bluuebunny/crossref_metadata_2025_split huggingface dataset:
Considerations in Stoma Reversal
Authors: Sherman Karen , Wexner Steven 
Published: May 2017

AbstractTemporary stomas are frequently used in the management of diverticulitis, colorectal cancer, and inflammatory bowel disease. These temporary stomas are used to try to mitigate septic complications from anastomotic leaks and to avoid the need for reoperation. Once acute medical conditions have improved and after the anastomosis has been proven to be healed, stomas can be reversed. Contrast enemas, digital rectal examination, and endoscopic evaluation are used to evaluate the anastomosis prior to reversal. Stoma reversal is associated with complications including anastomotic leak, postoperative ileus, bowel obstruction, enterocutaneous fistula, and, most commonly, surgical site infection. Furthermore, many stomas, which were intended to be temporary, may not be reversed due to postoperative complications, adjuvant therapy, or prohibitive comorbidities.
The Role of Temporary Fecal Diversion
Authors: Lightner Amy , Pemberton John 
Published: May 2017

AbstractThe use of temporary fecal diversion is of great importance to tenuous anastomosis, immunosuppressed patient, or actively infected patient. Its use protects newly constructed intestinal anastomoses from being the culprit of pelvic sepsis or systemic illness. Thus, potential morbidity and mortality can be averted. However, its appropriate or optimal use is often debated. We herein discuss the evidence for when to best use a diverting stoma for colorectal, coloanal, and ileoanal anastomoses. We also discuss the importance of considering a temporary diverting stoma in the setting of high-dose immunosuppression (e.g., transplant patients or inflammatory bowel disease), active infection, or upon creation of ileal pouch–anal anastomosis. Lastly, we discuss the advantages and disadvantages of a loop ileostomy versus colostomy for temporary diversion of fecal contents.
Obstetric Disorders in the ICU
Authors: Plante Lauren , Basualdo María , Plotnikow Gustavo , Vasquez Daniela 
Published: May 2017

AbstractPregnant and postpartum patients represent a challenge to critical care physicians, as two patients in one have to be cared for and because specific obstetric disorders, not universally covered in formal critical care training, need to be managed. Pregnancy also alters physiologic norms, so that the critical care physician may either fail to recognize a value as abnormal in pregnancy or mistakenly identify as abnormal a value within the normal range for a pregnant woman. In this article, we will review the most frequent obstetric causes of admission of pregnant/postpartum patients to the intensive care unit (hypertensive disease of pregnancy, obstetric hemorrhage, and obstetric sepsis) along with their diagnostic criteria, clinical presentation, and recommended treatment. We will also cover some specific, although less frequent, obstetric disorders, such as acute fatty liver of pregnancy, peripartum cardiomyopathy, and amniotic fluid embolism. Our primary aim is to improve quality of care for these types of patients.
Pulmonary Complications of Pregnancy: Venous Thromboembolism
Authors: Skeith Leslie , Rodger Marc 
Published: May 2017

AbstractUnique considerations are needed when diagnosing and treating venous thromboembolism (VTE) in women who are pregnant or postpartum. What are the risks to the fetus, such as drug exposure or the risk of radiation with diagnostic imaging? How does the physiology of pregnancy affect imaging techniques and anticoagulation management? How should anticoagulation be managed around labor and delivery? These questions highlight some of the important considerations needed when managing a pregnant patient with suspected or confirmed VTE. This review outlines what is known about the epidemiology, pathophysiology, clinical risk factors, diagnosis, and therapeutic management of VTE in pregnancy. We also review our preferred diagnostic and treatment algorithm for a pregnant patient with suspected or confirmed VTE.
Pulmonary Hypertension in Pregnancy
Authors: Banerjee Debasree , Ventetuolo Corey 
Published: May 2017

