bluuebunny/crossref_metadata_2025_split huggingface dataset:
Third Trimester Brain Growth in Preterm Infants Compared With In Utero Healthy Fetuses
Authors: Bouyssi-Kobar Marine , du Plessis Adré J. , McCarter Robert , Brossard-Racine Marie , Murnick Jonathan , Tinkleman Laura , Robertson Richard L. , Limperopoulos Catherine 
Published: March 2017

(Abstracted from Pediatrics 2016;138:e20161640)
Preterm birth is associated with lifelong neurodevelopmental disabilities even in the absence of destructive prematurity-related brain injury. The timing, progression, and functional impact of delayed brain maturation in the absence of structural brain injury remain unknown.
Sensitivity of Fetal RhD Screening for Safe Guidance of Targeted Anti–D Immunoglobulin Prophylaxis: Prospective Cohort Study of a Nationwide Programme in the Netherlands
Authors: de Haas Masja , Thurik Florentine F. , van der Ploeg Catharina P. B. , Veldhuisen Barbera , Hirschberg Hoang , Soussan Aicha Ait , Woortmeijer Heleen , Abbink Frithjofna , Page-Christiaens Godelieve C. M. L. , Scheffer Peter G. , van der Schoot C. Ellen 
Published: March 2017

(Abstracted from BMJ 2016;355:i5789)
The risk of maternal alloimmunization due to RhD incompatibility has decreased with use of antenatal and postnatal anti–D immunoglobulin prophylaxis. The discovery of cell-free fetal (cff) DNA in maternal plasma during pregnancy and the feasibility of fetal RhD testing using this source of DNA make it possible to determine fetal RhD type and to restrict the use of antenatal anti–D immunoglobulin to only those RhD-negative women carrying an RhD-positive fetus.
Common Pediatric Pain Disorders and Their Clinical Associations
Authors: Donnelly Theresa J. , Bott Aneeka , Bui Minh , Goh Shuxiang , Jaaniste Tiina , Chapman Cindy , Crawford Matthew , Hopper John L. , Champion David 
Published: March 2017

Background:
Common childhood pain conditions (nonmigraine headache, migraine, recurrent abdominal pain, growing pains, low back pain) and persistent pains are often associated with each other and have significant implications in later life. Emerging evidence suggests additional associations between these pain conditions and restless legs syndrome, iron deficiency, anxiety, and depression. The aim of this cross-sectional study in pediatric twin individuals and their siblings was to investigate these associations.

Materials and Methods:
Surveys were sent to Australian twin families via the Australian Twin Registry, yielding responses from 2530 pediatric individuals. The lifetime prevalence of the common pain disorders of childhood and of other persistent pains, restless legs syndrome and iron deficiency, and anxious/depressed score were determined by questionnaires. Random-effects logistic regression modeling was used to investigate univariate and multivariate associations between conditions.

Results:
Univariate associations were found between each of the pain conditions and persistent pain, and between the pain conditions with restless legs syndrome, iron deficiency, and anxious/depressed score. Derivative multivariate analyses retained statistically significant associations between each of the pain disorders included in the respective models (odds ratios [OR], 1.69-7.04) with the exception of growing pains with persistent pain. Of the nonpain conditions included in the multivariate analyses, restless legs syndrome remained associated with growing pains (OR, 8.50) and persistent pain (OR, 2.01). Iron deficiency remained significantly associated with migraine (OR, 2.38), persistent pain (OR, 3.70), and restless legs syndrome (OR, 5.10).

Conclusions:
In light of their extensive associations, the common pain conditions, persistent pain, restless legs syndrome, iron deficiency, anxiety and depression, are likely to involve common etiological mechanisms that warrant further investigation.
The Impact of Serum Drug Concentration on the Efficacy of Imipramine, Pregabalin, and their Combination in Painful Polyneuropathy
Authors: Sindrup Søren H. , Holbech Jakob V. , Bach Flemming W. , Finnerup Nanna B. , Brøsen Kim , Jensen Troels S. 
Published: March 2017

