bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Relation of Patient Expectations, Satisfaction, and Outcome in Surgery of the Cervical Spine
Authors: Krauss Philipp , Reinartz Feline , Sonnleitner Clara , Vazan Martin , Ringel Florian , Meyer Bernhard , Meyer Hanno S. 
Published: June 2022

Study Design.
We performed a prospective nonblinded single center observational study.

Objective.
To investigate the relationship between expectations, outcome, and satisfaction with the outcome in patients undergoing cervical spine stabilization surgery.

Summary of Background Data.
In modern healthcare, patient-reported outcome measures and patient satisfaction have become an important aspect of quality control. Therefore, outcome benchmarks for specific diseases are highly desired. Numerous studies have investigated patient-reported outcome measures and what constitutes satisfaction in degenerative lumbar spine disease. In cervical spine surgery, it is less clear what drives the postoperative symptom burden and patient satisfaction and how this depends on the primary diagnosis and other patient factors.

Methods.
This was a prospective, single center, observational study on patients undergoing cervical spine stabilization surgery for degenerative disease, trauma, infection, or tumor. Using the visual analogue scale for neck and arm pain, the neck disability index (NDI), the modified Japanese Orthopedic Association Score (mJOA) and patient-reported satisfaction, patient status and expectations before surgery, at discharge, 6 and 12 months after surgery were evaluated.

Results.
One hundred five patients were included. Score-based outcome correlated well with satisfaction at 6 and 12 months. Except for low NDI expectations (≥15 points) that correlated with dissatisfaction, expectations in no other score were correlated with satisfaction. Expectations did influence the outcome in some subgroups and meeting expectations resulted in higher rates of satisfaction. Pain reduction plays an important role for satisfaction, independently from the predominant symptom or pathology.

Conclusion.
Satisfaction correlates well with outcome. Meeting expectations did influence satisfaction with the outcome. The NDI seems to be a valuable preoperative screening tool for poor satisfaction at 12 months. In degenerative pathology, pain is the predominant variable influencing satisfaction independently from the predominant symptom (including myelopathy).

Level of Evidence.
5
Clinical Benefits of Early Concurrent Use of Cryoprecipitate and Plasma Compared With Plasma Only in Bleeding Trauma Patients
Authors: Endo Akira , Senda Atsushi , Otomo Yasuhiro , Firek Matthew , Kojima Mitsuaki , Coimbra Raul 
Published: June 2022

OBJECTIVES:
The effectiveness of cryoprecipitate (Cryo) in trauma has not been well established; the benefits of Cryo might have been overestimated in previous studies since the difference in the total amount of administered clotting factors was not considered. We aimed to evaluate the benefits of the concurrent use of Cryo in combination with fresh frozen plasma (FFP) for bleeding trauma patients.

DESIGN:
Retrospective cohort study.

SETTING:
The American College of Surgeons Trauma Quality Improvement Program database between 2015 and 2019.

PATIENTS:
Patients who received greater than or equal to 5 units of packed RBCs and at least 1 unit of FFP within the first 4 hours after arrival to a hospital were included and dichotomized according to whether Cryo was used within the first 4 hours of hospital arrival.

Intervention:
None.

MEASUREMENTS AND MAIN RESULTS:
The outcomes of patients treated with Cryo and FFP were compared with those treated with FFP only using propensity score-matching analysis. The dose of administered clotting factors in each group was balanced. The primary outcome was inhospital mortality, and the secondary outcome was the occurrence rate of adverse events. A total of 24,002 patients (Cryo+FFP group: 6,018; FFP only group: 17,984) were eligible for analysis, of whom 4,852 propensity score-matched pairs were generated. Significantly lower inhospital mortality (1,959 patients [40.4%] in the Cryo+FFP group vs 2,142 patients [44.1%] in the FFP only group; odds ratio [OR], 0.86; 95% CI, 0.79–0.93) was observed in the Cryo+FFP group; no significant difference was observed in the occurrence rate of adverse events (1,857 [38.3%] vs 1,875 [38.6%]; OR, 1.02; 95% CI, 0.94–1.10). Several sensitivity analyses showed similar results.

