bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prophylactic Negative Pressure Wound Therapy for Obese Women After Cesarean Delivery
Authors: Smid Marcela C. , Dotters-Katz Sarah K. , Grace Matthew , Wright Sarah T. , Villers Margaret S. , Hardy-Fairbanks Abbey , Stamilio David M. 
Published: October 2017

OBJECTIVE:
To summarize available studies on wound complication outcomes after prophylactic negative pressure wound therapy for obese women (body mass index 30 or greater).

DATA SOURCES:
We conducted a systematic review and meta-analysis using electronic database search (PubMed, Cumulative Index to Nursing and Allied Health Literature, EMBASE, Google scholar, and Web of Science), Cochrane, and trial registries including ClinicalTrials.gov.

METHODS OF STUDY SELECTION:
We conducted an electronic search of research articles from 1966 to January 2017 for randomized controlled trials (RCTs), prospective cohort, and retrospective cohort studies of negative pressure wound therapy compared with standard dressing after cesarean delivery among obese women. Our primary outcome was defined as a composite of wound complication, including wound or surgical site infection, cellulitis, seroma, hematoma, wound disruption, or dehiscence. For cohort studies and RCTs, we performed a descriptive systematic review. For available RCTs, we performed a meta-analysis and pooled risk ratios using a random-effects model. We assessed for heterogeneity using χ2 test for heterogeneity and I
2 test. We assessed for publication bias using a funnel plot.

TABULATION, INTEGRATION, AND RESULTS:
Of 10 studies meeting eligibility criteria, five were RCTs and five were cohort studies. Results of cohort studies were varied; however, all had a high potential for selection bias. In the meta-analysis, there was no difference in primary composite outcome among those women with negative pressure wound therapy (16.8%) compared with those who had standard dressing (17.8%) (risk ratio 0.97, 95% CI 0.63–1.49). There was no statistically significant heterogeneity (χ2 test 4.80, P=.31, I
2=17%).

CONCLUSION:
Currently available evidence does not support negative pressure wound therapy use among obese women for cesarean wound complication prevention.

SYSTEMATIC REVIEW REGISTRATION:
PROSPERO: International prospective register of systematic reviews, 42016033948.
Emergency Department Care in the Postpartum Period
Authors: Batra Priya , Fridman Moshe , Leng Mei , Gregory Kimberly D. 
Published: October 2017

OBJECTIVE:
To use population data to identify patient characteristics associated with a postpartum maternal emergency department visit within 90 days of discharge after birth.

METHODS:
This retrospective cross-sectional study analyzed linked maternal discharge and emergency department data for all live California births from 2009 to 2011. The primary outcome was at least one emergency department visit within 90 days of hospital discharge after birth. Secondary outcomes included three or more visits within 90 days (“high utilization”) and inpatient readmission. Independent variables included demographics (age, race or ethnicity, payer, income) and clinical characteristics (length of stay, antepartum complications, mode of delivery, and severe maternal morbidity at delivery). Multilevel logistic regression identified variables associated study outcomes; we validated the predictive model with a split-sample approach and receiver operating characteristic curve analysis.

RESULTS:
Of 1,071,232 deliveries included, 88,674 women (8.3%) visited the emergency department at least once in the 90 days after delivery discharge. Emergency department use was significantly associated with Medicaid insurance (adjusted odds ratio [OR] 2.15, 95% CI 2.08–2.21), age younger than 20 years (adjusted OR 2.08, 95% CI 1.98–2.19), severe maternal morbidity at delivery (adjusted OR 1.58, 95% CI 1.49–1.71), antepartum complications (adjusted OR 1.46, 95% CI 1.42–1.50), and cesarean delivery (adjusted OR 1.40, 95% CI 1.37–1.44). Approximately one fifth of visits occurred within 4 days of discharge, and more than half were within 3 weeks. High utilizers comprised 0.5% of the entire sample (5,171 women) and only 1.2% of women presenting for emergency department care were readmitted. Receiver operating curve model analysis using the validation sample supported predictive accuracy for postpartum emergency department use (area under the curve=0.95).

