bluuebunny/crossref_metadata_2025_split huggingface dataset:
Psychoeducation
Authors: Falk Avital , Bennett Shannon , Rozenman Michelle , Mohatt Justin , Bergman R. Lindsey 
Published: April 2023

Abstract
This chapter, “Psychoeducation,” describes this important initial component of intensive treatment. Psychoeducation reviews the important components of education for patients, including how to understand obsessive compulsive disorder (OCD) and the rationale, process, and benefits of intensive exposure and response prevention (ERP). Psychoeducation about OCD and common comorbid symptoms is important to reduce anxiety, shame, stigma, and blame around the symptom presentation for patients and their families. Early education about the process of intensive ERP prepares patients and families that this treatment can be quite challenging and uncomfortable and simultaneously allows them to understand how it will benefit and help. This chapter clearly lays out the key information to include in psychoeducation and describes the benefits of this intervention.
Treating Episodic Breathlessness
Authors: Eisenmann Yvonne , Simon Steffen 
Published: April 2023

Abstract
Episodic breathlessness, a time-limited worsening of breathlessness intensity, occurs frequently in patients with advanced disease despite optimal treatment of underlying disease. It requires symptomatic treatment. Breathlessness episodes are often associated with anxiety. Due to the short average duration of episodes, nonpharmacological strategies are the first-line treatment and facilitate self-management. Breathing techniques and body positioning help the patient to ease breathing. Cooling the face (e.g., by a handheld fan), activity pacing, and cognitive-behavioral strategies such as relaxation techniques and distraction can help the patient to manage episodes. Educating the patient and the family is crucial; teaching topics include information about breathlessness, underlying disease, average length of episodes, triggers, and strategies to manage episodes. For prolonged breathlessness episodes, opioids can provide symptomatic relief and benzodiazepines may reduce breathlessness-related anxiety.
Reducing Episodic Dyspnea in Heart Failure
Authors: Fahlberg Beth B. , Laramee Ann S. 
Published: April 2023

Abstract
Dyspnea is a common and distressing problem for patients with heart failure (HF), yet with comorbid conditions, diagnosis and prompt treatment can be challenging. Targeted assessment findings specific to HF include orthopnea, jugular vein distention, bibasilar crackles, ascites, peripheral edema, and weight gain. Diagnostic test findings in HF-related dyspnea include elevated brain natriuretic peptide levels and pulmonary congestion on chest x-ray. Diuresis is the primary focus of treatment, while guideline-directed medical therapies including procedures, surgeries, devices, and medications can promote improved heart function and prevent future episodes of dyspnea, with consideration for the patient’s prognosis and goals of care. Home monitoring for worsening HF symptoms and increasing weight and use of patient-focused symptom management plans are also essential to reducing episodes of dyspnea in HF, while advance care planning with HF-specific decision-making can promote appropriate concordant care in this population.
Dyspnea in Pediatric Congenital Heart Disease
Authors: Wright Jennifer , Spruit Jessica L. 
Published: April 2023

Abstract
This chapter discusses dyspnea, which is a common and potentially underrecognized symptom in infants, children, and adolescents who have complex congenital heart defects. The clinician caring for these children should strive to identify and relieve the experience of dyspnea through a combination of nonpharmacological and pharmacological interventions. Diagnostic evaluation and treatment of the underlying problem, including diuretic therapy for fluid management and agents to achieve afterload reduction, may be warranted. Environmental modifications including a cool airflow from a fan as well as pharmacological interventions such as opioids may be effective. Anxiety secondary to dyspnea should also be considered and addressed.
Treating Dyspnea in Lung Cancer with Noninvasive Ventilation
Authors: Comellini Vittoria , Nava Stefano 
Published: April 2023

Abstract
Dyspnea is a common and distressing symptom that is experienced by many patients with advanced cancer, in particular those who are approaching the end of their lives. Despite this, very little attention has been paid to the distress associated with breathlessness, and the condition frequently remains unrecognized, undetected, and consequently untreated. As cancer patients advance in their disease process, palliative therapies may be necessary for symptom relief. Both pharmacological and nonpharmacological treatments can be administered to assist patients and to improve the quality of their lives. This chapter defines the possible and promising fields of application of noninvasive mechanical ventilation in the treatment of dyspnea in lung cancer patients.
Palliative Care for Infants with Bronchopulmonary Dysplasia
Authors: Fortney Christine A. , Ulloa Jodi A. 
Published: April 2023

