bluuebunny/crossref_metadata_2025_split huggingface dataset:
No delay in care of ambulatory orthopaedic fractures observed during the early Coronavirus-2019 pandemic: a retrospective cohort study
Authors: Martin David , Bindner Corey , Dawson John , Mitchell Scott , Perkins Christopher , Atassi Omar 
Published: September 2022

Background:
The purpose of this study was to assess the impact of social distancing orders on ambulatory orthopaedic fracture care at a level 1 trauma center during the Coronavirus Disease 2019 (COVID-19) pandemic.

Methods:
All ambulatory orthopaedic fractures that presented to the author’s Level 1 trauma center were analyzed retrospectively between December 2019 and June 2020. Patients were divided into prepandemic (n=377) and pandemic (n=224) groups based on the date of presentation. Primary outcomes included new ambulatory fracture volume, and time to presentation and surgery. Secondary outcomes included fracture type and clinic no-show rates.

Results:
In the first 8 wk after the pandemic began, there was a 60.8% decrease in new patients with ambulatory fractures (24.6/week pre-pandemic, 9.63/week during the first 8 wk, P=0.001). The presentation rate of patients with new ambulatory fractures returned to the prepandemic baseline after the first 8 wk of the pandemic. No significant difference in time to presentation or surgery was noted between groups. There was no statistically significant difference in the presentation rate of the most commonly treated fracture types (ankle, distal radius, hand, or foot) between groups. There was a statistically significant increase in overall clinic no-show rate during the pandemic period.

Conclusions:
An initial decrease in ambulatory fracture volume was seen during the first 8 wk of the COVID-19 pandemic. No delay in time to presentation or time to surgery was seen between groups. After the first 8 wk of the pandemic, a return to normal ambulatory fracture volume was seen.

Level of Evidence:
Level III.
Arthroscopic treatment of type III acromioclavicular joint dislocation: a retrospective case series
Authors: Serri Rahmatollah , Farahanchi Baradaran Amir , Mirzaee Fateme , Zafarani Zohreh , Aslani Hamidreza 
Published: September 2022

Background:
Acromioclavicular joint dislocation (ACJD) is a common shoulder injury that can be classified into six types using the Rockwood classification. Surgical management of type III ACJD remains controversial.

Methods:
The authors performed a retrospective review of 36 patients who underwent surgical management of their type III ACJD using an arthroscopic technique with an EndoButton (Smith & Nephew, Watford, UK). Patients were followed for a minimum of 2 years and assessed by University of California-Los Angeles (UCLA) Shoulder Score and radiographs. The average follow-up period was 3.8 yr (2 to 6 yr); all patients were between 20 and 65 yr old.

Results:
There was no recurrence of dislocation or subluxation. All patients reached a normal range of motion by the final follow-up. No significant pain was reported after the surgery. UCLA score improved to an average of 31.73±3.05 at final follow-up.

Conclusions:
The surgical management of type III ACJD with arthroscopic EndoButton fixation leads to satisfactory patient outcomes with a low complication rate.

Level of Evidence:
Level IV.
Dynamic hip screw with stabilization plate in unstable intertrochanteric fractures: a case series
Authors: Lotfy Sherif Adel , El Nor Tarek Abo , Romeih Mohamed 
Published: September 2022

Background:
Unstable intertrochanteric fractures represent about 60% of all trochanteric fractures. Dynamic hip screw alone in an unstable fracture pattern has a high failure rate of about 50%. Proximal femoral nail is technically a difficult surgery and has complications including nail failure, femoral shaft fracture, malreduction, screw cut-out, and nonunion. Putting a buttress like a trochanteric-stabilization plate acts as a support to the dynamic hip screw and gives good lateral wall buttress, which prevents excessive shaft medialization.

Methods:
Twenty-one patients with closed unstable trochanteric fractures were treated by dynamic hip screw with trochanteric stabilization plate.

Results:
According to the modified Harris Hip Scoring system, 11 patients had excellent results, five patients had good results, four patients had fair results, and one patient had a poor result.

Conclusions:
The dynamic hip screw with trochanteric stabilization plate provides a stable construct for unstable intertrochanteric fractures as it gives a good lateral wall buttress which prevents excessive fracture collapse, femoral shaft medialization, and consecutive limb shortening. It effectively supports the unstable greater trochanteric fragment and can maintain the lever arm with adequate abductor strength.

