bluuebunny/crossref_metadata_2025_split huggingface dataset:
Longitudinal Change in Symptom Clusters in Patients With Ovarian Cancer
Authors: DAN Xin , TIAN Yalin , ZHOU Li , DU Juan , HE Yalin 
Published: February 2022

ABSTRACT

Background
The symptoms of patients with ovarian cancer at a specific time point during the treatment process have been investigated in previous studies. However, only a few longitudinal studies have been conducted in China to determine the symptom cluster of patients with ovarian cancer before surgery, after surgery, and during the initial stage of chemotherapy.

Purpose
This study was carried out to identify the symptom clusters in patients with ovarian cancer at different stages of treatment.

Methods
A longitudinal survey was designed, and 430 patients with ovarian cancer who had undergone surgical operation combined with chemotherapy were recruited as participants. Exploratory factor analysis was conducted to identify the components of symptom cluster at three different time points: 3 days before surgery (T1), 2 days after surgery (T2), and the first day after the completion of chemotherapy cycle 1 (T3).

Results
The symptom clusters varied across the three time points. Notably, the pain-related, emotional, cognitive, and disease-related symptom clusters occurred at T1 and persisted through T2 and T3; the treatment-related symptom cluster occurred at T2 and persisted through T3; and the numbness symptom and gastrointestinal symptom clusters were observed at T3.

Conclusions
Priority symptom management interventions should be provided according to the most severe symptom clusters such as the emotional symptom cluster at T1, the treatment-related symptom cluster at T2, and the gastrointestinal symptom cluster at T3.
Electronic Resources for Children Explaining COVID and Vaccinations
Authors: Bayless Katy R. 
Published: February 2022

Abstract
As parents are forced to become experts of a new virus, it is helpful to know there are resources to help navigate the conversation with children. There are now countless e-books for all ages explaining the virus, illness, social distancing, and even the vaccine. Below are suggestions for especially helpful and fun e-books to aid parents in having these conversations.
A Comparison of ECochG With the Subjective Sound Perception During Cochlear Implantation Under Local Anesthesia—A Case Series Study
Authors: Linder Pia , Iso-Mustajarvi Matti , Dietz Aarno 
Published: February 2022

Objective:
Intraoperative electrocochleography (ECochG) has been proposed for cochlear monitoring to minimize trauma during the insertion of the electrode of a cochlear implant (CI). CI surgery is normally performed under general anesthesia, which is why intraoperative ECochG measurements have never been validated against the patient's subjective sound perception. The main objectives of this study were to investigate the feasibility of cochlear monitoring based on the patients hearing and to validate it against intraoperative ECochG measurements during CI surgery under local anesthesia.

Study Design:
Prospective case series study.

Setting:
Tertiary referral center.

Patients:
Patients eligible for cochlear implantation with residual hearing (pure-tone threshold averages [PTA] 2501000 Hz ≤ 75 dB HL). Additionally, patients should be able to hear ECochG stimuli at 250, 500, or 1000 Hz at less than or equal to 100 dB (HL).

Interventions:
Cochlear implantation under local anesthesia without conscious sedation. Intraoperative ECochG monitoring.

Main Outcome Measures:
The development of ECochG amplitudes and the patients’ subjective perception to the sound stimuli.

Results:
In all patients, monitoring based on their subjective sound perception was feasible, whereas, reliable ECochG responses could be measured in seven patients. Sixty percent of the registered declines in ECochG amplitude were associated with a concomitant attenuation of the subjectively perceived sound.

Conclusions:
The developments in the ECochG responses matched well with the changes of the sound stimulus perceived by the patients, which supports the applicability of ECochG for preventing insertion trauma. Monitoring of the patients subjective hearing appears to be more reliable than ECochG but requires surgery under local anesthesia without conscious sedation.
Role of muscle-targeted nutritional therapy: new data
Authors: Cereda Emanuele , Veronese Nicola , Caccialanza Riccardo 
Published: February 2022

Purpose of review
To provide an updated overview of recent efficacy data on the use of muscle-targeted nutritional therapy, which should consider the optimization of protein and essential amino acids intakes, possibly in combination with supplementation with vitamin D (correction of deficiency/insufficiency status) and v-3 fatty acids.

