bluuebunny/crossref_metadata_2025_split huggingface dataset:
Methicillin-Resistant Staphylococcus aureus Nasal Swab and Suction Drain Tip Cultures in 4573 Spinal Surgeries
Authors: Kawabata Atsuyuki , Sakai Kenichiro , Sato Hirokazu , Sasaki Shinichi , Torigoe Ichiro , Tomori Masaki , Yuasa Masato , Matsukura Yu , Arai Yoshiyasu 
Published: August 2017

Study Design.
A retrospective single-center study.

Objective.
To assess the diagnostic value of methicillin-resistant Staphylococcus aureus (MRSA) nasal swab and suction drain tip cultures.

Summary of Background Data.
The prognostic value of MRSA nasal swab and suction drain tip cultures has not been firmly established in spinal surgery.

Methods.
This study retrospectively included 4573 consecutive patients who underwent spinal surgery between January 2008 and December 2014. Patients diagnosed with infectious disease were excluded. Prophylactic antibiotics were administered intraoperatively and postoperatively for 48 hours. MRSA nasal swab cultures were taken from all patients before surgery. Drains were removed when the volume of postoperative fluid drainage was less than 50 mL in the preceding 24 hours and cultures were made. Surgical site infection (SSI) was defined according to Centers for Disease Control and Prevention criteria.

Results.
SSI was identified in 94 cases (2.1%) and bacteria were isolated in 87 cases (92.6%). Positive MRSA nasal swab cultures were identified in 49 cases (1.1%). There was no significant difference in the SSI positivity rate between the MRSA nasal swab culture (+) and (−) groups. Positive drain tip cultures were found in 382 cases (8.4%), 28 of which developed SSI. There was a significant difference in the SSI positivity rate between the drain tip culture (+) and (−) groups. The sensitivity of drain tip culture was 29.8% and the specificity was 92.1%. In 16 of the 28 patients in the SSI (+) group with positive drain cultures, the same bacteria were isolated from the surgical site, giving a bacteria matching rate of 57.1%.

Conclusion.
MRSA nasal swab and drain tip cultures were not useful for predicting SSI. However, drain tip culture had a high positivity rate in the SSI group and the coincidence rate for the causative pathogen was relatively high.

Level of Evidence: 4
Alterations in Spanish Language Interpretation During Pediatric Critical Care Family Meetings*
Authors: Sinow Carolyn S. , Corso Irene , Lorenzo Javier , Lawrence Kiley A. , Magnus David C. , Van Cleave Alisa C. 
Published: August 2017

Objectives:
To characterize alterations in Spanish language medical interpretation during pediatric critical care family meetings.

Design:
Descriptive, observational study using verbatim transcripts of nine PICU family meetings conducted with in-person, hospital-employed interpreters.

Setting:
A single, university-based, tertiary children’s hospital.

Subjects:
Medical staff, family members, ancillary staff, and interpreters.

Interventions:
None.

Measurements and Main Results:
Interpreted speech was compared with original clinician or family speech using the qualitative research methods of directed content analysis and thematic analysis. Alterations occurred in 56% of interpreted utterances and included additions, omissions, substitutions, editorializations, answering for the patient/clinician, confessions, and patient advocacy. Longer utterances were associated with more alterations.

Conclusions:
To minimize interpreter alterations during family meetings, physicians should speak in short utterances (fewer than 20 words) and ask interpreters to interrupt in order to facilitate accurate interpretation. Because alterations occur, physicians may also regularly attempt to assess the family’s understanding.
Adaptation of the Acute Organ Failure Score for Use in a Medicare Population
Authors: Courtright Katherine R. , Halpern Scott D. , Bayes Brian , Harhay Michael O. , Raneses Eli , Kipnis Patricia , Escobar Gabriel J. , Kerlin Meeta Prasad 
Published: August 2017

Objectives:
Without widely available physiologic data, a need exists for ICU risk adjustment methods that can be applied to administrative data. We sought to expand the generalizability of the Acute Organ Failure Score by adapting it to a commonly used administrative database.

Design:
Retrospective cohort study.

Setting:
One hundred fifty-one hospitals in Pennsylvania.

Patients:
A total of 90,733 ICU admissions among 77,040 unique patients between January 1, 2009, and December 1, 2009, in the Medicare Provider Analysis and Review database.