Level of Evidence:
Level IV.
Effects of health coaching on menopausal symptoms in postmenopausal and perimenopausal women
Authors: Shokri-Ghadikolaei Alemeh , Bakouei Fatemeh , Delavar Mouloud Agajani , Azizi Alireza , Sepidarkish Mahdi 
Published: September 2022

Abstract

Objective
This study aimed to determine the effects of health coaching on reducing menopausal symptoms in postmenopausal and perimenopausal women.

Methods
This randomized controlled study was performed on 94 postmenopausal and perimenopausal women aged 45 to 55 years. The participants were randomly divided into intervention and control groups. In the intervention group, health coaching was performed in five coaching sessions biweekly (30-45 minutes each) by a midwifery coach. The primary outcome of this study was the menopausal score based on the modified Kupperman Index at 4 months after randomization. Depression (based on Zung's Self-Rating Depression Scale), physical activity (based on the International Physical Activity Questionnaire), quality of life (based on the 12-Item Short-Form Survey), smoking, alcohol intake, and anthropometric indices were also evaluated as secondary outcomes.

Results
There was a significant mean difference between the coaching and control groups in terms of change in the scores of menopausal symptoms from baseline (T0) to 4 months after the intervention (T1; −12.51; 95% confidence interval [CI], −10.59 to −14.42; P = 0.001). Moreover, a significant mean difference was observed between the two groups in terms of change in depression symptoms from T0 to T1 (−5.72; 95% CI, −7.61 to −3.83; P < 0.001) and in terms of quality of life (4.13; 95% CI, 2.95 to 5.31; P < 0.001). Health coaching, however, had no effects on the physical activity of the participants.

Conclusion
Based on the present results, the coaching intervention is a suitable method to improve quality of life by reducing weight, waist circumference, body mass index, depression, and menopausal symptoms in postmenopausal and perimenopausal women. It can have important effects on the development of health promotion programs to reduce menopausal symptoms in menopause clinics.
Group Vestibular Rehabilitation Program: A Cost-Effective Outpatient Management Option for Dizzy Patients
Authors: Han Jae Sang , Park Jung Mee , Kim Yeonji , Seo Jae-Hyun , Park So Young , Park Shi Nae 
Published: September 2022

Objectives
This study was performed to evaluate the effectiveness of our novel group vestibular rehabilitation therapy (G-VRT) and to analyze the factors affecting outcomes.

Study Design
Retrospective case series.

Setting
Tertiary referral center.

Patients
Patients with chronic dizziness who received G-VRT between December 2019 and July 2020.

Intervention
The G-VRT program consisted of a 1-hour physical therapy session by an otologist in a small group setting.

Main Outcome Measures
Dizziness Handicap Inventory, visual analog scale, functional level scales, and video head impulse test, as well as the compliance to the program, were evaluated.

Results
All scores of dizziness questionnaires were significantly improved after G-VRT (p < 0.001). The overall vestibule-ocular reflex gain calculated by video head impulse test increased compared to the initial scores, whereas the average PR scores of all three semicircular canals significantly decreased from the initial scores, indicating enhanced vestibular compensation (p < 0.05). Enrolled patients showed high compliance to the program.

Conclusion
G-VRT program is a cost-effective and efficient way to provide relief for chronic dizzy patients. Further case-control studies in a larger group, as well as comparative studies with generic or customized vestibular exercise, will be needed to validate the clinical value of G-VRT.
Electrode Impedance Fluctuations and Sudden Decline in Cochlear-Implant Benefit
Authors: Pitt Cache , Nagaraj Naveen K. , Salisbury Anna 
Published: September 2022

Objective
The main objective of this clinical capsule was to outline the narrative of three teen cochlear implant (CI) users who experienced a sudden increase in their CI electrode impedance values, which coincided with decreased overall speech perception ability. In addition, the study explored the following questions: Are there any similarities between cases? What recommendations should be made for continuing treatment regarding these cases?

Patients
Three teenagers who reported sudden change in CI benefit were included in this study.

Interventions
Electrode impedance values and speech identification scores were obtained routinely during the CI mapping appointments. Specifically, word and sentence recognition scores were obtained using the Consonant-Nucleus-Consonant word list and the AZBio sentence test, respectively. Both patient 1 and patient 2 underwent CI reimplantation operations as a result of their perceived difficulties and decreased impedances. Patient 3 did not undergo reimplantation surgery.