Objective:The aim of this study was to explore the serum concentration-effect relation for first-line drugs in neuropathic pain and to determine if efficacy could be increased.Methods:Data from a randomized, placebo-controlled, cross-over trial on imipramine, pregabalin, and their combination in painful polyneuropathy were used. Treatment periods were of 4 weeks’ duration, outcome was the weekly median of daily pain rated by a 0 to 10 numeric scale, and drug concentrations were determined by high-performance liquid chromatography.Results:In 47 patients, pain was reduced −1.0 (95% confidence interval [CI], −1.5 to −0.6) by imipramine, −0.4 (95% CI, −0.9 to 0.1) by pregabalin, and −1.6 (95% CI, −2.1 to −1.1) by combination therapy. On monotherapy, there was no difference between responders and nonresponders with respect to concentrations of imipramine (mean, 161 vs. 229 nmol/L,P=0.129) and pregabalin (mean, 9.8 vs. 11.7 μmol/L,P=0.178). There was no correlation between drug concentration and pain reduction for imipramine (r=0.17,P=0.247), whereas there was a marginally, positive correlation for pregabalin (r=0.28,P=0.057). There was no interaction between treatment and concentration classes (imipramine < or ≥100 nmol/L, pregabalin < or ≥10 μmol/L) either for monotherapy or for combination therapy (P=0.161 to 0.797). Isobolographic presentations of reponders with imipramine and pregabalin concentrations during combination therapy did not indicate synergistic interaction.Discussion:There were no important relations between drug concentrations and efficacy, or indication of synergistic interaction between the drugs. It was not concluded that treatment can be improved by measurement of drug concentration of pregabalin.
Postoperative Analgesia After Wound Infiltration With Tramadol and Dexmedetomidine as an Adjuvant to Ropivacaine for Lumbar Discectomies: A Randomized-controlled Clinical Trial
Authors: Mitra Saikat , Purohit Shobha , Sharma Mamta 
Published: March 2017

Introduction:
Crippling postoperative pain linked with lumbar discectomies not only shackles patient’s normal daily activities but also lengthens their hospital stay. So, allaying postoperative pain in these patients has become a substantive component in neuroanesthesia to expedite neurological recovery. Wound infiltration with local anesthetics is widely used to optimize postoperative pain. Different adjuvants like dexmedetomidine and tramadol when added to local anesthetics prolongs postoperative analgesia. The aim of this trial was to evaluate the analgesic efficacy of tramadol and dexmedetomidine when added to ropivacaine for wound infiltration in lumbar discectomies.

Methodology:
This study was prospective, randomized, double-blind, controlled in nature conducted among 45 adult patients belonging to American Society of Anesthesiologists’ physical status 1 and 2, of either sex aged between 30 and 70 years undergoing elective lumbar discectomies. They were randomly allocated into 3 equal groups: group R received 100 mg of 0.5% ropivacaine (20 mL) and 2 mL normal saline, group RT received 100 mg of 0.5% ropivacaine (20 mL) and 2 mg/kg tramadol (2 mL), and group RD received 100 mg of 0.5% ropivacaine (20 mL) and 0.5 μg/kg dexmedetomidine (2 mL) (total volume, 22 mL). Visual analog scale at 0, 2, 4, 6, 12, 18, and 24 hours; time to first rescue analgesia, total supplemental analgesic consumption and side effects (if any) were assessed during first 24 hours postoperatively.

Results:
The median time to first rescue analgesia (median; 95% confidence interval [CI]) in group RD was 930 (854.3 to 1005.7) minutes. This was significantly longer (P=0.000) than group RT (420 [366.3 to 473.7] min) or group R (270 [243.2 to 296.8] min). Postoperative diclofenac consumed (median [interquartile range]) was 150 (150 to 200) mg in group R, 150 (75 to 150) mg in group RT and 75 (75 to 150) mg in group RD (P=0.008). Significant differences in mean visual analog scale scores were observed among the 3 groups at hours 0 (P=0.033), 2 (P=0.001), 4 (P=0.000), 6 (P=0.001), and 24 (P=0.013). No statistical significant side effects could be discerned among the groups.

Conclusions:
We concluded that wound infiltration with combined ropivacaine and dexmedetomidine found to be significantly superior for postoperative analgesia compared with either combined ropivacaine and tramadol or ropivacaine alone for lumbar discectomies.
Occurrence, Predictors, and Prognosis of Alcohol Withdrawal Syndrome and Delirium Tremens Following Traumatic Injury
Authors: Salottolo Kristin , McGuire Emmett , Mains Charles W. , van Doorn Erika C. , Bar-Or David 
Published: March 2017

Objectives:
We sought to determine occurrence, predictors, and prognosis of alcohol withdrawal syndrome and delirium tremens in patients with traumatic injury.

