bluuebunny/crossref_metadata_2025_split huggingface dataset:
The epithelioid gastrointestinal stromal tumor with pulmonary metastasis
Authors: Xu Dan , Lin Xuyong , Qiu Xueshan 
Published: March 2020

Abstract

Rationale:
Available literature states that the histological subtype of the gastrointestinal stromal tumor (GIST) with pulmonary metastasis is often spindle cell type. To our knowledge, this is the first report of the GIST with pulmonary metastasis of very uncommon epithelioid subtype.

Patient concerns:
We report a 63-year-old male presenting with the symptom of bloodstained sputum without obvious inducement. The patient had no chest pain, low back pain, fatigue, fever or night sweats symptoms.

Diagnoses:
Combined chest digital radiography and the history of the patient who presented with the colon GIST of the epithelioid subtype two years ago that the mass may be a metastasis tumor. Combined with morphological and immunohistochemical staining results, a pathological diagnosis of the GIST with pulmonary metastasis was considered.

Interventions:
Right lobectomy and partial upper lobectomy were performed.

Outcomes:
The patient had not experienced any noticeable symptom and recurrent tumors at 6 months follow-up.

Lessons:
We report a rare case of the GIST with pulmonary metastasis of epithelioid subtype. This case is of great significance to the pathologist's clinical work. For pathologists, if an epithelioid tumor in the lung is found, it is necessary to check whether the gastrointestinal tract also has the tumor, which may be an epithelioid GIST with pulmonary metastasis.
Willingness to pay for a quality-adjusted life year among advanced non-small cell lung cancer patients in Viet Nam, 2018
Authors: Ha Thuy Van , Hoang Minh Van , Vu Mai Quynh , Hoang Ngoc-Anh Thi , Khuong Long Quynh , Vu Anh Nu , Pham Phuong Cam , Vu Chinh Van , Duong Lieu Huy 
Published: March 2020

Abstract
To examine the willingness to pay (WTP) for a quality-adjusted life year (QALY) gained among advanced non-small cell lung cancer (NSCLC) patients in Viet Nam and to analyze the factors affecting an individual's WTP.
A cross-sectional, contingent valuation study was conducted among 400 NSCLC patients across 6 national hospitals in Viet Nam. Self-reported information was recorded from patients regarding their socio-demographic status, EQ-5D (EuroQol-5 dimensions) utility, EQ-5D vas, and WTP for 1 QALY gained. To explore the factors related to the WTP, Gamma Generalized Linear Model and multiple logistic regression tools were applied to analyze data.
The overall mean and median of WTP/QALY among the NSCLC patients were USD $11,301 and USD $8002, respectively. Strong association was recorded between WTP/QALY amount and the patient's education, economic status, comorbidity status, and health utility.
Government and policymakers should consider providing financial supports to disadvantaged groups to improve their access to life saving cancer treatment.
Treatment of a high-energy transsyndesmotic ankle fracture
Authors: Yin Zhaowei , Wang Zitao , Ge Dawei , Yan Junwei , Jiang Chunzhi , Liang Bin 
Published: March 2020

Abstract

Introduction:
The “logsplitter injury” is a special type of ankle fractures that results from high energy violence with combined rotational forces and axial loads. So far, the diagnose and treatment of “logsplitter injury” remain largely unsettled and related literature is rare.

Patient concerns:
An 18-year-old male fell from a fence and got his left ankle injured with severe malformation and swollen condition. No open wound was observed.

Diagnosis:
Logsplitter injury, ankle fracture (AO/OTA classification 44C1.1, Lauge-Hansen classification: pronation-external rotation).

Interventions and outcomes:
The patient was initially treated by internal fixation of fibular, repair of deltoid ligaments, and 1 syndesmotic screw fixation. When the X-ray applied after surgery, another 2 syndesmotic screws were performed to enhance stability. The syndesmotic screws were removed at 12-week and 16-week respectively. The patient was allowed for full weight-bearing immediately. However, the syndesmotic space was slightly increased compared to the contralateral side in CT views at 1-year follow-up, the function outcome was satisfied.