Main Outcomes
All three patients' CI electrode impedances and speech perception scores eventually stabilized over time. No relationship could be drawn between revision surgery and stabilization of CI electrode impedances and speech perception scores.

Conclusions
Overall, we found no similarities between cases that could potentially explain the sudden electrode impedance value increase or the decrease in speech perception scores. Each case should be evaluated uniquely and carefully for CI revision operations by frequent monitoring, including mapping and speech perception testing. The most common factor contributing to each teen's eventual resolution of electrode impedance values and speech perception scores was time.
Synchronous or collision solid neoplasms and lymphomas: A systematic review of 308 case reports
Authors: Parra-Medina Rafael , Rocha Franky , Castañeda-González Juan Pablo , Moreno-Lucero Paula , Veloza Luis , Romero-Rojas Alfredo E. 
Published: September 2022

Background:
The presence of a lymphoma associated with a solid synchronous neoplasm or collision neoplasm has been rarely in the literature, and a detailed characterization of these cases is lacking to date.

Objective:
To describe the main clinicopathological features of synchronous/collision tumors.

Methods:
A systematic search in PubMed, Scielo, and Virtual Health Library literature databases for cases or case series of synchronous or collision lymphoma and other solid neoplasms reported up to March 2021 was performed. Three reviewers independently screened the literature, extracted data, and assessed the quality of the included studies. The systematic review was performed following the Preferred Reporting Items for Systematic Meta-Analyses guidelines.

Results:
Mean age of patients was 62.9 years (52.9% men). A total of 308 cases were included (62% synchronous and 38% collision). The most frequent location of both synchronous and collision tumors was the gastrointestinal tract with the most common solid neoplasm being adenocarcinoma, and the most frequent lymphoma diffuse large B-cell lymphoma (21.7%) and mucosa-associated lymphoid tissue lymphoma (20.4%). Of the total number of mucosa-associated lymphoid tissue lymphomas and gastric adenocarcinomas, the presence of Helicobacter pylori infection was documented in 47.3% of them. Only 2% of all cases had a previous history of lymphoma. Thus, in most cases (98%), lymphoma was discovery incidentally. In addition, nodal lymphoma was associated with metastasis in 29 (9.4%) cases as collision tumor, most commonly (90%) in locoregional lymph nodes of the solid neoplasm.

Conclusions:
The frequent association of some type of B-cell lymphoma and adenocarcinoma in synchronous/collision tumors of the gastrointestinal tract points to common pathogenic mechanisms in both neoplasia, particularly related to chronic inflammation in this location. In most cases, lymphoma identified in locoregional lymph nodes or distant of a carcinoma seems to represent an incidental finding during the carcinoma diagnostic/therapeutic approach. A synergy between carcinoma and lymphoma (involving inflammation and immunosuppression mechanisms) may favor tumor progression and dissemination. A better understating of the interactions lymphoma/carcinoma in the setting of synchronous/collision tumors may help to improve patient management and prognosis.
Can flunarizine be used routinely as the first option for childhood headache treatment?: Flunarizine and childhood headache
Authors: Çirakli Sevgi 
Published: September 2022

The prevalence of headache in childhood increases due to environmental factors. Various risk factors in children whose playgrounds are restricted outside and therefore remain inactive. So diagnosis and treatment can be challenging. The aim of this study was to evaluate the experience of flunarizine in childhood headache with a focus on efficacy and success.
We conducted a retrospective observational study of 185 pediatric patients at the tertiary pediatric emergency and pediatric neurology unit between May 2018 and May 2020. Patients with headache for >15 days of a month for at least 3 months were included in the study, whether or not receiving treatment. Also, all patients who had an adequate follow-up period were included in the study. All patients were evaluated by history, physical–neurological examination, blood tests, blood pressure, eye examination, and cranial magnetic resonance imaging. All data were evaluated statistically.
Ninety-eight (53%) of 185 cases were female and 87 (47%) were male. Average age was 11.4 years (min–max, 4–17). There was family history in 51.3% of the cases. The most frequent applicants were in the autumn season (43%), when schools were opened. Organic causes were hypertension in 1 case, brain tumor in 1 case, and papilledema due to idiopathic intracranial hypertension in 2 cases. The other cases were asked to make a 1-month pain chart and grading according to the visual analog scale. In this process, it was stated that painkillers could be used if needed. At the end of the first month, these patients were reevaluated. Flunarizine treatment was initiated in 95 patients who had to use painkillers for >4 times and who described ≥6 pain score according to the visual analog scale. The treatment was discontinued due to sleepiness and weakness in 2 patients. At the end of the third month, a 50% reduction in headache was observed in 82 cases (86.3%).
We used flunarizine as the first choice in all patients and we achieved a high rate of treatment success. Flunarizine can be considered as an alternative option for headache management in terms of low side effects, easy accessibility, and compliance with treatment.
Clinical effects of a new dispatcher-assisted basic life support training program in a metropolitan city
Authors: Park Gwan Jin , Song Kyoung Jun , Shin Sang Do , Hong Ki Jeong , Kim Tae Han , Park Yu Mi , Kong Joyce 
Published: September 2022