Recent findings
Intervention studies conducted in the last years in different healthcare settings and heterogeneous patient populations support the use of muscle-targeted oral nutritional supplementation to improve muscle mass, function and physical performance in patients with sarcopenia. Higher efficacy is likely to be achieved in combination with individually tailored resistance exercise training programs and when nutritional therapy and the provision of specific nutrients result in an adequate protein-calorie balance. However, not only a reactive but also a pro-active application of this therapy could be proposed as evidence exists on the maintenance of or improvement in the same outcome variables in patients at risk of losing skeletal muscle mass.

Summary
Based on available efficacy data, both a reactive and pro-active use of muscle-targeted nutritional therapy are promising and should be proposed. However, future research should be directed toward the management of patient populations characterized by substantial muscle wasting, as these have been frequently excluded from previous trials, perhaps to avoid confounding.
Prenatal imaging for the diagnosis of congenital Zika syndrome
Authors: Herrera Tania , Cubilla-Batista Idalina , Goodridge Amador 
Published: February 2022

Abstract

Introduction:
We aim to synthesize the best available evidence on the accuracy of prenatal imaging for the diagnosis of congenital Zika syndrome due to maternal Zika virus (ZIKV) infection. Specifically, we explored the factors that may influence diagnosis accuracy, such as geographic area, endemicity of ZIKA, operator, gestational age, and type of reference standard used.
Methods and analysis

Study selection criteria:
All types of observational studies were included, that examined pregnant women with ZIKV infection (positive real time polymerase chain reaction or immunoglobulin M (IgM) serological tests and plaque neutralization reduction test). The index tests included prenatal imaging studies (ultrasound and/or magnetic resonance imaging). The reference standard was defined as follows: 1) perinatal death, including stillbirth and neonatal death within the first 48 h of birth, 2) neonatal intensive care unit admission, and 3) composite adverse perinatal outcomes. Case reports will be excluded if they only included fewer than five case.

Sources of information:
PubMed, Scopus, ISI Web of Science, and Google Scholar will be search from inception to March 2021. Two researchers will independently screen study titles and abstracts for eligibility, followed by full-text assessment. Data extraction will include population, settings, timing, and use of the index test and reference standard used. We will assess the methodological quality of the included studies and a meta-analysis will be performed to estimate summary statistics. Bivariate and hierarchical summary receiver operating characteristic modeling will be used to evaluate the diagnostic performance. The quality of evidence will be assessed by the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) metholody.

Sources:
This systematic review is funded by Secretaria Nacional de Ciencia y Tecnología-Panama.

Ethics and dissemination:
Ethical approval will not be necessary. Results will be published in a peer review scientific journal.

Systematic review registration number in Prospero:
CRD42020162914
Aspiration of zinc tablet leading to chemical burn of the airway
Authors: Qian Edward T. , Lentz Robert J. , Johnson Joyce , Maldonado Fabien 
Published: February 2022

Abstract

Rationale:
Zinc supplementation has been considered a safe prophylactic measure against COVID-19 infection, but the risks have not been well established.

Patient concerns:
We describe a 73-year-old patient who presented with bronchoscopy 10 days after zinc tablet aspiration.

Diagnoses:
Circumferential Chemical Airway Burn leading to Airway Stenosis

Interventions:
Bronchoscopy with bronchodilation

Outcomes:
After the initial bronchoscopy, the patient was administered a course of steroids, but on repeat bronchoscopy, significant airway stenosis was encountered, and balloon dilationwas performed.

