bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perioperative Management of the Adult Patient on Venovenous Extracorporeal Membrane Oxygenation Requiring Noncardiac Surgery
Authors: Fierro Michael A. , Daneshmand Mani A. , Bartz Raquel R. 
Published: October 2017

Abstract
The use of venovenous extracorporeal membrane oxygenation is increasing worldwide. These patients often require noncardiac surgery. In the perioperative period, preoperative assessment, patient transport, choice of anesthetic type, drug dosing, patient monitoring, and intraoperative and postoperative management of common patient problems will be impacted. Furthermore, common monitoring techniques will have unique limitations. Importantly, patients on venovenous extracorporeal membrane oxygenation remain subject to hypoxemia, hypercarbia, and acidemia in the perioperative setting despite extracorporeal support. Treatments of these conditions often require both manipulation of extracorporeal membrane oxygenation settings and physiologic interventions. Perioperative management of anticoagulation, as well as thresholds to transfuse blood products, remain highly controversial and must take into account the specific procedure, extracorporeal membrane oxygenation circuit function, and patient comorbidities. We will review the physiologic management of the patient requiring surgery while on venovenous extracorporeal membrane oxygenation.
Myoepithelial-Rich and Infiltrative Giant Vascular Eccrine Spiradenoma: A Unique Presentation of a Rare Adnexal Tumor
Authors: Georgesen Corey , Magro Cynthia 
Published: October 2017

Abstract:A rare variant of the eccrine spiradenoma, the giant vascular eccrine spiradenoma, has been characterized as a large circumscribed and sometimes hemorrhagic solitary tumor occurring in adults older than 50 years. Histopathologically, the lesion is comprised of distinct cell populations and cystic hemorrhagic glandular spaces. We present a 68-year-old Bengali man with a giant vascular eccrine spiradenoma and describe immunohistochemical features of this tumor. In addition, we highlight unique aspects of this case, including a rich myoepithelial component and focal pseudocapsular infiltration.
Cold-Induced Dermatoses: Case Report and Review of Literature
Authors: Saenz Ibarra Barbara , Meeker Jason , Jalali Omid , Lynch Michael C. 
Published: October 2017

Abstract:
Cold panniculitis and perniosis are the most common cold-induced dermatologic disorders and are clinically characterized by indurated and erythematous nodules and plaques that develop at sites exposed to excessive cold and wet conditions. Cold panniculitis is most commonly seen in infants, but adult cases involving the thighs of equestrians are well known and have come to be known as equestrian cold panniculitis or equestrian perniosis. Recently, similar cases have been described in nonequestrian settings with the prolonged use of ice-packs or other cold-therapy devices. We describe the case of 51-year-old female patient who underwent recent arthroscopic shoulder surgery for repair of a rotator cuff tear and presented to the dermatology clinic for painful and erythematous nodules on her arm. A punch biopsy demonstrated a superficial and deep perivascular and periappendageal lymphocytic infiltrate with some spillover into the superficial subcutaneous adipose tissue. Focal vacuolar changes along the basal layer of the epidermis with a few dyskeratotic keratinocytes were present. A mild increase in interstitial mucin was seen, but no significant papillary dermal edema. On clinical questioning she admitted to sustained use of icepacks on the injured shoulder postoperatively for up to 18 hours a day. Based on clinical and histopathologic features the diagnosis of ice-pack dermatosis was made. A review of cold-induced dermatoses is considered with a focus on the main histologic differential diagnoses.
Heterotopic Cutaneous Meningioma: An Unusual Presentation Occurring in a Patient With a Remote History of Intracranial Meningioma
Authors: Enwereuzo Chibuike , Moral Luis , Henneberry Jean M. 
Published: October 2017