Measurements and Main Results:
We used multivariable logistic regression on a random split cohort to predict 30-day mortality, and to examine the impact of using different comorbidity measures in the model and adding historical claims data. Overall 30-day mortality was 17.6%. In the validation cohort, using the original Acute Organ Failure Score model’s β coefficients resulted in poor discrimination (C-statistic, 0.644; 95% CI, 0.639–0.649). The model’s C-statistic improved to 0.721 (95% CI, 0.711–0.730) when the Medicare cohort was used to recalibrate the β coefficients. Model discrimination improved further when comorbidity was expressed as the COmorbidity Point Score 2 (C-statistic, 0.737; 95% CI, 0.728–0.747; p < 0.001) or the Elixhauser index (C-statistic, 0.748; 95% CI, 0.739–0.757) instead of the Charlson index. Adding historical claims data increased the number of comorbidities identified, but did not enhance model performance.

Conclusions:
Modification of the Acute Organ Failure Score resulted in good model discrimination among a diverse population regardless of comorbidity measure used. This study expands the use of the Acute Organ Failure Score for risk adjustment in ICU research and outcomes reporting using standard administrative data.
P-407-induced Mouse Model of Dose-controlled Hyperlipidemia and Atherosclerosis: 25 Years Later
Authors: Johnston Thomas P. , Korolenko Tatyana A. , Sahebkar Amirhossein 
Published: August 2017

Abstract:
The poloxamer 407 (P-407) nongenetic, nondiet–induced mouse model of dose-controlled hyperlipidemia and atherosclerosis was first introduced in 1992. Dyslipidemia is produced in C57BL/6 mice of either sex after intraperitoneal administration of P-407 that is a polyether-based nonionic surface active agent. Aortic atherosclerotic lesions begin to form after 1 month of repeated P-407 administration and obtain maximum size, numerical density, and human-like pathological features by 4 months. Our laboratory published a review of this model in 2004, although an update would seem both appropriate and timely based on new findings since 2004. Using P-407–treated mice, we have investigated the effect that hyperlipidemia has on the activity of several classes of proteases in the heart, liver, and serum; extensively characterized lipoprotein fractions and subfractions associated with atherogenic plasma lipids; investigated whether several key vascular cell adhesion molecules were perturbed; and determined whether the biological activity of 2 peroxisome proliferator–activated receptors was modulated both in vitro and in vivo. Based on our findings since 2004, as well as those before 2004 (1992–2004), we would strongly suggest that the P-407–induced hyperlipidemic mouse model represents a convenient, inexpensive, and well-documented alternative mouse model with which to study cardiovascular heart disease arising from dyslipidemia and atherosclerosis.
Sexual function after prolapse repair
Authors: Shatkin-Margolis Abigail , Pauls Rachel N. 
Published: August 2017

Purpose of review
The purpose of this review is to summarize available literature (from the last 18 months) assessing sexual function following pelvic reconstructive surgery for pelvic organ prolapse (POP). We include vaginal native tissue repair, abdominal/laparoscopic sacrocolpopexy, transvaginal mesh repair, and obliterative procedures. The goal is to assist providers in counseling patients and to identify areas needed for further research.

Recent findings
When compared with pessary management, women who undergo POP surgical repair achieve their sexual function goals more often. In particular, vaginal native tissue repair has consistently been shown to improve sexual function. Furthermore, there does not appear to be a difference between uterosacral ligament suspension and sacrospinous ligament suspension (with or without uterine conservation) with regard to postoperative sexual function. Although less robust, literature evaluating the impact of abdominal/robotic sacrocolpopexy also supports benefit from surgical correction. However, data are conflicted with regard to transvaginal mesh repair and suggest the potential for a negative impact.

Summary
POP often affects a woman's sexual function. Following surgical repair, most patients experience improvements in their sexual response. However, surgical approaches involving abdominal or transvaginal mesh may result in a decline in sexual function and worsening dyspareunia.
OCRIPLASMIN FOR VITREOMACULAR TRACTION: LOOKING OUTSIDE THE MACULA
Authors: Cereda Matteo G. , Preziosa Chiara , D'Agostino Isabella , Cozzi Mariano , Bottoni Ferdinando , Pellegrini Marco , Giani Andrea , Staurenghi Giovanni 
Published: August 2017

Purpose:
To evaluate baseline features and morphologic changes of vitreoretinal adhesion and outer retinal layers outside the macula after intravitreal ocriplasmin injection. To study the relation between vitreous detachment and attenuation of retinal outer segments signal.

