bluuebunny/crossref_metadata_2025_split huggingface dataset:
Telemedicine in Cancer Pain Management: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Authors: Buonanno Pasquale , Marra Annachiara , Iacovazzo Carmine , Franco Massimo , De Simone Stefania 
Published: August 2022

AbstractObjectiveTelemedicine is defined as the delivery of medical services through a variety of telecommunication tools. This novel approach can fit the needs of cancer patients who cannot often reach clinics due to their disabling symptoms. In this population of patients, pain is undoubtedly the most important symptom which dramatically affects the quality of life. Our work aimed to investigate the effectiveness of telemedicine in the management of cancer pain in order to assess the feasibility of a combination between telemedicine and traditional in-person visits; we also propose a model of integration of these two approaches.MethodsWe followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework to conduct our study. Quality assessment and risk of bias were performed according Cochrane criteria. Results were reported as mean differences and summarized using forest plots. We performed a trial sequential analysis (TSA) to assess the conclusiveness of our results.ResultsPain severity score and pain interference were lower for patients treated with telemedicine compared to those undergoing classical management (mean difference: −0.408; P =&lt; .001 and −0.492; P = .004, respectively). TSA confirmed that our results were statistically significant and pointed out the need of other studies to reach the required sample size. PROSPERO registration: CRD42022333260.ConclusionsTelemedicine can be effectively used to manage cancer pain. This novel approach will certainly have a revolutionary economic and organizational impact on health care systems in the next future. Furthermore, the model herein proposed could help set up an algorithm to safely and efficiently implement telemedicine.
Percutaneous Radiofrequency Ablation for Trigeminal Neuralgia Management: A Randomized, Double-Blinded, Sham-Controlled Clinical Trial
Authors: Mansano André Marques , Frederico Thiago Nouer , Valentin Raquel Elisa B , Carmona Maria Jose Carvalho , Ashmawi Hazem Adel 
Published: August 2022

AbstractTrigeminal neuralgia, considered by many the worst pain that humankind can experience, has been called “the suicide disease.” Neuroablative procedures are good options when conservative treatment fails to promote pain relief or in those whose side effects are unbearable.The objective was to compare the effectiveness and safety of trigeminal percutaneous radiofrequency ablation in classical refractory trigeminal neuralgia in a prospective, randomized, double-blind, sham-controlled clinical trial. We included 30 consecutive patients with classical trigeminal neuralgia who had failed to respond to drug treatment. The patients were randomly assigned into two groups: a thermal radiofrequency and a sham group. The thermal radiofrequency group were submitted to a 75°C lesion for 60 seconds after proper sensory and motor stimulation. All steps were carried out in the sham group except the thermal lesion. Patients were evaluated using the Numerical Rating Scale (NRS), the 36-Item Short-Form Health Survey questionnaire, and anticonvulsant dose.After 1 month, the mean NRS score decreased from 9.2 to 0.7 in the radiofrequency group and from 8.9 to 5.8 in the sham group. This significant reduction was measurable starting at day one after the procedure and remained significant throughout the first month. Changing groups was allowed after one month, after which the pain reduction was similar between the two groups. Percutaneous trigeminal radiofrequency ablation results in statistically and clinically significant greater pain relief than the sham procedure after 1 month of follow-up. These results support using radiofrequency nerve ablation as a treatment for refractory trigeminal neuralgia.
Curve Characteristics and Surgical Outcomes in Scoliosis Associated With Childhood Sternotomy or Thoracotomy
Authors: Langner Joanna L. , Ezeonu Teeto , Shafau Abdul-Lateef , Javier Nadine , Bryson Xochitl , Kaur Japsimran , Poppino Kiley , Shivers Claire , Chilakapati Sai , Hall Kimberly E. , Imrie Meghan N. , Rinsky Lawrence , Riccio Anthony I. , Vorhies John S. 
Published: August 2022

Background:
The purpose of this study is to describe curve characteristics and postoperative outcomes in patients undergoing spinal fusion (SF) to treat thoracogenic scoliosis related to sternotomy and/or thoracotomy as a growing child.

Methods:
A retrospective review of electronic medical records of all patients with Post-Chest Incision scoliosis treated with SF was performed at 2 tertiary care pediatric institutions over a 19-year period. Curve characteristics, inpatient, and outpatient postoperative outcomes are reported.