Abstract
This chapter reviews the approach to an infant who has developed a complex chronic condition, bronchopulmonary dysplasia (BPD), as a result of her prematurity and continues to experience respiratory distress requiring conventional mechanical ventilation and sedation that is affecting her growth and development, as well as her ability to bond with her family. Diagnostic criteria and management for BPD are discussed. Early introduction of a combination of primary and consultative palliative care is advocated in the context of providing integrated and individualized services that meet the specific needs of the infant and family from hospital admission through discharge to home, as well as at end of life.
Palliative Sedation for Intractable Dyspnea
Authors: Bramati Patricia , Bruera Eduardo 
Published: April 2023

Abstract
Palliative sedation, the intentional lowering of awareness, is a well-established intervention at the end of life in patients who are terminally ill, in whom death is imminent, and in whom suffering persists after maximization of standard medical treatments. Palliative sedation is an ethically and legally accepted intervention that can be distinguished from assisted suicide and euthanasia. Proportionality is crucial to the ethics of this practice and consent should be obtained. Consultation with palliative care experts is highly recommended. Sedation should be started at the lowest possible dosage and titrated up until controlling the symptom with frequent assessment relative to achieving the treatment goal.
Sialorrhea in Amyotrophic Lateral Sclerosis
Authors: Bromberg Mark B. 
Published: April 2023

Abstract
Sialorrhea can be defined as pooling of saliva due to inefficient swallowing. In amyotrophic lateral sclerosis (ALS), weakness and poor coordination of cheek and tongue muscles and muscles involved with swallowing prevent clearing the 1-plus quarts or liters of saliva produced daily. Sialorrhea occurs in most ALS patients who have bulbar involvement and is a source of social distress, thus reducing quality of life. Treatment options focus on drugs with anticholinergic properties, followed by botulinum toxin injections into salivary glands, and lastly on irradiation of the glands. A reasonable degree of saliva control can be achieved for most ALS patients.
Perioperative Considerations for Success of Regional Anesthesia
Authors: Wardhan Richa , Jira Janet 
Published: April 2023

Abstract
Nerve block procedures are placed utilizing nerve stimulation, ultrasound, or both. The advent of ultrasound and nerve stimulation were both met with great enthusiasm when they were first introduced in their own respective eras; however, a thorough knowledge of ultrasound and/or nerve stimulation is required to deliver a safe and successful outcome every time. This chapter will discuss the perioperative considerations for placing a nerve block starting from the steps that lead to the decision to place it, to consent, time out, sedation, equipment, till sending some patients home with a nerve block catheter. Good understanding of the ultrasound machine and nerve stimulator will result in the optimal use of them. Ergonomics also plays an equally important role in improving the efficiency of a procedure and in preventing operator fatigue.
Shoulder Arthroplasty Analgesic Strategies
Authors: Nin Olga “Kiki” , Grosh Taras 
Published: April 2023

Abstract
Total shoulder arthroplasty is a common procedure performed for patients suffering from rotator cuff tears, severe fractures, avascular necrosis, severe osteoarthritis, rheumatoid arthritis, or failed previous shoulder surgery. There are three types of total shoulder surgery depending on the indication. These are: hemiarthroplasty, anatomical total shoulder replacement, and reverse shoulder arthroplasty. Postoperative pain control is an important component of the anesthetic plan as this will facilitate recovery as well as discharge home. Multimodal pain approaches utilizing a combination of nonsteroidal anti-inflammatory drugs, acetaminophen, gabapentinoids, N-methyl-D-aspartate (NMDA) antagonists, opioids, and local anesthetic through surgical site infiltration or nerve blockade have proven to be superior to use of a single pharmacologic modality. The innervation of the shoulder is derived from the brachial plexus, which is composed of three trunks (superior [C5–C6], middle [C7], and inferior [C8–T1]). The glenohumeral joint is innervated by the axillary, suprascapular, supraclavicular, and lateral pectoral nerves. Establishing an enhanced recovery after surgery (ERAS) protocol for total shoulder arthroplasty has been shown to help standardize patient care, decrease length of stay, reduce medical errors and complications, and increase patient satisfaction.
Regional Anesthesia and Pain Management for Total Hip Arthroplasty
Authors: Lee Bradley H. , Mamic Marko , Liu Jiabin 
Published: April 2023

