75% ropivacaine with fentanyl differed when the bevel direction of a 26-G Whitacre needle was changed.
A Perioperative Course of Gabapentin Does Not Produce a Clinically Meaningful Improvement in Analgesia After Cesarean Delivery
Authors: Monks D.T. , Hoppe D.W. , Downey K. , Shah V. , Bernstein P. , Carvalho J.C. 
Published: May 2016

(Anesthesiology. 2015;123:320–326)
Gabapentin is an analgesic that has proven itself to be beneficial perioperatively for several surgeries, some of which, such as abdominal hysterectomy, are similar to cesarean delivery. There is also extensive information on this drug from its use as an anticonvulsant, in which it has been shown to be safe for use during pregnancy and breastfeeding. But while there have been studies evaluating its efficacy for pain management following cesarean delivery, studies evaluating use of a single preoperative dose for pain management following cesarean delivery have not produced definitive results. The authors of this trial sought to test the analgesic effect of gabapentin when given perioperatively for cesarean delivery.
Scheduled Acetaminophen With As-needed Opioids Compared With As-needed Acetaminophen Plus Opioids for Postcesarean Pain Management
Authors: Valentine A.R. , Carvalho B. , Lazo T.A. , Riley E.T. 
Published: May 2016

(Int J Obstet Anesth. 2015;24:210–216)
Postoperative multimodal regimens like oral opioid-acetaminophen combination drugs can produce adverse maternal opioid-related side effects. Uncoupling these 2 drugs and administering them separately on a scheduled basis (acetaminophen plus as-needed opioids) may thereby be advantageous and lead to decreased opioid use. In the present study, the authors compared opioid use for scheduled acetaminophen plus as-needed opioid regimens with as-needed opioid-acetaminophen combination drug regimens.
Post-traumatic Stress Disorder Managed Successfully With Hypnosis and the Rewind Technique: 2 Cases in Obstetric Patients
Authors: Slater P.M. 
Published: May 2016

(Int J Obstet Anesth. 2015;24:272–275)
Posttraumatic stress disorder (PTSD) occurs in 1% to 2% of women following childbirth and is associated with subjective distress in labor, obstetric emergencies, trait anxiety, and a history of psychological problems. PTSD itself is also a risk factor for the development of depressive and psychiatric disorders, and suicide remains a leading cause of maternal death. The rewind technique, in combination with hypnosis, is a specific treatment for PTSD. Patients are asked to rapidly fast-forward and rewind images associated with the event, to allow for reframing the event as nonthreatening. Currently, there are no reports focusing on the rewind technique and hypnosis as treatments for this disorder in the medical literature. In this present report, the authors describe 2 obstetric patients presenting with PTSD who underwent hypnosis with or without the rewind technique.
Chronic Adhesive Arachnoiditis After Repeat Epidural Blood Patch
Authors: Carlswärd C. , Darvish B. , Tunelli J. , Irestedt L. 
Published: May 2016

(Int J Obstet Anesth. 2015;24:280–283)
An epidural blood patch (EBP) has variable efficacy in managing postdural puncture headache (PDPH). The authors of this case report describe a patient who developed chronic adhesive arachnoiditis (CAA), which might have resulted from a repeat EBP. The patient was a healthy, 29-year-old woman with an uncomplicated pregnancy who delivered vaginally. Upon epidural placement for labor analgesia, an accidental dural puncture occurred. The epidural catheter was placed intrathecally and effective labor analgesia was provided with intermittent doses of 0.25% bupivacaine. A total of 15 mg was administered throughout labor and delivery. She developed a severe PDPH 36 hours after the accidental dural puncture.
Quality of Care Provided by Board-Certified Versus Non-Board-Certified Psychiatrists and Neurologists
Authors: Wallace Anna , McFarland Bentson H. , Selvam Nandini , Sahota Gurvaneet 
Published: May 2016

Purpose
To examine associations between board certification of psychiatrists and neurologists and quality-of-care measures, using multilevel models controlling for physician and patient characteristics, and to assess feasibility of linking physician information with patient records to construct quality measures from electronic claims data.

Method
The authors identified quality measures and matched claims data from 2006 to 2012 with 942 board-certified (BC) psychiatrists, 868 non-board-certified (nBC) psychiatrists, 963 BC neurologists, and 328 nBC neurologists. Using the matched data, they identified psychiatrists who treated at least one patient with a schizophrenia diagnosis, and neurologists attending patients discharged with a principal diagnosis of ischemic stroke, and analyzed claims from these patients. For patients with schizophrenia who were prescribed an atypical antipsychotic, quality measures were claims for glucose and lipid tests, duration of any antipsychotic treatment, and concurrent prescription of multiple antipsychotics. For patients with ischemic stroke, quality measures were dysphagia evaluation; speech/language evaluation; and prescription of clopidogrel, low-molecular-weight heparin, intravenous heparin, and warfarin (for patients with co-occurring atrial fibrillation).