AbstractPulmonary arterial hypertension (PAH) is a pulmonary vasculopathy associated with abnormal cardiopulmonary hemodynamics and a limited life expectancy due to right heart failure. Young women are preferentially affected. Women with PAH are at increased risk of complications and death during pregnancy for both the mother and the fetus. While it is not well characterized how changes in sex steroids and other hormones during pregnancy affect pulmonary hypertension, many expected systemic and heart–lung physiologic adaptations during gestation are poorly tolerated in women with PAH. Despite the approval of numerous therapies for PAH in recent years, pregnancy avoidance or early termination is still recommended in women with PAH because of poor outcomes. In this review, we will discuss physiologic and hormonal changes in pregnancy as they relate to pulmonary vascular disease and right heart function. We will review current consensus recommendations and outline the management of pregnancy in PAH when it does occur.
Glioblastoma Multiforme: an Advanced Analysis of 153 Patients and Review of the Literature
Authors: Nikdad Mohammad , Farhan Farshid , Shafizadeh Milad , Mirmohseni Atefeh , Afarideh Mohsen , Komeleh Shabnam , Lashkari Marzieh , Ganji Morsaleh , Ghajar Alireza , Shafiei Saeed , Shafizadeh Yalda , Kazemian Ali , Saberi Hooshang 
Published: May 2017

Objective Glioblastoma multiforme (GBM) is an aggressive primary tumor with frequent recurrences that leaves patients with a short survival time and a low quality of life. The aim of this study was to review the prognostic factors in patients with glioblastoma multiforme.
Material and Methods The focus of this retrospective study was a group of 153 patients with supratentorial GBM tumors, who were admitted to a tertiary-care referral academic center from 2005 to 2013. The factors associated with survival and local recurrence were assessed using the hazard ratio (HR) function of Cox proportional hazards regression and neural network analysis.
Results Out of the 153 patients, 99 (64.7%) were male. The average age of the patients was 55.69 ± 15.10 years. The median overall survival (OS) and progression-free survival (PFS) rates were 14.0 and 7.10 months respectively. In the multivariate analysis, age (HR = 2.939, p < 0.001), operative method (HR = 7.416, p < 0.001), temozolomide (TMZ, HR = 11.723, p < 0.001), lomustine (CCNU, HR = 8.139, p < 0.001), occipital lobe involvement (HR = 3.088, p < 0.001) and Karnofsky Performance Status (KPS, HR = 4.831, p < 0.001) scores were shown to be significantly associated with a higher OS rate. Furthermore, higher KPS (HR = 7.292, p < 0.001) readings, the operative method (HR = 0.493, p = 0.005), the use of CCNU (HR = 2.047, p = 0.003) and resection versus chemotherapy (HR = 0.171, p < 0.001) were the significant factors associated with the local recurrence of the tumor.
Conclusion Our findings suggest that the use of CCNU and TMZ, the operative method and higher KPS readings are associated with both higher survival and lower local recurrence rates.
Hematologic Malignancies Are Associated with Adverse Perioperative Outcomes following Total Knee Arthroplasty
Authors: Wagner Timothy , Naziri Qais , North W. , Navale Suparna , Klika Alison , Barsoum Wael , Higuera Carlos , Newman Jared 
Published: May 2017

