bluuebunny/crossref_metadata_2025_split huggingface dataset:
sEEG is a Safe Procedure for a Comprehensive Anatomic Exploration of the Insula: A Retrospective Study of 108 Procedures Representing 254 Transopercular Insular Electrodes
Authors: Salado Anne Laure , Koessler Laurent , De Mijolla Gabriel , Schmitt Emmanuelle , Vignal Jean-Pierre , Civit Thierry , Tyvaert Louise , Jonas Jacques , Maillard Louis Georges , Colnat-Coulbois Sophie 
Published: May 2017

Abstract

BACKGROUND
The exploration of the insula in pre-surgical evaluation of epilepsy is considered to be associated with a high vascular risk resulting in an incomplete exploration of the insular cortex.

OBJECTIVE
To report a retrospective observational study of insular exploration using stereoelectroencephalography (sEEG) with transopercular and parasagittal oblique intracerebral electrodes from January 2008 to January 2016. The first purpose of this study was to evaluate the surgical risks of insular cortex sEEG exploration. The second purpose was to define the ability of placing intracerebral contacts in the whole insular cortex.

METHODS
Ninety-nine patients underwent 108 magnetic resonance imaging (MRI)-guided stereotactic implantations of intracerebral electrodes in the context of preoperative assessment of drug-resistant epilepsy, including at least 1 electrode placed in the insular cortex. On postoperative computed tomography images co-registered with MRI, followed by MRI segmentation and application of a transformation matrix, intracerebral contact coordinates of the insular electrodes’ contacts were anatomically localized in the Talairach space. Finally, dispersion and clustering analysis was performed.

RESULTS
There was no morbidity, in particular hemorrhagic complications, or mortality related to insular electrodes. Statistical comparison of intracerebral contact positions demonstrated that whole insula exploration is possible on the left and right sides. In addition, the clustering analysis showed the homogeneous distribution of the electrodes within the insular cortex.

CONCLUSION
In the presurgical evaluation of drug-resistant epilepsy, the insular cortex can be explored safely and comprehensively using transopercular sEEG electrodes. Parasagittal oblique trajectories may also be associated to achieve an optimal exploration.
Spinal Cord Suspension Using Dentate Ligament Hitch Stitches: A Novel Technique for the Repair of Ventral Spinal Cord Herniation
Authors: Lui Jonathan , Sayal Parag , Choi David 
Published: May 2017

Abstract

BACKGROUND
Idiopathic spinal cord herniation is usually repaired by releasing the spinal cord and inserting a dural patch to close the herniated segment of dura. However, reherniation is a potential limitation of this standard technique.

OBJECTIVE
To describe early results of a novel technique that utilizes the dentate ligament to hitch the spinal cord and prevent reherniation.

METHODS
Two patients underwent dural hernia repair and the dentate hitch technique was performed.

RESULTS
Restored lower limb power and mobility, and satisfactory reduction of spinal cord herniation on magnetic resonance imaging in 2 patients at 6- and 24-mo follow-ups, respectively.

CONCLUSION
The dentate hitch technique can achieve repair of spinal cord herniation, with satisfactory postoperative results and minimizes the risk of reherniation.
Pharmacists’ Role in Opioid Safety: A Focus Group Investigation
Authors: Hartung Daniel M , Hall Jennifer , Haverly Sarah N , Cameron David , Alley Lindsey , Hildebran Christi , O’Kane Nicole , Cohen Deborah 
Published: May 2017

Abstract

Objective
The pharmacist’s role and responsibilities in addressing the opioid epidemic have yet to be clearly defined, particularly from the patient’s point of view. This qualitative study explores the pharmacist’s role in promoting opioid safety from the perspective of pharmacists and patients.

Design
Focus groups.

Setting
Patient groups were held in person, and pharmacist groups were held online.

Subjects
Oregon pharmacists (N = 19, Mage = 39.0 years, range = 26–57 years, 58% female) and patients (N = 18, Mage = 60.1 years, range = 30–77 years, 71% female) with current experience dispensing or receiving opioid medications.

Methods
Pharmacists were asked about the challenges and opportunities for opioid safety monitoring and prescription dispensing. Patients were asked about their experiences accessing care, medications, and safety information. Focus group data were analyzed by a multidisciplinary team using an immersion-crystallization approach.