Conclusion:
The logsplitter injury is a high-energy ankle fracture that requires both axial and rotational load. It is categorized as 44B or 44C by the AO/OTA classification. In the classification scheme of Lauge-Hansen, our case is in line with the pronation-external rotation classification. Anatomic reduction and fixation of ankle syndesmotic injuries are required to restore the biomechanics of the ankle joint so that long-term complications can be prevented. How to fixation the syndesmosis, whether to reconstruct the deltoid ligament remains in debate in the treatment of logsplitter injury, whether and when to remove the syndesmotic screws were still debated. Correct surgical intervention is successful in the treatment of “logsplitter injury”, however, the optimal fixation of syndesmosis and repair of deltoid ligaments need further investigate.
Does the ZipTightTM effective to maintain reduction after the treatment of acute acromioclavicular joint dislocation?
Authors: Kurtoglu Alper , Sukur Erhan , Cicekli Ozgur , Daldal Ismail , Kochai Alauddin , Sen Zafer , Hali Abdullah 
Published: March 2020

Abstract

Background:
The present study evaluated the functional and radiographic outcomes of acute acromioclavicular (AC) joint reconstruction performed using the mini-open technique and a knotless suspensory loop device

Methods:
A total of 25 patients (20 male and 5 female patients; mean age, 30.7 years; standard deviation, 10 years; range, 17–57 years) who fulfilled the inclusion criteria were included in the study. A functional assessment was performed using the Constant and University of California Los Angeles score. The radiologic assessment included standard anterior-posterior views of the AC and coracoclavicular (CC) distances.

Results:
The mean follow-up period was 18.6 months (range, 12–23 months). The mean Constant score was 87.2 ± 3.2, and the mean University of California Los Angeles score was 30.1 ± 2.4 at the final follow-up. Radiological evaluation at the last follow-up of the patients: Although there was no statistically significant increase in the AC and CC values of the patients (Fig. 2) at the last follow-up, the average CC value in 6 (24%) of the 25 patients was greater than 50% compared with the unaffected side CC and early postoperative CC values. However, there was no statistically significant difference in the Constant and UCLA scores between the 6 patients with reduction loss and the 19 patients with reduction maintenance (P = .86).

Conclusions:
Clinical results of fixation of acute AC joint dislocations using the ZipTightTM knotless suspensory loop device system and mini-open technique were favorable in terms of functional recovery and pain relief. However, the major disadvantage of this method was radiological loss of AC joint reduction when compared to the contralateral shoulder.
Analysis of the hemostatic therapy in liver transplantation guided by rotational thromboelastometry or conventional laboratory tests
Authors: Nascimento Jose C.R. , Neto Edson B.L. , da Silva Eliana L. , Nunes Rogean R. , Marinho David S. , Muniz Felipe N. , Praciano Andrea M. , Brasil Ivelise R.C. 
Published: March 2020

Background
Coagulopathy is quite common in chronic liver disease patients undergoing orthotopic liver transplantation (OLT). Diagnosis of intraoperative bleeding disorders is based on conventional laboratory tests (CLTs), and thus, the patients are frequently exposed to unnecessary transfusions of blood products. The present study aimed to analyze the intraoperative administration of blood products in patients undergoing OLT, using rotational thromboelastometry (ROTEM) or CLTs.

Patients and methods
A cohort comprising 153 patients undergoing OLT, of whom 82 were evaluated with ROTEM and 71 by CLTs. Both groups were analyzed intraoperatively: the transfusion of blood products.

Results
The incidence of patients transfused with cryoprecipitate (CRYO) and/or fibrinogen concentrate (54.9 vs. 19.7%; P < 0.001) and prothrombin complex concentrate (PCC) (32.9 vs. 9.9%; P = 0.008) increased significantly in the ROTEM group than in CLT group, respectively. The amount of transfused patient with CRYO (7.6 vs. 1.2; P < 0.001), fibrinogen concentrate (0.8 vs. 0.2; P = 0.004) and PCC (1.4 vs. 0.2; P = 0.002) increased significantly in the ROTEM group than in the CLT group, respectively. In the analysis of fresh–frozen plasma (FFP), the incidence of transfused patients was significantly higher in the CLT group than in the ROTEM group (46.5 vs. 30.5%; P = 0.047, respectively), with a moderate correlation with red blood cells transfusion (r = 0.67, P < 0.001). The incidence of patients receiving antifibrinolytics was significantly higher in the CLT group than in the ROTEM group (85.9 vs. 47.6%; P < 0.001, respectively).

