bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trends in Perinatal Mental Health Within a Tertiary Institution From 2013 to 2022
Authors: Bertram G , Becuzzi N , Wilson E 
Published: August 2024

(Aust N Z J Obstet Gynaecol. 2023;63(6):821–824. doi: 10.1111/ajo.13720)
There is a high risk of developing mood and other psychiatric disorders during the perinatal period, which can be detrimental to the morbidity and mortality of women and their offspring. The rate of perinatal mental health (PMH) that has been reported is likely to be between 10% and 20% for the Australian population. The Royal Australian and New Zealand College of Obstetrics and Gynaecology recommends that the psychological well-being of pregnant women and new mothers should be attended to as part of regular antenatal and postnatal care and should be regarded as just as vital as their physical health needs.
Pregestational Maternal Risk Factors for Preterm and Term Preeclampsia: A Population-based Cohort Study
Authors: Sande AK , Dalen I , Torkildsen EA , Sande RK , Morken N-H 
Published: August 2024

(Acta Obstet Gynecol Scand. 2023;102(11):1549-1557. doi: 10.1111/aogs.14642)
Preeclampsia represents a large proportion of global maternal and neonatal morbidity and mortality. Through evidence and careful study, it has been classified into preterm and term preeclampsia, but few population-based studies have made this distinction in diagnosis. The only curative treatment for preeclampsia is delivery, and all other treatments known for this disease are preventive. In addition to differences in timing and presentation, preterm preeclampsia has several risk factors that do not apply to individuals with term preeclampsia, such as chronic hypertension, type 1 diabetes, and maternal allergy. This study was designed to assess the associations of prepregnancy conditions (diabetes types 1 and 2, chronic kidney disease, asthma, epilepsy, rheumatoid arthritis, and chronic hypertension) with preterm versus term preeclampsia at a population level.
Developmental Anesthesia Neurotoxicity: Lessons From the Heart
Authors: Ing C , Vutskits L 
Published: August 2024

(Anesthesiology. 2023;139(4):371–373. doi: 10.1097/ALN.0000000000004648)
The topic of whether anesthetics affect neurodevelopment outcomes or not is still unsettled among many medical professionals in the field. Several studies have already been performed resulting in negligible or no differences for single or short exposures to anesthetics in healthy children, but additional research is needed for longer anesthetic exposures or in children who have more elaborate medical issues that require surgery.
Calculation of Effective Dose of Phenylephrine Bolus for Treatment of Post–Spinal Hypotension in Preeclamptic Patients Undergoing Caesarean Section—A Nonrandomized Controlled Trial
Authors: Mohta M , Kumari S , Malhotra RK , Tyagi A , Agarwal R 
Published: August 2024

(Int J Obstet Anesth. 2023;56:103929. doi: 10.1016/j.ijoa.2023.103929)
Preeclampsia (PEC), a condition marked by high blood pressure during pregnancy, poses risks for both mother and fetus. Although post–spinal hypotension is rare in PEC, if it occurs (especially for over two minutes), it can worsen fetal health by impacting blood flow to the placenta and increasing oxygen free radicals. Prompt treatment of hypotension is crucial to mitigate maternal symptoms and improve outcomes for both mother and baby.
Neuraxial Buprenorphine for Postcesarean Delivery Analgesia: A Case Series
Authors: Sorabella LL , Ende HB , Bellenger SR , Stewart MF , French B , McIlroy DR , Raymond BL 
Published: August 2024

(Int J Obstet Anesth. 2023;56:103906. doi: 10.1016/j.ijoa.2023.103906)
Neuraxial morphine is standard for postcesarean pain relief, yet morphine shortages lead to off-label use of alternative opioids. Buprenorphine, considered since the 1980s, lacks robust studies but shows promise. This study assesses buprenorphine's efficacy and side effects in current practice. After institutional approval, a retrospective analysis was conducted on women receiving neuraxial buprenorphine at a Tennessee community hospital from November 2019 to September 2020. All received intrathecal or epidural buprenorphine 0.3 mg. Exclusions included certain medical conditions.
Successful Outcome of VASER Liposuction Followed by Keto Diet in a 35-year-old Man with Class III Obesity
Authors: Ali Hasan 
Published: August 2024