Abstract
Total hip replacement is a very common procedure. Anesthesiologists should be familiar with the indications and the surgical approaches. Postoperative pain relief is important in this group of patients for enhanced recovery after surgery. Strategies for postoperative pain management in patients undergoing total hip arthroplasty include multimodal pain management including various regional techniques. Regional anesthesia requires a good understanding of hip innervation and anatomy. Basics of hip replacement surgery, innervation of the hip joint, and its anatomy are reviewed, along with specific regional techniques and the associated evidence for postoperative pain control, as well as advantages and limitations of each.
Regional Anesthesia for Open Reduction and Internal Fixation of an Ankle Fracture
Authors: Nilforoshan Maryam , Huang Stephanie , Elkassabany Nabil 
Published: April 2023

Abstract
Ankle fracture is a very common orthopedic injury, and its incidence is expected to continually rise. A thorough understanding of ankle joint anatomy and various ankle fracture classification systems provides a foundation to evaluate such injuries and to determine the most appropriate treatment for an ankle fracture. Ankle fractures requiring ORIF present the challenge of postoperative pain control. Although parenteral opioids and neuraxial anesthesia have been used for ankle surgery, regional anesthesia in the form of the popliteal sciatic nerve block and the saphenous nerve block have been shown to be particularly effective. These peripheral nerve blocks have been successfully used for both postoperative analgesia as well as primary regional anesthetics for ankle surgery. The chapter explores the indications, anatomy, and ultrasound-guided technique required for both of these peripheral nerve blocks.
Epidural for Labor in a Morbidly Obese Patient and Neuraxial Ultrasound
Authors: Vallejo Manuel C. 
Published: April 2023

Abstract
Point of care pre-procedure neuraxial ultrasound imaging of the lower lumbar vertebrae is becoming the gold standard in labor and delivery neuraxial analgesia and anesthesia. Pre-procedure ultrasound imaging can be used to facilitate successful neuraxial placement by determining the optimal vertebral interspace, identification of the midline, locating the optimal insertion point as well as the best angle for needle insertion, and to provide an accurate measurement depth for needle advancement to the epidural or intrathecal space. Neuraxial ultrasound can enhance the parturient’s overall comfort, experience, and satisfaction by reducing the risk for failed or traumatic lumbar punctures and epidural catheterizations, the number of insertion attempts, and needle redirections. Furthermore, neuraxial ultrasound imaging can be of particular benefit in parturients with difficult anatomy or landmarks.
Post-Dural Puncture Headache
Authors: Sayre Lauren , Gaiser Robert 
Published: April 2023

Abstract
Post-dural puncture headache is a positional bilateral frontal-occipital headache that occurs after the dura is punctured. The etiology is felt to be loss of cerebrospinal fluid resulting in possible sagging of the brain with traction on the dura in the frontal and occipital areas. Factors that increase the risk of the development of a headache after dural puncture include age (younger patients at greater risk), vaginal delivery, and use of a Quincke needle (applies only to spinal anesthesia). Following an accidental dural puncture with an epidural needle, there is no effective means that will prevent the patient from developing a headache, even an intrathecal catheter. Caffeine is not effective for the treatment or the prevention of headache. The best treatment is an epidural blood patch, which involves injecting autologous whole blood in the epidural space. A sphenopalatine block is effective for relieving the symptoms of the headache; it does not treat the etiology.
Orthopedic Trauma in a Patient With Complex Regional Pain Syndrome
Authors: Tolba Reda , Fayed Mohamed 
Published: April 2023