Methods:
Retrospective cases series of 15 eyes. Each eye was scanned with the 55° wide-field optical coherence tomography lens in 6 different locations, three horizontal B-scan (central, temporal, and nasal) and three vertical B-scan (central, superior, and inferior) at baseline, 1 week, 1 month, 3 months, and 6 months after injection.

Results:
After ocriplasmin injection, vitreomacular traction (VMT) resolved in 12 patients (80%), 3 of them presenting a complete posterior vitreous detachment. Eight patients (53%) showed a panretinal attenuation of photoreceptors outer segment signal, 7 with VMT resolution and 1 with non-posterior vitreous detachment and no VMT resolution. In three patients after VMT resolution the attenuation involved also areas with no posterior vitreous detachment. The attenuation resolved during follow-up in 7/8 eyes (87.5%).

Conclusion:
Intravitreal ocriplasmin injection induced resolution of VMT in most cases and more rarely a release of vitreopapillary adhesion and a complete posterior vitreous detachment. An acute panretinopathy was visible in more than half of the patients and was not related to vitreous detachment.
New Graft Insertion Device for Descemet Stripping Automated Endothelial Keratoplasty
Authors: Soma Takeshi , Koh Shizuka , Maeda Naoyuki , Mitomo Kikuo , Quantock Andrew J. , Nishida Kohji 
Published: August 2017

Purpose:
Corneal endothelial dysfunction is a major indication for corneal graft surgery worldwide, and although surgical intervention through a range of posterior lamellar surgeries has proven to be hugely beneficial, challenges remain. This is especially so where the anterior chamber is relatively shallow, as is often the case in the Asian population, though not exclusively so. In this study, we introduce a new insertion device to deliver endothelial graft tissue for Descemet stripping automated endothelial keratoplasty (DSAEK).

Methods:
A new surgical tool was designed and manufactured so as to enable a 1-step insertion of corneal graft tissue into the anterior chamber based on a pressure–flow concept, rather than the a pull-through one. This was tested ex vivo to assess endothelial cell damage, and then performed in 12 first-in-human surgeries.

Results:
Precut DSAEK lenticules implanted in donor corneas ex vivo through the new technique showed that less endothelial cell damage occurs compared with a pull-through technique. Grafts were successful in all patients receiving the new surgery, with no cases of primary graft failure.

Conclusions:
The newly developed DSAEK inserter is a simple and useful tool for endothelial graft delivery, lessening intraoperative mechanical stress on the graft tissue.
Short-term Results of Trabeculectomy Using Adjunctive Intracameral Bevacizumab Versus Mitomycin C: A Randomized Controlled Trial
Authors: Vahedian Zakieh , Mafi Mostafa , Fakhraie Ghasem , Zarei Reza , Eslami Yadollah , Ghadimi Hadi , Mohebbi Masomeh 
Published: August 2017

Purpose:
To compare the outcome of trabeculectomy using adjunctive intracameral bevacizumab versus intraoperative mitomycin C (MMC).

Materials and Methods:
In this double-blind, randomized clinical trial 87 eyes of 87 patients with primary open-angle or pseudoexfoliation glaucoma were assigned to each treatment group (44 cases received 1.25 mg intracameral bevacizumab at the end of operation and in 43 cases MMC was applied during surgery). Success was defined as intraocular pressure (IOP) between 6 and 21 mm Hg and at least 30% IOP drop with (qualified) or without (complete) glaucoma medications without additional glaucoma surgery.

Results:
The follow-up time was 17.12±2.58 months in the bevacizumab group and 17.23±2.42 months in the MMC group (P=0.845). The preoperative IOP was 29.17±3.94 and 28.8±4.08 mm Hg in the bevacizumab and MMC groups, respectively (P=0.689). Last visit IOP was 17.41±3.11 mm Hg in the bevacizumab group and 15.34±3.62 mm Hg in the MMC group (P<0.009). Compared with baseline, IOP drop at last visit was 11.76±5.51 and 13.43±5.92 in the bevacizumab and MMC groups, respectively (P=0.207). At last visit, complete success was achieved in 25 cases (61%) of bevacizumab group and 23 cases (66%) of MMC group (P=0.669). Early filtering bleb leak was more prevalent in bevacizumab group (29% vs. 11%).

