bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tranexamic Acid for the Prevention of Blood Loss After Cesarean Among Women With Twins: A Secondary Analysis of the TRAnexamic Acid for Preventing Postpartum Hemorrhage Following a Cesarean Delivery Randomized Clinical Trial
Authors: Sentilhes L. , Madar H. , Le Lous M. , Sénat M.V. , Winer N. , Rozenberg P. , Kayem G. , Verspyck E. , Fuchs F. , Azria E. , Gallot D. , Korb D. , Desbrière R. , Le Ray C. , Chauleur C. , de Marcillac F. , Perrotin F. , Parant O. , Salomon L.J. , Gauchotte E. , Bretelle F. , Sananès N. , Bohec C. , Mottet N. , Legendre G. , Letouzey V. , Haddad B. , Vardon D. , Mattuizzi A. , Froeliger A. , Bouchghoul H. , Daniel V. , Regueme S. , Roussillon C. , Georget A. , Darsonval A. , Benard A. , Deneux-Tharaux C. ,   Groupe de Recherche en Obstétrique et Gynécologie
Published: September 2023

(Am J Obstet Gynecol 2022;227:889e1–17)
Tranexamic acid (TXA) has been proposed as a preventive medication in obstetrics to reduce the risk of postpartum hemorrhage (PPH). However, previous research has not shown TXA to be clinically beneficial for vaginal or cesarean delivery among a general obstetric population. Information is lacking on whether TXA might be more effective for women who are at increased risk of PPH. This study aimed to evaluate the effectiveness of prophylactic TXA in one group of women at high risk for PPH—those with multiple gestation. The purpose of this study was to examine the effect of TXA and a uterotonic agent compared with the uterotonic agent alone on the risk of PPH. The primary outcome was the incidence of calculated estimated blood loss of more than 1000 mL or a red blood cell transfusion by day 2 after delivery. Secondary outcomes included clinical and laboratory measurements of postpartum blood loss, adverse effects related to TXA, and maternal satisfaction.
Predicting Postpartum Haemorrhage: A Systematic Review of Prognostic Models
Authors: Carr B.L. , Jahangirifar M. , Nicholson A.E. , Li W. , Mol B.W. , Licqurish S. 
Published: September 2023

(Aust N Z J Obstet Gynaecol. 2022;62:813–825)
The impact of postpartum hemorrhage (PPH, loss of ≥500 mL blood within 24 h of birth) on women, families, and communities is significant. PPH has been reported with increasing incidence and severity in well-resourced countries and is a major contributor to global maternal morbidity and mortality. Diagnosis can be challenging due to variability of risk factors and underestimation of blood loss leading to delayed response and treatment. Prognostic models to identify patients at risk and to provide resources and facilitate early intervention are not commonly integrated into clinical practice. Few, if any, are considered validated for use in the general obstetric population. This systematic review provides a comprehensive evaluation of current PPH prognostic models to identify best practices for prediction, describe model characteristics, and compare performance.
General or Regional Anaesthesia for Postpartum Hemorrhage: A National Population-based Cohort Study
Authors: Wikkelsø A.J. , Secher E.L. , Edwards H. 
Published: September 2023

(Acta Anaesthesiol Scand. 2022;66:103–113)
Postpartum hemorrhage (PPH) continues to be a life-threatening complication following delivery. Anesthesia is required for the treatment of PPH when emptying the uterine cavity or manual placenta removal, and the choice between using general or regional anesthesia is impacted by factors such as airway, existing epidural, hypovolemia, and tradition. This study aimed to describe the variation in anesthesia for PPH treatment procedures as well as the occurrence of aspiration and difficult or failed intubation for Danish nationals between 2010 and 2015.
Prevention of Pre-eclampsia With Aspirin: A Systematic Review of Guidelines and Evaluation of the Quality of Recommendation Evidence
Authors: Ninan K. , Ali R. , Morfaw F. , McDonald S.D. 
Published: September 2023

(Int J Gynecol Obstet. 2022;00:1–14)
Aspirin, or acetylsalicylic acid (ASA) has been shown repeatedly to reduce the risk of pre-eclampsia. Literature has shown that ASA can additionally reduce other pregnancy complications such as gestational hypertension, intrauterine growth restriction, and perinatal death, as well as reducing direct healthcare costs by a significant margin in the United States and Canada. Despite these findings, there is also research that indicates that many women at risk of pre-eclampsia do not receive ASA as a preventative treatment. This study aimed to review clinical guidelines on ASA and pre-eclampsia and determine if the current guidelines are evidence-based and of good quality.
Percreta Score to Differentiate Between Placenta Accreta and Placenta Percreta With Ultrasound and MR Imaging
Authors: Pain F.A. , Dohan A. , Grange G. , Marcellin L. , Uzan-Augui J. , Goffinet F. , Soyer P. , Tsatsaris V. 
Published: September 2023

