bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness of Standard-Dose vs. Low-Dose Alteplase for Acute Ischemic Stroke Within 3–4.5 h
Authors: Chen Chih-Hao , Tang Sung-Chun , Chen Yu-Wei , Chen Chih-Hung , Tsai Li-Kai , Sung Sheng-Feng , Lin Huey-Juan , Huang Hung-Yu , Po Helen L. , Sun Yu , Chen Po-Lin , Chan Lung , Wei Cheng-Yu , Lee Jiunn-Tay , Hsieh Cheng-Yang , Lin Yung-Yang , Lien Li-Ming , Jeng Jiann-Shing 
Published: February 2022

BackgroundThe efficacy and safety of intravenous alteplase administered 3–4.5 h after acute ischemic stroke have been demonstrated. However, whether responses differ between low-dose and standard-dose alteplase during this time window and whether certain subgroups benefit more remain unknown.Patients and MethodsThe current analysis was based on a multicenter matched-cohort study conducted in Taiwan. The treatment group comprised 378 patients receiving intravenous alteplase 3–4.5 h after stroke onset, and the control group comprised 378 age- and sex-matched patients who did not receive alteplase treatment during the same period. Standard- and low-dose alteplase was administered to patients at the physician's discretion.ResultsOverall, patients receiving alteplase exhibited more favorable outcomes than did controls [34.0 vs. 22.7%; odds ratio (OR): 1.75, 95% confidence interval (CI): 1.27–1.42], and the effectiveness was consistent in all subgroups. Although patients in the standard-dose group (n = 182) were younger than those in the low-dose (n = 192) group, the proportions of patients with favorable outcomes (36.3 vs. 31.8%; OR: 1.22, 95% CI: 0.80–1.88) and symptomatic hemorrhage (2.8 vs 4.2%; OR: 0.65, 95% CI: 0.21–2.02) were consistently comparable in a covariate-adjusted model and an age-matched cohort. In the subgroup analysis, patients with cardioembolism, atrial fibrillation, and hypercholesterolemia were more likely to achieve favorable outcomes after receiving standard-dose than low-dose alteplase.ConclusionIn the 3–4.5 h time window, the effectiveness and safety of standard-dose and low-dose alteplase may be comparable. A standard dose may be selected for patients with cardioembolism, atrial fibrillation, or hypercholesterolemia.
Social Disparities of Pain and Pain Intensity Among Women Diagnosed With Early Stage Breast Cancer
Authors: Choi Hyo Young , Graetz Ilana , Shaban-Nejad Arash , Schwartzberg Lee , Vidal Gregory , Davis Robert Lowell , Shin Eun Kyong 
Published: February 2022

BackgroundBreast cancer is one of the most commonly diagnosed cancers among women in the United States and pain is the most common side effect of breast cancer and its treatment. Yet, the relationships between social determinants of pain and pain experience/intensity remain under-investigated. We examined the associations between social determinants of pain both at the individual level and the neighborhood level to understand how social conditions are associated with pain perception among early stage breast cancer patients.MethodsWe conducted integrated statistical analysis of 1,191 women with early stage breast cancer treated at a large cancer center in Memphis, Tennessee. Combining electronic health records, patient-reported data and census data regarding residential address at the time of first diagnosis, we evaluated the relationships between social determinants and pain perception. Pain responses were self-reported by a patient as a numerical rating scale score at the patient’s initial diagnosis and follow-up clinical visits. We implemented two sets of statistical analyses of the zero-inflated Poisson model and estimated the associations between neighborhood poverty prevalence and breast cancer pain intensity. After adjustment for demographic characteristics, cancer stage, and chemotherapy, pain perception was significantly associated with poverty and blight level of the neighborhood.ResultsAmong women living in the highest-poverty areas, the odds of reporting pain were 2.48 times higher than those in the lowest-poverty area. Women living in the highest-blight area had 5.43 times higher odds of reporting pain than those in the lowest-blight area. Neighborhood-level social determinants were significantly associated with pain intensity among women diagnosed with early-stage breast cancer.ConclusionsDistressed neighborhood conditions are significantly associated with higher pain perception. Breast cancer patients living in socio-economically disadvantaged neighborhoods and in poor environmental conditions reported higher pain severity compared to patients from less distressed neighborhoods. Therefore, post-diagnosis pain treatment design needs to be tailored to the social determinants of the breast cancer patients.
The Compulsory Care Act: Early Observations and Expectations of In- or Outpatient Involuntary Treatment
Authors: Gemsa Stephan , Noorthoorn Eric O. , Lepping Peter , de Haan Hein A. , Wierdsma Andre I. , Hutschemaekers Giel J. M. 
Published: February 2022