Abstract:
Meningioma is a neoplasm of the meninges, which usually occurs in intracranial sites. Extracranial meningioma has been frequently reported in the sinonasal tract and skull bone, often as extension of intracranial meningiomas. Isolated heterotopic meningioma without contiguous intracranial lesion is extremely rare. A 56-year-old woman presented in December 2015 with 2 firm subcutaneous scalp masses; one in the left lateral (temporal) and the other in the left superior (parietal) region. The clinical impression was that of lipoma. Pathologic examination revealed an ill-defined proliferation of uniform meningothelial cells in a fibroblastic stroma interspersed within adipose tissue. The excised lesions had similar histologic features. Immunohistochemical stains were performed and the tumor cells were positive for epithelial membrane antigen and negative for S-100. A diagnosis of extracranial meningioma, WHO grade I was made. The patient's medical history was significant for intracranial meningioma of the frontal lobe in October 2007, which was diagnosed as atypical meningioma, WHO grade II. Comparison of the scalp masses to her previous meningioma revealed a distinctly different morphologic pattern. In light of the 8-year interval between the scalp and intracranial meningioma and the difference in histologic grades, it is unlikely that her most recent tumors represent a recurrence or metastasis of the intracranial tumor.
The Effectiveness of Transitions-of-Care Interventions in Reducing Hospital Readmissions and Mortality
Authors: Kamermayer Angela K. , Leasure A. Renee , Anderson Lisa 
Published: October 2017

Background:
The Affordable Care Act of 2010 set forth payment models that provided $10 billion to incent the health care system in developing innovative programs that target reform, including transitional care to reduce preventable readmissions. While transitional care programs exist, US hospitals remain challenged, with 1 in 5 readmissions within 30 days.

Objective:
This systematic review examined the effectiveness of select evidence-based transitions-of-care interventions on reducing 30-day readmission rates, reducing emergency room visits, and reducing mortality rates.

Methods:
The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines formed the framework for this systematic review. Key study characteristics informed the eligibility criteria and search strategy. Two reviewers independently appraised selected studies using the Critical Appraisal Skills Programme tools. Included studies were summarized and synthesized in order to draw conclusions across studies.

Results:
Interventions are aimed at reducing the readmission rate of the adult general medical population. The population of focus in this review includes patients at risk of avoidable readmissions, which includes patients requiring higher levels of care secondary to complications that can contribute to higher mortality after discharge from an acute care setting.

Discussion:
The findings of this review support the use of transitions-of-care interventions such as tailored discharge planning and postdischarge phone calls.
Incongruence in Perceptions
Authors: Thomas Sarah , Quirk Lindsay , Blevins Cheri , Quatrara Beth , Letzkus Lisa 
Published: October 2017

Background:
Patient satisfaction is at the forefront of quality care and patient outcomes. The literature identifies the discrepancy between nurse and patient perceptions in a variety of care settings; few studies have investigated the perceptions of care in a critical care unit. Understanding the perceptions in a critical care unit is necessary to optimize organizational performance related to quality, safety, patient-centered care, and efficiency.

Objective:
The purpose of the study was to determine whether a discrepancy exists between what patients and families perceive as satisfaction with their care as compared with the nurses’ perception of what constitutes positive patient satisfaction in a medical critical care unit.

Methods:
A cross-sectional, prospective study was conducted to assess patient-perceived satisfaction with nursing care versus nursing perceptions in the medical intensive care unit. A convenience sample of patients and/or family members and the nurses providing their care was conducted. The validated Patient Satisfaction with Nursing Care Quality Questionnaire and Nurse’s Assessment of the Patient’s Expectations Questionnaire were used to assess perceptions. Patients and/or their family members and nurses’ responses were evaluated as matched pairs. The data were analyzed using Spearman correlation.

Results:
Forty-eight matched pairs of questionnaires were completed. There was not a correlation (r = 0.135; 95% confidence interval, −0.16 to 0.41; P = .363) between the overall patient and nurse averages for common questions. The analysis of the individual patient and nurse items revealed statistically significant correlations between only 2 of the 19 items, information given (P = .027) and recognition of opinions (P = .043).
Correlations within patient questionnaires were noted in some areas such as patients’ perception of quality of care and expectations, overall quality of nursing care, and patient expectations and patients’ likelihood to recommend the hospital to family and friends. Patient satisfaction was influenced by a number of factors, most notably patient expectations.

Implications for Practice:
Nurses’ perceptions of positive patient satisfaction in critical care are incongruent with patients’ perceptions. Improving nurses’ awareness of the patient experience could improve patient satisfaction. Further studies examining patient expectations could be beneficial in improving patient satisfaction in the critical care setting.
INTRAVITREAL AFLIBERCEPT AND RANIBIZUMAB INJECTIONS FOR TYPE 3 NEOVASCULARIZATION
Authors: Cho Han Joo , Hwang Hyun Ji , Kim Hyoung Seok , Han Jung Il , Lee Dong Won , Kim Jong Woo 
Published: October 2017

Purpose:
To compare the effectiveness of intravitreal injection of aflibercept with ranibizumab in patients with Type 3 neovascularization.

