bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multimodal postoperative analgesia with transdermal buprenorphine is a safe option in arthroscopic rotator cuff repair
Authors: Muñoz David , Orozco Sergio , Jaramillo Santiago , Herrera Torres Ana Milena 
Published: August 2023

Background: Arthroscopic rotator cuff repairs are associated with moderate-to-severe pain. Opioids are not the first line for postsurgical pain control due to their potential misuse and side effects. Transdermal buprenorphine represents an alternative for multimodal postoperative pain control. Methods: This was a single-centre, prospective longitudinal exploratory study of patients undergoing arthroscopic rotator cuff repairs managed with multimodal analgesia with transdermal buprenorphine. Patients were followed-up by telephone at eight time points, assessing pain levels, rescue analgesics requirement and side effects. Findings: Twenty-five patients with an average age of 63.4 ± 8.2 were included. Fourteen patients were ⩾65 years. Pain levels were similar among age groups at all time points, with no pain or mild pain (visual analogue scale 1–4) in most patients. The most frequent side effects were dizziness and somnolence. Conclusion: Transdermal buprenorphine provided a sustained analgesic effect after an arthroscopic rotator cuff repair during the acute postsurgical period. It showed a similar safety profile among younger and older patients.
Effects of Crohn’s disease exclusion diet on remission: a systematic review
Authors: Zhu Zhanhui , Lei Yang , Lin Zheng 
Published: August 2023

Background: Dietary therapy may potentially reduce inflammation and promote mucosal healing in patients with Crohn’s disease and is associated with fewer side effects and lower cost compared to medical therapy. Recently the Crohn’s disease exclusion diet (CDED) has been developed to reduce exposure to individualized dietary components which negatively affect the intestine in patients with Crohn’s disease. Objectives: This systematic review aimed to explore the effectiveness of CDED in Crohn’s disease patients. Design: A systematic review Data sources and methods: A systematic search was performed on the PubMed, EBSCOhost, Cochrane library, OVID, Embase, Scopus, and CINHAL to identify relevant clinical trials published from 1 January 2014 to 31 August 2022. Results: A total of 1120 studies were identified and 7 studies were finally included in the analysis. The study was reported according to Preferred Reporting Items for Systematic Reviews and Meta-analysis statement. Conclusion: Our findings suggested that the use of CDED seemed to be effective for induction and maintenance of remission in children and adults with mild to moderate Crohn’s disease. However, heterogeneity and limitations existed among the studies included. Further investigation in the form of well-designed randomized clinical trials is needed to validate the present findings. Registration: PROSPERO registration number CRD42022335453.
Prevalence and risk factors of anxiety and depression in adult patients with epilepsy: a multicenter survey-based study
Authors: Shi Wenyan , Sun Hanlin , Peng Wei , Chen Ziyi , Wang Qun , Lin Weihong , Ding Meiping , Sun Hongbin , Wang Xiangqing , Wang Tiancheng , Wang Xuefeng , Liu Yonghong , Chen Yangmei , Zhu Guoxing , Zhou Dong , Li Jinmei 
Published: August 2023

Background: Depression and anxiety are the most common psychiatric comorbidities in patients with epilepsy (PWE). However, they are often unrecognized and consequently untreated. Objective: The study was conducted to evaluate the prevalence and risk factors of anxiety and depression among Chinese adult PWE. Design: Cross-sectional study. Methods: Adult PWE were recruited from 13 tertiary epilepsy centers from February to September 2022. Generalized Anxiety Disorder-7 and Neurological Disorders Depression Inventory for Epilepsy were applied to evaluate anxiety and depression, respectively. Both univariate and multivariate logistic regression analyses models were performed to explore the risk factors of anxiety and depression. Results: A total of 1326 PWE were enrolled in this study. The prevalence of anxiety and depression was 31.45% and 27.30%, respectively. Being female [odds ratio (OR) = 1.467, 95% CI: 1.134–1.899; p = 0.004], focal and focal to bilateral tonic-clonic seizures (TCSZ) (OR = 1.409, 95% CI: 1.021–1.939; p = 0.036), and seizure occurrence in the last 3 months (OR = 1.445, 95% CI: 1.026–2.044; p = 0.036) were the risk factors for anxiety. Focal and focal to bilateral TCSZ (OR = 1.531, 95% CI: 1.094–2.138; p = 0.013) and seizure occurrence in the last 3 months (OR = 1.644, 95% CI: 1.130–2.411; p = 0.010) were the risk factors for depression. In addition, for every 1-year increment of age, the odds of developing depression were decreased by 3.8% ( p = 4.12e−5). Nevertheless, up to 70% of PWE did not receive any treatment for comorbidity. Conclusion: There were approximately 30% of PWE screened positive for anxiety or depression. Both focal and focal to bilateral TCSZ and seizure occurrence in the last 3 months were estimated as risk factors for anxiety and depression. However, the current status of treatment was not optimal.
Limited health literacy in shoulder and elbow patients
Authors: Wright Melissa A , Shapiro Danielle S , Chopra Aman , Murthi Anand M 
Published: August 2023