This study estimates the effect of a new dispatcher-assisted basic life support training program on the survival outcomes of out-of-hospital cardiac arrest (OHCA).
Before-and-after intervention trials were conducted in Seoul. Patients who suffered OHCA in a private place from January 2014 to December 2017 were included. The intervention group was 3 districts; the other 22 districts were regarded as the control group. The primary outcome was survival up to hospital discharge. The difference-in-difference (DID) was calculated to evaluate changes in the survival outcomes of the 2 groups over the period.
A total of 10,127 OHCA patients were included in the final analysis. OHCA patients in the intervention group were less likely to receive bystander cardiopulmonary resuscitation (57.8% vs 61.1%; P = .02) and showed lower survival outcomes (5.7% vs 6.4% for survival up to hospital discharge; P = .34 and 2.8% vs 3.7% for good neurological recovery; P = .11), but this was not statistically significant. Compared to 2014, good neurological recovery in 2017 was significantly improved in the intervention group (DID for good neurological recovery = 3.2%; 0.6–5.8). There were no statistically significant differences in return of spontaneous circulation and survival up to hospital discharge between the 2 groups (DID for survival to discharge was 1.8% [−1.7 to 5.3] and DID for return of spontaneous circulation was −2.5% [−9.8 to 4.8]).
Improvement in neurological recovery was observed in the 3 districts after implementing the new dispatcher-assisted basic life support training program.
Low-frequency HIV-1 drug resistance mutations in antiretroviral naïve individuals in Botswana
Authors: Maruapula Dorcas , Seatla Kaelo K. , Morerinyane Olorato , Molebatsi Kesaobaka , Giandhari Jennifer , de Oliveira Tulio , Musonda Rosemary M. , Leteane Melvin , Mpoloka Sununguko W , Rowley Christopher F. , Moyo Sikhulile , Gaseitsiwe Simani 
Published: September 2022

Background:
Individuals living with human immunodeficiency virus (HIV) who experience virological failure (VF) after combination antiretroviral therapy (cART) initiation may have had low-frequency drug resistance mutations (DRMs) at cART initiation. There are no data on low-frequency DRMs among cART-naïve HIV-positive individuals in Botswana.

Methods:
We evaluated the prevalence of low-frequency DRMs among cART-naïve individuals previously sequenced using Sanger sequencing. The generated pol amplicons were sequenced by next-generation sequencing.

Results:
We observed low-frequency DRMs (detected at <20% in 33/103 (32%) of the successfully sequenced individuals, of whom four also had mutations detected at >20%. K65R was the most common low-frequency DRM detected in 8 individuals. Eighty-two of the 103 individuals had follow-up viral load data while on cART. Twenty-seven of the 82 individuals harbored low-frequency DRMs. Only 12 of 82 individuals experienced VF. The following low-frequency DRMs were observed in four individuals experiencing VF: K65R, K103N, V108I, and Y188C. No statistically significant difference was observed in the prevalence of low-frequency DRMs between individuals experiencing VF (4/12) and those not experiencing VF (23/70) (P = .97). However, individuals with non-nucleoside reverse transcriptase inhibitors-associated low-frequency DRMs were 2.68 times more likely to experience VF (odds ratio, 2.68; 95% confidential interval, 0.4–13.9) compared with those without (P = .22).