Design:
Retrospective multicenter cohort study.

Setting:
Three U.S. trauma centers.

Patients:
Twenty-eight thousand one hundred one trauma patients admitted from 2010-2014.

Interventions:
None.

Measurements and Main Results:
Measures included occurrence of alcohol withdrawal syndrome and delirium tremens, injury characteristics, risk factors for alcohol withdrawal syndrome, clinical outcomes, pharmacologic treatment for alcohol withdrawal syndrome, and Clinical Institute Withdrawal Assessment for Alcohol, Revised (CIWA-Ar) scores. Alcohol withdrawal syndrome severity was defined by CIWA-Ar score as minimal (< 10), moderate (10–20), and severe (> 20). Alcohol withdrawal syndrome developed in 0.88% (n = 246), including 12% minimal, 36% moderate, and 53% severe. Alcohol withdrawal syndrome progressed to delirium tremens in 11%. Before adjustment, alcohol withdrawal syndrome severity was associated with injury severity, hypokalemia, baseline CIWA-Ar score, and established alcohol withdrawal syndrome risk factors. Logistic regression identified the following predictors of delirium tremens: baseline CIWA-Ar score greater than or equal to 10 (odds ratio, 6.05; p = 0.02) and age greater than or equal to 55 (odds ratio, 3.24; p = 0.03). In patients with severe alcohol withdrawal syndrome, severe head injury also predicted progression to delirium tremens (odds ratio, 6.08; p = 0.01), and hypokalemia was borderline significant (odds ratio, 3.23; p = 0.07). Clinical outcomes of hospital length of stay, ICU length of stay, and alcohol withdrawal syndrome complications differed significantly by alcohol withdrawal syndrome severity and were worse with more severe manifestations of alcohol withdrawal syndrome. Mortality also significantly differed by alcohol withdrawal syndrome severity but was only greater in patients who progressed to delirium tremens (11.1%; p = 0.02); otherwise, there were no differences in mortality by severity (4%, 4%, and 0% by minimal, moderate, and severe alcohol withdrawal syndrome).

Conclusions:
Trauma patients with alcohol withdrawal syndrome experience a high occurrence of delirium tremens that is associated with significant mortality. These data demonstrate the predictive ability of baseline CIWA-Ar score, age, and severe head injury for developing delirium tremens.
Perspectives From Patients and Care Providers on the Management of Fecal Incontinence: A Needs Assessment
Authors: Helewa Ramzi M. , Moloo Husein , Williams Lara , Foss Kristine M. , Baksh-Thomas Waheeda , Raiche Isabelle 
Published: March 2017

BACKGROUND:
A large proportion of Canadians experience fecal incontinence, with no avenue for effective treatments. The Ottawa Hospital has recently started a percutaneous tibial nerve stimulation program for patients who have not improved with conservative efforts.

OBJECTIVE:
As part of this program implementation, a qualitative needs assessment was undertaken to better define successful outcomes and to identify barriers for program sustainability.

DESIGN:
This was a cross-sectional, qualitative study involving standardized, semistructured interviews.

SETTINGS:
The study was conducted at a single tertiary care center.

PATIENTS:
Patients experiencing fecal incontinence, as well as nurses, physical therapists, and physicians, were enrolled in the study.

MAIN OUTCOME MEASURES:
Interview questions revolved around success definitions, barriers, and promoters of fecal incontinence care. Transcripts were analyzed to develop themes surrounding fecal incontinence care.

RESULTS:
Twelve interviews were undertaken raising a total of 17 different themes. Barriers to fecal incontinence care included education for both the care provider and patients. Access issues for treatments were also highlighted. Promoters of fecal incontinence care were reflected by the impact that it has on quality of life, personal hygiene, psychological burden, and activity and productivity. The definition of fecal incontinence success was focused on improvements in quality of life rather than a numerical reduction of incontinence episodes.

LIMITATIONS:
This study was limited in its small number of interviews conducted. We were unable to identify patients who were unable to seek out care for fecal incontinence.

CONCLUSIONS:
Patient and care provider education surrounding fecal incontinence is lacking. Furthermore, access for effective treatments is a real barrier for Canadians experiencing fecal incontinence. Programs should focus on improvement of overall quality of life rather than a reduction of incontinence episodes.
Endoscopic Pilonidal Sinus Treatment Combined With Crystalized Phenol Application May Prevent Recurrence
Authors: Gecim Ibrahim Ethem , Goktug Utku Ufuk , Celasin Haydar 
Published: March 2017

BACKGROUND:
No single treatment yet exists for pilonidal disease that has a short healing time, good cosmetic results, and a low rate of recurrence. Phenol crystal application and diathermy ablation through an endoscope have been used for the treatment of pilonidal disease, but this cohort is the first one to combine them.