CONCLUSIONS:
Cryo use combined with FFP was significantly associated with reduced mortality in bleeding trauma patients. Future randomized controlled trials are warranted to confirm these results.
Better outcomes with desmopressin melt than enuretic alarm therapy in children with nocturnal enuresis during coronavirus disease 2019 (COVID-19)
Authors: Unal Umut , Anil Hakan , Deniz Mehmet Eflatun , Vuruskan Ediz , Altunkol Adem , Ercil Hakan 
Published: June 2022

Abstract

Objectives:
This study aimed to investigate the effect of the coronavirus disease 2019 (COVID-19) pandemic on the treatment of children with primary monosymptomatic nocturnal enuresis (MNE) with desmopressin melt versus an enuresis alarm.

Materials and methods:
This study included 56 children with primary MNE who were taking desmopressin melt or using an alarm. Their anxiety levels were evaluated using the Social Anxiety Scale for Children-Revised. For both treatment methods, data from a 3-month bedwetting diary between the third and sixth months of the pre-pandemic treatment were compared with those assessed during the same period during the pandemic.

Results:
Prior to the COVID-19 pandemic, the median 3-month mean frequency of MNE was 1 (0–7.67) in children using desmopressin melt versus 1.33 (0–6) in those using alarm treatment (p = 0.095). During the COVID-19 pandemic period, the median monthly mean frequency of MNE was 1.33 (0–7.33) in children using desmopressin melt versus 6 (1.33–13) in those using alarm treatment (p < 0.001).

Conclusions:
The COVID-19 pandemic and its accompanying psychological effects did not affect the treatment efficacy of desmopressin melt in children with primary MNE but did adversely affect that of enuresis alarms.
Polymedication and its association with individual factors in Portuguese older adults–a cross-sectional study
Authors: Pedroso-Remelhe Mariana , Amaral Teresa F. , Santos Alejandro , Padrão Patricia , Moreira Pedro , Afonso Cláudia , Borges Nuno 
Published: June 2022

Background:
Population aging is a reality resulting in polymedication and its harmful consequences. Therefore, determining polymedication state in Portugal and identifying its associated characteristics is vital.

Methods:
Among the cross-sectional study Nutrition UP 65, information on socio-demographic data, cognitive performance, lifestyle, health, and nutritional status was collected in the Portuguese older population. Frequency of polymedication (self-reported concomitant administration of ≥5 medications and/or supplements) was calculated. Associated factors were determined.

Results:
A total of 1317 individuals were included in the sample and the frequency of polymedication was 37.1%. Characteristics associated with higher odds of polymedication were living in an institution (OR: 1.97; CI: 1.04-3.73); being overweight (OR: 1.52; CI: 1.03–2.25) or obese (OR: 1.57; CI: 1.06–2.34); perceiving health status as reasonable (OR: 1.68; CI: 1.25–2.27) or bad/very bad (OR: 2.04; CI: 1.37–3.03); having illnesses of the circulatory system (OR: 2.91; CI: 2.14–3.94) or endocrine, metabolic, and nutritional diseases (OR: 1.79; CI: 1.38–2.31).

Conclusions:
A 3 to 4 out of 10 Portuguese older adults are polymedicated. Intervention in modifiable factors and the monitorization of others is an important strategy in the care of the elderly.
The effectiveness of e-healthcare interventions for mental health of nurses
Authors: Park Jung-Hyun , Jung Su-Eun , Ha Da-Jung , Lee Boram , Kim Myo-Sung , Sim Kyo-Lin , Choi Yung Hyun , Kwon Chan-Young 
Published: June 2022

Abstract

Background:
Mental health problems, including burnout among nurses, are common and important. With the rapid development of information and communication technologies and the rise in use of smartphones, the use of e-mental health strategies is increasing in public and clinical settings, and initial clinical trials using this intervention have been conducted. This systematic review evaluated whether e-healthcare interventions improve burnout and other mental health aspects in nurses.

Methods:
Six electronic databases including MEDLINE (via PubMed), EMBASE (via Elsevier), the Cochrane Library Central Register of Controlled Trials, the Cumulative Index of Nursing and Allied Health Literature, the Allied and Complementary Medicine Database, and PsycARTICLES were searched to collect relevant randomized controlled trials up to January 28, 2021, using e-healthcare interventions for mental health in nurses. The e-healthcare intervention was classified as web-based, smartphone-based, and real-time online interventions. The primary outcome was burnout in this population. Due to the heterogeneity of the interventions used in the included studies, quantitative synthesis was not performed, but included studies were analyzed qualitatively. Also, the details of e-healthcare for the mental health of nurses were analyzed. The methodological quality of included studies was assessed using Cochrane's Risk of Bias tool.