Lessons:
Zinc tablet aspiration is a previously unreported risk of zinc prophylaxis and requires prompt bronchoscopic evaluation for foreign body removal.
Papillary thyroid carcinoma with maxillary metastasis
Authors: Awny Shadi , Halim Amal A.F. , Khedr Doaa , Agamy Ahmed , Salah Heba , Abdo Islam , Fareed Ahmed M. , Attia Esam , Roshdy Mohamed , Elzayat Sara , Setit Ahmed , Zeid Amir 
Published: February 2022

Abstract

Introduction:
The incidence of distant metastasis in papillary thyroid carcinoma (PTC) is less than5%. Most such metastases occur in the lungs and bones. More than 80% of bone metastases are located in the axial skeleton. Metastasis to the facial bones is extremely rare.

Patient concerns:
A 36-year-old man presented with intermittent attacks of epistaxis, nasal obstruction, right-sided facial swelling, and a progressive headache without fever or preceding dental trauma. He had undergone total thyroidectomy with neck dissection for PTC in 2017.

Diagnosis:
Computed axial tomography and magnetic resonance imaging of the head and neck region showed a well-defined mass occupying the right maxillary sinus with bony erosion, measuring approximately 5.8 × 3.2 × 5.3 cm. Biopsy revealed metastatic PTC, which was confirmed using immunohistochemistry.

Interventions:
The patient underwent debulking surgery in the form of partial maxillectomy and reconstruction of the mucosal defect using a buccal pad of fat. A post operative therapeutic dose of radioactive iodine (TDRI) was administered.

Outcomes:
A whole-body iodine scan performed 5 days after the dose revealed multiple metastases affecting the right maxilla, both lungs, and left tibia. The patient was discharged on the fifth day following TDRI and resumed thyroid suppressive therapy. The patient was scheduled for another TDRI six months later.

Conclusion:
Maxilla metastasis of PTC is rare, usually occurs in women, and is usually associated with other metastases. When maxillary bone metastasis occurs, physicians, dentists, and pathologists should not exclude the possibility of metastatic PTC.
Microgranulomas at Diagnosis Are Associated With Need for Antitumor Necrosis Factor Escalation in Pediatric Crohn Disease
Authors: Moran Christopher J. , Pankaj Amaya , Kaplan Jess L. , Deshpande Vikram 
Published: February 2022

ABSTRACTIntroduction:Granulomas are a pathologic hallmark of Crohn disease (CD) although they are found in only a subset of patients. Well‐formed granulomas are associated with an aggressive phenotype although it is unknown if microgranulomas confer a similar phenotype. This study sought to define the incidence of microgranulomas in pediatric CD and compare the clinical course with cases with granulomas and those without granulomatous inflammation.Methods:We performed a single‐center, retrospective study of pediatric CD patients who had at least 3 years of follow‐up. initial diagnostic biopsies were systematically re‐examined by a gastrointestinal pathologist. A priori definitions of granuloma (10+ histiocytes) and microgranuloma (4–9 histiocytes) were used. Disease outcomes of hospitalization, development of complicated disease behavior, perianal disease, and the use of anti‐tumor necrosis factor (anti‐TNF) therapy were assessed by Kaplan‐Meier survival plots.Results:This study included 138 subjects with an average follow‐up of 4.6 years. Granulomas were seen in 38 of 138 subjects (27.5%) and an additional 38 subjects (27.5%) had at least 1 microgranuloma (in the absence of granulomas). Escalation to anti‐TNF therapy was higher in CD with granulomas (P = 0.001) and microgranulomas (P = 0.0001) compared with those without granulomatous inflammation.Conclusions:A significant subset of pediatric CD patients have microgranulomas (in the absence of well‐defined granulomas). Children with CD who have microgranulomas are escalated to anti‐TNF therapy more frequently than those without granulomatous inflammation (and at a similar rate to those with granulomas). Pathologists should have a low threshold to report microgranulomas as they may help to predict disease behavior.
A Case With New-Onset Neuromyelitis Optica Spectrum Disorder Following COVID-19 mRNA BNT162b2 Vaccination
Authors: Caliskan Ilay , Bulus Eser , Afsar Nazire , Altintas Ayse 
Published: February 2022

Introduction:
In the midst of the coronavirus disease of 2019 pandemic, active immunization by effective vaccination gained utmost importance in terms of global health. The messenger RNA (mRNA) vaccines are novel strategies requiring clinical surveillance for adverse events.