OBJECTIVE:
The purpose of this study was to examine the safety, effectiveness, and short- and long-term outcomes of crystalized phenol treatment combined with endoscopic pilonidal sinus treatment for pilonidal disease.

DESIGN:
This was a prospective cohort study.

SETTINGS:
Procedures were performed in 2 hospitals by the same surgeon between February and July 2014.

PATIENTS:
Twenty-three patients underwent surgical treatment for pilonidal disease.

INTERVENTIONS:
Under local anesthesia and sedation, all of the patients underwent a video-assisted diathermy ablation of the sinus cavity and the application of phenol crystals.

MAIN OUTCOME MEASURES:
Adverse events were recorded as a measure of safety and tolerability. Failure to heal and recurrence rate were documented and evaluated.

RESULTS:
Patients were discharged on the same day as surgery. There was no or minimal postoperative pain (mean visual analog scale score, 1.40 ± 0.95). Mean operation time was 20.43 ± 6.19 minutes, and the median return-to-work duration was 2.00 days (mean, 3.03 ± 2.95 d). Patients were followed-up for 18 to 24 months (mean, 22.00 ± 1.88 mo). No serious complications or rehospitalization were observed. No primary failure to heal or recurrence was observed.

LIMITATIONS:
This study did not include a control group with which to compare and consisted of a relatively small number of patients.

CONCLUSIONS:
Crystalized phenol treatment combined with endoscopic pilonidal sinus treatment was safe, tolerable, and achieved fast and durable healing with no recurrence over an average of 22 months of follow-up.
MRI for Local Staging of Colon Cancer: Can MRI Become the Optimal Staging Modality for Patients With Colon Cancer?
Authors: Nerad Elias , Lambregts Doenja M. J. , Kersten Erik L. J. , Maas Monique , Bakers Frans C. H. , van den Bosch Harrie C. M. , Grabsch Heike I. , Beets-Tan Regina G. H. , Lahaye Max J. 
Published: March 2017

BACKGROUND:
Colon cancer is currently staged with CT. However, MRI is superior in the detection of colorectal liver metastasis, and MRI is standard in local staging of rectal cancer. Optimal (local) staging of colon cancer could become crucial in selecting patients for neoadjuvant treatment in the near future (Fluoropyrimidine Oxaliplatin and Targeted Receptor Preoperative Therapy trial).

OBJECTIVE:
The purpose of this study was to evaluate the diagnostic performance of MRI for local staging of colon cancer.

DESIGN:
This was a retrospective study.

SETTINGS:
The study was conducted at the Maastricht University Medical Centre.

PATIENTS:
In total, 55 patients with biopsy-proven colon carcinoma were included.

MAIN OUTCOME MEASURES:
All of the patients underwent an MRI (1.5-tesla; T2 and diffusion-weighted imaging) of the abdomen and were retrospectively analyzed by 2 blinded, independent readers. Histopathology after resection was the reference standard. Both readers evaluated tumor characteristics, including invasion through bowel wall (T3/T4 tumors), invasion beyond bowel wall of ≥5 mm and/or invasion of surrounding organs (T3cd/T4), serosal involvement, extramural vascular invasion, and malignant lymph nodes (N+). Interobserver agreement was compared using κ statistics.

RESULTS:
MRI had a high sensitivity (72%–91%) and specificity (84%–89%) in detecting T3/T4 tumors (35/55) and a low sensitivity (43%–67%) and high specificity (75%–88%) in detecting T3cd/T4 tumors (15/55). For detecting serosal involvement and extramural vascular invasion, MRI had a high sensitivity and moderate specificity, as well as a moderate sensitivity and specificity in the detection of nodal involvement. Interobserver agreements were predominantly good; the more experienced reader achieved better results in the majority of these categories.

LIMITATIONS:
The study was limited by its retrospective nature and moderate number of inclusions.