Abstract
Complex regional pain syndrome (CRPS) is a chronic neurological disorder involving a region characterized by disabling pain, swelling, vasomotor instability, sudomotor abnormality, and impairment of motor function. It mostly occurs acutely in patients who have limb fractures or limb surgery. Possible pathophysiological mechanisms include neurogenic inflammation, peripheral and central sensitization, brain plasticity, sympatho-afferent coupling, genetic or psychological factors. The syndrome is diagnosed based on clinical signs and symptoms. Effective management of the chronic form of the syndrome is often challenging. It mainly involves multidisciplinary clinical care, which centers around controlling pain and intensive rehabilitation therapies. Elective surgery should be performed when features of previous episodes of CRPS have improved and when the patient is stable; surgery should be avoided during exacerbations.
The Painful Vaso-Occlusive Sickle Cell Episode
Authors: Orr Amberly , Elmofty Dalia , Kohan Lynn 
Published: April 2023

Abstract
Sickle cell disease (SCD) is an inherited blood disorder. The disease affects approximately 100,000 Americans and is most prevalent among African Americans. SCD is an autosomal recessive disorder caused by mutations of the gene that encodes the β-globin chain of hemoglobin. Acute vaso-occlusive (VOC) pain episodes are the hallmark of the disease presentation. Pain is the most common reason that patients with SCD are admitted to the hospital. A multidisciplinary care team model and use of multimodal analgesic regimens can provide optimal pain management in patients with SCD. Lines of management include pharmacologic and non-pharmacologic modalities for pain control. It is important to distinguish between VOC pain and pain that signifies more serious complications of the disease.
Sleep, Immune Function, and Vaccinations in Military Personnel: Challenges and Future Directions
Authors: Anderson Melissa S , Chinoy Evan D , Harrison Elizabeth M , Myers Christopher A , Markwald Rachel R 
Published: April 2023

ABSTRACT
The U.S. military invests substantial resources to vaccinate all personnel, including recruits, against operationally important infectious disease threats. However, research suggests that vaccine immune response and, therefore, vaccine effectiveness may be inadvertently reduced because of chronic and/or acute sleep deficiency experienced by recipients around the time of vaccination. Because sleep deficiency is expected and even necessary in deployed and training contexts, research investigations of the impacts of sleep and related physiological systems such as circadian rhythms on vaccine effectiveness in military settings are needed. Specifically, research should be aimed at understanding the effects of sleep deficiency, as well as vaccine administration schedules, on response to vaccination and clinical protection. Furthermore, knowledge gaps among military medical leadership on sleep, vaccines, and immune health should be assessed. This area of research may benefit the health and readiness of service members while also decreasing health care utilization and associated costs from illness.
Does the distance to the cancer center affect psycho-oncological care and emergency visits of patients with IDH wild-type gliomas? A retrospective study
Authors: Fischl Anna , Gerken Michael , Roos Philipp , Haedenkamp Tareq , Hillberg Andrea , Klinkhammer-Schalke Monika , Kölbl Oliver , Linker Ralf , Proescholdt Martin , Pukrop Tobias , Riemenschneider Markus J , Schmidt Nils Ole , Schön Ingrid , Vogelhuber Martin , Hau Peter , Bumes Elisabeth 
Published: April 2023

Abstract

Background
Malignant isocitrate dehydrogenase wild-type (IDHwt) gliomas impose a high symptomatic and psychological burden. Wide distances from patients’ homes to cancer centers may affect the delivery of psycho-oncological care. Here, we investigated, in a large brain tumor center with a rural outreach, the initiation of psycho-oncological care depending on spatial distance and impact of psycho-oncological care on emergency visits.

Methods
Electronic patient charts, the regional tumor registry, and interviews with the primary care physicians were used to investigate clinical data, psycho-oncological care, and emergency unit visits. Interrelations with socio-demographic, clinical, and treatment aspects were investigated using univariable and multivariable binary logistic regression analysis and the Pearson’s Chi-square test.