Background The aim of this study was to evaluate health literacy in orthopedic shoulder and elbow patients. Methods This retrospective cross-sectional study included all new English-speaking adult patients presenting to two fellowship-trained shoulder and elbow surgeons from October 2020–July 2021. Patients who did not complete the Brief Health Literacy Screen Tool (BRIEF) were excluded, leaving 594 patients. Patient demographics and patient-reported outcome scores were also collected. Results Average BRIEF score was 18.7 (range, 4–20), with limited health literacy (BRIEF <17) in 84 patients (14.1%). Patients with limited health literacy were significantly older (58 ± 18 vs. 54 ± 15 years, p = 0.03), less likely to be employed (34 [40%] vs. 332 [65%], p < 0.001), and less likely to have private insurance (35 [42%] vs. 330 [65%], p < 0.001). Average area deprivation index percentile was significantly higher (more deprivation) with limited (38 ± 20) compared to adequate health literacy (32 ± 21; p = 0.027). PROMIS physical (40.5 ± 8.5 vs. 45.5 ± 7.6, p = 0.001) and mental health scores (46.9 ± 10.5 vs. 51.0 ± 8.6, p = 0.015) and pain visual analog scale scores (5.3 ± 2.9 vs. 4.6 ± 2.7, p = 0.017) were significantly worse with limited health literacy. Discussion Limited health literacy is present in shoulder and elbow patients and may affect patient-reported outcomes. Surgeons must recognize this in order to provide high-level equitable care. Level of evidence Level III, retrospective cohort.
Achievement of higher thresholds of clinical responses and lower levels of disease activity is associated with improvements in workplace and household productivity in patients with axial spondyloarthritis
Authors: Rudwaleit Martin , Machado Pedro M. , Taieb Vanessa , de Peyrecave Natasha , Hoepken Bengt , Gensler Lianne S. 
Published: August 2023

Background: Patients with active axial spondyloarthritis (axSpA) exhibit more absences and lower levels of productivity in the workplace and household than the general population, which can improve upon treatment. Objectives: The objective of this study is to determine the long-term impact of achieving different levels of clinical response or disease activity on workplace and household productivity in patients with axSpA. Design: RAPID-axSpA (NCT01087762) was a 204-week phase III trial evaluating the safety and efficacy of certolizumab pegol (CZP) in adult patients with active axSpA. Methods: The impact of axSpA on workplace and household productivity was evaluated using the validated arthritis-specific Work Productivity Survey. Outcomes included the percentage of patients achieving Assessment of SpondyloArthritis International Society (ASAS) response and Ankylosing Spondylitis Disease Activity Score (ASDAS) thresholds. This post hoc study used a generalised estimating equations model to determine the association between the threshold of clinical response achieved and patient productivity. Results: Of 218 CZP-randomised patients, 65.1% completed week 204. At baseline, 72.0% were employed outside the home. Of the patients who were unemployed, 42.6% were unable to work due to arthritis. Achievement of higher treatment response thresholds, such as clinical remission, was associated with fewer days affected by workplace absenteeism (ASAS-partial remission: 4.0 days, ASAS40: 8.6 days, ASAS20 but not reaching ASAS40 response: 29.4 days, ASAS20 non-response: 69.2 days; ASDAS-inactive disease: 5.0 days, ASDAS-low disease activity: 15.6 days, ASDAS-high disease activity: 32.7 days, ASDAS-very high disease activity: 93.4 days). Similar associations were found for workplace presenteeism, and household absenteeism and presenteeism. Conclusions: Over 4 years, achievement of higher clinical response thresholds and lower levels of disease activity was associated with fewer cumulative days affected by absenteeism or presenteeism, with clinical remission associated with the greatest improvements in productivity. This highlights the importance of targeting these thresholds to limit the burden of axSpA on society and on patients’ daily lives.
The Reconstruction of Mandible Defects in War Injuries: Systematic Review and Meta-Analysis
Authors: Rehman Umar , Shemie Melissa , Sarwar Mohammad Sohaib , Adebayo Oluwasemilore , Brennan Peter A. 
Published: August 2023