Results
Pharmacists and patients agreed that pharmacists are responsible for medication safety. Pharmacists expressed discomfort filling potentially high-risk opioid prescriptions and noted barriers such as lack of clinical information and discomfort policing high-risk prescribing. Patients were concerned about pharmacists potentially overstepping their professional responsibilities by interfering with prescribers’ clinical decisions.

Conclusions
Feedback from both pharmacists and patient participants suggests that there is uncertainty in the degree to which pharmacists can and should confront the prescription opioid epidemic directly. Ambiguities in the pharmacist’s role may be best clarified through structured training promoting enhanced between-party communication.
Incidence and Timing of Thromboembolic Events in Patients With Ovarian Cancer Undergoing Neoadjuvant Chemotherapy
Authors: Greco Patricia S. , Bazzi Ali A. , McLean Karen , Reynolds R. Kevin , Spencer Ryan J. , Johnston Carolyn M. , Liu J. Rebecca , Uppal Shitanshu 
Published: May 2017

OBJECTIVE:
To identify the incidence and timing of venous thromboembolism as well as any associated risk factors in patients with ovarian, fallopian tube, or primary peritoneal cancer undergoing neoadjuvant chemotherapy.

METHODS:
We conducted a retrospective cohort study of patients diagnosed with ovarian, fallopian tube, and primary peritoneal cancer and receiving neoadjuvant chemotherapy from January 2009 to May 2014 at a single academic institution. The timing and number of venous thromboembolic events for the entire cohort were categorized as follows: presenting symptom, during neoadjuvant chemotherapy treatment, after debulking surgery, and during adjuvant chemotherapy.

RESULTS:
Of the 125 total patients with ovarian cancer undergoing neoadjuvant chemotherapy, 13 of 125 patients (10.4%, 95% confidence interval [CI] 6.1–17.2%) had a venous thromboembolism as a presenting symptom and were excluded from further analysis. Of the 112 total patients at risk, 30 (26.8%, 95% CI 19.3–35.9%) experienced a venous thromboembolism. Based on the phase of care, 13 (11.6%, 95% CI 6.8–19.1%) experienced a venous thromboembolism during neoadjuvant chemotherapy, six (5.4%, 95% CI 2.4–11.5%) developed a postoperative venous thromboembolism, and 11 (9.9%, 95% CI 5.5–17%) developed a venous thromboembolism during adjuvant chemotherapy. Two of the four patients with clear cell histology developed a venous thromboembolism in this cohort.

CONCLUSION:
Overall new diagnosis of venous thromboembolism was associated with one fourth of the patients undergoing neoadjuvant chemotherapy for ovarian cancer with nearly half of these diagnosed during chemotherapy cycles before interval debulking surgery. Efforts to reduce venous thromboembolism so far have largely focused on the postoperative period. Additional attention to venous thromboembolic prophylaxis during chemotherapy (neoadjuvant and adjuvant) in this patient population is warranted in an effort to decrease the rates of venous thromboembolism.
Universal Cervical Length Screening and Antenatal Corticosteroid Timing
Authors: Sahasrabudhe Nicole , Igel Catherine , Echevarria Ghislaine C. , Dar Pe'er , Wolfe Diana , Bernstein Peter S. , Angert Robert , Dayal Ashlesha , Gallagher Patience , Rosner Mara 
Published: May 2017

OBJECTIVE:
To evaluate the relationship between universal transvaginal screening for short cervical length in the second trimester and the timing of antenatal corticosteroids.

METHODS:
We performed a retrospective cohort study of patients with nonanomalous singleton gestations and spontaneous preterm birth between 24 and 34 weeks of gestation after the initiation of a universal transvaginal cervical length screening program between October 2012 and August 2015. Our primary outcome was antenatal corticosteroid administration to a delivery interval of fewer than 7 days. Secondary outcomes were delivery 24 hours to 7 days after the initial steroid injection, steroid administration to delivery interval, neonatal survival, neonatal intensive care unit length of stay, and respiratory distress syndrome. Multivariable logistic regression was used to estimate the association between antenatal corticosteroid timing and the diagnosis of a short cervix adjusted for potential confounders.