CONCLUSION:
One in 12 California women visited the emergency department in the first 90 days after postpartum discharge. Women at increased risk for postpartum emergency department use per our validated model (eg, low income, birth complications) may benefit from earlier scheduled postpartum visits.
Salpingectomy for Sterilization
Authors: Powell C. Bethan , Alabaster Amy , Simmons Sarah , Garcia Christine , Martin Maria , McBride-Allen Sally , Littell Ramey D. 
Published: October 2017

OBJECTIVE:
To evaluate the utilization rate of salpingectomy for cesarean deliveries and postpartum and interval tubal sterilization procedures.

METHODS:
This is a retrospective cohort study using the electronic medical record to identify women older than 18 years of age undergoing surgical sterilization from June 2011 to May 2016 in an integrated health care system. The primary objective is to describe the change in utilization rate of salpingectomy for tubal sterilization procedures over time and after a systemwide practice recommendation was issued in 2013. Rates of salpingectomy and tubal occlusion were calculated for each of the five 1-year intervals in the study. Secondary outcomes included blood loss, operating time, length of stay, readmission, and emergency department visits.

RESULTS:
A total of 10,741 tubal sterilization procedures were identified. There was an increase in salpingectomies from 0.4% (8/1,938; 95% CI 0.2–0.8) to 35.5% (902/2,538; 95% CI 33.7–37.4) of tubal sterilization procedures performed over the study period (test for trend, P<.001). Salpingectomy instead of tubal occlusion increased at cesarean delivery from 0.1% (1/1,141; 95% CI 0.0–0.5) to 9.2% (125/1,354; 95% CI 7.8–10.9) (test for trend, P<.001); postpartum from 0% (0/124; 95% CI 0.0–3.0) to 4.5% (9/201; 95% CI 2.4–8.3) (test for trend, P=.003); and as an interval (nonpartum) tubal sterilization procedure from 1% (7/673; 95% CI 0.5–2.1) to 78% (768/983; 95% CI 75.4–80.6) (test for trend, P<.001). Median operative minutes was increased from 52 (95% CI 51–52) to 61.5 (95% CI 57–64), from 33 (95% CI 32–34) to 50 (95% CI 35–64), and from 30 (95% CI 29–30) to 33 (95% CI 32–33), respectively, for salpingectomy compared with tubal occlusion at cesarean delivery and postpartum and interval sterilization. Median blood loss was similar for salpingectomy and tubal occlusion at cesarean delivery (660 mL; 95% CI 600–700 mL compared with 700 mL; 95% CI 680–700 mL) and interval sterilization (both 5 mL; 95% CI 5–5 mL) but was more for salpingectomy postpartum (250 mL; 95% CI 200–500 mL compared with 200 mL; 95% CI 200–200 mL).

CONCLUSION:
There was a significant increase in salpingectomy for sterilization from June 2011 to May 2016. In the final year of the study, salpingectomy accounted for 78% of interval laparoscopic tubal sterilization procedures and 9% of intrapartum and postpartum procedures.
Inflammation in bone physiology and pathology
Authors: Adamopoulos Iannis E. 
Published: October 2017

Purpose of review
Bone is constantly being remodeled throughout adult life through constant anabolic and catabolic actions that maintain tissue homeostasis. A number of hormones, cytokines growth factors, and the proximity of various cells to bone surfaces influence this process. Inflammatory changes at the bone microenvironment result in alterations leading to both excessive bone loss and bone formation. Detailed understanding of the physiological and pathological mechanisms that dictate these changes will allow us to harness inflammatory signals in bone regeneration.

Recent findings
Recent reports have suggested that inflammatory signals are able to stimulate transcription factors that regulate osteoblast differentiation from their precursors.

Summary
In this review, we summarized current understanding of the roles of inflammation in bone resorption and bone formation, which give rise to different disorders and discuss the huge potential of harnessing these inflammatory signals to achieve bone regeneration.
An Anatomic and Radiographic Study of the Distal Tibial Epiphysis
Authors: Nguyen Cynthia V. , Greene Janelle D. , Cooperman Daniel R. , Liu Raymond W. 
Published: October 2017

Background:
Although the undulating shape of the distal tibial epiphysis is well recognized, its anatomic features have not been well quantified in the literature. To guide the placement of surgical implants about the distal tibial physis, we investigated the topographical anatomy of the distal tibial epiphysis and explored the ability of standard radiographs to visualize the physis.

Methods:
We studied 30 cadaveric distal tibial epiphyses in specimens 3 to 14 years of age. Anteroposterior (AP) and lateral radiographs were obtained of each specimen and then repeated after flexible radiopaque markers were placed on the major undulations. All radiographs were analyzed to determine the height or depth of each landmark, and measurements with and without markers for each landmark were compared using intraclass correlation coefficients (ICC). In 9 specimens, similar measurements were obtained on high-resolution 3-dimensional (3D) surface scans.