(Acta Obstet Gynecol Scand. 2022;101:1135–1145)
In approximately 1.7 to 4.6 per 10,000 deliveries, the placenta remains attached to the uterine wall after birth, indicating that it is embedded in the myometrium; this is called placenta accrete spectrum (PAS) disorder. Cesarean delivery is associated with a significantly increased risk of PAS, and diagnosis of PAS is associated with severe delivery complications such as postpartum hemorrhage and peripartum hysterectomy. Placenta percreta is a severe form of PAS, where the placenta grows through the wall of the uterus and potentially into nearby organs, severely threatening the mother’s life: placenta percreta is associated with significant maternal morbidity. Being able to diagnose and correctly treat this condition is of paramount importance in reducing maternal morbidity due to these conditions. This study was designed to assess the ability of ultrasound and magnetic resonance imaging (MRI) features in classifying PAS (accreta/increta vs. percreta) predictively.
Changes in Sensory Block Level During a Programmed Intermittent Epidural Bolus Regimen for Labor Analgesia: A Prospective Observational Cohort Study
Authors: Casellato J.F. , Ye X.Y. , Downey K. , Carvalho J.C.A. 
Published: September 2023

(Can J Anesth/J Can Anesth. 2022;69:1471–1476)
Currently, one of the most widely used methods of pain management is epidural analgesia, with drug delivery in a programmed intermittent epidural bolus (PIEB) in conjunction with patient-controlled epidural analgesia. Previously the investigators reported 2 sensory block levels associated with epidural analgesia: (1) upper sensory block level (USBL), the highest dermatome with any altered sensation to cold, and (2) lower sensory block level (LSBL), the highest dermatome with complete sensory block to cold. The purpose of this study was to further explore these sensory block levels and how they change over time with PIEB and patient-controlled epidural analgesia as a pain management method.
Effect of Continuous Infusion of a Subhypnotic Dose of Propofol on Nausea and Vomiting after Carboprost Administration at Cesarean Delivery: A Randomized, Double-blind, Placebo-controlled Trial
Authors: Yanmei B. , Ruihan Z. , Jinxiang H. , Huang H. 
Published: September 2023

(Int J Gynecol Obstet. 2022;157:283–288)
Postpartum hemorrhage (PPH) is one of the leading causes of maternal mortality. Carboprost is a 15-methyl F2a prostaglandin that induces uterine contractions and is recommended for PPH treatment. Carboprost has adverse side effects, the most prominent being nausea and vomiting. Propofol, when used at its subhypnotic dose, is known for reducing nausea and vomiting after chemotherapy treatment. This study aimed to show whether a steady administration of a subhypnotic dose of propofol prevents nausea and vomiting after carboprost is administered during cesarean delivery (CD).
Respiratory Depression After Administration of Single-dose Neuraxial Morphine for Postcesarean Delivery Analgesia: A Retrospective Cohort Study
Authors: Palleschi G.T. , Gerasimov M. , Blitz M.J. , Aronsohn J.L. , Shore-Lesserson L. , Ruggiero A. , Lim G. , Habib A.S. 
Published: September 2023

(Int J Obstet Anesth. 2022;52:103592)
Neuraxial anesthesia is the analgesia of choice during cesarean delivery which frequently includes long‐acting morphine. While the standard practice, neuraxial morphine poses an increased risk of delayed respiratory depression. While the risk is low at 1.08 to 1.63 per 10,000 cases, patient comorbidities can increase occurrence. In 2019, the Society for Obstetric Anesthesia and Perinatology (SOAP) gave guidelines for patient surveillance following cesarean delivery (CD) with morphine though evidence-based research is lacking and is rather a result of expert opinion. The aim of this retrospective study was to determine the occurrence of respiratory depression in CD patients who received neuraxial morphine for pain management.
Update on muscle imaging in myositis
Authors: Tan Ai Lyn , Di Matteo Andrea , Wakefield Richard J. , Biglands John 
Published: September 2023

Purpose of review
Imaging techniques such as MRI, ultrasound and PET/computed tomography (CT) have roles in the detection, diagnosis and management of myositis or idiopathic inflammatory myopathy (IIM). Imaging research has also provided valuable knowledge in the understanding of the pathology of IIM. This review explores the latest advancements of these imaging modalities in IIM.