Results:
Seven randomized controlled trials were included in this study. The 20-minute session of an online form of the emotional freedom technique was reported to significantly improve burnout severity compared to no intervention (P < .001). Other outcomes, such as career identity, quality of work life, workplace bullying, job stress, turnover intention, distress, anxiety, and resilience in nurses, were also reported to be improved by e-healthcare interventions. The methodological quality of the included studies was generally poor.

Conclusions:
In conclusion, there was some evidence that e-healthcare interventions may improve mental health outcomes, including burnout in nurses, compared with no intervention. However, due to the poor methodological quality and wide heterogeneity of the interventions and outcomes in the included studies, we were not able to reach sufficiently reliable conclusions. E-healthcare intervention for nurses in the new coronavirus disease era was discussed. High-quality clinical trials in this area should be conducted in the future.
The relationship between a fish-rich diet and poststroke cognitive impairment
Authors: Li Jia-Rui , Yu Yang , Meng Fan-Xia , Luo Ben-Yan , Gao Jian 
Published: June 2022

Abstract
Whether a fish-rich diet is positively associated with cognitive function after stroke remains unclear; thus, the present study investigated the relationship between them.
The present study was part of a prospective multicenter study, in which 920 individuals (609 males, mean age, 62.78 ± 11.79 years) were included from November 2013 to December 2015. The cognitive function of the patients was evaluated, and the diagnosis of poststroke cognitive impairment (PSCI) was made during their stay in the hospital. A subgroup of 439 patients from a single center was followed up for 4 to 6 years and was reassessed for cognitive function.
According to the diagnostic criteria, the PSCI prevalence was lower in the fish-rich diet group (P < .05). After adjusting for demographic and clinical variables by logistic regression, patients with a habit of consuming a fish-rich diet had a lower risk of developing PSCI than patients without a fish-rich diet (odds ratio [OR]: 0.74; 95% confidence interval [CI]: 0.46–0.95). When MMSE score was considered the cognitive function outcome variable, the long-term cognitive function of the fish-rich diet group was better (28 [26–30] vs 27 [25–29], P < .01), but the statistical results were not significant after correcting for the related confounding factors (β: 0.13; 95% CI: −0.99–1.25; P = .82).
There was a negative relationship between consuming a fish-rich diet and the prevalence of PSCI, and there was no statistically significant difference in the relationship of a fish-rich diet on long-term cognitive function after stroke, which requires further study.
Assessment of Canadian Syncope Risk Score in the prediction of outcomes of patients with syncope at the Emergency Department of Suez Canal University
Authors: Moussa Bassant Sayed , Ali Mohamed Amin , Ali Ahmed Abd El-Nasser , Abou Zeid Ahmed EL Sayed Mohammed 
Published: June 2022

Abstract
Syncope is a temporary loss of consciousness usually related to insufficient blood flow to the brain. It's also called fainting or "passing out.” Syncope is responsible for 3% to 5% of emergency department visits, with a hospitalization rate in about 40% of cases, with an average stay of 5.5 days. The Canadian Syncope Risk Score showed good discrimination and calibration for 30-day risk of serious adverse events after disposition from the emergency department.
The aim was to assess Canadian Syncope Risk Score in predicting outcomes and mortality at the emergency department of Suez Canal University Hospitals.
A prospective observational cohort study was carried out in emergency department in Suez Canal University Hospital. After approval by the Ethical and Research Committee of Faculty of Medicine, Suez Canal University, 60 patients with syncope attending to emergency department were included to this study. All included participants were assessed by history taking and they also assessed by the Canadian Syncope Risk Score.
The Canadian Syncope Risk Score's mean of the study group was 4.9 and the range of the scores was from −2 to 11. The mean of the percentage of risk of serious events at 30 days in the study group was 29.17% and it ranged from 0.7% to 83.6%.There was a statistically significant difference between means Canadian Syncope Risk Score's score regarding complication occurrence. Cases which showed complications had a mean score of 7.33 compared to a mean score of 1.25 in case of no complication occurrence P-value <.001. At a cut-off point of more than 3 for the Canadian Syncope Risk Score's, sensitivity of that score in complication's occurrence prediction was 100% and the specificity was 87.5% P-value <.001.
The Canadian Syncope Risk Score's is strong predictor for risk of serious adverse events and a good indicator for admission, with 100% sensitivity and 87.5% specificity at cut off point more than 3.
Induced membrane technique for large bone defects
Authors: Sun Shih-Heng , Tsai Wen-Wen , Shiu Sz-Iuan , Chen Chih-Hui 
Published: June 2022