Summary:
Obesity is a widespread health concern worldwide, necessitating diverse interventions for effective weight management. Despite prior unsuccessful attempts at weight loss through conventional methods, including dietary restrictions and physical exercises, this case underscores the challenges faced by individuals with morbid obesity. This case report presents the successful outcome of VASER liposuction followed by a 6-month postoperative ketogenic diet regimen in a 35-year-old man with a body mass index (BMI) of 40. The patient, initially weighing 127 kg with a BMI of 40.9 kg/m² and significant fatty deposition primarily on the chest, abdomen, and flanks, underwent tumescent VASER liposuction, removing 5 L of fat. Subsequently, adhering to a modified ketogenic diet plan led to a notable reduction in weight (from 127 kg to 97 kg) and BMI (from 40 to 31.5) over the 6-month follow-up period. Effective pain management postoperatively and improvements in skin retraction and energy levels were observed. The combined approach of VASER liposuction and a ketogenic diet yielded favorable outcomes, including significant weight loss, improved BMI, and enhanced body contouring. Importantly, minimal loose skin was observed despite substantial weight reduction, highlighting the synergistic effects of the intervention. This case highlights the potential synergistic effects of VASER liposuction and a ketogenic diet in addressing obesity, offering a promising approach for weight management in morbid obese individuals. The synergistic effects included enhanced skin tightening, safety, faster recovery, minimal pain, and substantial weight loss.
Elevated Cystatin C Predicts Higher Mortality in Chronic Heart Failure Independently of Renal Function
Authors: Carreira Marta , Araújo José Paulo , Bettencourt Paulo , Lourenço Patrícia 
Published: August 2024

Introduction:
Cystatin C (CysC) is a known prognostic marker in cardiovascular diseases and its role in acute heart failure (HF) has been documented.

Methods:
We prospectively recruited HF patients followed in a HF clinic. Inclusion criteria: HF diagnosed ≥6 months, optimized evidence-based therapy, and ejection fraction <40% (Heart Failure with reduced ejection fraction). Exclusion criteria: renal replacement therapy and hospitalizations or therapeutic adjustments in the previous 2 months. A venous blood sample and 24-hour urine were collected. Follow-up: 5 years; endpoint: all-cause mortality. CysC was measured and creatinine clearance (CrCl) was calculated using 24-hour urine creatinine excretion. A Receiver operating characteristic curve was used to assess association of CysC with 5-year mortality. The prognostic role of CysC was determined using Cox-regression analysis. The multivariate model included CrCl (24-hour urine).

Results:
We evaluated 215 chronic stable Heart Failure with reduced ejection fraction patients. Mean age was 68 years, 72.1% were male. Median CysC = 1.15 mg/L, creatinine = 1.20 mg/dL, and CrCl = 63.6 mL/min. During follow-up, 103 (47.9%) patients died. The area under the curve for CysC in predicting mortality was 0.77 (0.70–0.83). Best cut-off value for death prediction = 1.00 mg/L with a sensitivity = 83.5%, specificity = 56.2%, positive predictive value = 63.7%, and negative predictive value = 78.7%. Multivariate-adjusted (age-, B-type natriuretic peptide-, evidence-based therapy, New York Heart Association class, and CrCl) 5-year mortality Hazard ratio = 2.40 (95% Confidence interval, 1.25–4.61), P value = 0.008 when CysC ≥1.00 mg/L.

Conclusions:
Patients with CysC <1.00 mg/L have almost 80% probability of being alive at 5 years; If CysC ≥1.00 mg/L, there is almost 2.5-fold higher death risk independently of B-type natriuretic peptide and CrCl.
Applying a Computer-based Warfarin Management System at a Large Tertiary Cardiovascular Center in Iran
Authors: Barati Somayyeh , Mohammadpour Mohammad Mehdi , Sadrameli Mohammad Ali , Hosseini Saeed , Maleki Majid , Golpira Reza , Bakhshandeh Hooman , Kyavar Majid , Moosavi Jamal , Mohebbi Bahram , Talasaz Azita H. , Barco Stefano , Klok Frederikus A. , Sadeghipour Parham 
Published: August 2024

Background:
Regarding adjustments to warfarin dosage, numerous studies have shown that computerized methods are superior to those based on personal experience.

Objectives:
To report the efficacy of a computer-based warfarin management system (WMS) in the Iranian population.

Methods:
By utilizing the existing dosing algorithms and obtaining expert opinions, we developed a computer-based WMS at a large tertiary cardiovascular center. The time in therapeutic range and the number of international normalized ratio (INR) tests of clinic patients were compared before and after the implementation of WMS.