AbstractThe treatment of hematologic malignancies has advanced over the years, resulting in an improved survival of patients. As a result, these patients may be a part of the increasing population requiring total knee arthroplasty (TKA); however, they might be at a higher risk of adverse perioperative outcomes. The purpose of this study was to determine the perioperative outcomes (complications, length of stay [LOS], and costs) of patients with hematologic malignancies following TKA. This study used the Nationwide Inpatient Sample (NIS) to identify patients who underwent TKA in the United States from 2000 to 2011. Patients diagnosed with any hematologic malignancy (N = 24,714) were then stratified by Hodgkin's disease (N = 791), Non-Hodgkin's lymphoma (N = 7,096), plasma cell dyscrasias (N = 1,621), leukemia (N = 8,005), myeloproliferative disease (N = 5,746), and/or myelodysplastic syndromes (N = 1,608) for determining the complications that occurred during admission. Propensity matching was performed for demographics, hospital characteristics, and comorbidities, which yielded 24,491 patients with any hematologic malignancy and 24,458 control patients. Additionally, propensity matching was performed for the hematologic malignancy subtypes. Multivariable regression models were used to analyze the surgical and medical complications, LOS, and costs. The annual frequency of THA in patients with any hematologic malignancy increased from 2000 to 2011 (p < 0.0001). Hematologic malignancies were associated with an increased risk of any surgery-related complication (odds ratio [OR] = 1.31, p < 0.0001) and any general medical complication (OR = 1.38, p < 0.0001). Patients with any hematologic malignancy had increased odds of complications, including acute postoperative anemia (OR = 1.29, p < 0.0001), hematoma/seroma (OR = 1.65, p < 0.02), peripheral vascular disease (OR = 2.23, p = 0.046), deep venous thrombosis (DVT) (OR = 1.95, p = 0.02), and blood transfusion (OR = 1.61, p < 0.0001). Hematologic malignancies were associated with an increased incremental LOS (0.13 d, p < 0.0001) and an increased incremental cost ($788, p < 0.0001). Thus, we conclude that following TKA, patients with hematologic malignancies are at an increased risk of perioperative complications, longer LOS, and higher costs. The risk quantification for adverse perioperative outcomes in association with an increased cost may help design different risk stratification and reimbursement methods in such patients when undergoing TKA.
Revision Total Knee Arthroplasty Using a Constrained Condylar Knee Prosthesis Combined with a Posterior Stabilized Articular Surface
Authors: Tsai Shang-Wen , Chen Cheng-Fong , Wu Po-Kuei , Chen Chao-Ming , Chen Wei-Ming 
Published: May 2017

AbstractIntraoperative assessment of valgus–varus stability is crucial for choosing articular surfaces with different levels of constraint. Legacy constrained condylar knee (CCK) prostheses are readily available to assemble and use with a CCK articular surface or a posterior stabilized (PS) articular surface in revision knee arthroplasty surgeries. We wanted to validate outcomes of revision total knee arthroplasty (TKA) using legacy CCK prostheses combined with a PS articular surface. Thirty-seven patients were enrolled and followed up for more than 2 years. Range of motion (ROM), the Knee Society score (KSS), the Knee Society functional score (KSS-F), and the Western Ontario and McMaster Universities Arthritis Index (WOMAC) were used to evaluate outcomes. Follow-up was a mean of 86.5 months (range: 28–152 months). The mean age of the participants was 69.8 years (range: 31–86 years). The mean ROM was 110.5 degrees, the KSS was 86.2 points, the KSS-F was 68.3 points, and the WOMAC score was 22.6 points. Seven participants had implant failures: five because of delayed infections and two because of posterior dislocations. In conclusion, revision TKA using a CCK prosthesis combined with a PS articular surface might provide satisfactory mid-term outcomes. Delayed infection was the most common cause of implant failure. Dislocation might occur in middle-old or older patients despite careful intraoperative examination of valgus–varus stability, extension–flexion gap balancing, and signs of recurvatum.
Does Age Influence How Patients Rate Their Experience of Care after Total Knee Arthroplasty?
Authors: Gwam Chukwuweike , Mistry Jaydev , Mohamed Nequesha , Chughtai Morad , Thomas Melbin , Mont Michael , Delanois Ronald 
Published: May 2017