Abstract

Aims:
The aim of this study was to evaluate the efficacy of induced membrane technique (IMT), and to analyze the relationships between patient factors and surgical parameters as well as their impacts on achieving bone union and complication rates.

Materials and methods:
A comprehensive, computerized search of PubMed, Embase, and The Cochrane Library was conducted, and articles published from January 1, 1978 to February 1, 2021 were included. Clinical trials matching the following inclusion criteria were included:
Univariate and multivariate logistic regression were performed with random intercepts to determine the association of specific predictor variables with nonunion rate, postoperative infection, the need for additional procedures, and time to union.

Results:
Seventy eight trials were included in the study with a total of 3840 patients managed with IMT. Mean age was 38.6 (0.8–88) years, mean size of bone defects was 6.4 (0–25) cm primarily distributed in the tibia (n = 1814, 60.9%), and overall union rate was 87.6%. Multivariate analysis showed the odds of nonunion were significantly increased in patients with an interval between two stages from 8 to 12 weeks and ≥12 weeks. Patients with preoperative infection and addition of antibiotic to bone cement during IMT had significantly decreased odds of longer union time, but preoperative infection caused increased odds of additional surgery. External fixation throughout 2 stages had significantly increased odds of postoperative infection and additional surgery.

Conclusions:
We recommend that the timing of the second stage should be delayed until 6 to 8 weeks after the first stage. Bone cement with antibiotics can control the infection rate and shorten the healing time. Furthermore, there is no need to avoid using internal fixation due to possible concerns about causing postoperative infection.
Highlighting hybridization: a case report of virtual reality-augmented interventions to improve chronic post-stroke recovery
Authors: Bailey Rachel Blanchette 
Published: June 2022

Abstract

Rationale:
Cerebrovascular accident, or stroke, is a leading cause of serious long-term disability, and incidence is expected to continue rising in the coming years. Stroke-related disability can manifest as motor, sensory, or cognitive impairment, and although current therapies can improve these impairments, many stroke patients are still left with reduced abilities and struggle to maintain independence in their daily lives. Virtual reality (VR) has been proposed as a novel therapeutic tool to treat stroke-related disability, particularly in conjunction with traditional post-stroke therapies.

Patient concerns:
Here, we report 1 case of a 75-year-old male with ongoing right upper extremity impairment.

Diagnosis:
The patient was previously diagnosed with an ischemic stroke.

Interventions:
Seven years post-stroke, during which he did not receive any therapies, and on the recommendation of his neurologist, the patient sought VR therapy as an innovative treatment strategy. His clinicians employed a combination of traditional exercise and VR therapy to improve his strength and mobility.

Outcomes:
The combination of traditional and VR therapy was able to provide meaningful improvement to his daily quality of life, even years after the stroke.

Conclusions:
These results suggest that combination therapy with VR is a viable tool for treating post-stroke impairment, even several years on from the cerebrovascular accident.
Gastrointestinal symptoms in patients hospitalized with COVID-19
Authors: Song Jun , Patel Jay , Khatri Rishabh , Nadpara Neil , Malik Zubair , Parkman Henry P. 
Published: June 2022