Results:
Overall, 803 patients with 5407 INR tests were included in the before phase and 679 patients with 4189 INR tests in the after phase. The mean time in therapeutic range was 57.3% before and 59% after WMS implementation [mean difference, 1.64; 95% confidence interval (CI), −1.12–4.40]. In the before phase, the mean number of INR tests was 6.7, which dropped to 6.1 tests in the after phase (mean difference, −0.61; 95% CI, −0.97 to −0.24). Only 54.5% of the warfarin dosing prescriptions were consistent with the dosing recommendations of the WMS, and adherence to the WMS was poorest in the highest INR target range.

Conclusions:
For the first time in Iran, we demonstrated that a computerized system was as effective as a traditional experience-based method to monitor INR in VKA-anticoagulated patients. Furthermore, it could reduce both the number of INR tests and that of visits.
Reported Physical Symptoms During Screening Echocardiography Are Not Associated With Presence of Suspected Hypertrophic Cardiomyopathy
Authors: Movahed Mohammad Reza , Bahrami Ashkan , Bates Sharon 
Published: August 2024

Background:
The prevalence of hypertrophic cardiomyopathy (HCM) can be silent and can present with sudden death as the first manifestation of this disease. The goal of this study was to evaluate any association between reported physical symptoms with the presence of suspected HCM.

Method:
The Anthony Bates Foundation has been performing screening echocardiography across the United States for prevention of sudden death since 2001. A total of 4120 subjects between the ages of 4 and 79 underwent echocardiographic screening. We evaluated any association between various symptoms and suspected HCM defined as any left ventricular wall thickness³ ≥15 mm.

Results:
The total prevalence of suspected HCM in the entire study population was 1.1%. The presence of physical symptoms was not associated with HCM (chest pain in 4.3% of participants with HCM vs. 9.9% of the control, P = 0.19, palpitation in 4.3% of participants with HCM vs. 7.3% of the control, P = 0.41, shortness of breath in 6.4% of participant with HCM vs. 11.7% of the control, P = 0.26, lightheadedness in 4.3% of participant with HCM vs. 13.1% of the control, P = 0.07, ankle swelling in 2.1% of participant with HCM vs. 4.0% of the control, P = 0.52, dizziness in 8.5% of participant with HCM vs. 12.2% of the control, P = 0.44).

Conclusions:
Echocardiographic presence of suspected HCM is not associated with a higher prevalence of physical symptoms in the participants undergoing screening echocardiography.
TEN-YEAR FOLLOW-UP OF FELLOW EYES IN PATIENTS WITH UNILATERAL NAIVE EXUDATIVE AGE-RELATED MACULAR DEGENERATION
Authors: Pozzo Giuffrida Francesco , Nassisi Marco , de Sanctis Lorenzo , Milella Paolo , Malerba Alessia , Mapelli Chiara , Dell'Arti Laura , Casaluci Marco , Romano Francesco , Invernizzi Alessandro , Staurenghi Giovanni , Viola Francesco 
Published: August 2024

Purpose:
To determine the 10-year morphologic outcomes and identify potential risk factors of exudative age-related macular degeneration (AMD) in the fellow eyes (FEs) in patients with naive exudative AMD.

Methods:
Data from 100 patients were retrospectively reviewed. Baseline macular neovascularization (MNV) type in the exudative AMD eye and presence of drusen, intraretinal hyperreflective foci, nonfoveal incomplete retinal pigment epithelium and outer retinal atrophy, central retinal thickness, and subfoveal choroidal thickness in the FEs were analyzed as biomarkers for progression in the second eye.

Results:
Fifty-four patients developed exudative AMD in the FE at the end of the follow-up. Subjects with Type 2 and Type 3 macular neovascularization in the exudative AMD eye had a higher risk of exudative AMD in the FE (hazard ratio [HR] = 3.365; P = 0.039 and HR = 3.801; P = 0.037). Fellow eyes with drusen (large HR = 6.938, P = 0.001; cuticular HR = 6.937, P < 0.0001; subretinal drusenoid deposits HR = 13.678, P < 0.0001) and intraretinal hyperreflective foci (HR = 1.853, P = 0.041) were also at higher risk. Seven patients were legally blind by the end of the follow-up.