Recent findings
Recent advancements in imaging of IIM have seen a shift away from manual and qualitative analysis of the images. Quantitative MRI provides more objective, and potentially more sensitive characterization of fat infiltration and inflammation in muscles. In addition to B-mode ultrasound changes, shearwave elastography offers a new dimension to investigating IIM. PET/CT has the added advantage of including IIM-associated findings such as malignancies.

Summary
It is evident that MRI, ultrasound and PET/CT have important roles in myositis. Continued technological advancement and a quest for more sophisticated applications help drive innovation; this has especially been so of machine learning/deep learning using artificial intelligence and the developing promise of texture analysis.
Work Productivity Loss After Minimally Displaced Complete Lateral Compression Pelvis Fractures
Authors: McKibben Natasha S. , O’Hara Nathan N. , Slobogean Gerard P. , Gaski Greg E. , Nascone Jason W. , Sciadini Marcus F. , Natoli Roman M. , McKinley Todd , Virkus Walter W. , Sorkin Anthony T. , Howe Andrea , O’Toole Robert V. , Levy Joseph F. 
Published: September 2023

ABSTRACT

Objective:
To quantify work impairment and economic losses due to lost employment, lost work time (absenteeism), and lost productivity while working (presenteeism) after a lateral compression pelvic ring fracture. Secondarily, we compared productivity loss of patients treated with surgical fixation versus nonoperative management.

Design:
A secondary analysis of a prospective, multicenter trial.

Setting:
Two level 1 academic trauma centers.
Patients/Participants: Sixty-four adult patients with a minimally displaced lateral compression pelvic fracture who were working before their injury. Forty-seven percent (30/64) of patients were treated with surgical fixation, and 53% (30/64) with nonoperative management.

Main Outcome Measurements:
Work impairment, including hours lost to unemployment, absenteeism, and presenteeism, measured by Work Productivity and Activity Impairment (WPAI) assessments in the year after injury.

Results:
Of the 64 included patients, 63% returned to work within 1 year of injury. Workers lost an average of 67% of a 2,080-hour average work year, corresponding with $56,276 in lost economic productivity. Of the 1,395 total hours lost, 87% was due to unemployment, 3% to absenteeism, and 10% to presenteeism. Surgical fixation was associated with 27% fewer lost hours (1,155 versus 1,583, P = 0.005) and prevented $17,266 in average lost economic productivity per patient compared to nonoperative management.

Conclusions:
Lateral compression pelvic fractures are associated with a substantial economic impact on patients and society. Our findings suggest surgical fixation might reduce work impairment and the corresponding economic burden.

Level of Evidence:
Economic Level II. See Instructions for Authors for a complete description of levels of evidence.
The Impact of Postoperative Patient Aromatherapy on Nurse Self-Efficacy
Authors: Manning Mollie H. , Nix Elizabeth S. 
Published: September 2023

ABSTRACT:
A nurse-driven aromatherapy program investigated the effect on nurses' self-efficacy when using an essential oil inhalation protocol to reduce patients' postoperative pain and associated symptoms. After viewing an investigator-developed training module, staff nurses implemented aromatherapy. Results of changes in nurses' report of self-efficacy were evaluated using the Self-Efficacy in Providing Non-Drug therapies (SEND) survey tool. Results support that an integrated approach of adding nonpharmacologic pain management to postoperative pain and nausea care may increase nurse self-efficacy.
Fostering Nursing Students' Growth in Patient Teaching and Empathy Toward Homeless People
Authors: DeBrew Jacqueline Kayler 
Published: September 2023

ABSTRACT:
Helping nursing students explore personal perceptions toward the poor can support students' ability to care for impoverished people in their later nursing practice. A community-based mental health clinical site at a transitional housing complex for the homeless provided a meaningful experience for accelerated baccalaureate nursing students. Students offered basic health screening to the low-income residents and participated in a virtual health education question-and-answer meeting with former transitional housing residents. Through reflective journaling, students described how they gained empathy and new understanding of the needs of people living in poverty or unhoused, and developed confidence in patient teaching.
Remission Strategies with Fat Grafting to Prevent Recurrence of Pedal Ulcerations and Pain: A Case Series
Authors: Kress Gavin Thomas , Swerdlow Mark , Mohan Natasha , Patel Ketan , Shin Laura 
Published: September 2023

Background:
Foot deformities and gait abnormalities can result in locally elevated peak pedal pressures or atypical pedal biomechanics. Combined with underlying comorbidities such as neuropathy, stroke, atrophic fat padding and history of ulcerations, this can lead to recurrent ulcerations and pain. Pedal fat grafting (PFG) is a treatment modality that has been shown to reduce peak pressures and accelerate wound healing. This study aimed to investigate the utility of PFG to treat and prevent ulcerations.