Conclusion
Transfusion protocol-based thromboelastometry was able to guide administration of hemostatic factors and reduced administration of FFP and antifibrinolytics.
Retinal Vessel Analysis as a Novel Screening Tool to Identify Childhood Acute Lymphoblastic Leukemia Survivors at Risk of Cardiovascular Disease
Authors: Azanan Mohamad S. , Chandrasekaran Sudhashini , Rosli Erda S. , Chua Ling Ling , Oh Lixian , Chin Tong Foh , Yap Tsiao Yi , Rajagopal Revathi , Rajasuriar Reena , MacGillivray Tom , Trucco Emanuele , Ramli Norlina , Kamalden Tengku A. , Ariffin Hany 
Published: March 2020

Background:
Microvascular endothelial dysfunction is central to the pathogenesis of cardiovascular disease (CVD). The eye offers direct access for endothelial health assessment via the retinal microvasculature. The aim of the study was to investigate whether image-based retinal vessel analysis is a feasible method of assessing endothelial health in survivors of childhood acute lymphoblastic leukemia (cALL).

Materials and Methods:
Cardiovascular risk factors (CRFs) were estimated using the 30-year Framingham Risk Score in 73 childhood leukemia survivors (median age: 25; median years from diagnosis: 19) and 78 healthy controls (median age: 23). Radial arterial stiffness was measured using pulse wave analyzer, while endothelial activation markers were measured by soluble intercellular adhesion molecule 1 (sICAM-1) and soluble vascular cell adhesion molecule 1 (sVCAM-1). Retinal fundus images were analyzed for central retinal artery/vein equivalents (CRAE/CRVE) and arteriolar-venular ratio (AVR).

Results:
cALL survivors had higher CRF (P<0.0001), arterial stiffness (P=0.001), and sVCAM-1 (P=0.007) compared with controls. Survivors also had significantly higher CRVE (P=0.021) while AVR was significantly lower (P=0.026) in survivors compared with controls, compatible with endothelial dysfunction. In cALL survivors with intermediate risk for CVD, CRAE, and AVR are significantly lower, while sVCAM-1 and sICAM-1 are significantly higher when compared with survivors with low CVD risk after adjusting with covariates (age, sex, and smoking status).

Conclusions:
cALL survivors have an increased risk of CVD compared with age-matched peers. The survivors demonstrated microvasculopathy, as measured by retinal vascular analysis, in addition to physical and biochemical evidence of endothelial dysfunction. These changes predate other measures of CVD. Retinal vessel analysis may be utilized as a robust screening tool for identifying survivors at increased risk for developing CVD.
Association Between Resilience and Psychological Morbidity in Parents of Critically Ill Children*
Authors: Rothschild Charles B. , Rychlik Karen L. , Goodman Denise M. , Charleston Elizabeth , Brown Melanie L. , Michelson Kelly N. ,   for the Navigate Study Investigators
Published: March 2020

Objective:
To determine whether parental resilience, measured at ICU admission, is associated with parent-reported symptoms of depression, anxiety, posttraumatic stress, and satisfaction with ICU care 3–5 weeks following ICU discharge.

Design:
Planned prospective, observational study nested in a randomized comparative trial.

Setting:
PICUs and cardiac ICUs in two, free-standing metropolitan area children’s hospitals.

Participants:
English- and Spanish-speaking parents whose children were younger than 18 years old and had anticipated ICU stay of greater than 24 hours or Pediatric Index of Mortality score of greater than or equal to 4 at the time of consent. All ICU admissions were screened for inclusion. Of 4,251 admissions reviewed, 1,360 were eligible. Five hundred families were approached and 382 enrolled. Two hundred thirty-two parents from 210 families with complete data were included in analysis.

Interventions:
All participating parents completed the Connor-Davidson Resilience Scale at the time of consent and outcome measures 3–5 weeks after ICU discharge.

Measurements and Main Results:
All parents completed the Patient-Reported Outcome Measurement Information System Short Forms 8a for Depression and Anxiety, Impact of Event Scale-Revised for posttraumatic stress, and Pediatric Family Satisfaction-ICU 24 for parental satisfaction 3–5 weeks after ICU discharge. Higher parental resilience was associated with fewer symptoms of depression, anxiety, and posttraumatic stress in the final model (all p < 0.0001). Shorter length of stay, early mechanical ventilation, Latino ethnicity, and lower illness severity (both objective and parental perceptions) were associated with less morbidity in some or all measured mental health outcomes.