Conclusions:
A single 1.25 mg dose of intracameral bevacizumab improves the success of trabeculectomy comparable with MMC; however, it increases the risk of early filtering bleb leakage.
Impact of Birth HIV-PCR Testing on the Uptake of Follow-up Early Infant Diagnosis Services in Cape Town, South Africa
Authors: Dunning Lorna , Kroon Max , Fourie Lezanne , Ciaranello Andrea , Myer Landon 
Published: August 2017

Introduction:
Polymerase chain reaction testing at birth (“birth-testing”) is suggested by new World Health Organization guidelines for rapid diagnosis of infants infected with HIV in utero. However, there are few data on the implementation of this approach in sub-Saharan Africa, and whether birth testing affects uptake of subsequent routine early infant diagnosis (EID) testing at 6–10 weeks of age is unknown.

Methods:
We reviewed 575 consecutive infants undergoing targeted high-risk birth testing in Cape Town, South Africa, and matched those testing HIV negative at birth (n = 551) to HIV-exposed infants who did not receive birth testing (n = 551). Maternal and infant clinical and demographic data, including EID testing uptake, were abstracted from routine records.

Results:
Overall, 3.8% of all birth tests conducted were positive while later EID testing positivity rates were 0.5% for those infants testing HIV negative at birth and 0.4% for those without birth testing. Infants who underwent birth testing were less likely to present for later EID compared with those without a birth test (73% vs. 85%; P < 0.001). This difference persisted after adjusting for maternal and infant characteristics (adjusted odds ratio, 0.60; 95% confidence interval: 0.41–0.86) and across demographic and clinical subgroups. Infants undergoing birth testing also presented for later EID at a significantly older age (mean age, 60 vs. 50 days; P < 0.001).

Conclusions:
While the yield of targeted high-risk birth testing in this setting appears high, neonates testing HIV negative at birth may be less likely to present for subsequent EID testing. For birth testing implementation to contribute to overall EID program goals, structured interventions are required to support follow-up EID services after negative birth test results.
Better Completion of Pediatric Latent Tuberculosis Treatment Using 4 Months of Rifampin in a US-based Tuberculosis Clinic
Authors: Gaensbauer James , Aiona Kaylynn , Haas Michelle , Reves Randall , Young Janine , Belknap Robert 
Published: August 2017

Background:
Children less than 5 years of age have the highest age-specific rate of progression from latent tuberculosis infection (LTBI) to active disease. Therefore, regimens for treatment of pediatric LTBI must be not only efficacious but practical enough to overcome the unique childhood barriers to regimen adherence. Since 2012, a 4-month regimen of daily rifampin (4R) has been the standard recommendation for pediatric LTBI at the Denver Metro Tuberculosis Clinic.

Methods:
Using univariate and multivariate analyses, we compared treatment completion rates between 4R and 9-month isoniazid (9H) regimens for all pediatric patients treated for LTBI at the Denver Metro Tuberculosis Clinic between January 1, 2006, and December 31, 2015, and assessed the influence of clinical and demographic characteristics on successful completion of the 2 regimens.

Results:
There were 395 children in the 4R cohort and 779 in the 9H cohort. Completion rates overall were significantly higher for 4R than 9H (83.5% vs. 68.8%, P < 0.001). Drug toxicity leading to treatment noncompletion was low in both groups (1.5% in 4R and 0.7% in 9H, P = 0.23), and no patient progressed to active tuberculosis in either cohort. The 9H cohort was more likely to fail treatment completion because of barriers potentially related to the longer duration of treatment such as relocation or loss to follow-up.

Conclusions:
Pediatric patients were significantly more likely to complete LTBI treatment using a 4R than with a 9-month isoniazid regimen. Better completion rates of 4R may increase efficacy of tuberculosis prevention and decrease demand on public health resources.
Ultrasonographic Assessment of Bladder Volumes in Children Undergoing Penile Surgery: Does the Type of Anesthesia Matter?
Authors: Ekstein Margaret , Bar-Yosef Yuval , Ben-Chaim Jacob , Flaishon Ron , Weinbroum Avi A. 
Published: August 2017

Background:
There are scant data reporting postoperative ultrasonographically measured bladder volumes in children undergoing penile surgery.

Study Question:
We studied the effect of various anesthesia techniques on return of micturition after penile surgery in children, using ultrasonographically measured bladder volumes.

Data Sources:
Ultrasonographically measured postvoiding residual bladder volumes indexed to age-appropriate capacity, and time elapsed between the end of surgery and spontaneous voiding after pediatric circumcision, distal hypospadias repair, or repair of urethrocutaneous fistula, were studied.

Study Design:
Children between 4 months and 12 years were randomized to caudal block, intravenous (IV) fentanyl or penile block, in association with inhaled general anesthesia. Bladder volumes were measured before surgery and immediately after voiding for the first time. Time to first postsurgery void was also recorded.