Methods:
We retrospectively analyzed medical history, demographics, wound volume at time of procedure, volume of fat injected, surgical outcomes, and presence of new wounds in 15 patients who underwent PFG at Keck Hospital between 2018 and 2023.

Results:
Seventeen feet from 15 patients (63 ± 12 years old, body mass index 30.9 ± 3.1) received PFG with an average volume of fat injected of 10.7 mL and procedure time of 84.6 minutes. At the time of PFG, nine wounds were present on nine feet with an average wound volume of 1.6 ± 2.7 cm3. Average follow-up was 6.9 months (range 1–36 months), with no complications or recurrent ulcerations since the procedure.

Conclusions:
PFG is a promising treatment option for reducing peak pedal pressure and preventing ulcer recurrence in patients with various conditions. Further study is warranted for long-term follow-up.
The Use of Nerve Caps after Nerve Transection in Headache Surgery: Cadaver and Case Reports
Authors: Hwang Charles D. , Chegireddy Vishwanath , Remy Katya , Irwin Timothy J. , Valerio Ian L. , Gfrerer Lisa , Austen William G. 
Published: September 2023

Background:
Nerve transection with nerve reconstruction is part of the treatment algorithm for patients with refractory pain after greater occipital nerve (GON) and lesser occipital nerve (LON) decompression or during primary decompression when severe nerve injury or neuroma formation is present. Importantly, the residual nerve stump is often best addressed via contemporary nerve reconstruction techniques to avoid recurrent pain. As a primary aim of this study, nerve capping is explored as a potential viable alternative that can be utilized in certain headache cases to mitigate pain.

Methods:
The technical feasibility of nerve capping after GON/LON transection was evaluated in cadaver dissections and intraoperatively. Patient-reported outcomes in the 3- to 4-month period were compiled from clinic visits. At 1-year follow-up, subjective outcomes and Migraine Headache Index scores were tabulated.

Results:
Two patients underwent nerve capping as a treatment for headaches refractory to medical therapy and surgical decompressions with significant improvement to total resolution of pain without postoperative complications. These improvements on pain frequency, intensity, and duration remained stable at a 1-year time point (Migraine Headache Index score reductions of –180 to –205).

Conclusions:
Surgeons should be equipped to address the proximal nerve stump to prevent neuroma and neuropathic pain recurrence. Next to known contemporary nerve reconstruction techniques such as targeted muscle reinnervation/regenerative peripheral nerve interface and relocation nerve grafting, nerve capping is another viable method for surgeons to address the proximal nerve stump in settings of GON and LON pain. This option exhibits short operative time, requires only limited dissection, and yields significant clinical improvement in pain symptoms.
Primary Regenerative Peripheral Nerve Interfaces Using Devascularized Vastus Lateralis Muscle in Sensate Anterolateral Thigh Flap Donor Sites
Authors: Isbester Kelsey A. , Ferrin Peter , Krakauer Kelsi N. , Peters Blair R. 
Published: September 2023

Summary:
Sensate flaps are increasingly used in diverse areas of plastic surgery. Concurrently, modern techniques in neuroma prevention have emerged, such as regenerative peripheral nerve interface (RPNI). Despite increasing use of sensate flaps, the combined use of donor-site neuroma prevention techniques has yet to be described. We report on the use of primary donor-site RPNI at the time of sensate anterolateral thigh (ALT) reconstructions. In ALT flaps, the vastus lateralis muscle can be segmentally devascularized from perforator dissection. These segments of devascularized vastus lateralis muscle can easily be used and repurposed as the free muscle grafts needed for RPNI, providing a physiologic target for the regenerating neurons. Donor-site neuroma has not been shown to be a significant issue at standard ALT flap donor sites. Sensate ALT flaps involve harvest of the lateral femoral cutaneous nerve and/or additional femoral sensory branches at a more proximal location close to the level of the anterior superior iliac spine, where injury to the lateral femoral cutaneous nerve may be associated with pain. In this series, eight patients underwent senate ALT flaps with the use of primary RPNI at the sensate ALT donor site. At a mean follow-up of 16.3 months (range 5–25 months), there was minimal to no nerve pain and no clinical evidence of donor-site neuroma. As sensate flap reconstructions are increasingly performed in plastic surgery and data on neuroma prevention techniques continue to grow, we propose consideration of their combined use.
Secondary salvage intravenous chemotherapy for refractory/recurrent retinoblastoma: A study of 41 eyes
Authors: Kaliki Swathi , Gavara Suneetha , Patil Gaurav , Reddy Palkonda Vijay Anand 
Published: September 2023