Conclusion:
The rate of exudative AMD in the FE was 54% 10 years after the diagnosis in the exudative eye. The FE of patients with Type 2 and Type 3 macular neovascularization was at high risk of early progression. Drusen and intraretinal hyperreflective foci were also significant risk factors for macular neovascularization development.
HIGHER SUBFOVEAL CHOROIDAL THICKNESS IN CHOROIDAL MELANOMAS THAN IN CHOROIDAL NEVI
Authors: Benlarbi Abdelmajid , Malaise Denis , Estrada Walker Juliana , Apéré François , Lumbroso-Le Rouic Livia , Behar-Cohen Francine , Cassoux Nathalie , Matet Alexandre 
Published: August 2024

Purpose:
To compare subfoveal choroidal thickness between eyes with choroidal melanoma and choroidal nevi.

Methods:
Retrospective study of 126 consecutive patients in a tertiary ocular oncology center. Eyes with tumors located less than two disk diameters from the fovea were excluded. In eyes with nevi, factors of potential transformation into melanoma were recorded (orange pigment, subretinal fluid, thickness >2 mm, diameter >5 mm, ultrasound hollowness). Subfoveal choroidal thickness was assessed by three independent observers on horizontal spectral-domain optical coherence tomography scans.

Results:
Sixty-seven eyes with choroidal melanoma and 59 eyes with choroidal nevi were included. The melanoma and nevi groups did not differ in gender (P = 0.14) nor age (P = 0.34). There was a very good agreement between the three independent observers for subfoveal choroidal thickness measurements (intraclass correlation coefficient = 0.89). Mean subfoveal choroidal thickness was higher in melanomas (294.3 ± 89.9 µm) than nevi (260.3 ± 76.7 µm) (P = 0.013), and the difference remained significant between melanomas and 28 nevi with ≥2 growth risk factors (256.3 ± 77.0 µm) (P = 0.027). In a multivariate model, the significant contributors to subfoveal choroidal thickness were presence of melanoma (P = 0.004), younger age (P < 0.0001), and shorter lesion distance to the fovea (P = 0.016).

Conclusion:
Subfoveal choroidal thickness may reflect the interplay between melanocytic tumors and their choroidal microenvironment. Its clinical utility should be explored in future studies.
Laparoscopic versus open pancreatoduodenectomy for periampullary tumors: a randomized clinical trial
Authors: Yoon Yoo-Seok , Lee Woohyung , Kang Chang Moo , Hong Taeho , Shin Sang Hyun , Lee Jung Woo , Hwang Dae Wook , Song Ki Byung , Kwon Jae Woo , Sung Min Kyu , Shim In Kyong , Lee Jung Bok , Kim Song Cheol ,   for Korean Study Group on Minimally Invasive Pancreatic Surgery (K-MIPS)
Published: August 2024

Background:
There is a lack of robust evidence on the efficacy of laparoscopic pancreatoduodenectomy compared to open surgery. This study was aimed to compare time to functional recovery (FR) between laparoscopic and open pancreatoduodenectomy.

Materials and methods:
This pragmatic, multicenter, randomized controlled phase 3 trial was conducted in seven tertiary centers. Patients with periampullary tumors were randomized using a block design in a 1:1 ratio and stratified by pancreatic fistula risk. Participants were randomized to undergo open or laparoscopic pancreatoduodenectomy by expert pancreatic surgeons. The primary outcome was the time to FR, defined as the number of days until FR was achieved in all five domains. The secondary endpoints included perioperative and short-term oncological outcomes.

Results:
Between March 2019 and June 2022, 252 patients were randomly assigned to laparoscopic (n=125) or open groups (n=127). Primary outcomes were reported in 235 patients. The mean time to FR was shorter in laparoscopic group compared to the open group (7.7 vs. 9.0 days, P=0.03). Laparoscopic group exhibited a higher cumulative rate of FR compared to the open group (Hazard ratio,1.34; 95% CI, 1.03–1.74; P=0.02). Severe complications, R0 resection, the number of retrieved lymph nodes and short-term survival rates were comparable between the two groups.

Conclusions:
Laparoscopic pancreatoduodenectomy demonstrated modest advantages in FR time over open surgery for selected patients with experienced surgeons.
Epidemiology of advanced cystic fibrosis lung disease in the modulator era
Authors: Westhoff Julia , Naehrlich Lutz 
Published: August 2024

Purpose of review
Advanced cystic fibrosis lung disease remains the main cause of death in people with cystic fibrosis (pwCF). Cystic fibrosis transmembrane regulator (CFTR) modulators have changed the disease burden for eligible pwCF with access to this therapy.