Results
Overall, multilevel models (patients nested within physicians) showed no statistically significant differences in quality measures between BC and nBC psychiatrists and neurologists.

Conclusions
The authors demonstrated the feasibility of linking physician information with patient records to construct quality measures from electronic claims data, but there may be only minimal differences in the quality of care between BC and nBC psychiatrists and neurologists, or there may be a difference that could not be measured with the quality measures used.
Influence of Complex Loading Conditions on Intervertebral Disc Failure
Authors: Berger-Roscher Nikolaus , Casaroli Gloria , Rasche Volker , Villa Tomaso , Galbusera Fabio , Wilke Hans-Joachim 
Published: May 2016

Study Design.
High resolution imaging investigation of the failure of ovine lumbar intervertebral discs under complex loading.

Objective.
To investigate how different loading combinations influence the mechanism and extent of intervertebral disc failure.

Summary of Background Data.
Even though there has been extensive research on how an intervertebral disc fails under various conditions, failure mechanisms remain unclear. In addition, the influence of different loading directions on the mode and extent of failure under complex loading was never systematically investigated.

Methods.
Thirty ovine lumbar spinal segments were loaded in a newly developed, dynamic, 6-degree-of-freedom (6-DOF) disc loading simulator under five combinations of the following loading parameters: 0°–13° flexion, 0°–10° lateral bending, 0°–4° axial rotation, 0–800 N axial compression. A total of 1000 cycles at 2 Hz were done. After testing, imaging of the discs was performed in an ultra-high field magnetic resonance imaging (11.7 T) scanner and with a micro-computed tomography scanner.

Results.
A total of 13 large endplate junction failures (EPJFs) occurred, of which all but one maintained an intact cartilaginous endplate. Ten out of 13 EPJFs occurred caudally. Four solely annulus failures occurred affecting only the outer posterior annulus. A herniation was not observed. The maximum moments measured in any group (median) were 52.5 N · m flexion, 16.5 N · m lateral bending, and 14.0 N · m axial rotation.

Conclusion.
Complex loading protocols could lead to EPJFs (76%) and annulus failures (24%) in vitro. The combination of flexion, lateral bending, axial rotation, and axial compression bears the highest risk for caudal EPJF. Flexion without lateral bending and vice versa has the lowest risk for failure. Both axial compression and axial rotation seem to have a smaller influence than flexion and lateral bending. It seems that a herniation requires an additional failure of the cartilaginous endplate, likely initiated by further axial compressive load.

Level of Evidence: 4
Deletion of Opg Leads to Increased Neovascularization and Expression of Inflammatory Cytokines in the Lumbar Intervertebral Disc of Mice
Authors: Li Xiao-Feng , Xue Chun-Chun , Zhao Yong-Jian , Cheng Shao-Dan , Zhao Dong-Feng , Liang Qian-Qian , Chen Lin , Wang Qiang , Lu Sheng , Shi Qi , Wang Yong-Jun , Shu Bing 
Published: May 2016

Study Design.
Neovascularization and expression of inflammatory cytokines were examined in Osteoprotegerin (Opg) knockout (KO) mice that show intervertebral disc (IVD) degeneration.

Objective.
The aim of this study was to clarify the pathological changes in lumbar IVD degeneration in Opg KO mice.

Summary of Background Data.
Osteoporosis is a controversial risk factor for IVD degeneration. Deletion of Opg resulted in IVD degeneration in mice. Neovascularization and inflammatory cytokines are key factors in IVD degeneration.

Methods.

Opg KO mice and their wild-type (WT) littermates were euthanized. Lumbar IVDs were harvested. Safranin O/Fast Green staining was performed to examine the pathological changes. Microcomputed tomographic (micro-CT) analysis was performed to determine the structural changes at the junction of lumbar IVD cartilage and vertebrae. Tartrate-resistant acid phosphatase (TRAP) staining was performed to evaluate osteoclast formation. Protein expression of vascular endothelial growth factor A (VEGF-A), CD31, VE-cadherin, CD 34, interleukin-1β (IL-1β), and tumor necrosis factors α (TNF-α) were analyzed by immunohistochemistry (IHC) assays. Gene expressions of IL-1β, IL-6, and TNF-α were analyzed by real-time polymerase chain reaction (RT-PCR).

Results.
In 12-week-old Opg KO mice, new bone was formed in the endplate cartilage of lumbar IVDs and this became more obvious in 24-week-old Opg KO mice. Three-dimensional (3D) μCT reconstruction analyses showed that the edges of the L4 and L5 vertebrae were rugged with bone marrow cavities in it. Protein expression of VEGF-A, CD31, VE-cadherin, and CD34 was increased in the endplate and growth plate of lumbar IVDs of Opg KO mice. Gene expression of IL-1β, IL-6, and TNF-α as well as protein expression of IL-1β and TNF-α were highly expressed in the lumbar IVDs of Opg KO mice.