AbstractThe Centers for Medicare and Medicaid Services (CMS) have recently modified models for physician compensation with the use of patient administered surveys, such as the Press Ganey (PG). Currently, it is not well understood how the age of total knee arthroplasty (TKA) patients influences PG scores and hospital ratings. Therefore, we asked: (1) is there a difference in how patients rate PG survey elements between patients < 50 years of age, 50 to 80 years of age, and > 80 years of age and (2) what factors influence PG overall hospital rating in the various age groups? The PG database from our institution was queried from November 2009 to January 2015, yielding 728 patients who received a primary TKA. Patients were stratified by age at the time of surgery, based on those < 50 years (n = 43), 50 to 80 years (n = 639), and > 80 years of age (n = 46). The means for each domain was calculated and multiple regression analyses were performed separately for the three cohorts, to assess the influence (β-weight) of each domain on overall hospital ratings. Chi-square tests and Student's t-tests were performed appropriately to assess differences in categorical and continuous data between the three cohorts. No significant difference in mean scores was observed in any individual domain category between the three age groups. Communication with nurses had a significant influence on overall hospital rating in all three age groups. In addition, perception of pain demonstrated a significant influence on overall hospital rating for patients < 50 years of age (β = 0.807, p = 0.011) and those 50 to 80 years of age (β = 0.248, p = 0.014). For patients who were < 50 years of age, communication regarding medication had a significantly negative influence on overall hospital ratings (β = − 0.387, p = 0.025). For patients who were > 80 years of age, staff responsiveness (β = 0.403, p = 0.002) also significantly influenced overall hospital ratings. With physician reimbursement partially dependent on patient-reported experiences of care, orthopaedists must recognize and improve on the factors that affect patient satisfaction to avoid financial penalties. Although age was found to not have a global effect on PG scores after TKA, the factors that patients consider most important during their experience of care may vary by age group.
Phenotypic Variability and mTOR Pathway Gene Aberrations in Familial Tuberous Sclerosis
Authors: Sekar Shobana , Nasser Sara , Adkins Jonathan , Cuyugan Lori , Enriquez Daniel , Rangasamy Sampath , Narayanan Vinodh , Liang Winnie 
Published: May 2017

AbstractTuberous sclerosis complex (TSC) is an autosomal dominant disorder that demonstrates variable severity, such that affected family members may have mild or severe disease. We performed exome and RNA sequencing of blood leukocytes from mild and severe cases across four families to identify mTOR pathway aberrations that may underlie phenotypic variability. In each family, we identified TSC1/TSC2 aberrations along with different mTOR pathway gene alterations, including base substitutions, deletions, and skewed allelic frequencies. Here, we describe the first reported DNA and RNA analysis of TSC families demonstrating mTOR pathway aberrations in mild and severe forms of the disease.
Survival, Short-Term, and Long-Term Morbidities of Neonates with Birth Weight < 500 g
Authors: Bashir Rani , Thomas Julianne , MacKay Margot , Agnew Jennifer , Hubber-Richard Philippa , Grunau Ruth , Synnes Anne 
Published: May 2017

Objectives The objective of this study was to describe survival, short-term, and long-term morbidities of neonates with birth weight < 500 g.
Study Design Retrospective cohort studies to calculate survival, short-term, and long-term morbidity rates of neonates born weighing < 500 g from 1993 to 2012 and neurodevelopmental impairment rates at 4.5 years for births 1993 to 2008 in one center.
Results Of 549 inborn neonates with birth weight < 500 g, 4% survived. For live births and neonatal intensive care unit (NICU) admissions, 10 and 55% survived, respectively. Of 28 NICU (inborn and outborn) survivors (median birth weight 460 g and gestation 25.9 weeks [range: 22.6–30.3 weeks]), 71% were inborn, 50% male, and 75% were small for gestational age. One in five neonates was a twin or multiple. Short-term morbidities noted were bronchopulmonary dysplasia (91%), culture proven sepsis (50%), retinopathy of prematurity (41%), and severe brain injury (22%); 27% had no long-term impairment, 23% one, 23% two, 18% three, and 9% four impairments in motor, cognitive, vision, and/or hearing domains. At 4.5 years, 29% had visual impairment, 10% wore hearing aids, 50% had IQ < 70, 18% cerebral palsy, and 68% had low motor scores.
Conclusion Only 4% of births < 500 g survived. All survivors had short-term morbidities; 27% neonates survived without long-term major impairments.
Assessment of Anthropometric Measurements as Predictors of Car Seat Screening Failure
Authors: Donald Elena , Heffernan Maura , Corwell Brian , Davis Natalie 
Published: May 2017