Study Design Systematic Review and Meta-Analysis. Objective There has been an increasing trend in maxillofacial injuries associated with combat trauma. Within the maxillofacial complex, the mandible is the most likely structure to be damaged during combat. The structural deficits as a result can be reconstructed with many options. These include vascularised bone grafts (VBGs), non-vascularised bone grafts (NVBGs), alloplastic implants, reconstruction bars and distraction osteogenesis. This study aimed to determine the common modality and efficacy of mandibular reconstruction in combat trauma-related defects. Methods A literature search was conducted on Pubmed, Prospero, Dynamed, DARE, EMBASE, COCHRANE and BMJ databases. Results A total of six articles met the inclusion criteria identifying 165 patients requiring mandibular reconstruction. Non-vascularised iliac bone graft (n = 137) was the most common method followed by ileac crest bone chips harvest using Dacron urethran osteomesh tray (n = 24) and frontoparietal grafts (n = 4). Meta-analysis of five out of six trials demonstrated an overall success rate of 85% (95% CI 79–90; I2 = 59%). A total of 13% (n = 22) of reconstructions failed either completely or partially and 21% (n = 34) of patients suffered postoperative complications. Conclusions NVBGs are a practical, cost-effective and favourable method of war zone management of mandibular defects with success rates comparable to those reported in the civilian literature. However, general trauma principles take precedence to rule out life-threatening injuries. Due consideration of patient factors, surgical factors, and available resources are required in the first-line management of combat-related mandibular defects.
Physiotherapy: A potential and novel treatment approach for phantom limb pain in post-amputee patients – A systematic review
Authors: Gautam Sunny , Srivastav Adarsh Kumar , Sharma Digvijay 
Published: August 2023

Objective To evaluate the efficacy of conventional and novel non-pharmacologic, non-invasive therapeutic interventions in physiotherapy for the treatment of phantom limb pain (PLP) in post-amputee patients. Methods A systematic search for the articles was conducted in multiple electronic databases such as PUBMED, Google Scholar, EMBASE, Cochrane library and Physiotherapy Evidence Database (PEDro), following the PRISMA method and only published articles from the last 12 years (2010–2022) evaluating the efficacy of different physiotherapy interventions for the treatment of PLP in post-amputee patients were included. The methodological quality and risk of bias of the articles were assessed and evaluated by two independent reviewers using the PEDro scale, Methodological index for non-randomized studies scale (MINORS), and Cochrane collaboration’s assessment tool. Result A total of 1840 articles were identified, out of which 17 articles (11 RCTs and 6 pilot studies) were ultimately chosen after the full-text screening. After reviewing the articles, evidence identified in RCTs and pilot studies indicates towards significant improvement in reducing the severity of PLP in post-amputee patients by using different physiotherapy interventions. Conclusion and discussion Physiotherapy interventions with advance modalities and exercises can be used to increase the overall effectiveness of the treatment and to reduce the severity of phantom limb pain in post-amputee patients. However, due to the lack of consistent evidence for a given intervention, it becomes even more difficult to reach a majority consensus as to which intervention better assess all the mechanism of PLP thereby alleviating the problem of PLP in post-amputee patients. Therefore, more rigorous randomized controlled trials will be required in the future to reach a conclusion.
Characteristics of pain and their relationship to disease activity in UK patients with Behçet’s syndrome: a prospective cohort study
Authors: Plant K , Goebel A , Nair J , Moots R , Chadwick L , Goodson N 
Published: August 2023