Results:
Thirty-nine patients (62% female) were identified. Eighteen had sternotomy alone, 14 had thoracotomy alone, and 7 had both. Mean age at the time of first chest wall surgery was 2.5 years (range: 1.0 d to 14.2 y). Eighty-five percent of patients had a main thoracic curve (mean major curve angle 72 degrees, range: 40 to 116 degrees) and 15% had a main lumbar curve (mean major curve angle 76 degrees, range: 59 to 83 degrees). Mean thoracic kyphosis was 40 degrees (range: 4 to 84 degrees). Mean age at the time of SF was 14 years (range: 8.2 to 19.9 y). Thirty-six patients had posterior fusions and 3 had combined anterior/posterior. Mean coronal curve correction measured at the first postoperative encounter was 53% (range: 9% to 78%). There were 5 (13%) neuromonitoring alerts and 2 (5%) patients with transient neurological deficits. Mean length of hospital stay was 9±13 days. At an average follow-up time of 3.1±2.4 years, 17 complications (10 medical and 7 surgical) were noted in 9 patients for an overall complication rate of 23%. There was 1 spinal reoperation in the cohort. 2/17 (12%) complications were Clavien–Dindo-Sink class III and 5/17 (29%) were class IV.

Conclusion:
Kyphotic thoracic curves predominate in patients with Post-Chest Incision scoliosis undergoing SF. Although good coronal and sagittal plane deformity can be expected after a fusion procedure, postoperative complications are not uncommon in medically complex patients, often necessitating longer postoperative stays.

Level of Evidence:
Level III.
How to reduce bacillus Calmette-Guérin discontinuation in patients with severe functional impairment
Authors: Di Gianfrancesco Luca , Ragonese Mauro , Foti Massimiliano , Palermo Giuseppe , Sacco Emilio , Bassi PierFrancesco , Racioppi Marco 
Published: August 2022

Abstract

Background
Severe functional impairment is often considered a contraindication to intravesical therapy for nonmuscle-invasive bladder cancer (NMIBC). A tailored intravesical bacillus Calmette-Guérin (BCG) procedure was evaluated in high-risk (HR)-NMIBC patients with severe functional impairment.

Materials and methods
Patients with a Katz Index score of 2 or less and an initial diagnosis of HR-NMIBC with atraumatic insertion of a Foley-type indwelling catheter, bladder emptying, and BCG instillation were prospectively treated; after 2 hours, the bladder was emptied and the catheter was removed (group A).
After propensity score matching, 52 patients in group A were compared with that of 52 consecutive patients in group B using a retrospective database, with similar baseline/oncological characteristics and treated with standard intermittent catheterization. Moreover, groups A and B were compared with that of 130 consecutive patients (group C) retrospectively evaluated, with similar oncological characteristics but with a Katz Index score of 3 or greater and treated with standard intermittent catheterization.

Results
The discontinuation rates were 11.5%, 35%, and 9% in groups A, B, and C, respectively (A vs. B, log-rank score 42.52 [p < 0.05]; B vs. C, 107.6 [p < 0.05]; A vs. C, 3.45 [p > 0.05]). The overall adverse event rates were 38.5%, 57.7%, and 39.2%, respectively (A vs. B, p = 0.04; B vs. C, 0.03; A vs. C, 0.92). The rates of severe adverse events were 1.9%, 1.9%, and 1.5%, respectively, without statistically significant differences. The cumulative HR disease-free survival rates were 63.4%, 48%, and 69.2%, respectively (A vs. B, log-rank score 154.9 [p < 0.05]; B vs. C, 415 [p < 0.05]; A vs. C, 244 [p < 0.05]).

Conclusions
A tailored intravesical instillation procedure may reduce BCG discontinuation and adverse effects.
Phase retardation and corneal sublayer thickness repeatability using ultrahigh-resolution polarization-sensitive OCT
Authors: Patil Rahul , Shetty Rohit , Patel Yash , Pisharody Anchana , Narasimhan Raghav , Pircher Michael , Hitzenberger Christoph K. , Nuijts Rudy M.M.A. , Sinha Roy Abhijit 
Published: August 2022

Purpose:
To assess phase retardation and corneal sublayer thickness repeatability using ultrahigh-resolution polarization-sensitive optical coherence tomography (PS-OCT).

Setting:
Narayana Nethralaya Eye Hospital, Bangalore.

Design:
Observational.

Methods:
In this study, all eyes were imaged using a custom-built ultrahigh-resolution PS-OCT and high-resolution hybrid OCT (MS-39). The repeatability of phase retardation en face maps and corneal sublayer thickness profiles was evaluated. The reflectivity and phase retardation were calculated from the 2 orthogonal polarization channels to generate en face maps of phase retardation and corneal sublayer thicknesses. 3 consecutive measurements of all participants were acquired for each eye. For each measurement, the participant was asked to sit back and was realigned again. The repeatability was assessed using the intraclass correlation coefficient (ICC).