Conclusion:
Next-generation sequencing was able to detect low-frequency DRMs in this cohort in Botswana, but these DRMs did not contribute significantly to VF.
Comparison of pressure resistance of double-rows and triple-rows circular stapler in rectal double stapling technique: In vitro study
Authors: Mazaki Junichi , Katsumata Kenji , Udo Ryutaro , Tago Tomoya , Kasahara Kenta , Kuwabara Hiroshi , Enomoto Masanobu , Ishizaki Tetsuo , Nagakawa Yuichi , Tsuchida Akihiko 
Published: September 2022

Background:
Anastomotic leak after gastrointestinal anastomosis is a serious complication. Anastomotic failure depends on various parameters. The aim of our study was to evaluate the pressure resistance of a new device, EEA™ circular stapler with Tri-Staple™ technology 28 mm Medium/Thick (Triple-rows circular stapler; TCS) compared with EEA™ circular stapler with DST series™ technology 28 mm, 4.8 mm staples (double-rows circular stapler; DCS).

Patients and methods:
We performed 30 anastomoses (DSC: 15, TCS: 15) of DST with porcine colon model in vitro. We performed following 3 comparative experiences; Experiment 1: observation of staple shape with a colonoscopy, Experiment 2: comparison of the pressure resistance, Experiment 3: comparison of leakage points.

Results:
There was no hypoplasia of staples and the shapes were well-formed by colonoscopy. The leakage pressure of DCS was 19.6 ± 4.4 mm Hg (mean ± standard deviation) and that of TCS was 38.6 ± 10.2 mm Hg (mean ± standard deviation). There was a significantly difference between 2 groups (P < .001). 12 cases of DCS (80%) and 10 cases of TCS (66.7%) had leakages from Circular stapler point. 2 cases of DCS (13.3%) and 5 cases of TCS (33.3%) had leakages from Crossing points. Only 1 case of DCS had leakages from Dog ear point (6.7%). There was no significantly difference in leakage site between 2 groups (P = .195).

Conclusions:
TSC showed high pressure resistance during DST compared with that of DCS. It was suggested that TCS may contribute to the reduction of anastomotic leakage rate.
The current management of scaphoid fractures in the emergency department across an Australian metropolitan public health service: A retrospective cohort study
Authors: Chang Margaret Ting-Kwei , Price Maggie , Furness James , Kemp-Smith Kevin , Simas Vini , Pickering Rowan , Lenaghan Deborah 
Published: September 2022

Background:
Scaphoid fractures are commonly present to emergency departments (EDs), challenging medical practitioners to achieve accurate diagnosis and management. This is because of the prevalence of radiographically occult scaphoid fractures and complications associated with missed diagnoses. Clinical Guidelines are limited for treatment of suspected scaphoid fractures, and heterogeneity in the literature further complicates management. This study aimed to explore the differences in management between practitioners in the ED and determine if immobilizing clinically suspected scaphoid fractures is supported by current evidence. This study also aimed to establish if there are predictors to assist in the diagnosis of a scaphoid fracture in the ED.

Methods:
A retrospective cohort study analyzed clinical data from patient’s charts who attended the ED for a scaphoid fracture in 2019. Using retrospective patient chart audits and a Data Extraction Form, the clinical data regarding the assessment, treatment, diagnosis, and follow-up outcomes were collected. Descriptive analysis and multivariable logistic regression were performed to assess current management and find out predictors of a scaphoid fracture.

Results:
There was significance between practitioners performing physical assessments and providing treatment (P < .001). Physiotherapists performed assessment and education combined treatment more frequently than nurse practitioners and doctors. Thirty-four cases (11.7%) were negative for fracture in ED and positive in follow-up at the orthopedic clinic. There was an estimated loss of income of $327,433.60 (Australian dollar) for 221 patients who missed work due to overtreatment with immobilization. The strongest predictors for a confirmed scaphoid fracture were of male gender (odds ratio, 3.2; 95% confidence interval, 2.1–5.0; P < .001) and a positive x-ray in ED (odds ratio, 36.6; 95% confidence interval, 17.4–77.0; P < .001).

Conclusion:
Management of scaphoid fractures across the Gold Coast Hospital Health Service ED followed commonly accepted practices involving x-ray and immobilization; however, this conservative approach to management is associated with increased health costs and low rates of conversion to a confirmed scaphoid fracture. Male gender was the only significant predictor associated with a scaphoid fracture.