Results:
There were 4 distinct physeal undulations usually present: an anteromedial peak (Kump’s bump), a posterolateral peak, an anterior central valley, and a posterior central valley. On the 3D scans, Kump’s bump averaged 5.0 mm (range, 3.0 to 6.4 mm), the posterolateral peak 2.4 mm (range, 1.2 to 5.0 mm), the anterior valley 1.3 mm (range, 0 to 3.6 mm), and the posterior valley 0.77 mm (range, 0 to 2.7 mm). Lateral radiographs with markers correlated with measurements from 3D scans better than those without markers (ICC=0.61 vs. 0.24). For AP radiographs, correlation was good to excellent regardless of marker use (ICC=0.76 vs. 0.66).

Conclusions:
There are 4 major undulations of the distal tibial physis. Kump’s bump is the largest. A centrally placed epiphyseal screw in the medial/lateral direction or screws from anterolateral to posteromedial and anteromedial to posterolateral would tend to avoid both valleys. Particular caution should be taken when placing metaphyseal screws in the anteromedial or posterolateral distal tibia. Physeal undulations were more difficult to visualize on the lateral view.

Clinical Relevance:
This study provides quantitative data on the topography of the distal tibial physis to aid hardware placement. Lateral views should be interpreted with caution, as the physeal undulations are not as visible, whereas AP views can be interpreted with more confidence.
Trends and Disparities in Cervical Spine Fusion Procedures Utilization in the New York State
Authors: Feng Rui , Finkelstein Mark , Bilal Khawaja , Oermann Eric K. , Palese Michael , Caridi John 
Published: October 2017

Study Design.
A retrospective review of the Statewide Planning and Research Cooperative System database of the New York State.

Objective.
This study examined the rate of increase of cervical spine fusion procedures at low-, medium-, and high-volume hospitals, and analyzed racial and socioeconomic characteristics of the patient population treated at these three volume categories.

Summary of Background Data.
There has been a steady increase in spinal fusion procedures performed each year in the United States, especially cervical and lumbar fusion. Our study aims to analyze the rate of increase at low-, medium-, and high-volume hospitals, and socioeconomic characteristics of the patient populations at these three volume categories.

Methods.
The New York State, Statewide Planning and Research Cooperative System (SPARCS) database was searched from 2005 to 2014 for the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) Procedure Codes 81.01 (Fusion, atlas-axis), 81.02 (Fusion, anterior column, other cervical, anterior technique), and 81.03 (Fusion, posterior column, other cervical, posterior technique). Patients’ primary diagnosis (ICD-9-CM), age, race/ethnicity, primary payment method, severity of illness, length of stay, hospital of operation were included. All 122 hospitals were categorized into high-, medium-, and low-volume. Trends in annual number of cervical spine fusion surgeries in each of the three hospital volume groups were reported using descriptive statistics.

Results.
Low-volumes centers were more likely to be rural and non-teaching hospitals. African American patients comprised a greater portion of patients at low-volume hospitals, 15.1% versus 11.6% compared with high-volume hospitals. Medicaid and self-pay patients were also overrepresented at low-volume centers, 6.7% and 3.9% versus 2.6% and 1.7%, respectively. Compared with Caucasian patients, African American patients had higher rates of postoperative infection (P = 0.0020) and postoperative bleeding (P = 0.0044). Compared with privately insured patients, Medicaid patients had a higher rate of postoperative bleeding (P = 0.0266) and in-hospital mortality (P = 0.0031).

Conclusion.
Our results showed significant differences in hospital characteristics, racial distribution, and primary payments methods between the low- and high-volume categories. African American and Medicaid patients had higher rates of postoperative bleeding, despite similar rates between the three volume categories. This suggests racial and socioeconomic disparities remains problematic for disadvantaged populations, some of which may be attributed to accessibility to care at high-volume centers.

Level of Evidence: 3
Healing Time Correlates With the Quality of Scaring: Results From a Prospective Randomized Control Donor Site Trial
Authors: Werdin Frank , Tenenhaus Mayer , Becker Martin , Rennekampff Hans-Oliver 
Published: October 2017

BACKGROUND
Scar formation remains a potential problem after surgery or trauma. Factors influencing scar tissue have been recognized, most notably healing time and wound depth.