Abstract
To characterize outcomes in patients hospitalized with coronavirus disease 2019 (COVID-19) who present with gastrointestinal (GI) symptoms.
Clinical outcomes in patients with COVID-19 associated with GI symptoms have been inconsistent in the literature.
The study design is a retrospective analysis of patients, age 18 years or older, admitted to the hospital after testing positive for COVID-19. Clinical outcomes included intensive care unit requirements, rates of discharges to home, rates of discharges to outside facilities, and mortality.
Seven hundred fifty patients met the inclusion criteria. Three hundred seventy three (49.7%) patients presented with at least one GI symptom and 377 (50.3%) patients presented with solely non-GI symptoms. Patients who presented with at least one GI symptom had significantly lower ICU requirements (17.4% vs 20.2%), higher rates of discharges home (77.2% vs 67.4%), lower rates of discharges to other facilities (16.4% vs 22.8%), and decreased mortality (6.4% vs 9.8%) compared with patients with non-GI symptoms. However, patients who presented with solely GI symptoms had significantly higher ICU requirements (23.8% vs 17.0%), lower rates of discharges home (52.4% vs 78.7%), higher rates of discharges to facilities (28.6% vs 15.6%), and higher mortality (19.0% vs 5.7%) compared with those with mixed GI and non-GI symptoms.
Although patients with COVID-19 requiring hospitalization with GI symptoms did better than those without GI symptoms, those with isolated GI symptoms without extra-GI symptoms had worse clinical outcomes. COVID-19 should be considered in patients who present with new onset or worsening diarrhea, nausea, vomiting, and abdominal pain even without pulmonary symptoms.
A forgotten double-J ureteral stent resulting in an emphysematous perinephric abscess
Authors: Lee In Hee , Shin Hong Seok , Ahn Dong Jik 
Published: June 2022

Abstract

Rationale:
Double-J stents (DJSs) are urologic devices widely used for urinary tract obstruction treatment. Perinephric abscess is a condition with purulent accumulation resulting from urinary tract infection retained between the renal capsule and Gerota's fascia. Emphysematous urinary tract infection in patients with a forgotten DJS is extremely rare. Herein, we report a case of emphysematous perinephric abscess as a complication in a 56-year-old non-diabetic woman who neglected a 10-year-old DJS placed for obstructive uropathy treatment.

Patient concerns:
The patient presented with fever and abdominal pain that persisted for 4 days. Laboratory examinations showed leukocytosis, hypoalbuminemia (2.3 g/dL), and elevated C-reactive protein level (305.5 mg/L) with no azotemia.

Diagnosis:
Abdominal computed tomography scan revealed a DJS with encrustation and multiple stones in the right kidney as well as a perinephric abscess with gas formation.

Interventions:
Intravenous administration of piperacillin/tazobactam was initiated immediately and percutaneous catheter drainage was performed. Extended-spectrum beta-lactamase-producing Escherichia coli was identified on abscess culture and antibiotics were switched to meropenem, resulting in gradual improvement of the inflammatory lesion. The patient was referred to the urology department for retained DJS removal and vesicolitholapaxy. A piece of fractured stent was removed via open ureterolithotomy.

Outcomes:
Since discharge on hospital day 42, she has been under regular follow-up, and the surgical wound has been healing with no significant sequelae.

Lessons:
Prompt medical therapy for inflammation and thorough urologic correction of the stent-induced structural deformities are crucial in long-term neglected DJS and resulting emphysematous perinephric abscess. Patients who undergo DJS placement should be systematically followed up to prevent potential neglect of device management.
Emergency and critical care professionals’ opinion on escape room as a health sciences evaluation game
Authors: Gómez-Urquiza Jose L. , Requena-Palomares Iván , Gorjón-Peramato Esther , Gómez-Salgado Juan , Cañadas-De la Fuente Guillermo A. , Albendín-García Luis 
Published: June 2022

Abstract
New teaching and evaluation methods are growing in health sciences. The escape room is a game that is showing benefits for assessing knowledge and important competencies in healthcare professionals. The aim of this study is to analyse the opinion of emergency and critical care professionals on the use of escape rooms as an evaluation game.
A quantitative, descriptive, cross-sectional study was conducted using an ad-hoc questionnaire with a Likert-type scale. The study included emergency and critical care professionals who participated in the escape room “The Frustrated Emergency and Critical Care Professional,” that took place during an emergency and critical care national congress. Data collection was carried out in June 2019.
The sample was composed of n = 50 emergency and critical care professionals, 52% of whom were physicians and 48% were nurses. Professionals believe that this is a good teaching game for evaluation and useful for strengthen knowledge (4.7 points), as well as to improve teamwork and the ability to work under pressure (4.9).
The escape room is a useful evaluation game in the context of emergency and critical care units that also allows training the teamwork and working under pressure competencies.