BackgroundOn January 1, 2020, the Dutch Compulsory Care Act (WvGGZ) replaced the Special Admissions Act (BOPZ). While the old law only allowed compulsory treatment in hospitals, the new law allows it both inside and outside the hospital. Moreover, the new law prioritizes the patient's own opinion on coercive measures. By following patients' own choices, the Compulsory Care Act is hoped to lead to fewer admission days and less inpatient compulsory treatment in involuntarily admitted patients.MethodsWe studied the seclusion and enforced-medication events before and after January 1, 2020, using coercive measures monitoring data in a Mental Health Trust. Trends in hours of seclusion and the number of enforced-medication events per month from 2012 to 2019 were compared with 2020. We used generalized linear models to perform time series analysis. Logistic regression analyses and generalized linear models were performed to investigate whether patient compilation determined some of the observed changes in seclusion use or enforced-medication events.ResultsThe mean number of hours of seclusion between 2012 and 2019 was 27,124 per year, decreasing from 48,542 in 2012 to 21,133 in 2019 to 3,844 h in 2020. The mean incidence of enforced-medication events between 2012 and 2019 was 167, increasing from 90 in 2012 to 361 in 2019 and then fell to 294 in 2020. In 2020, we observed 3,844 h of seclusion and 294 enforced-medication events. Near to no outpatient coercion was reported, even though it was warranted. The time series analysis showed a significant effect of the year 2020 on seclusion hours (β = −1.867; Exp(β) = 0.155, Wald = 27.22, p = 0.001), but not on enforced-medication events [β = 0.48; Exp(β) = 1.616, Wald = 2.33, p = 0.13].DiscussionThere was a reduction in the number of seclusion hours after the introduction of the Compulsory Care Act. The number of enforced-medication events also increased from a very low baseline, but from 2017 onwards. To see whether these findings are consistent over time, they need to be replicated in the near future.ConclusionWe observed a significant increase in enforced-medication use and a decrease in seclusion hours. The year 2020 predicted seclusion hours, but not enforced-medication events.
Improving Healthcare Workers' Adherence to Surgical Safety Checklist: The Impact of a Short Training
Authors: Ferorelli Davide , Benevento Marcello , Vimercati Luigi , Spagnolo Lorenzo , De Maria Luigi , Caputi Antonio , Zotti Fiorenza , Mandarelli Gabriele , Dell'Erba Alessandro , Solarino Biagio 
Published: February 2022

BackgroundAlthough surgery is essential in healthcare, a significant number of patients suffer unfair harm while undergoing surgery. Many of these originate from failures in non-technical aspects, especially communication among operators. A surgical safety checklist is a simple tool that helps to reduce surgical adverse events, but even if it is fast to fill out, its compilation is often neglected by the healthcare workers because of unprepared cultural background. The present study aims to value the efficacy of a free intervention, such as a short training about risk management and safety checklist, to improve checklist adherence.MethodsIn March 2019, the medical and nursing staff of the General Surgical Unit attended a two-lesson theoretical training concerning surgical safety and risk management tools such as the surgical safety checklist. The authors compared the completeness of the surgical checklists after and before the training, considering the same period (2 months) for both groups.ResultThe surgical safety checklists were present in 198 cases (70.97%) before the intervention and 231 cases (96.25%) after that. After the training, the compilation adherence increased for every different type of healthcare worker of the unit (surgeons, nurses, anesthetists, and scrab nurses). Furthermore, a longer hospitalization was associated with a higher surgical checklist adherence by the operators.ConclusionsThe results showed that a free and simple intervention, such as a two-lesson training, significantly stimulated the correct use of the surgical safety checklist. Moreover, the checklist adherence increased even for the operators who did not attend the training, maybe because of the positive influence of the colleagues' positive behaviors. As the results were promising with only two theoretical lessons, much more can be done to build a new safety culture in healthcare.
Analysis of the Growth of the Axial Length of the Eye in Children with Progressive Myopia using Combined Design Orthokeratological Lenses
Authors: Бездетко П.А. , Пархомец Р.А. 
Published: February 2022