Case Report:
We report a 43-year-old previously healthy female with an optic neuritis attack 24 hours following immunization with the second dose of coronavirus disease of 2019 mRNA BNT162b2 vaccine. A second transverse myelitis attack together with an elevated anti-AQP-4 antibody titer confirmed the diagnosis of neuromyelitis optica spectrum disorder.

Conclusion:
Our case identifies the BNT162b2 vaccine as a possible trigger for neuromyelitis optica spectrum disorder. This rare and potentially coincidental event has no implications for vaccine administration practices. However, further research is needed to elucidate the effects of mRNA vaccines on humoral and cell-mediated immunity.
Intra- and Interrater Reliability of the Spanish Version of the Gross Motor Function Measure (GMFM-SP-88)
Authors: Ferre-Fernández Marina , Murcia-González María Antonia , Ríos-Díaz José 
Published: February 2022

Purpose:
To assess intra- and interrater reliability of the Spanish version of the 88-item Gross Motor Function Measure (GMFM-SP-88), and its correlation to age and severity of children with cerebral palsy.

Methods:
Six raters assessed 50 videotapes and 4 viewed 50 recordings to determine intra- and interrater reliability, respectively. Intraclass correlation coefficients (ICCs), standard error of measurement (SEm), smallest real difference (SRD), and limits of agreement (LoA) were calculated.

Results:
Intra- and interrater reliability were excellent for both total (ICC2,1 = 1.00, 95% confidence interval [CI] 0.99-1.00) and dimension scores (ICC2,1 = 0.99, 95% CI 0.99-1.00). The SEm and the SRD for the total score were acceptable (1.60 and 3.14, respectively). The average differences in dimension scores were below 1 and 0.1 points (95% LoA: −1.65 to 1.94, −1.06 to 0.86 for intra- and interrater reliability, respectively).

Conclusions:
The results support the potential use of the GMFM-SP-88 as a reliable tool, having correlation with age and severity.

What this adds to the evidence:
The GMFM-SP-88 is a reliable outcome measure to assess gross motor function in cerebral palsy. The GMFM-SP is the only tool available in Spanish to assess gross motor function in children and adolescents with cerebral palsy. The GMFM-SP-88 is a valuable resource for both Spanish physical therapists and researchers.
Reconstructive Surgeons as Essential Operative Consultants: Quantifying the True Value of Plastic Surgeons to an Academic Medical Center
Authors: Vartanian Emma D. , Ebner Peggy J. , Liu Alice , Wilson Todd A. , Wong Alex K. , Carey Joseph N. , Urata Mark M. , Patel Ketan M. 
Published: February 2022

Background:
The revenue generated by plastic surgeons assisting other surgical services is poorly captured by hospital accounting systems, which categorize solely by attending physician of record. The financial impact of reconstructive surgery is thus systematically underestimated. The authors sought to quantify the overlooked value of plastic surgeons as consultants who facilitate complex and profitable operations.

Methods:
Hospital billing data were reviewed for inpatient operations over a 3-year fiscal period (2015 to 2017). Cases in which a plastic surgeon assisted were identified. Case mix index, a measure of complexity that correlates with profit, and contribution margin, defined as revenue minus cost, were obtained for each case.

Results:
Five hundred fifty-four cases required a reconstructive surgeon; 18,904 nonconsultation cases were identified for comparison. Average net revenue per case involving a consultation was 1.79 times greater than for control cases (p < 0.0001). Average contribution margin was 1.73 times greater (p < 0.005). The highest contribution margins stemmed from joint cases with cardiothoracic surgery and neurosurgery. Case mix index was significantly higher for consultation cases than for controls (4.5 versus 3.9; p < 0.0001). In 434 cases (78 percent), plastic surgery assisted with an integral aspect of the operation, meaning the surgery could not have been technically performed without reconstructive assistance.