RESULTS:
Among 266 eligible patients, 69 with a short cervical length and 197 without a short cervical length were identified. There were no statistically significant differences in baseline characteristics between the groups. During the study period, 64 of 69 (92.8%) of patients with a short cervix and 176 of 197 (89.3%) without a short cervix received at least one steroid injection before delivery (P=.411). Steroids were given within 7 days of delivery in 33 of 69 (47.8) patients with a short cervix compared with 126 of 197 (64%) patients in the no short cervix group (P=.015; adjusted odds ratio 0.51, 95% confidence interval 0.29–0.9). Median interval between steroid administration and delivery was 8 days in patients diagnosed with a short cervix compared with 3 days for those without a short cervical length (P<.001).

CONCLUSION:
Patients identified as having a short cervical length by universal transvaginal ultrasound screening were at greater risk of delivering more than 7 days after the initiation of corticosteroids for fetal lung maturation compared with women without a short cervical length.
Nonpresenting Dichorionic Twins and Placental Vascular Malperfusion
Authors: Weiner Eran , Kahn Michael , Giltvedt Kristine , Kibel Mia , Sherman Christopher , Kingdom John , Barrett Jon , Melamed Nir 
Published: May 2017

OBJECTIVE:
To explore the hypothesis that selective placental pathology affecting the nonpresenting twin is a significant contributory factor mediating the smaller size at birth of nonpresenting dichorionic twins.

METHODS:
We conducted a retrospective cohort study of all dichorionic twin deliveries in a single tertiary center between 2002 and 2015 where by departmental policy, all placentas from multifetal gestations are routinely sent for pathologic examination. Maternal charts, neonatal charts, and pathology reports were reviewed. Placental abnormalities were classified into lesions associated with maternal vascular malperfusion, fetal vascular malperfusion, placental hemorrhage, and chronic villitis. Comparison of neonatal outcomes and placental abnormalities was made between all nonpresenting and all presenting twins as well as within twin pairs.

RESULTS:
A total of 1,322 women with dichorionic twins were studied. Nonpresenting twins were smaller at birth compared with the presenting cotwin starting at 32 weeks of gestation (birth weight [±standard deviation] 2,224±666 g compared with 2,278±675 g, P=.036). Nonpresenting twins had smaller placentas (361±108 g compared with 492±129 g, P<.001) as early as 24 weeks of gestation. Nonpresenting twins had higher odds for any placental abnormality (adjusted odds ratio [OR] 1.91, 95% confidence interval [95% CI] 1.63–2.23), small placenta (adjusted OR 4.69, 95% CI 3.75–5.88), and maternal vascular malperfusion (OR 2.75, 95% CI 2.32–3.27) compared with their presenting cotwins. In nonpresenting twins, the presence of maternal vascular malperfusion pathology was associated with lower birth weight compared with their presenting cotwin during the third trimester.

CONCLUSION:
The lower birth weight of nonpresenting fetuses in dichorionic twin pregnancies is correlated with a higher rate of placental maternal vascular malperfusion pathology.
Pregnancy Outcomes After Fertility Preservation in Transgender Men
Authors: Maxwell Susan , Noyes Nicole , Keefe David , Berkeley Alan S. , Goldman Kara N. 
Published: May 2017

BACKGROUND:
Transgender individuals, individuals whose gender identity does not align with their sex assigned at birth, undergoing gender-affirming hormonal or surgical therapies may experience loss of fertility. Assisted reproductive technologies have expanded family-building options for transgender men who were assigned female at birth.

CASES:
Three transgender men underwent oocyte cryopreservation before gender-affirming hormonal therapy. One patient underwent fertility preservation as an adolescent. Two adult patients had children using their cryopreserved oocytes, with the pregnancies carried by their sexually intimate partners.

CONCLUSION:
Transgender men with cryopreserved gametes can build families in a way that affirms their gender identity. Obstetrician–gynecologists should be familiar with the fertility needs of transgender patients so appropriate discussions and referrals can be made.
Association Between Planned Cesarean Delivery and Neonatal Mortality and Morbidity in Twin Pregnancies
Authors: Schmitz Thomas , Prunet Caroline , Azria Elie , Bohec Caroline , Bongain André , Chabanier Pierre , D'Ercole Claude , Deruelle Philippe , De Tayrac Renaud , Dreyfus Michel , Dupont Corinne , Gondry Jean , Graesslin Olivier , Kayem Gilles , Langer Bruno , Marpeau Loïc , Morel Olivier , Parant Olivier , Perrotin Franck , Pierre Fabrice , Poulain Patrice , Riethmuller Didier , Rozenberg Patrick , Rudigoz René-Charles , Sagot Paul , Sénat Marie-Victoire , Sentilhes Loïc , Vayssière Christophe , Venditelli Françoise , Verspyck Eric , Winer Norbert , Lecomte-Raclet Laurence , Ancel Pierre-Yves , Goffinet François ,   for the JUmeaux MODe d'Accouchement (JUMODA) Study Group and the Groupe de Recherche en Obstétrique et Gynécologie (GROG)
Published: May 2017

OBJECTIVE:
To evaluate the association between the planned mode of delivery and neonatal mortality and morbidity in an unselected population of women with twin pregnancies.