Цель. Провести анализ роста аксиальной длины глаза у детей с прогрессирующей миопией на фоне использования ортокератологических линз (ОКЛ) комбинированного дизайна. Материалы и методы. В исследовании приняли участие 120 детей с миопией, I группа - 60 детей, которым назначались ортокератологические линзы, II группа - 60 детей, которым были назначены очки. Определялась рефракция до назначения коррекции и через 24 месяца после. Измерялась аксиальная длина глаза до начала коррекции и каждые 6 месяцев. Результаты. Дети, которые использовали ортокератологические линзы, имели прирост длины глазного яблока значительно меньше, чем дети в группе сравнения. В I группе прирост аксиальной длины может соответствовать прогрессированию миопии на 0,24 дптр/год, а в группе сравнения на 1,02 дптр/год. Выводы. Использование ОКЛ комбинированного дизайна является эффективным методом контроля прогрессирования миопии у детей.
Purpose. To analyze the growth of the axial length of the eye in children with progressive myopia while using combined design orthokeratological lenses Materials and methods. 120 children with myopia took part, group I - 60 children who were prescribed orthokeratological lenses, group II - 60 children who were assigned glasses. Refraction was determined before correction was prescribed and 24 months later. The axial length of the eye was measured before the start of the correction and each 6 months later. Results. Children who used orthokeratological lenses had an increase in the length of the eyeball significantly less than children in the comparison group. In group I, the increase in axial size of the eyes can correspond to the progression of myopia by 0.24 diopters/year, and in the comparison group by 1.02 diopters/year. Conclusion. The use of a combined design OKL is an effective method for controlling the progression of myopia in children.
Fixed Combination in the Treatment of Patients with Primary Open-Angle Glaucoma
Authors: Джумова М.Ф. , Марченко Л.Н. , Чекина А.Ю. , Далидович А.А. , Джумова А.А. 
Published: February 2022

Эффективной и доказанной стратегией для сохранения зрительных функций и качества жизни пациента является воздействие на внутриглазное давление (ВГД), которое должно быть снижено до целевого уровня. В ряде случаев достижение целевого уровня возможно при одновременном применении нескольких топических гипотензивных средств. Предпочтительно применение фиксированных комбинированных препаратов. За последние десятилетия были разработаны и внедрены в практику несколько оригинальных гипотензивных препаратов различного принципа действия и их дженериков, применяемых для лечения пациентов с глаукомой. Возможность взаимозаменяемости оригинального препарата аналогом является актуальной для каждого офтальмолога. В данном обзоре обобщены данные о простагландиновых и непростагландиновых фиксированных комбинированных препаратах, их дженериках, преимуществах бесконсервантных препаратов, гипотензивном эффекте, безопасности и переносимости в сравнении с другими гипотензивными средствами и их комбинациями.
Reduction of intraocular pressure (IOP) is an effective strategy for preserving visual functions and quality of life in patients with primary open-angle glaucoma (POAG). In some cases, achieving the target level of IOP is possible with the use of several topical antihypertensive agents. The use of fixed combinations of drugs is preferable. Over the past decades, several original antihypertensive drugs and their generics used to treat patients with glaucoma have been developed and put into practice. In this review, we will try to summarize the data on fixed prostaglandin and non-prostaglandin combined drugs, generics, the advantages of preservative-free drugs, their hypotensive effect in comparison with other antihypertensive agents and their combinations.
Features of the Course of Bipolar Affective Disorder in Patients with Alcohol Addiction
Authors: Демьянов И.А. , Бойко Е.О. , Ложникова Л.Е. , Зайцева О.Г. , Демьянов А.В. , Мельник Е.Ю. 
Published: February 2022

За время проведения клинического исследования выполнена оценка коморбидности биполярного аффективного расстройства с зависимостью от алкоголя, развившейся на фоне биполярного расстройства и предшествовавшей биполярному расстройству, с целью определения особенностей течения заболевания. В исследование вошли 120 пациентов в возрасте от 18 до 65 лет (75 мужчин, 45 женщин) с биполярным аффективным расстройством первого типа, которые проходили стационарное лечение в ГБУЗ «СКПБ № 1» (Краснодар) в период с 2013 по 2018 г.
During the course of the clinical study, the comorbidity of bipolar disorder (BD) with alcohol addiction following BD (BD-A) and preceding BD was assessed in order to determine the features of the course of the disorder. The study involved 120 patients aged from 18 to 65 years (75 men, 45 women) with bipolar disorder of the first type, who underwent inpatient treatment at State budgetary institution of health care “Specialized Clinical Psychiatric Hospital No. 1” (Krasnodar) in the period from 2013 to 2018.
Сonjuntivities in Children and Adolescents in the Conditions of Pandemic COVID-19: What Should the First Contact Doctor Know? Questions and Answers
Authors: Бекетова Г.В. , Витовская О.П. 
Published: February 2022