Conclusions:
The authors’ findings demonstrate that cases involving plastic surgeons have a higher profit margin than those performed by any department alone. However, this revenue is not appropriately attributed because of oversimplified financial metrics. The skill set of reconstructive surgeons is an undervalued resource for both patient care and hospital economics.
Law of Diminishing Returns in Ventral Hernia Repair: Fact or Fiction?
Authors: Patel Viren , Jia Hanna , Rios-Diaz Arturo J. , Christopher Adrienne N. , Morris Martin P. , Diatta Fortunay , Cunning Jessica R. , Broach Robyn B. , Fischer John P. 
Published: February 2022

Background:
Repeated ventral hernia repair is associated with increased risk of complications and recurrence. The authors present the first study looking at how repeated ventral hernia repair affects quality of life, and whether there is a relationship between the number of prior repairs and quality-of-life improvement after surgery.

Methods:
A retrospective chart review was conducted of patients undergoing ventral hernia repair between August of 2017 and August of 2019, who completed at least one preoperative and postoperative Abdominal Hernia-Q. Patients were split into four cohorts based on number of prior repairs (zero, one, two, or three or more). Categorical data were compared using chi-square and Fisher’s exact tests, and continuous data were analyzed using Kruskal-Wallis tests.

Results:
Ninety-three patients met inclusion criteria, with 19 (20 percent), 45 (48 percent), 15 (16 percent), and 14 patients (15 percent) in each cohort, ranging from zero to three or more prior repairs. Patients with more prior repairs were significantly more likely to be readmitted and undergo reoperation (p = 0.04 and p = 0.01, respectively), in addition to significantly higher cost of care (p = 0.004). Patients with three or more prior repairs had significantly lower preoperative quality of life when compared to patients with two or fewer prior repairs (p = 0.04). However, all patients reported a similar absolute level of quality of life postoperatively, irrespective of prior repairs (p = 0.34).

Conclusions:
Treatment of recurrent hernia remains a challenge because of poor clinical outcomes and higher risk of recurrence. This study shows that patients with multiple prior ventral hernia repairs report similar postoperative quality of life as patients undergoing primary repair. This information is valuable in determining appropriate surgical candidates and improving preoperative counseling.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Risk, II.
Incidence and Nerve Distribution of Symptomatic Neuromas and Phantom Limb Pain after Below-Knee Amputation
Authors: Chang Brian L. , Mondshine Josh , Fleury Christopher M. , Attinger Christopher E. , Kleiber Grant M. 
Published: February 2022

Background:
Patients with major lower limb amputations suffer from symptomatic neuromas and phantom-limb pain due to their transected nerves. Peripheral nerve surgery techniques, such as targeted muscle reinnervation and regenerative peripheral nerve interface, aim to physiologically prevent this nerve-specific pain. No studies have specifically reported on which nerves most frequently cause chronic pain. The authors studied the nerve-specific incidence of symptomatic neuroma formation and phantom limb pain in patients undergoing a below-knee amputation, to better tailor use of targeted muscle reinnervation and regenerative peripheral nerve interface.

Methods:
This was a retrospective review of all patients undergoing a below-knee amputation from January 1, 2013, to December 31, 2018, at MedStar Georgetown University Hospital. All below-knee amputations were performed with a posterior skin flap, myotenodesis, and traction neurectomies of all nerves. Postoperative notes were reviewed for the presence of a symptomatic neuroma, defined as localized pain and a Tinel sign over a known sensory nerve, and nerve-specific phantom limb pain, defined as pain of the missing limb corresponding to a known dermatome.

Results:
One hundred ninety-eight patients were included in this study. The rate of symptomatic neuroma formation was 14.6 percent (29 of 198), with the superficial peroneal and saphenous nerves most often involved. Diabetes and obesity were protective against symptomatic neuroma formation. The rate of nerve-specific phantom limb pain was 12.6 percent (25 of 198) and highly correlated with the presence of a symptomatic neuroma.

Conclusion:
To optimize outcomes for amputees, it is critical that surgeons best understand what nerves are more likely to form symptomatic neuromas and lead to nerve-specific phantom limb pain, so that surgeons can best tailor primary or secondary management of the major sensory nerves.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Risk, III.