Conclusions:
Higher parental resilience is associated with fewer reported symptoms of anxiety, depression, and posttraumatic stress 3–5 weeks after ICU discharge. Parental resilience may impact parental post-ICU psychological morbidity. Measuring parental resilience could be one approach to identify parents at risk for post-ICU psychological morbidity. Future research into the impact of interventions designed to boost parental resilience is warranted.
The “RealSelf Effect”
Authors: Sanati-Mehrizy Paymon , Margulies Ilana G. , Sayegh Farah , Ingargiola Michael J. , Taub Peter J. 
Published: March 2020

Background
Whether patient driven or surgeon driven, social media can serve as a strong marketing tool to attract plastic surgery patients. At many training programs, chief residents have the opportunity to run an independent clinic, in which patients are evaluated for aesthetic and reconstructive procedures. In this study, the authors sought to investigate the downstream effect of a single positive review on a major social review site on cosmetic surgery volume.

Methods
A retrospective pre-post intervention study was performed. Operating room case logs at an urban training program were queried for purely aesthetic cases performed through the chief resident clinic in 2012 to 2018. Procedures performed by nonplastic surgery services were excluded.

Results
A total of 1734 cases met the inclusion criteria. Before the online review, aesthetic cases grew from 61 to 82 (10% compounded annual growth rate). However, after the review was posted, 107 aesthetic cases were performed in the 2016–2017 academic year, driving a 30% growth rate. A large portion of this increase in growth can be attributed to the growth in number of rhytidectomies performed.

Discussion
This study evaluated the impact of social media on the volume of aesthetic cases performed through an established chief resident clinic and its utility in patient recruitment. Chief residents had an increase in the number of aesthetic surgery cases they performed after their clinic was featured on an online social media physician review website. This further reinforces the impact social media and an online presence have on plastic surgery training.
A Multidisciplinary Technique for Concurrent Panniculectomy–Living Donor Renal Transplantation
Authors: Ngaage Ledibabari M. , Messner Franka , McGlone Katie L. , Masters Brian M. , Highstein Mallory , Chopra Karan , Phelan Michael , Singh Devinder , Scalea Joseph , Niederhaus Silke V. , Bromberg Jonathan S. , Bartlett Stephen T. , Rasko Yvonne M. 
Published: March 2020

Background
Recently, it has been shown that panniculectomy concurrent to living donor renal transplantation is a safe option for management of renal transplant recipients with a large focal pannus. This combined management requires precise coordination of teams. We describe the technique, timing, and sequence for combined renal transplantation and panniculectomy.

Methods
We conducted a retrospective chart review of adult patients (≥18 years old) who underwent simultaneous living donor renal transplantation–panniculectomy from 2015 to 2019. A multi–team approach that included urology, transplant, and plastic surgery was used to perform the combined operations. Typically, the plastic surgery team initiates the operation by performing the panniculectomy. This is followed by kidney transplantation and graft anastomosis. The plastic surgery team then completes the operation with closure of the wound.

Results
Twenty patients were identified. Most were male (12:8) with a mean age of 55 years and an average body mass index of 35 kg/m2. The mean total operative duration was 394 minutes. On average, 17% of operating time was devoted to panniculectomy. At 90 days follow-up, there was 100% graft survival and all patients had primary graft function. There was a 25% wound complications rate and a 15% reoperation rate.

Conclusion
By performing panniculectomy first in the sequence, concurrent panniculectomy provides wide exposure and a large operative field for transplantation. Wound closure by plastic surgeons may mitigate the high complication rate commonly seen in obese patients with end-stage renal disease. Future studies are needed to evaluate the cost-benefit of the combined living donor renal transplantation–panniculectomy.
Should 1 or 2 Venous Anastomoses Be Done in Microsurgical Flap Transfer?
Authors: Khan Sara , Khan Zuhera , Ali Mohsin , Shaikh Safdar Ali , Rahman Mohammad Fazlur 
Published: March 2020

Background
Venous compromise is still the most common cause of free flap failure. The need of a second venous anastomosis to prevent free flap failure is controversial. It is proposed that the use of dual venous anastomoses reduces venous compromise. However, some surgeons suggest that dual venous drainage reduces venous blood flow causing a potential risk of thrombosis.

Objective
This study aimed to compare the frequency of reexploration secondary to venous thrombosis in free flap surgeries in reconstruction of soft tissue defects with 1-vein versus 2-vein anastomosis.

Materials and Methods
We performed a retrospective cohort study including 298 flaps. In 180 of these patients, 2-vein anastomosis was done, and in 118, 1-vein anastomosis was done. The study was conducted at Aga Khan University Hospital from January 2017 to December 2018.