METHODS:
The JUmeaux MODe d'Accouchement (JUMODA) study was a national prospective population-based cohort study. All women with twin pregnancies and their neonates born at or after 32 weeks of gestation with a cephalic first twin were recruited in 176 maternity units in France from February 2014 to March 2015. The primary outcome was a composite of intrapartum mortality and neonatal mortality and morbidity. Comparisons were performed according to the planned mode of delivery, planned cesarean or planned vaginal delivery. The primary analysis to control for potential indication bias used propensity score matching. Subgroup analyses were conducted, one according to gestational age at delivery and one after exclusion of high-risk pregnancies.

RESULTS:
Among 5,915 women enrolled in the study, 1,454 (24.6%) had planned cesarean and 4,461 (75.4%) planned vaginal deliveries, of whom 3,583 (80.3%) delivered both twins vaginally. In the overall population, composite neonatal mortality and morbidity was increased in the planned cesarean compared with the planned vaginal delivery group (5.2% compared with 2.2%; odds ratio [OR] 2.38, 95% confidence interval [CI] 1.86–3.05). After matching, neonates born after planned cesarean compared with planned vaginal delivery had higher composite neonatal mortality and morbidity rates (5.3% compared with 3.0%; OR 1.85, 95% confidence interval 1.29–2.67). Differences in composite mortality and morbidity rates applied to neonates born before but not after 37 weeks of gestation. Multivariate and subgroup analyses after exclusion of high-risk pregnancies found similar trends.

CONCLUSION:
Planned vaginal delivery for twin pregnancies with a cephalic first twin at or after 32 weeks of gestation was associated with low composite neonatal mortality and morbidity. Moreover, planned cesarean compared with planned vaginal delivery before 37 weeks of gestation might be associated with increased composite neonatal mortality and morbidity.
Cumulative Incidence of a Subsequent Surgery After Stress Urinary Incontinence and Pelvic Organ Prolapse Procedure
Authors: Wu Jennifer M. , Dieter Alexis A. , Pate Virginia , Jonsson Funk Michele 
Published: May 2017

OBJECTIVE:
To assess the 5-year risk and timing of repeat stress urinary incontinence (SUI) and pelvic organ prolapse (POP) procedures.

METHODS:
We conducted a retrospective cohort study using a nationwide database, the 2007–2014 MarketScan Commercial Claims and Encounters and Medicare Supplemental Databases (Truven Health Analytics), which contain deidentified health care claims data from approximately 150 employer-based insurance plans across the United States. We included women aged 18–84 years and used Current Procedural Terminology codes to identify surgeries for SUI and POP. We identified index procedures for SUI or POP after at least 3 years of continuous enrollment without a prior procedure. We defined three groups of women based on the index procedure: 1) SUI surgery only; 2) POP surgery only; and 3) Both SUI+POP surgery. We assessed the occurrence of a subsequent SUI or POP procedure over time for women younger than 65 years and 65 years or older with a median follow-up time of 2 years (interquartile range 1–4).

RESULTS:
We identified a total of 138,003 index procedures: SUI only n=48,196, POP only n=49,120, and both SUI+POP n=40,687. The overall cumulative incidence of a subsequent SUI or POP surgery within 5 years after any index procedure was 7.8% (95% confidence interval [CI] 7.6–8.1) for women younger than 65 years and 9.9% (95% CI 9.4–10.4) for women 65 years or older. The cumulative incidence was lower if the initial surgery was SUI only and higher if an initial POP procedure was performed, whether POP only or SUI+POP.

CONCLUSIONS:
The 5-year risk of undergoing a repeat SUI or POP surgery was less than 10% with higher risks for women 65 years or older and for those who underwent an initial POP surgery.
Effects of Exercise on Mild-to-Moderate Depressive Symptoms in the Postpartum Period
Authors: McCurdy Ashley P. , Boulé Normand G. , Sivak Allison , Davenport Margie H. 
Published: May 2017

OBJECTIVE:
To examine the influence of exercise on depressive symptoms and the prevalence of depression in the postpartum period.