Results
Of 491, 229 adult patients of this retrospective cohort fulfilled the inclusion criteria for analysis. During the last three months of their lives, 48.9% received at least one psycho-oncological consultation, and 37.1% visited the emergency unit at least once. The distance from the cancer center did neither affect the initiation of psycho-oncological care nor the rate of emergency unit visits. Receiving psycho-oncological care did not correlate with the frequency of emergency unit visits in the last three months of life.

Conclusion
We conclude that the distance of IDHwt glioma patients’ homes from their cancer center, even in a rural area, does not significantly influence the rate of psycho-oncological care.
Factors influencing medium- and long-term occupational impact following COVID-19
Authors: O’Sullivan O , Houston A , Ladlow P , Barker-Davies R M , Chamley R , Bennett A N , Nicol E D , Holdsworth D A 
Published: April 2023

Abstract

Background
Significant numbers of individuals struggle to return to work following acute coronavirus disease 2019 (COVID-19). The UK Military developed an integrated medical and occupational pathway (Defence COVID-19 Recovery Service, DCRS) to ensure safe return to work for those with initially severe disease or persistent COVID-19 sequalae. Medical deployment status (MDS) is used to determine ability to perform job role without restriction (‘fully deployable’, FD) or with limitations (‘medically downgraded’, MDG).

Aims
To identify which variables differ between those who are FD and MDG 6 months after acute COVID-19. Within the downgraded cohort, a secondary aim is to understand which early factors are associated with persistent downgrading at 12 and 18 months.

Methods
Individuals undergoing DCRS had comprehensive clinical assessment. Following this, their electronic medical records were reviewed and MDS extracted at 6, 12 and 18 months. Fifty-seven predictors taken from DCRS were analysed. Associations were sought between initial and prolonged MDG.

Results
Three hundred and twenty-five participants were screened, with 222 included in the initial analysis. Those who were initially downgraded were more likely to have post-acute shortness of breath (SoB), fatigue and exercise intolerance (objective and subjective), cognitive impairment and report mental health symptoms. The presence of fatigue and SoB, cognitive impairment and mental health symptoms was associated with MDG at 12 months, and the latter two, at 18 months. There were also modest associations between cardiopulmonary function and sustained downgrading.

Conclusions
Understanding the factors that are associated with initial and sustained inability to return to work allows individualized, targeted interventions to be utilized.
Paclitaxel With or Without Cixutumumab as Second-Line Treatment of Metastatic Esophageal or Gastroesophageal Junction Cancer: A Randomized Phase II ECOG-ACRIN Trial
Authors: Stockton Shannon , Catalano Paul , Cohen Steven J , Burtness Barbara A , Mitchell Edith P , Dotan Efrat , Lubner Sam J , Kumar Pankaj , Mulcahy Mary F , Fisher George A , Crandall Theodore L , Benson Al 
Published: April 2023

Abstract

Background
Patients with advanced esophageal cancer carry poor prognoses; limited data exist to guide second-line therapy in the metastatic setting. Paclitaxel has been used yet is associated with limited efficacy. There is preclinical evidence of synergy between paclitaxel and cixutumumab, a monoclonal antibody targeting insulin-like growth factor-1 receptor. We conducted a randomized phase II trial of paclitaxel (arm A) versus paclitaxel plus cixutumumab (arm B) in the second-line for patients with metastatic esophageal or gastroesophageal junction (GEJ) cancers.

Methods
The primary endpoint was progression-free survival (PFS); 87 patients (43 in arm A, 44 in arm B) were treated.

Results
Median PFS was 2.6 months in arm A [90% CL 1.8-3.5] and 2.3 months in arm B [90% 2.0-3.5], P = .86. Stable disease was observed in 29 (33%) patients. Objective response rates for Arms A and B were 12% [90% CI, 5-23%] and 14% [90% CI, 6-25%]. Median overall survival was 6.7 months [90% CL 4.9-9.5] in arm A and 7.2 months [90% CL 4.9-8.1] in arm B, P = 56.

Conclusion
The addition of cixutumumab to paclitaxel in second-line therapy of metastatic esophageal/GEJ cancer was well tolerated but did not improve clinical outcomes relative to standard of care (ClinicalTrials.gov Identifier: NCT01142388).