Methods:
Sixty-three treatment-naive eyes with Type 3 neovascularization (58 patients) were retrospectively analyzed. The eyes had received intravitreal aflibercept or ranibizumab injections. All patients were treated using an initial series of three monthly loading injections, followed by further injections as required. The visual and anatomical outcomes of treatment were evaluated after 12 months.

Results:
The mean best-corrected visual acuity in the aflibercept-treated group (21 eyes), expressed as the logarithm of the minimum angle of resolution, improved from 0.71 ± 0.42 (Snellen equivalent; 20/102) to 0.54 ± 0.39 (20/69) after 12 months of treatment (P = 0.022). Similarly, in the ranibizumab-treated group (42 eyes), the best-corrected visual acuity improved from 0.68 ± 0.38 (20/95) to 0.53 ± 0.36 (20/67) (P = 0.013) at 12 months. The central foveal thickness decreased in the aflibercept-treated group from 356 ± 139 μm to 212 ± 155 μm and in the ranibizumab-treated group from 348 ± 177 μm to 208 ± 161 μm (P = 0.014 and P = 0.017, respectively). There was no significant difference between the groups about improvement in best-corrected visual acuity or decrease in central foveal thickness. However, geographic atrophy was significantly more frequent in the aflibercept-treated group, occurring in 42.9% of eyes, than in the ranibizumab-treated group (19.0% of eyes; P = 0.045).

Conclusion:
There was no difference between the aflibercept and ranibizumab treatments in terms of visual acuity improvement after 12 months in patients with Type 3 neovascularization. However, geographic atrophy developed more frequently in the aflibercept-treated group.
Suprachoroidal Bleeding After XEN Gel Implantation
Authors: Prokosch-Willing Verena , Vossmerbaeumer Urs , Hoffmann Esther , Pfeiffer Norbert 
Published: October 2017

Purpose:
To report for the first time a clinical case of suprachoroidal bleeding after XEN45 gel implantation.

Observations:
A 84-year old female patient with pseudoexfoliation glaucoma with intraocular pressure (IOP) (20 mm Hg) above target despite maximal IOP-lowering therapy was scheduled for XEN45 gel implantation. The XEN45 gel implantation went without complications and was properly placed in the anterior chamber and beneath the conjunctiva. On the first postoperative day, the patient presented with an IOP of 4 mm Hg, a functioning bleb and a deep anterior chamber. On the second day she developed suprachoroidal bleeding. A wait and see strategy was followed and the patient monitored steadily. The bleeding resolved spontaneously after 6 weeks.

Conclusions and Importance:
Minimally invasive glaucoma surgery is developed to provide a safer and less-invasive option to reduce IOP in glaucoma patients compared with trabeculectomy. Although the concept of the XEN45 gel stent seems to be a favorable to reach IOP-lowering results similar to those of trabeculectomy, complications may be similar, too. We have to keep this in mind when informing patients about surgical options.
Antisense oligonucleotides selectively suppress target RNA in nociceptive neurons of the pain system and can ameliorate mechanical pain
Authors: Mohan Apoorva , Fitzsimmons Bethany , Zhao Hien T. , Jiang Yuhong , Mazur Curt , Swayze Eric E. , Kordasiewicz Holly B. 
Published: October 2017