DATA SOURCES:
A structured search of MEDLINE, EMBASE, CINAHL, Sport Discus, Ovid's All EBM Reviews, and ClinicalTrials.gov databases was performed with dates from the beginning of the databases until June 16, 2016. The search combined keywords and MeSH-like terms including, but not limited to, “exercise,” “postpartum,” “depression,” and “randomized controlled trial.”

METHODS OF STUDY SELECTION:
Randomized controlled trials comparing postpartum exercise (structured, planned, repetitive physical activity) with the standard care for which outcomes assessing depressive symptoms or depressive episodes (as defined by trial authors) were assessed. Trials were identified as prevention trials (women from the general postpartum population) or treatment trials (women were classified as having depression by the trial authors). Effect sizes with 95% confidence intervals (CIs) were calculated using Hedges' g method and standardized mean differences in postintervention depression outcomes were pooled using a random-effects model.

TABULATION, INTEGRATION, AND RESULTS:
Across all 16 trials (1,327 women), the pooled standardized mean difference was −0.34 (95% CI −0.50 to −0.19, I2=37%), suggesting a small effect of exercise among all postpartum women on depressive symptoms. Among the 10 treatment trials, a moderate effect size of exercise on depressive symptoms was found (standardized mean difference−0.48, 95% CI −0.73 to −0.22, I2=42%). In six prevention trials, a small effect (standardized mean difference−0.22, 95% CI −0.36 to −0.08, I2=2%) was found. In women with depression preintervention, exercise increased the odds of resolving depression postintervention by 54% (odds ratio 0.46, Mantel-Haenszel method, 95% CI 0.25–0.84, I2=0%). The trials included in this meta-analysis were small and some had methodologic limitations.

CONCLUSION:
Light-to-moderate intensity aerobic exercise improves mild-to-moderate depressive symptoms and increases the likelihood that mild-to-moderate depression will resolve.
Breastfeeding and Endometrial Cancer Risk
Authors: Jordan Susan J. , Na Renhua , Johnatty Sharon E. , Wise Lauren A. , Adami Hans Olov , Brinton Louise A. , Chen Chu , Cook Linda S. , Dal Maso Luigino , De Vivo Immaculata , Freudenheim Jo L. , Friedenreich Christine M. , La Vecchia Carlo , McCann Susan E. , Moysich Kirsten B. , Lu Lingeng , Olson Sara H. , Palmer Julie R. , Petruzella Stacey , Pike Malcolm C. , Rebbeck Timothy R. , Ricceri Fulvio , Risch Harvey A. , Sacerdote Carlotta , Setiawan Veronica Wendy , Sponholtz Todd R. , Shu Xiao Ou , Spurdle Amanda B. , Weiderpass Elisabete , Wentzensen Nicolas , Yang Hannah P. , Yu Herbert , Webb Penelope M. 
Published: May 2017

OBJECTIVE:To investigate the association between breastfeeding and endometrial cancer risk using pooled data from 17 studies participating in the Epidemiology of Endometrial Cancer Consortium.METHODS:We conducted a meta-analysis with individual-level data from three cohort and 14 case–control studies. Study-specific odds ratios (ORs) and 95% confidence intervals (CIs) were estimated for the association between breastfeeding and risk of endometrial cancer using multivariable logistic regression and pooled using random-effects meta-analysis. We investigated between-study heterogeneity withI 2and Q statistics and metaregression.RESULTS:After excluding nulliparous women, the analyses included 8,981 women with endometrial cancer and 17,241 women in a control group. Ever breastfeeding was associated with an 11% reduction in risk of endometrial cancer (pooled OR 0.89, 95% CI 0.81–0.98). Longer average duration of breastfeeding per child was associated with lower risk of endometrial cancer, although there appeared to be some leveling of this effect beyond 6–9 months. The association with ever breastfeeding was not explained by greater parity and did not vary notably by body mass index or histologic subtype (grouped as endometrioid and mucinous compared with serous and clear cell).CONCLUSION:Our findings suggest that reducing endometrial cancer risk can be added to the list of maternal benefits associated with breastfeeding. Ongoing promotion, support, and facilitation of this safe and beneficial behavior might therefore contribute to the prevention of this increasingly common cancer.