Results:
The study included 20 healthy eyes of 20 participants. The phase retardation en face maps showed preferential arrangement of collagen fibrils with least retardation in the apex and maximum retardation in the periphery. The phase retardation showed excellent repeatability (ICC >0.95) in all zones. The Bowman layer and stromal layer thicknesses were measured with excellent repeatability (ICC >0.93 and >0.99, respectively). Significant differences (P < .05) in stromal layer thickness were observed between MS-39 and PS-OCT. The repeatability of epithelial thickness measurements was better with PS-OCT than MS-39.

Conclusions:
The combinational assessment of corneal birefringence and sublayer thicknesses shows the advanced potential of ultrahigh-resolution PS-OCT in routine clinical practice over current OCT devices.
Corneal opacities after small-incision lenticule extraction
Authors: Kartal Serdar , Nuijts Rudy M.M.A. , Hjortdal Jesper , Daya Sheraz , Kweon Kim Eung , Sekundo Walter , Ganesh Sri , Brar Sheetal , Moshirfar Majid , Hansen Annika M. , Payne Carter J. 
Published: August 2022

A 36-year-old woman was referred to our clinic in October 2021 with suboptimal vision at intermediate and near distances and halos and photophobia after a small-incision lenticule extraction (SMILE) in December 2019. The patient needs to increase font size of her computer to 150% to read text, but images still appear blurred. She indicates that sunglasses seem to improve her contrast. Preoperatively, her refractive error was −2.5 diopters (D) and −2.25 D for right and left eyes. The optical zone size of the SMILE procedure was 6.8 mm. There is no further information available on the peroperative course of the SMILE procedure.
Her uncorrected distance visual acuity (UDVA) is 20/20 in both eyes and does not improve with correction. The Schirmer tear test is 14 to 13 mm. Slitlamp biomicroscopy of the right eye and the left eye reveals hyperreflective small opacities in the anterior one-third of the corneal stroma (Figures 1 and 2

JOURNAL/jcrs/04.03/02158034-202209000-00021/figure1/v/2023-08-19T002640Z/r/image-tiff

JOURNAL/jcrs/04.03/02158034-202209000-00021/figure2/v/2023-08-19T002640Z/r/image-tiff

). No other abnormalities are seen.
The scotopic pupil sizes are 6.41 and 6.73 mm. Straylight measurements are within normal limits. Higher-order aberrations (HOAs) measure for the right eye (6.03 mm pupil) 0.818 μm and for the left eye (6.17 mm pupil) 0.560 μm. The corneal Scheimpflug tomography quad maps for both eyes are shown in Supplemental Figures 1 and 2 (http://links.lww.com/JRS/A663, http://links.lww.com/JRS/A664).
What is your diagnosis or are additional diagnostic methodologies needed to establish a diagnosis? What is your treatment advice for this patient?
Comparative study of refractive and visual quality after wavefront-optimized FS-LASIK for angle kappa adjustment in dominant and nondominant eyes
Authors: Lin Shuhua , Liu Hong-Bo , Zhao Jinghua , Li Yingjun 
Published: August 2022

Purpose:
To investigate the differences between dominant and nondominant eyes in femtosecond laser–assisted laser in situ keratomileusis (FS-LASIK) with 50% angle kappa compensation on diopter and visual quality.

Setting:
University hospital.

Design:
Retrospective clinical study.

Methods:
109 patients (218 eyes, 100%) with myopia who underwent FS-LASIK were randomly selected. The preoperative pupil size, center position, and offset between the coaxially sighted corneal light reflex (P-Dist) of the patients was recorded. In preoperative and postoperative 6 months, an iTrace wavefront aberrometer was used to measure the corneal, internal optics, and total aberrations.

Results:
The 6 months postoperatively for corneal coma of the dominant eyes were 0.141 ± 0.055 μm and the nondominant eyes were 0.157 ± 0.033 μm, which was significantly greater than the dominant eyes (P = .028). The postoperative corneal coma aberration changes were positively correlated with preoperative P-Dist, the dominant eyes (r = 0.221, P = .023), and the nondominant eyes (r = 0.251, P = .009).