Recent findings
Real-world data show that there are no safety concerns for patients with advanced cystic fibrosis lung disease treated with highly effective triple CFTR modulator therapy. The improvements are comparable to those in other people with cystic fibrosis and in part even better. Mortality and rates of lung transplantation have decreased since the approval of CFTR modulator therapy and, especially, highly effective triple CFTR modulator therapy. Nevertheless, at least 10% of people with cystic fibrosis are not eligible for highly effective CFTR modulator therapy, and the development of alternative treatments remains important.

Summary
The approval of highly effective CFTR modulator therapies has been a breakthrough in treatment for most people with cystic fibrosis, especially those with advanced lung disease, improving survival and reducing the burden of the disease.
Prophylactic red cell transfusions for sickle cell disease pregnancy: increased use of therapy could transform outcomes
Authors: Alan Sheinei , Sharma Deva , Pecker Lydia H. 
Published: August 2024

Purpose of review
Pregnancy for people with sickle cell disease (SCD) is high risk with persistently high rates of severe maternal and fetal mortality and morbidity. Transfusion therapy is the best-studied treatment for SCD in pregnancy; hydroxyurea is not usually used because of teratogenicity concerns. In high-resource settings, red cell transfusions are likely underutilized, while in low-resource settings, they may be altogether unavailable.

Recent findings
A randomized controlled trial and meta-analysis, two of the strongest forms of clinical research, show transfusion significantly reduces maternal and fetal death, painful crisis, thrombosis, and acute respiratory failure. Downstream benefits of treatment are less well measured and may include improving maternal anemia, reducing opioid exposure, and avoiding hospitalization, which presents risk for additional complications. Alloimmunization is a particular transfusion risk in SCD. However, many strategies can mitigate this risk. Accordingly, the American Society of Hematology classifies chronic transfusion in pregnancy as low risk.

Summary
Given the low risk classification, lack of alternative therapies, dismal, stagnant pregnancy outcomes and the potential for profound treatment benefit, wider use of chronic transfusion therapy for SCD pregnancy is likely indicated. This review discusses the benefits and potential risks of prophylactic transfusions for SCD pregnancy. Use of chronic transfusions during pregnancy is indicated to help urgently transform outcomes.
Video-Based Study of the Progression of Pediatric Emergency Medicine Fellows' Tracheal Intubation Performance During Training
Authors: Thomas Phillip , Kerrey Benjamin , Edmunds Katie , Dean Preston , Frey Mary , Boyd Stephanie , Geis Gary , Ahaus Karen , Zhang Yin , Sobolewski Brad 
Published: August 2024

Background
The lower clinical exposure of Pediatric Emergency Medicine (PEM) fellows to critical procedures may impede skill acquisition. We sought to determine the tracheal intubation learning curve of PEM fellows during training and compared PEM fellow success against standards for tracheal intubation success.

Methods
This was a retrospective, video-based study of a cohort of PEM fellows at a single academic pediatric emergency department (PED). All forms of tracheal intubation were included (rapid sequence intubation and crash or no medication). The cohort consisted of 36 PEM fellows from all or part of 5 consecutive fellowship classes. Data were collected by structured review of both existing ceiling-mounted videos and the electronic medical record. The main outcome was PEM fellows' success on the first or second attempt. We used cumulative summation to generate tracheal intubation learning curves. We specifically assessed the proportion of PEM fellows who reached 1 of 4 thresholds for procedural performance: 90% and 80% predicted success on the first and the first or second attempt.

Results
From July 2014 to June 2020, there were 610 patient encounters with at least 1 attempt at tracheal intubation. The 36 PEM fellows performed at least 1 attempt at tracheal intubation for 414 ED patient encounters (65%). Median patient age was 2.1 years (interquartile range, 0.4–8.1). The PEM fellows were successful on the first attempt for 276 patients (67%) and on the first or second attempt for 337 (81%). None of the 36 PEM fellows reached the 90% threshold for either first or second attempt success. Four fellows (11%) met the 80% threshold for first attempt success and 11 (31%) met the 80% threshold for first or second attempt success.

Conclusions
Despite performing the majority of attempts, PEM fellows often failed to reach the standard thresholds for performance of tracheal intubation. Clinical exposure alone is too low to ensure acquisition of airway skills.