Abstract

Purpose:
To determine the efficacy of secondary salvage intravenous chemotherapy (IVC) for refractory/recurrent retinoblastoma (RB).

Methods:
Retrospective, nonrandomized interventional case series of 41 eyes of 33 patients with RB

Results:
Of the 33 patients, mean age at the time of commencement of salvage IVC was 5 years (median, 5 years; range, 2 to 8 years). At presentation, RB in 41 eyes of 33 patients were classified by the International Classification of Retinoblastoma as Group B (n=7, 17%), Group C (n=3, 7%), Group D (n=16, 39%) and Group E (n=15, 37%). All patients received 6 cycles of IVC as primary treatment. The indication for secondary salvage IVC with focal treatment included recurrent solid tumor (n=36; 88%), subretinal seeds (n=22; 54%), or persistent solid tumor (n=2; 5%). Mean number of cycles of salvage IVC were 8 (median, 6; range, 6 to 18). Over a mean follow-up period of 43 months (median, 43 months; range, 12 to 96 months) after completion of salvage IVC, globe salvage was achieved in 22 (54%) eyes, 1 (3%) patient had histopathology-proven bone metastasis, and 1 (3%) patient died due to presumed metastasis.

Conclusion:
Secondary salvage IVC with appropriate focal treatment allows globe salvage in 54% eyes with refractory/recurrent RB and thus serves as an alternative to intra-arterial chemotherapy or enucleation.
Life Experience of Chinese Pediatric Medulloblastoma Survivors: A Qualitative Study
Authors: Feng Jinzhi , He Qingqing , Sun Lin 
Published: September 2023

ABSTRACTBACKGROUND:With the improvement of technology and the advancement of medical treatment in recent decades, more and more pediatric medulloblastoma survivors reintegrate to the community. This study aimed to examine the experiences of pediatric medulloblastoma survivors.METHODS: A qualitative research was conducted. Twenty Chinese pediatric medulloblastoma survivors were interviewed. Interviews were recorded and transcribed. Colaizzi's analysis method was used to analyze data.RESULTS:There were 4 themes in this study: physical health issues, community reintegration challenges, overcoming psychological pressure, and multiple unmet needs.CONCLUSION: Pediatric medulloblastoma survivors face challenges in the physical, psychological, and social aspects of their health, along with multiple unmet healthcare needs. Nurses should comprehensively assess the survivor's needs from admission, plan for discharge, and provide regular follow-up care after discharge. Furthermore, nurses should collaborate with caregivers, clinicians, and schoolteachers to develop programs aimed at enhancing the quality of life for survivors. It is also important to explore the survival experiences of individuals in different regions.
The efficacy of dexmedetomidine for septic shock: A meta-analysis of randomized controlled trials
Authors: Huang Xue , He Chunyan 
Published: September 2023

Introduction:
The efficacy of dexmedetomidine was elusive for septic shock. This meta-analysis aimed to explore the efficacy of dexmedetomidine for septic shock.

Methods:
PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases have been searched through October 2022 and we included randomized controlled trials reporting the effect of dexmedetomidine in patients with septic shock.

Results:
Five randomized controlled trials were included in the meta-analysis. Compared with control group for septic shock, dexmedetomidine treatment was able to substantially decrease Sequential Organ Failure Assessment score (mean difference [MD] = ‐0.99; 95% confidence interval [CI] = ‐1.14 to ‐0.84; P < .00001) and duration of mechanical ventilation (MD = ‐0.90; 95% CI = ‐1.27 to ‐0.54; P < .00001), but showed no obvious influence on morality at 28 days (odds ratio = 0.79; 95% CI = 0.38 to 1.66; P = 054), hospital mortality (odds ratio = 0.66; 95% CI = 0.35 to 1.24; P = .20) or intensive care unit length of stay (MD = ‐1.47; 95% CI = ‐4.60 to 1.66; P = .36).

Conclusions:
Dexmedetomidine administration may help treat patients with septic shock.