Results:
Thirty-one children completed all assessments; 12 underwent caudal block, 9 IV fentanyl anesthesia, and 7 were given penile block. The mean first postvoid bladder residual volumes were highest in the caudal and lowest in the penile block children (27.5 vs. 17.3 mL, P = 0.003). The time elapsing between the end of surgery and first voiding was the longest in the fentanyl group compared with caudal and penile blocks (232, 178, 150 minutes, respectively, P = 0.02).

Conclusions:
None of the anesthetic techniques provoked postoperative urinary retention after minor penile surgery in children. The penile block appears superior to caudal block or to IV fentanyl–based anesthesia with regard to postoperative recovery of normal micturition.
Neighborhood Health Care Access and Sexually Transmitted Infections Among Women in the Southern United States: A Cross-Sectional Multilevel Analysis
Authors: Haley Danielle F. , Edmonds Andrew , Belenky Nadya , Hickson DeMarc A. , Ramirez Catalina , Wingood Gina M. , Bolivar Hector , Golub Elizabeth , Adimora Adaora A. 
Published: August 2017

Introduction
The United States has experienced an increase in reportable sexually transmitted infections (STIs) while simultaneously experiencing a decline in safety net services for STI testing and treatment. This multilevel study assessed relationships between neighborhood-level access to health care and STIs among a predominantly Human Immunodeficiency Virus (HIV)-seropositive cohort of women living in the south.

Methods
This cross-sectional multilevel analysis included baseline data from HIV-seropositive and HIV-seronegative women enrolled in the Women’s Interagency HIV Study sites in Alabama, Florida, Georgia, Mississippi, and North Carolina between 2013 and 2015 (N = 666). Administrative data (eg, United States Census) described health care access (eg, percentage of residents with a primary care provider, percentage of residents with health insurance) in the census tracts where women lived. Sexually transmitted infections (chlamydia, gonorrhea, trichomoniasis, or early syphilis) were diagnosed using laboratory testing. Generalized estimating equations were used to determine relationships between tract-level characteristics and STIs. Analyses were conducted using SAS 9.4.

Results
Seventy percent of participants were HIV-seropositive. Eleven percent of participants had an STI. A 4-unit increase in the percentage of residents with a primary care provider was associated with 39% lower STI risk (risk ratio, 0.61, 95% confidence interval, 0.38–0.99). The percentage of tract residents with health insurance was not associated with STIs (risk ratio, 0.98, 95% confidence interval, 0.91–1.05). Relationships did not vary by HIV status.

Conclusions
Greater neighborhood health care access was associated with fewer STIs. Research should establish the causality of this relationship and pathways through which neighborhood health care access influences STIs. Structural interventions and programs increasing linkage to care may reduce STIs.
A Splenic IgG4+ Sclerosing Angiomatoid Nodular Transformation (SANT) Treated by Hemisplenectomy: A Radiologic, Histochemical, and Immunohistochemical Study
Authors: Gaeta Raffaele , Donati Francescamaria , Kauffmann Emanuele F. , Campani Daniela 
Published: August 2017

Introduction:
Sclerosing angiomatoid nodular transformation (SANT) is a rare benign lesion of unknown origin for which total splenectomy is the standard treatment.

Case Presentation:
A 54-year-old man with a history of recurrent pancreatitis, bicuspid aortic valve, and aortic dissection underwent abdominal ultrasound, Computed tomography and magnetic resonance imaging, which revealed a 6-cm hypoechoic splenic mass diagnosed as cavernous hemangioma. Owing to his relevant past history, he was considered eligible for emisplenectomy and not for total excision, which is associated with long-term risks, especially infections.

Results:
Histologic examination revealed several nodules of varying size separated by sclerotic stroma with scattered inflammatory cells rich in IgG4+ in a background of splenic red pulp. Immunohistochemical stains showed a characteristic panel for CD34, CD31, and CD8.

Conclusions:
The diagnosis of SANT should be considered in any patient presenting with a splenic lesion containing an angiomatoid or inflammatory component. The only method able to establish a correct diagnosis is histologic and immunohistochemical evaluation. Complete splenectomy is generally considered the best approach. However, if the patient is at high risk of infection and localization of the lesion allows for selective devascularization of the affected part of the spleen, the lesion could be removed by hemisplenectomy. In some patients SANT is related to high blood levels of IgG4. Thus, corticosteroids might be useful for treating IgG4+ SANT and for preventing other IgG4-related diseases.