Abstract
There is an urgent need for better treatments for chronic pain, which affects more than 1 billion people worldwide. Antisense oligonucleotides (ASOs) have proven successful in treating children with spinal muscular atrophy, a severe infantile neurological disorder, and several ASOs are currently being tested in clinical trials for various neurological disorders. Here, we characterize the pharmacodynamic activity of ASOs in spinal cord and dorsal root ganglia (DRG), key tissues for pain signaling. We demonstrate that activity of ASOs lasts up to 2 months after a single intrathecal bolus dose. Interestingly, comparison of subcutaneous, intracerebroventricular, and intrathecal administration shows that DRGs are targetable by systemic and central delivery of ASOs, while target reduction in the spinal cord is achieved only after direct central delivery. Upon detailed characterization of ASO activity in individual cell populations in DRG, we observe robust target suppression in all neuronal populations, thereby establishing that ASOs are effective in the cell populations involved in pain propagation. Furthermore, we confirm that ASOs are selective and do not modulate basal pain sensation. We also demonstrate that ASOs targeting the sodium channel Nav1.7 induce sustained analgesia up to 4 weeks. Taken together, our findings support the idea that ASOs possess the required pharmacodynamic properties, along with a long duration of action beneficial for treating pain.
Effect of High-Dose Allopurinol Pretreatment on Cardiac Biomarkers of Patients Undergoing Elective Percutaneous Coronary Intervention: A Randomized Clinical Trial
Authors: Alemzadeh-Ansari Mohammad Javad , Hosseini Seyed Kianoosh , Talasaz Azita Hajhossein , Mohammadi Mohammad , Tokaldani Masumeh Lotfi , Jalali Arash , Pourhosseini Hamidreza 
Published: October 2017

Background:
Increased accumulation of reactive oxygen species contributes to pathophysiologic states such as endothelial dysfunction, metabolic and functional impairment, inflammatory activation, and other features of cardiovascular pathophysiology. Allopurinol acts as a xanthine oxidase inhibitor that reduces the amount of free radicals after reactive oxygen species generation.

Methods and Results:
In this placebo-controlled randomized clinical trial, all patients admitted with coronary artery disease who are candidates for elective percutaneous coronary intervention (PCI) were included. The 254 patients were randomly divided into 2 groups. Blood samples for cardiac biomarkers (creatine kinase [CK]-MB and troponin T [cTnT]) were collected from all patients after admission (the day before PCI), and also 8 and 16 hours after intervention. In group 1 (133 patients), 600 mg allopurinol was orally administered on the day before PCI, and another same dose on the day of PCI, and the elective PCI was performed. In group 2 (121 patients), elective PCI was performed without pretreatment with allopurinol. In an unadjusted model, the serum levels of both CK-MB and cTnT, 16 hours after PCI were higher in the placebo group as compared with the allopurinol group, although it was statistically insignificant. We compared the maximum levels of CK-MB and cTnT (8 or 16 hours after PCI) and their maximum changes in both groups. After adjustment for confounders, use of allopurinol did not have any statistically significant association with the rise of cardiac-spec–fic enzymes.

Conclusions:
Allopurinol could not be effective significantly, in patients undergoing elective PCI, to decrease cardiac-specific enzymes, and seems not to be of use before PCI.
Clinically Significant Differences in Ki-67 Proliferation Index Between Primary and Metastases in Resected Pancreatic Neuroendocrine Tumors
Authors: Richards-Taylor Sebastian , Tilley Charles , Jaynes Eleanor , Hu Haixiao , Armstrong Thomas , Pearce Neil W. , Plant Rachel , Cave Judith 
Published: October 2017

Objective
Pancreatic neuroendocrine tumors (NETs) (pNETs) have a varied prognosis according to their grade. The European Neuroendocrine Tumor Society grading system uses assessment of the proliferation index via Ki-67 immunohistochemistry to aid prognosis. There is evidence that the proliferation index can vary significantly within a single tumor, but it is not fully understood to what extent heterogeneity occurs between the primary and metastatic sites and how this may affect the grade. The aim of this study is to determine whether the grade assigned to a pNET varies depending on which site is selected for Ki-67 immunolabeling.

Methods
Patients were selected from our institution's NET database. Patients were included if they had a confirmed pNETs, had multiple resection specimens, and had consented to research being performed on their specimens. Ki-67 immunohistochemistry was performed on all resected specimens meeting the inclusion criteria.

Results
Pancreatic neuroendocrine tumors specimens resected from 16 patients were analyzed. There was no trend to higher Ki-67 in metastatic than primary disease. Ki-67 was on average 3% higher in liver metastases than lymph node metastases (P < 0.001).