Conclusions:
Adjusting the angle kappa percentage in the nondominant eyes to be higher than that of the dominant eyes in individualized corneal refractive surgery may help find the ablation center closest to the visual axis.
The Clinical and Economic Burden of Tardive Dyskinesia in Israel
Authors: Barer Yael , Ribalov Rinat , Yaari Ayelet , Maor Ron , Arow Qais , Logan John , Chodick Gabriel , Arkadir David , Eitan Renana 
Published: August 2022

Abstract

Purpose/Background
Tardive dyskinesia (TD) is a hyperkinetic movement disorder caused by exposure to dopamine-receptor blockers. Data on TD burden in Israel are scarce. This analysis assesses the clinical and economic burden of TD in Israeli patients.

Methods/Procedures
This retrospective analysis used a national health plan database (Maccabi Healthcare Services), representing 25% of the Israeli population. The study included adults alive at index date with an International Classification of Diseases, Ninth Revision, Clinical Modification TD diagnosis before 2018 and more than or equal to 1-year enrollment before diagnosis. Tardive dyskinesia patients were matched to non-TD patients (1:3) by underlying psychiatric condition, birth year, and sex. Treatment patterns and 2018 annual health care resource utilization and costs were assessed.

Findings/Results
Of 454 TD patients alive between 2013 and 2018, 333 alive on January 1, 2018, were matched to 999 non-TD patients. At baseline, TD patients had lower socioeconomic status and higher proportion of chronic kidney disease and antipsychotic medication use; all analyses were adjusted accordingly. Tardive dyskinesia patients had significantly more visits to general physicians, neurologists, psychiatrists, physiotherapists, and emergency departments versus non-TD patients (all P < 0.05). Tardive dyskinesia patients also had significantly longer hospital stays than non-TD patients (P = 0.003). Total healthcare and medication costs per patient were significantly higher in the TD versus non-TD population (US $11,079 vs US $7145, P = 0.018).

Implications/Conclusions
Israeli TD patients have higher clinical and economic burden than non-TD patients. Understanding real-world health care resource utilization and costs allows clinicians and decision makers to quantify TD burden and prioritize resources for TD patients' treatment.
Prevalence and Risk Factors of Sarcopenia in Patients with Dizziness
Authors: Kamo Tomohiko , Ogihara Hirofumi , Tanaka Ryozo , Kato Takumi , Azami Masato , Tsunoda Reiko , Fushiki Hiroaki 
Published: August 2022

Objective
This study aimed to investigate the prevalence of sarcopenia and factors associated with sarcopenia in patients with dizziness.

Study Design
This is a cross-sectional study.

Patients
A total of 162 patients 65 years or older with the chief complaint of dizziness or vertigo (dizziness group) and 132 community-dwelling elderly (control group) were recruited during their visit to the otolaryngology clinic between May 2020 and October 2021.

Results
Of the 162 patients with dizziness (dizziness group), 53 (32.7%) were classified as sarcopenia according to the 2019 criteria of the Asian Working Group for Sarcopenia. There were significant differences in the prevalence of sarcopenia between the dizziness group and the control group (p < 0.01). The factors that significantly affected the sarcopenia, in order of greater odds ratio, were HADS_A, age, and DHI_Total (odds ratio = 1.223, 1.130, and 1.022, respectively).

Conclusions
The present study shows that (i) the prevalence of sarcopenia in patients with dizziness is higher than a community-dwelling elderly; (ii) patients with dizziness and sarcopenia have higher DHI_functional, DHI_emotional, DHI_total, and HADS_A compared with patients with dizziness but without sarcopenia; and (iii) age, HADS_A, and DHI were associated with sarcopenia in patients with dizziness.
Screening for Child Abuse in Children With Isolated Skull Fractures
Authors: Chen Stephanie Y. , Gao Leland , Imagawa Karen Kay , Roseman Eric R. , Shin Cathy E. , Kim Eugene S. , Spurrier Ryan G. 
Published: August 2022

Objective
Head trauma is the most common cause of death from child abuse, and each encounter for recurrent abuse is associated with greater morbidity. Isolated skull fractures (ISF) are often treated conservatively in the emergency department (ED). We determined patterns of physical abuse screening in a children's hospital ED for children with ISF.

Methods
A retrospective review was performed for children aged 3 years and younger who presented to the ED with ISF from January 1, 2015 to December 31, 2019. Children were stratified by age (<12 mo, ≥12 mo) and witnessed versus unwitnessed injury. Primary outcome was social work (SW) assessment to prescreen for abuse. Secondary outcomes were suspicion for abuse based on Child Protective Services (CPS) referral and subsequent ED encounters within 1 year.