Background Behçet’s syndrome (BS) is a rare multi-systemic vasculitis of unknown aetiology. Fibromyalgia syndrome (FMS) is more prevalent in rheumatological conditions such-as BS, than the general population. However, there is limited research into the aetiology and characteristics of pain in BS. Objectives To describe the pain characteristics and incidence of FMS in people with BS and investigate their relationship with BS disease activity. Methods A cohort study of BS patients attending the Liverpool Behçet's Centre between February 2017 and March 2019. BS was defined using the International Study Group Criteria. BS severity was assessed using the Behçet's Disease Current Activity Form. FMS was determined from consultant diagnosis. Assessments of pain included: Pain Visual Analogue Scale (PVAS), Pain Mannequin, Brief Pain Inventory, EQ-5D-3L and Short Form McGill. Pain and FMS prevalence were compared between high and low disease activity. Results 90% reported moderate-severe pain with a median PVAS score of 68/100 [38, 81]. 35.6% of participants had FMS and 46.5% experienced generalized pain. 76% of participants with high disease activity reported severe pain, compared to 39.1% with low disease activity ( p = .003). Pain was more generalised in high disease activity (72%) compared to low disease activity (37.7%) ( p = .003). FMS was more prevalent in the high disease activity group (52%) than the low disease activity group (29%) ( p = .04). Conclusions This is the first study to explore pain in participants with BS in the United Kingdom. The majority of BS patients experience moderate-severe widespread pain. Severe widespread pain is more prevalent in those with high disease activity. We have demonstrated a relationship between high disease activity, worse pain intensity, and FMS. This paper contributes to the understanding of two conditions which remain to be fully understood, FMS and BS, and generates new hypotheses to describe the interplay between.
Hospitalization risk among patients with Mpox infection—a propensity score matched analysis
Authors: Henao-Martínez Andrés F. , Orkin Chloe M. , Titanji Boghuma K. , Rodriguez-Morales Alfonso J. , Salinas Jorge L. , Franco-Paredes Carlos , Tuells Jose , Chastain Daniel B. 
Published: August 2023

Background: Monkeypox (Mpox) is a reemerging, neglected viral disease. By May 2023, worldwide Mpox cases surpassed 87,000. Predictive factors for hospitalization with Mpox are lacking. Objective: We aim to compare clinical characteristics and outcomes in hospitalized and nonhospitalized patients with Mpox infection. Design: A multicenter retrospective case-control cohort of patients with Mpox infection. Methods: We performed a propensity score match analysis from a global health network (TrinetX). We compare clinical characteristics and outcomes between hospitalized and nonhospitalized patients with Mpox. Results: Of 1477 patients, 6% were hospitalized, 52% required an ED visit, and 29% received treatment at urgent care. After propensity score matching, 80 patients remained in each group. Hospitalizations were more common among Black persons (51% versus 33%, p = 0.01), people with HIV (50% versus 20%, p < 0.0001), and those with proctitis (44% versus 12.5%, p < 0.001). Conclusion: Independent predictive factors of hospitalization in our cohort for Mpox included people who are Black with a diagnosis of HIV, severe proctitis, pain requiring opioids, and elevated lactate dehydrogenase. Greater recognition of factors associated with increased risk of Mpox severity and hospitalization is paramount.
Program Evaluation of Fit to Pass®, a Remotely Accessible Health Promotion Program for Commercial Motor Vehicle Truck Drivers
Authors: Snyder Pamela , Carbone Eva , Heaton Karen , Hammond Stephanie 
Published: August 2023