Conclusions
The grade of pNETs varies according to the tumor selected for Ki-67 immunolabeling. Useful information can be gained by performing Ki-67 PI on liver metastases.
Different Clinical Characteristics Between Distal Cholangiocarcinoma and Pancreatic Head Carcinoma With Biliary Obstruction
Authors: Yokoyama Yukihiro , Ebata Tomoki , Igami Tsuyoshi , Sugawara Gen , Mizuno Takashi , Yamaguchi Junpei , Nagino Masato 
Published: October 2017

Objectives
The aim of this study was to compare the perioperative clinical characteristics between patients with distal cholangiocarcinoma (DCC) and pancreatic head carcinoma (PHC) with biliary obstruction.

Methods
This study included patients who underwent pancreatoduodenectomy and were diagnosed with DCC (n = 85) or PHC (n = 90) by final pathological examination. Perioperative clinical characteristics were compared for patients with DCC versus PHC with biliary obstruction.

Results
Median coronal thickness of the pancreatic neck was significantly greater, whereas the main pancreatic duct diameter was significantly smaller in patients with DCC than patients with PHC. Most patients with DCC (95%) had a soft pancreas, whereas only 29% of patients with PHC had. The incidence rates of overall morbidity, infectious complications, and pancreatic fistula were significantly higher in patients with DCC than those in patients with PHC. Eleven DCC patients (12%) were preoperatively misdiagnosed with PHC. Among them, intraductal ultrasonography of the bile duct was performed in 7 patients, and the presence of PHC was suspected in 3 of these patients because intraductal ultrasonography detected a small intrapancreatic mass.

Conclusions
This study clearly showed different perioperative characteristics between patients with DCC and PHC. It is not uncommon to misdiagnose PHC as DCC. Intraductal ultrasonography may be helpful in differentiating DCC and PHC.
SPINK1 Gene is Significantly Associated With Pancreatitis
Authors: Liu Jie , Lu Shun-yuan , Wang Yan-gui , Wei Zhi-yun , Zhang Hong-xin 
Published: October 2017

Objectives
This research was applied to case-control studies of the association between pancreatitis and SPINK1 gene to assess the joint evidence for the association, the influence of individual studies, and evidence for publication bias.

Methods
MEDLINE and Embase were searched to identify longitudinal studies evaluating pancreatitis and SPINK1. Odds ratios (ORs) and 95% confidence interval (CI) were pooled using random-effect models and calculated using Carlin method. Publication bias was assessed using Egger et al's approach (A famous statistic method by Egger et al). Sensitivity, heterogeneity, and trim and fill analyses were conducted.

Results
Based on the results, we found that (1) the results support for the association between pancreatitis and SPINK1, when analyzed totally and by subdivision (total [OR, 7.771; 95% CI, 5.232–11.543; P < 0.000]; European [OR,6.400; 95% CI, 4.346–9.426; P < 0.000]; Asian [OR, 11.823; 95% CI, 4.612–30.310; P < 0.000]; American [OR, 3.777; 95% CI, 1.596–8.939; P = 0.002]; mixed: [OR, 13.566; 95% CI, 2.322–79.252, P = 0.004]); (2) no evidence indicates that this association is accounted for by any one study, and no evidence indicates any publication bias exists.

Conclusions
The results indicated that SPINK1 gene, particularly the N34S mutation, has a genetic association with the development of pancreatitis.
Disrupted Executive Function and Aggression in Individuals With a History of Adverse Childhood Experiences
Authors: Xue Jiao-Mei , Lin Ping-Zhen , Sun Ji-Wei , Cao Feng-Lin 
Published: October 2017

AbstractHere, we explored the functional and neural mechanisms underlying aggression related to adverse childhood experiences. We assessed behavioral performance and event-related potentials during a go/no-go and N-back paradigm. The participants were 15 individuals with adverse childhood experiences and high aggression (ACE + HA), 13 individuals with high aggression (HA), and 14 individuals with low aggression and no adverse childhood experiences (control group). The P2 latency (initial perceptual processing) was longer in the ACE + HA group for the go trials. The HA group had a larger N2 (response inhibition) than controls for the no-go trials. Error-related negativity (error processing) in the ACE + HA and HA groups was smaller than that of controls for false alarm go trials. Lastly, the ACE + HA group had shorter error-related negativity latencies than controls for false alarm trials. Overall, our results reveal the neural correlates of executive function in aggressive individuals with ACEs.