CONCLUSIONS:
MRI has a good sensitivity for tumor invasion through the bowel wall, extramural vascular invasion, and serosal involvement. In addition, together with its superior liver imaging, MRI might become the optimal staging modality for colon cancer. However, more research is needed to confirm this. See Video Abstract at http://links.lww.com/DCR/A309.
Should we forget about embryos till day 5?
Authors: Bronet Fernando , Agudo David 
Published: March 2017

Purpose of review
To find the way of having more and better blastocyst is essential. How to culture embryos up to blastocyst stage remains critical.

Recent findings
Several studies show how a blastocyst score can predict the implantation potential. If that score is enough to choose the best blastocyst, as culture conditions would not be affected in these days, we would not need to check early cleavage embryos, even it could be better for the embryo development.

Summary
The item that should be discussed is if it is better to evaluate or not embryos at early cleavage stages. If we do not check embryos on days 2 and 3, we should change our way to work and how to culture those embryos. First step would be to perform all embryo transfers on day 5 or 6. If we let embryos grow to blastocyst without any morphology evaluation, we should adapt several steps in our laboratory, for example we should move to a single-step culture medium or we should not do assisted hatching on day 3 embryos.
Efficacy of a biobehavioral intervention for hot flashes: a randomized controlled pilot study
Authors: Barton Debra L. , Schroeder Kelliann C. Fee , Banerjee Tanima , Wolf Sherry , Keith Timothy Z. , Elkins Gary 
Published: March 2017

Abstract

Objective:
The need for effective nonhormonal treatments for hot flash management without unwanted side effects continues. The primary aim of this pilot study was to evaluate the effect of combining a nonhormonal pharmacologic agent with a behavioral treatment for hot flash reduction.

Methods:
Seventy-one postmenopausal women were randomized to one of four groups: venlafaxine 75 mg + hypnosis (VH) versus venlafaxine 75 mg + sham hypnosis (VSH) versus a placebo pill + hypnosis (PH) versus placebo pill + sham hypnosis (PSH). Women recorded hot flash severity and frequency in a daily diary, in real time. The intrapatient difference in hot flash score (frequency × severity) at 8 weeks was analyzed using a General Estimating Equation model, using VSH as the referent arm, controlling for baseline hot flashes.

Results:
The active arms including PH or VH were not statistically significantly different than VSH (P = 0.34, P = 0.05, respectively). Women in each active arm reported hot flash reductions of about 50%, with the PSH group reporting a 25% reduction. Women receiving the PSH reported statistically significantly smaller reductions in hot flash score than women in the referent VSH arm (P = 0.001). There were no significant negative side effects during the course of the study.

Conclusions:
Hypnosis alone reduced hot flashes equal to venlafaxine alone, but the combination of hypnosis and venlafaxine did not reduce hot flashes more than either treatment alone. More research is needed to clarify whether combining hypnosis with a different antidepressant would provide synergistic benefits.
Predictors of Pharmacotherapy Response in Generalized Anxiety Disorder: A Systematic Review
Authors: Ferreira-Garcia Rafael , Mochcovitch Marina , Costa do Cabo Mariana , Nardi Antonio Egídio , Christophe Freire Rafael 
Published: March 2017

AbstractBackgroundPharmacotherapy for generalized anxiety disorder (GAD) may be effective in reducing symptoms in the majority of patients. The study of moderators and predictors of treatment response may help clinicians both to select appropriate interventions to maximize the probability of response and to inform the general prognosis.MethodsA systematic literature search of electronic databases, selected authors, and reference lists was used to identify articles that reported trials of drug monotherapy in GAD. Data on predictors and moderators were extracted. Quality of evidence was determined by the presence of a priori hypotheses, number of variables investigated, adequate quality of the measurement, and use of interaction-effects testing.ResultsFrom the 98 articles meeting inclusion criteria, 24 reported a total of 22 factors associated with treatment response. The reported results were heterogeneous, ranging over sociodemographic, clinical, comorbidity, genetic, and functional-imaging studies. Major depressive symptoms were found to moderate treatment outcome in favor of antidepressants versus benzodiazepines. Neuroticism, previous treatment, genetic polymorphisms (including serotonin receptor gene 2A), and functional activation of the anterior cingulate cortex and amygdala were identified as potential predictors of treatment response.ConclusionsCorrelates of poor emotion regulation predicted poor treatment response, but subclinical depression was the only variable capable of informing treatment selection in this review. Future research should focus on further exploring the value of depression as a moderator and on a narrower list of potential genetic, brain-imaging, and temperament predictors of response to pharmacotherapy in GAD.