Objective The objective of this study was to determine whether anthropometric measurements such as head circumference (HC), body mass index (BMI), and body surface area (BSA) can predict car seat tolerance screen (CSTS) failure. We hypothesized that subjects with larger HC and lower BMI/BSA would have increased risk of failure.
Study Design We performed retrospective medical record review of infants born in 2013 who qualified for CSTS due to being born preterm (< 37 weeks) or low birth weight (LBW). We performed bivariate analyses of clinical and demographic risk factors including anthropometrics to identify predictors of CSTS failure.
Results In this study, 19 of 366 subjects failed their CSTS (5.3%). There were no significant differences in HC, length, BSA, BMI, or ratio of HC to length, BMI, or BSA between those who passed versus failed. On subgroup analysis of preterm infants, the significant predictor of failure was multiple gestation (p = 0.024). In the term LBW cohort, requiring nasal canula (NC) (p = 0.03) and having limited or no prenatal care (PNC) (p = 0.0006) were both significant predictors of failure.
Conclusion Neither absolute measurements nor the ratios of HC to body measurements predicted CSTS outcome. Multiple gestation was a significant predictor of failure in preterm infants, while NC requirement and poor PNC were predictors in LBW term infants.
Präoperative Vorbereitung und Evaluation: der ältere Patient
Authors: Olotu-Steffen Cynthia , Gurlit Simone , Kiefmann Rainer 
Published: May 2017

ZusammenfassungAufgrund der steigenden Lebenserwartung müssen sich heutzutage immer mehr ältere und hochbetagte Patienten einer Operation unterziehen – eine Herausforderung für die Chirurgie und insbesondere für die Anästhesiologie. Dieser Beitrag beschreibt, wie altersbedingte Besonderheiten präoperativ erfasst und entsprechende Maßnahmen eingeleitet werden können, um das Risiko der postoperativen Morbidität – oder gar Pflegebedürftigkeit – zu verringern.
Entwicklung möglich?
Authors: Majerczyk-Kuhn Ursula 
Published: May 2017

Zusammenfassung
Bindungsfähigkeit im Kindes- und Jugendalter Wie geht es Kindern, deren
Bindung zu den Eltern aus unterschiedlichen Gründen gestört ist? Sind sie in der
Lage, trotz dieser Störung noch Vertrauen zu entwickeln und Bindung zuzulassen?
Eine Pflegemutter in der Bereitschaftspflege berichtet.
Geht es Ihnen gut?
Authors: Probst Karin 
Published: May 2017

Zusammenfassung
Selbstfürsorge aus hypnosystemischer Sicht Psychiatrisch Pflegenden ist es
wichtig, dass es ihren Klienten gut geht. Selbst kommen sie manchmal kaum dazu,
ausreichend zu trinken oder erholsame Pausen zu verbringen. Falls es Ihnen auch
so geht und Sie gerne besser auf sich achtgeben möchten, hat unsere Autorin ein
paar Tipps für Sie.
Empathische Kompetenz in der
Pflegeausbildung
Authors: Rößler Manuela 
Published: May 2017

Zusammenfassung
Handlungskompetenz Empathie in der Pflege ist eine wichtige Voraussetzung,
damit Patienten sich verstanden und angenommen fühlen. Aber ist Empathie erlern-
und messbar? Unsere Autorin hat im Rahmen ihrer Bachelorarbeit geprüft, wie
empathische Kompetenz in der Pflegeausbildung durch Unterricht angebahnt werden
kann. Außerdem hat sie Beobachtungskriterien erfasst, die eine professionelle
empathische Kompetenz in der Pflegeausbildung zeigen.
Basisassessment für die psychiatrische
Pflege
Authors: Fiebig Madlen , Rabenschlag Franziska , Gehri Beatrice , Metzenrath Anke , Sippel Birgit , Söyler Murat , Hunstein Dirk 
Published: May 2017