OBJECTIVE
To examine the association between healing time and the quality of scar tissue formation.

MATERIALS AND METHODS
Scarring was assessed at 3 and 12 months after treatment in an RCT of 219 patients and consecutive 438 split-thickness skin graft donor sites. The primary end point of the study was healing time and the quality of scar tissue, which was scored by a validated scar scale evaluating scar height, surface, and color.

RESULTS
The mean time of wound healing was 15.8 days, with a mean scar score of 6.89 at 3 months and 4.66 at 12 months. There was a significant (p < .000001) and linear correlation between healing time and scar quality. Of particular note, at 12 months, all subparameters of the score demonstrated worsening with prolonged time to heal.

CONCLUSION
The authors could objectively demonstrate that epithelialization time is an important factor influencing scar quality. In contrast to previous assumptions, this correlation follows linearly. It is reasonable then to assume that treatment strategies expediting healing will also improve scar outcome.
NOVEL CONE DYSTROPHY WITH CENTRAL ELLIPSOID ZONE LOSS ASSOCIATED WITH HUMAN RETINAL FASCIN GENE (FSCN2) MUTATION
Authors: Gui Wei , Nusinowitz Steven , Sarraf David 
Published: October 2017

Purpose:
To report the first case of a cone dystrophy with central ellipsoid zone loss associated with a mutation in the human retinal fascin gene (FSCN2).

Methods:
Multimodal retinal imaging findings including spectral domain optical coherence tomography and fundus autofluorescence are presented. The results of functional testing and mutational analysis are also discussed.

Patients:
Single patient with a diagnosis of cone dystrophy.

Results:
Spectral domain optical coherence tomography imaging illustrated central loss of the ellipsoid zone band in each eye. Full-field and multifocal electroretinogram testing confirmed a diagnosis of cone dystrophy in a 35-year-old male patient. Subsequent cone dystrophy genetic panel identified a novel mutation (p.Pro406Leu:c.1217C>T) in the FSCN2 gene.

Conclusion:
This is the first case report of a patient diagnosed with cone dystrophy associated with a novel mutation in the FSCN2 gene. FSCN2 genetic testing should be considered in patients with central ellipsoid loss and cone dystrophy, especially as specific gene therapy treatments emerge in the future.
ACUTE MACULAR NEURORETINOPATHY AND PERIPHERAL RETINAL VASCULAR ABNORMALITIES IN A PATIENT BORN HIV SEROPOSITIVE
Authors: Giuffrè Chiara , Rabiolo Alessandro , Corbelli Eleonora , Carnevali Adriano , Sacconi Riccardo , Querques Lea , Bandello Francesco , Querques Giuseppe 
Published: October 2017

Purpose:
To describe the case of a born HIV seropositive woman who developed outer retinal alterations secondary to vascular abnormalities in the perimacular region and in the periphery of both eyes.

Methods:
Case report.

Results:
A 21-year-old woman born HIV seropositive was referred for a routinary visit. Her best-corrected visual acuity was 20/20 in both eyes, and during the visit, only mild superotemporal metamorphopsia in the left eye was reported. Multimodal imaging disclosed findings consistent with acute macular neuroretinopathy such as reddish-brown lesions at fundus examination and disruption of ellipsoid zone at spectral domain optical coherence tomography. Peripheral vascular alterations were also noted at fluorescein angiography.

Conclusion:
Several associations or risk factors have been identified in patients with acute macular neuroretinopathy, including oral contraceptives, epinephrine/ephedrine, or systemic shock. To the best of our knowledge, this is the first case describing peripheral vascular alterations and acute macular neuroretinopathy in association with HIV seropositivity at birth.
Spontaneous Resolution of Delayed Suprachoroidal Hemorrhage in the Single Eye Following Needling in Congenital Glaucoma
Authors: Rezapour Jasmin , Hoffmann Esther M. , Prokosch-Willing Verena , Gericke Adrian , Pfeiffer Norbert 
Published: October 2017

Introduction:
Suprachoroidal hemorrhage (SCH) is a rare, but potentially vision-threatening event with poor long-term visual prognosis. At present, there is disagreement whether surgical intervention or conservative treatment is superior in the management. We report on a case of spontaneous resolution of severe SCH after needling procedure in the only eye of a young patient with congenital glaucoma.