Results
Sixty-six ISF patients were identified. Of unwitnessed injury patients aged younger than 12 months (n = 17/22), 88.2% (n = 15/17) underwent SW assessment and 47.1% (n = 8/17) required CPS referral. Of witnessed injury patients aged younger than 12 months (n = 23/44), 60.9% (n = 14/23) underwent SW assessment, with no CPS referrals. Overall, 18.2% (n = 4/22) unwitnessed and 20.5% (n = 9/44) witnessed injury patients returned to our ED: 2 were aged younger than 12 months and had recurrent trauma.

Conclusions
To decrease risk of missed physical abuse, SW consultation should be considered for all ISF patients.
Surgical Challenges in the Management of Post COVID-19 Midface Mucormycosis (PCoMM): An Institutional Protocol
Authors: Tomar Kapil , Roy Indranil Deb , Natarajan Mohan Rangan , Singh Anup Kumar , Ramanujam Vasanthanarayanan 
Published: August 2022

Background:
The coronavirus disease 2019 (COVID-19) pandemic has posed another serious threat, mucormycosis infection, affecting the maxilla and orbitocerebral region. This condition has not spared world population from its merciless claws. This article addresses the challenges faced by the maxillofacial surgeons in setting the protocols from preoperative diagnosis, surgical management to postoperative care, including short-term and long-term rehabilitation. To manage this relentlessly progressing condition, a multispecialty team approach is to be activated in diagnosing, managing, and rehabilitating the patients.

Purpose:
The purpose of this clinical study is to document and analyze the clinical and demographic data, presentation of the lesion, the diagnostic methods followed for early clinical detection, and management of post COVID-19 midface mucormycosis. The article also discusses postoperative medical management and prosthetic rehabilitation.

Results:
Most of the mucormycosis cases reporting to our center were treated and recovered patients of Severe Acute Respiratory Syndrome Coronavirus 2 infection. Thirty-four (n=34) case were operated for post COVID-19 midface mucormycosis between October 2020 and December 2021. Male to Female ratio is 1:42. The average age of the patients was 57.5 years. Maximum patients were in fifth and sixth decade of life. Maxilla was the involved bone. Treatment was primarily surgical debridement to extended or radical maxillectomy. All patients were treated with Liposomal Amphotericin B and tab posaconazole for 3 to 4 weeks depending upon the age, weight, and physiological state of the patients to attain an optimal cumulative load. Three patients succumbed to illness postoperatively (n=3, 1.02%). Average duration of hospital stay was 47 days. The average review period was 5.1 months.
INTRAPULMONARY TREATMENT WITH A NOVEL TLR4 AGONIST CONFERS PROTECTION AGAINST KLEBSIELLA PNEUMONIA
Authors: Hernandez Antonio , Zhou Jing , Bohannon Julia K. , McBride Margaret A. , Gibson-Corley Katherine N. , Patil Naeem K. , Owen Allison M. , Burelbach Katherine R. , Sherwood Edward R. 
Published: August 2022

ABSTRACT

Objectives: Nosocomial pneumonia is a common complication in critically ill patients. The goal of this study was to examine the efficacy of the Toll-like receptor 4 agonist 3-deacyl phosphorylated hexacyl disaccharide (3D PHAD), in a clinically relevant murine model of pneumonia, and assess the cellular mechanisms that mediate the protective response. Design: Mice received intrapulmonary 3D PHAD (20 μg) or vehicle for 2 consecutive days before challenge with intrapulmonary Klebsiella pneumoniae (2.3 × 103 colony-forming units). Mice were followed for 14-day survival, pulmonary K. pneumoniae burden, lung leukocyte profile, leukocyte phagocytic capacity, and cytokine production. Pneumonia severity and leukocyte recruitment were further assessed by histological evaluation. Setting: Research laboratory. Subjects: Wild-type, male C57BL/6 J mice. Interventions: Intrapulmonary treatment with 20 μg 3D PHAD for 2 consecutive days. Measurements and main results: Intrapulmonary treatment with 3D PHAD decreased lung K. pneumoniae colony-forming units and pneumonia severity with an associated improvement in survival compared with mice treated with vehicle. The numbers of neutrophils, monocytes, and macrophages in the lungs of 3D PHAD–treated mice were higher than those in vehicle-treated mice before infection but were not significantly different from vehicle-treated mice at 48 h after K. pneumoniae challenge. Lung innate leukocytes from 3D PHAD–treated mice had increased phagocytic capacity. Treatment with 3D PHAD alone increased cytokines in the lungs but decreased cytokines in plasma during K. pneumoniae pneumonia as compared with control. Conclusions: Intrapulmonary treatment with 3D PHAD augments innate immunity in the lung and facilitates resistance to K. pneumoniae pneumonia.