В педиатрии существует много вопросов, касающихся дифференциации и диагностики офтальмологических заболеваний врачом первого контакта. В статье в форме вопросов и ответов представлена мультидисциплинарная дискуссия педиатра и офтальмолога в отношении анатомо-физиологических подходов к формированию диагнозов, тех состояний, которые сопровождаются симптомом «красного глаза». Авторы обсуждают алгоритмы диагностики, постановки диагноза и современных подходов к лечению синдрома «красного глаза». Представлены клинические критерии острого конъюнктивита различной этиологии. Рассмотрены современные подходы к диагностике и лечению поражений глаза с использованием местных антибактериальных средств в различных формах выпуска, с разными комбинациями действующих веществ, в том числе препаратов Флоксанекст, Тоброцим-Некст комби и Тоброцим-Некст.
There are a lot of questions regarding the differentiation and diagnosis of ophthalmic diseases by a doctor of first contact. The article in the form of questions and answers presents a multidisciplinary discussion of a pediatrician and an ophthalmologist in relation to anatomical and physiological approaches to the formation of diagnoses, those conditions that are accompanied by the symptom of "red eye". The authors discuss algorithms for diagnosis, and modern approaches to the treatment of red eye syndrome. Clinical criteria for acute conjunctivitis of various etiology are presented. Considered modern approaches to the diagnosis and treatment of eye lesions using local antibacterial agents in various forms of releases, different combinations of active substances, including the drugs Floxanext, Tobrotsim-Next-Сombi and Tobrotsim-Next.
Tratamiento definitivo en traumatismo avulsivo de la región cérvico-facial. Presentación de caso clínico
Authors: Suarez Pupo Amilkar , Arias Pla Carlos Antonio , Vargas Baños Marcelo Jorge , Yagual Jiménez Karol Magdalena 
Published: February 2022

Introducción: Las lesiones autoinfligidas por armas de fuego con cañón largo en la zona cérvico-facial no siempre logran consumar el suicidio y pueden ocasionar una herida avulsiva de esta región anatómica. Objetivo: Socializar los beneficios del tratamiento multidisciplinario inmediato en la atención al paciente con traumatismo facial complejo. Caso clínico. Paciente masculino de 60 años de edad con intento autolítico por arma de fuego, con pérdida importante de tejido a nivel mandibular y compromiso de la vía aérea. Resultados: Las distintas etapas de accionar quirúrgico se lograron en las primeras cuatro horas desde que sucedió el incidente. El paciente no presentó complicaciones postoperatorias ni necesidad de una nueva operación. Discusión: En la actualidad existe la tendencia a realizar tratamiento definitivo en un solo tiempo quirúrgico inicial. Conclusión: La intervención inmediata y protocolizada de las especialidades Cirugía General, Maxilofacial y Cirugía Plástica–Reconstructiva en pacientes con heridas avulsivas de la región cérvico facial pueden lograr un tratamiento definitivo en un único tiempo quirúrgico y con resultados favorables.
A double blind randomized clinical trial to compare the efficacy of bupivacaine and ropivacaine for painless delivery
Authors: Kamali Alireza , Anousheh Narges , Shokrpour Maryam , Pazouki Shirin 
Published: February 2022

Background & objective: Childbirth is an important phenomenon in the life of the mother and although this experience is the wish of every mother, it also concerns her due to the labor pain and the possible dangers that threaten her. There are several medications for painless delivery, such as epidural analgesia with the help of bupivacaine and ropivacaine. The aim of this study was to compare the efficacy of painless delivery with epidural method by bupivacaine and ropivacaine in women candidates for painless delivery.
Methodology: This study is a double blind randomized clinical trial. In this study, patients were randomly divided into two equal groups of bupivacaine and ropivacaine using cubic random method. The demographic data, incidence of cesarean section and mean birth phases were evaluated. Finally, data were analyzed using SPSS 22 software, ANOVA and T-test.
Results: A total of 112 patients were enrolled in the study. There was no significant difference between the two groups in terms of mean active phase of labor, mean Apgar score of min 1 and 5, incidence of cesarean section and mothers motor block score, but the mean of the second phase of labor and mean use of delivery helping instruments (such as forceps and vacuum) were lower in the ropivacaine group. Also, the mean score of patients' satisfaction was higher in ropivacaine group.
Conclusion: It could be concluded that the combination of ropivacaine and fentanyl versus the combination of bupivacaine and fentanyl was a very suitable combination for controlling labor pain by epidural method, while it did not increase the rate of cesarean section and did not have a negative effect on neonatal Apgar scores of min 1 and 5, it had a significant effect on decreasing the mean of second stage of labor, decreasing the use of delivery helping instruments and increasing patient satisfaction score.
Key words: Bupivacaine; Ropivacaine; Epidural analgesia; Painless delivery
Citation: Anousheh N, Shokrpour M, Pazouki S, Kamali A. A double blind randomized clinical trial to compare the efficacy of bupivacaine and ropivacaine for painless delivery. Anaesth. pain intensive care 2021;25(3): 274–279. DOI: doi.org/10.35975/apic.v25i3.1146
Received: November 2, 2020, Reviewed: February 22, 2021, Accepted: March 26, 2021
The intensity of extremely low frequency electromagnetic field by target temperature of MEGAWARMERⓇ patient temperature management system
Authors: Kim Se Hun , Park Yei Heum , Lee Hyunseong , Lee Sang Eun , Park Jae Hong , Lee Ki Hwa , Kim Yong Han 
Published: February 2022