Zusammenfassung
Praxis-Forschungsprojekt Bisher stand im deutschsprachigen Raum kein
Basisassessment zur Verfügung, das speziell für den Einsatz in der
psychiatrischen Pflege entwickelt wurde. Dieser Mangel mag auch darin begründet
sein, dass die Komplexität der zu messenden Phänomene besondere Anforderungen an
ein Assessmentinstrument stellt. Wir stellen ein solches Basisassessment für die
psychiatrische Pflege vor, das in einem deutsch-schweizerischen
Kooperationsprojekt entwickelt wurde.
50 Jahre psychiatrische Einstellungsforschung in Deutschland
Authors: Angermeyer Matthias , Matschinger Herbert , Schomerus Georg 
Published: May 2017

Zusammenfassung
Ziel Analyse der Entwicklung der psychiatrischen Einstellungsforschung in Deutschland.
Methode Historischer Überblick auf der Basis systematischer Reviews.
Ergebnisse Die Einstellung der Bevölkerung zu psychisch Kranken und zur Psychiatrie wurde ursprünglich aus soziologischer Perspektive untersucht, später dominierte die sozialpsychologische bzw. individualpsychologische Perspektive.
Schlussfolgerung Auch wenn dieser Ansatz wichtige Einblicke in die dem Stigma zugrunde liegenden Prozesse erlaubte, erscheint es an der Zeit die individuelle Perspektive durch eine gesellschaftliche zu ergänzen.
Russische Forschungen zur Massenpsychologie aus dem 19.
Jahrhundert
Authors: Engmann Birk , Steinberg Holger 
Published: May 2017

ZusammenfassungIm 19. Jahrhundert erlebte die Massenpsychologie als wenngleich randständiges
sozialpsychologisches und psychiatrisches Forschungsfeld doch eine
beachtenswerte Publikationstätigkeit. Heute beschränkt sich die medizin- und
psychologiehistorische Darstellung vor allem auf deutsch-, französisch- und
englischsprachige Beiträge über induzierte psychische Massenerscheinungen. In
modernen Erklärungsmodellen nehmen aber weiterhin die im 19. Jahrhundert
postulierten Thesen einen hohen Stellenwert ein bzw. behielten ihre Gültigkeit.
Da jedoch die diesbezüglichen russischen Arbeiten in der Rezeptionsgeschichte
fehlen, sollen diese hier näher beleuchtet werden.Wie in vergleichbaren westeuropäischen Publikationen, so wurden von den
russischen Autoren Erklärungsmodelle wie Nachahmung, Suggestion und erbliche
Prädisposition diskutiert. Eine besondere Stellung nimmt dagegen die Monographie
von Viktor Kandinskij aus dem Jahr 1881 ein. Kandinskij unterbreitete darin eine
eigene Hypothese zur Entstehung psychologischer Massenphänomene, die einen
fließenden Übergang zwischen normal und pathologisch auf hirnanatomischer
Grundlage postulierte, was bedeutet, dass prinzipiell kein Individuum vor
„psychischer Ansteckung“ in der Masse geschützt ist. Kandinskij beschrieb dabei
eine Kausalkette, beginnend mit Exaltiertheit über Ekstase, Illusionen bis – in
der Extremform – hin zu Halluzinationen. Mit der Exaltiertheit ist die
Vorbedingung erfüllt, die aufgrund der gleichzeitigen Schwächung des Willens die
Person für andere Ideen leicht empfänglich macht. Sind mehrere Leute bereits
exaltiert, reiche dann eine einzige Person aus, die z. B. zu halluzinieren
beginne und die anderen anstecke. Menschen mit starken religiösen Gefühlen, mit
einer Neigung zum Mystizismus und mit der Leidenschaft zum Geheimnisvollen und
Ungewöhnlichen sah Kandinskij als besonders empfänglich an.
Kognitive Störungen bei Schizophrenie
Authors: Krug Axel , Kircher Tilo 
Published: May 2017

ZusammenfassungRisikopatienten für eine spätere Schizophrenie zeigen bereits vor einer 1. Episode kognitive Funktionseinbußen. Im Verlauf bleiben
diese relativ stabil auf niedrigem Niveau. Trainingsprogramme können hier psychosoziale und kognitive Defizite verbessern.