Background: Chronic health conditions are highly prevalent among truck drivers due to many unique occupational and environmental stressors. Health promotion programs are shown to be effective in improving truck driver health outcomes; however, there is no research on whether such programs can increase the length of a driver’s Department of Transportation (DOT) medical certificate. The purpose of this quality improvement project was to evaluate Fit to Pass (FTP), a remotely accessible health promotion program available for truck drivers on improved health outcomes and increased DOT medical certificate length. Method: Program evaluation included an evaluation of the FTP coaching guide against evidence-based practice guidelines. An analysis of a limited dataset of 22 truck driver records examined the effectiveness of the program in achieving improved health outcomes and increased medical certification length. Findings: A review of the literature revealed three major themes: (a) motivational interviewing to increase driver intention and self-efficacy; (b) mobile health care technology to connect hard-to-reach truck drivers; and (c) effectiveness of structured multicomponent health promotion programs. After participation in FTP, truck drivers experienced a mean decrease in weight and body mass index (BMI) of 4.6 lbs and 1.3 kg/m2, respectively. The lengths of initial DOT medical certificates were compared with DOT medical certificates received at the time of recertification (post—FTP). Only eight participants had the potential for improvement in certificate length. Of those, three truck drivers achieved an increased DOT medical certificate length at the time of recertification. Conclusion/Applications to Practice: FTP offers tailored and comprehensive health coaching for truck drivers using current evidence-based practice guidelines to educate and reinforce healthy lifestyle habits. Analysis of a limited dataset revealed a mean decrease in BMI and a trend of increased DOT medical certification lengths after participation in FTP; however, further research with larger sample sizes is recommended.
Comorbidity Burden in Psoriasis Patients With Skin of Color
Authors: Peterson Hannah , Huang Margaret Y. , Lee Kathryn , Kingston Paige , Yee Danielle , Korouri Edwin , Agüero Rosario , Armstrong April W. 
Published: August 2023

Background Psoriasis is a chronic disease with increased risk of numerous comorbidities. Known differences exist regarding treatment outcomes for psoriasis patients with skin of color (SOC). Factors contributing to these differences are relatively unknown. Objectives This study aims to compare the comorbidity burden in SOC psoriasis patients vs White patients, as measured by the Charlson Comorbidity Index (CCI). Methods We utilized the National Ambulatory Medical Care Survey (NAMCS) to identify visits for adult psoriasis patients occurring in the years 2002-2016 and 2018. The CCI was used to objectively measure comorbidity burden. Patients were identified by race, and SOC was defined as any reported race besides White Only. A multiple linear regression was run to compare the CCI among adult psoriasis patients based on race and ethnicity, controlling for age, sex, insurance status, and geographic region. Results A total of 39, 176, 928 weighted visits were analyzed. Compared to White patients, patients with SOC did not have statistically significant differences in comorbidity burden, as measured by CCI ( P = .073 for Black/African American Only vs White Only, P = .073 for American Indian/Alaska Native Only vs White Only, P = .435 for Asian Only vs White Only, P = .403 for Native Hawaiian/Pacific Islander Only vs White Only, P = .195 for Other vs White Only). Conclusion Patients with SOC were not found to have differences in comorbidity burden compared to White patients. These results highlight that social factors such as socioeconomic status and access to health care may contribute more directly to psoriasis treatment outcomes than patient race.
Factors Associated With Esophagus Cancers in Togo, Sub-Saharan Africa
Authors: Darré Tchin , Djiwa Toukilnan , Kogoe Roland-Moise Lidawu , Eklu Kodjo Eugene , Alassani Fousseni , Simgban Panakinao , Bombone Mayi , Sama Bagassam , Tchangai Boyodi , Bagny Aklesso , Napo-Koura Gado 
Published: August 2023

Background: Esophagus cancer is cancer of poor prognosis, of often late diagnosis. The objective of this study was to describe the factors associated with esophagus cancers in the Togolese population. Methods: It was a retrospective descriptive, cross-sectional study, on esophagus cancers histologically diagnosed at the Pathological Laboratory of Lomé over a period of 31 years (1990-2021). Results: We have collected 144 cases of esophagus cancer. The average age of patients was 57 ± 12 years, and the sex ratio was 2.34. The most applicant service was the service of Hepato Gastroenterology of CHU Campus (30.6%). Alcohol (57.6%), tobacco (45.8%) were the most present risk factors. Biopsies were the most addressed (97.2%). The average duration of symptom evolution was 6.42 months and the main symptom at the time of diagnosis was dysphagia (36.8%). The location of cancer was the lower third for 71.5% of cases. At histology, epidermoid carcinoma was the dominant type (90.3%). Male sex was statistically associated with the occurrence of epidermoid carcinoma and female sex with the occurrence of adenocarcinoma ( P < .001). Alcohol, smoking, and consumption of hot foods were statistically associated with the occurrence of epidermoid carcinoma in this study ( P < .05). Conclusion: Esophagus cancer remains a serious condition for late diagnosis. These are mainly epidermoid carcinomas and having alcohol and tobacco as risk factors. The awareness of the population on the main risk factors would reduce the incidence of oesophagus cancers within the Togolese population.