Case Presentation:
A 43-year-old woman with congenital glaucoma was scheduled for bleb needling in her only eye. Preoperative best-corrected visual acuity was 20/40 and intraocular pressure 20 mm Hg. On the third postoperative day, she developed a massive delayed SCH with appositional (kissing) choroidal bullae and visual acuity was hand motion. Scleral drainage was performed after 10 days, but did not show a significant decrease of the choroidal swelling and further conservative treatment was discussed. After 2 months, choroidal swelling had completely resolved, best-corrected visual acuity was 20/50, and intraocular pressure was 11 mm Hg.

Discussion:
Full functional recovery and decrease of choroidal swelling may be attained with a conservative treatment of massive delayed SCH after needling procedure in congenital glaucoma.
The Impact of Medication Anticholinergic Burden on Cognitive Performance in People With Schizophrenia
Authors: Ang Mei San , Abdul Rashid Nur Amirah , Lam Max , Rapisarda Attilio , Kraus Michael , Keefe Richard S.E. , Lee Jimmy 
Published: October 2017

Abstract

Background
Cognitive deficits are prevalent in people with schizophrenia and associated with functional impairments. In addition to antipsychotics, pharmacotherapy in schizophrenia often includes other psychotropics, and some of these agents possess anticholinergic properties, which may impair cognition. The objective of this study was to explore the association between medication anticholinergic burden and cognition in schizophrenia.

Methods
Seven hundred five individuals with schizophrenia completed a neuropsychological battery comprising Judgment of Line Orientation Test, Wechsler Abbreviated Scale of Intelligence Matrix Reasoning, Continuous Performance Test–Identical Pairs Version, and the Brief Assessment of Cognition in Schizophrenia. Cognitive g and 3 cognitive factor scores that include executive function, memory/fluency, and speed of processing/vigilance, which were derived from a previously published analysis, were entered as cognitive variables. Anticholinergic burden was computed using 2 anticholinergic scales: Anticholinergic Burden Scale and Anticholinergic Drug Scale. Duration and severity of illness, antipsychotic dose, smoking status, age, and sex were included as covariates.

Results
Anticholinergic burden was associated with poorer cognitive performance in cognitive g, all 3 cognitive domains and most cognitive tasks in multivariate analyses. The associations were statistically significant, but the effect sizes were small (for Anticholinergic Burden Scale, Cohen f
2 = 0.008; for Anticholinergic Drug Scale, Cohen f
2 = 0.017).

Conclusions
Although our results showed a statistically significant association between medications with anticholinergic properties and cognition in people with schizophrenia, the impact is of doubtful or minimal clinical significance.
A Preliminary Study of the Effects of a Multitheory-Driven Intervention in Adults With Prediabetes Mellitus
Authors: TSAI Fu-Mian , LIN Chiu-Chu , LIN Huey-Shyan , LIU Yi 
Published: October 2017

ABSTRACT

Background:
Prediabetes mellitus (pre-DM) is an important predictive indicator of Type 2 diabetes. A person with pre-DM is eight times more likely to develop diabetes than a person without pre-DM. Prior research suggests that proactive interventions may delay the progression of this disease and reduce the rate of disease development.

Purpose:
The purposes of this preliminary study were to develop a multitheory-driven lifestyle intervention protocol for adults with pre-DM and to evaluate its feasibility and impacts on knowledge regarding pre-DM, dietary behaviors, and physical activity (primary outcomes) as well as to describe the disease progression indicators (secondary outcomes).

Methods:
A single-group, longitudinal study design was used. Thirty-nine participants were included in the analysis. A generalized estimating equation model was used to determine the trends in changes in the outcomes. All of the participants underwent testing at baseline (T0) and at 3 (T1), 6 (T2), and 12 (T3) months after the 4-week lifestyle intervention.

Results:
There were significantly increasing trends for each study parameter (Pre-DM Knowledge Assessment Form-12, p < .01; Dietary Behavior Scale, p < .01) and significantly positive changes in body weight (p < .01), body mass index (p < .01), fasting glucose level (p < .01), and glycated hemoglobin level (p < .01) over the 12-month study period.

Conclusions/Implications for Practice:
This study supports the feasibility of the developed multitheory-driven lifestyle intervention protocol and suggests that its application may improve the effectiveness of diabetes prevention programs in clinical settings. Further randomized controlled trials are needed.