Conclusion.
Deletion of Opg leads to increased neovascularization and expression of inflammatory cytokines in the lumbar disc in Opg KO mice, which may play important roles in IVD degeneration.

Level of Evidence: N/A
Inhibition of TNF-α–mediated NF-κB Activation by Ginsenoside Rg1 Contributes the Attenuation of Cardiac Hypertrophy Induced by Abdominal Aorta Coarctation
Authors: Tang Futian , Lu Meili , Yu Lan , Wang Qiuning , Mei Meng , Xu Chonghua , Han Ronghui , Hu Jin , Wang Hongxin , Zhang Yingjie 
Published: May 2016

Abstract:
Ginsenoside Rg1 (Rg1), a protopanaxadiol saponin extracted from Chinese medicine Panax ginseng C.A. Meyer, has been demonstrated to inhibit the cardiac hypertrophy. However, the molecular mechanisms underlying the inhibition remain poorly understood. Activation of nuclear factor-kappa B (NF-κB) mediated by tumor necrosis factor α (TNF-α) gets involved in the cardiac hypertrophy. This study is designed to investigate the effects and the potential mechanism of Rg1 on the abdominal aorta coarctation (AAC)-induced cardiac hypertrophy with focus on TNF-α/NF-κB signaling pathway. The results showed that oral administration of Rg1 dose-dependently improved the pathological changes, decreased the ratios of left ventricular weight/body weight (LVW/BW) and heart weight/BW (HW/BW), corrected the dysfunction of the cardiac hemodynamics by decreasing the left ventricular systolic pressure and left ventricular end-diastolic pressure and increasing the maximal rate of left ventricular systolic and diastolic pressure (±dp/dtmax) compared with the AAC alone. Rg1 also downregulated the atrial natriuretic peptide mRNA expression and decreased the mRNA and protein expression of TNF-α in the heart tissue of rats compared with the AAC alone. In addition, Rg1 and BAY, the specific inhibitor of NF-κB, decreased the protein content and downregulated the mRNA expression of atrial natriuretic peptide in neonatal rat ventricular myocytes treated with TNF-α. Furthermore, Rg1 increased the protein expression of p65, the subunit of NF-κB, in cytoplasm and decreased the expression p65 in nucleus of the heart tissue of rats undergoing the AAC and of neonatal rat ventricular myocytes treated with TNF-α. The results suggested that Rg1 attenuates the AAC-induced cardiac hypertrophy through inhibition of TNF-α/NF-κB signaling pathway.
Exercise training reduces the frequency of menopausal hot flushes by improving thermoregulatory control
Authors: Bailey Tom G. , Cable N. Timothy , Aziz Nabil , Dobson Rebecca , Sprung Victoria S. , Low David A. , Jones Helen 
Published: May 2016

Abstract

Objective:
Postmenopausal hot flushes occur due to a reduction in estrogen production causing thermoregulatory and vascular dysfunction. Exercise training enhances thermoregulatory control of sweating, skin and brain blood flow. We aimed to determine if improving thermoregulatory control and vascular function with exercise training alleviated hot flushes.

Methods:
Twenty-one symptomatic women completed a 7-day hot flush questionnaire and underwent brachial artery flow-mediated dilation and a cardiorespiratory fitness test. Sweat rate and skin blood flow temperature thresholds and sensitivities, and middle cerebral artery velocity (MCAv) were measured during passive heating. Women performed 16 weeks of supervised exercise training or control, and measurements were repeated.

Results:
There was a greater improvement in cardiorespiratory fitness (4.45 mL/kg/min [95% CI: 1.87, 8.16]; P = 0.04) and reduced hot flush frequency (48 hot flushes/wk [39, 56]; P < 0.001) after exercise compared with control. Exercise reduced basal core temperature (0.14°C [0.01, 0.27]; P = 0.03) and increased basal MCAv (2.8 cm/s [1.0, 5.2]; P = 0.04) compared with control. Sweat rate and skin blood flow thresholds occurred approximately 0.19°C and 0.17°C earlier, alongside improved sweating sensitivity with exercise. MCAv decreased during heating (P
< 0.005), but was maintained 4.5 cm/s (3.6, 5.5; P < 0.005) higher during heating after exercise compared with control (0.6 cm/s [−0.4, 1.4]).

Conclusions:
Exercise training that improves cardiorespiratory fitness reduces self-reported hot flushes. Improvements are likely mediated through greater thermoregulatory control in response to increases in core temperature and enhanced vascular function in the cutaneous and cerebral circulations.