Background: Extremely low frequency electromagnetic field (ELF-EMF) emitted by electronic devices is associated with various biological effects on the human body. MEGAWARMERⓇ patient temperature management system (PTMS) is widely used for the patient temperature management in anesthesia and critical care. We investigated the intensity of ELF-EMF according to the distance and target temperature of MEGAWARMERⓇ PTMS to find the distance allowing minimized exposure to ELF-EMF.
Methodology: This study was a prospective experimental study. Target temperature was set at 31℃, 36℃ and 41℃. After setting each target temperature, the intensity of ELF-EMF was measured 300 times during 10 min at interval of 2 sec, at distances of 15, 30, and 45 cm from the MEGAWARMERⓇ PTMS, respectively. Nine measurement groups from 3 different target temperatures and 3 different distances resulted in 2700 data. Including background EMF intensity with the MEGAWARMERⓇ PTMS also turned off, total 3000 data in 10 groups were collected.
Results: At the distance of 15 cm from the MEGAWARMERⓇ PTMS, mean values of ELF-EMF were 4.6721 milligauss (mG), where 1 G is equivalent to 10⁻⁴ Tesla (T) (or 1 mG = 0.1 μT) at 31℃, 4.2852 mG at 36℃, and 3.9935 mG at 41℃. At the distance of 30 cm, mean values of ELF-EMF were 2.0948 mG at 31℃, 2.0790 mG at 36℃, and 2.0633 mG at 41℃. At the distances of 15 cm and 30 cm, the lower target temperature showed statistically significantly higher mean values of ELF-EMF (p < 0.05). In all three target temperatures, longer distance made statistically significantly lower mean value of ELF-EMF (p < 0.05).
Conclusions: The mean intensity of ELF-EMF from the MEGAWARMERⓇ Patient Temperature Management at the distance of 15 cm and 30 cm exceeded 2 mG recommended by Swedish Confederation of Professional Employees guideline.
Key words: Extremely low frequency electromagnetic field; Temperature management; Intensive care unit
Abbreviations: ELF-EMF– Extremely Low Frequency ElectroMagnetic Field; PRMS – Patient Temperature Management System; mG – milligauss
Citation: Kim SH, Park YH, Lee H, Lee SE, Park JH, Lee KH, Kim YH. The intensity of extremely low frequency electromagnetic field by target temperature of MEGAWARMERⓇ patient temperature management system. Anaesth. pain intensive care 2021;25(6):741-745;
DOI: 10.35975/apic.v25i6.1693
Received: August 11, 2021, Reviewed: September 30, 2021, Accepted: October 6, 2021
Anesthesia without opioids
Authors: Butt Mohsin Nazir , Faraz Asma , Fazal Maheen 
Published: February 2022

Summary
Opium was the first opioids with sedative and analgesic effects, so was readily adopted by the surgical doctors to be used during surgeries. Later on its natural alkaloid, morphine, was extensively used, till synthetic alkaloids were introduced in the clinical practice. Now many non-narcotic analgesic drugs have been synthesized and proven to be devoid of serious side effects, commonly associated with the opioid use. There have been some staunch advocates of non-narcotic based anesthesia, who claim that the side effects of the opioids outweigh their benefits in the anesthesia. This editorial throws some light on the current and the future trends in analgesic use in anesthesia.
Key words: Opioids; Analgesics; Non-opioid analgesics; Perioperative pain; Side effects
Citation: Butt MN, Faraz A, Fazal M. Anesthesia without opioids (Editorial). Anaesth. pain intensive care 2021;26(1):4–7;
DOI: 10.35975/apic.v26i1.1758
Received: January 10, 2022, Accepted: January 12, 2022