Results
The number of venous anastomosis was not associated with flap survival. The group with dual anastomosis required more frequent reexploration as compared with 1 venous anastomosis group (8% vs 1.7%).
Outcome and salvage rate were better in the 2-vein group as compared with the 1-vein group (64% vs 50%).

Conclusion
There is no difference in flap survival in single or dual venous anastomosis, but we have noticed higher reexploration rates in the 2-vein group. However, outcome is better in the 2-vein group.
Evaluation of Auricular Cartilage Reconstruction Using a 3-Dimensional Printed Biodegradable Scaffold and Autogenous Minced Auricular Cartilage
Authors: Min Sun-Hong , Kim Jun-Hyung , Lee Mun-Ik , Kwak Ho-Hyun , Woo Heung-Myong , Shim Jin-Hyung , Choi Da-Mi , Lee Jeong-Seok , Jeong Jae-Yong , Kang Byung-Jae 
Published: March 2020

Abstract
Auricular cartilage reconstruction represents one of the greatest challenges for otolaryngology–head and neck surgery. The native structure and composition of the auricular cartilage can be achieved by combining a suitable chondrogenic cell source with an appropriate scaffold. In reconstructive surgery for cartilage tissue, autogenous cartilage is considered to be the best chondrogenic cell source. Polycaprolactone is mainly used as a tissue-engineered scaffold owing to its mechanical properties, miscibility with a large range of other polymers, and biodegradability. In this study, scaffolds with or without autogenous minced auricular cartilage were implanted bilaterally in rabbits for auricular regeneration. Six weeks (n = 4) and 16 weeks (n = 4) after implantation, real-time quantitative reverse transcription polymerase chain reaction and histology were used to assess the regeneration of the auricular cartilage. Quantitative reverse transcription polymerase chain reaction analysis revealed that the messenger RNA expression of aggrecan, collagen I, and collagen II was higher in scaffolds with 50% minced cartilage than the scaffold-only groups or scaffolds with 30% minced cartilage (P < 0.05). Furthermore, histological analysis demonstrated significantly superior cartilage regeneration in scaffolds with the minced cartilage group compared with the scaffold-only and control groups (P < 0.05). Autogenous cartilage can be easily obtained and loaded onto a scaffold to promote the presence of chondrogenic cells, allowing for an improvement of the reconstruction of auricular cartilage. Here, the regeneration of auricular cartilage was also successful in the 50% minced cartilage group. The results presented in this study could have clinical implications, as they demonstrate the potential of a 1-stage process for auricular reconstruction.
Anatomical Classification of Tessier Craniofacial Clefts Numbers 3 and 4
Authors: Omodan Abiola , Pillay Pamela , Lazarus Lelika , Gounden Karen , Madaree Anil , Satyapal Kapil 
Published: March 2020

Background:
Craniofacial clefts are rare occurrences with an incidence of about 1.43 to 4.85 per 100,000 live births. Understanding the skeletal deformity in these clefts is basic to any reconstructive surgery of the face. This study documented the skeletal defects present in Tessier numbers 3 and 4 using anthropometric measurements to generate a subclassification which will aim to improve the means of communication between surgeons managing this anomaly.

Methods:
Seven computed tomography scans of patients who had been treated for Tessier 3 and 4 clefts between 2003 and 2017 were analyzed. Measurements of the expected defects in each cleft was taken and compared with unaffected side as the reference. Emerging patterns of their analysis was then used to generate a subclassification for these clefts. The reliability and validity of the measurements were ensured by allowing the data to be examined by both an intra- and interobserver.

Results:
The presence or absence of an alveolar cleft, the emerging patterns of comparison of the measurements of the maxilla and the orbits of the cleft side and the noncleft side as well as absence of the bone were used to arrive at a subclassification system using (a), (b), (c), (M+ O+), (M− O−), and (0).

Conclusion:
The study recommends a subclassification for Tessier clefts numbers 3 and 4 that will allow physicians anticipate the extent and the form of skeletal defects present before even seeing the patient. This can improve the communication among surgeons and team members regarding Tessier craniofacial clefts.
Pseudomyogenic Hemangioendothelioma: A Rare Vascular Tumor of the Oral Cavity
Authors: Ramos-Fuentes Hector , Ortiz-Diaz Cristina , Sifuentes-Cervantes Salvador , Castro-Núñez Jaime 
Published: March 2020

Abstract
Pseudomyogenic hemangioendothelioma is a vascular neoplasm that presents a borderline biological behavior, intermediate between entirely benign hemangiomas and highly malignant angiosarcomas. Up to date, only 1 case of this entity has been reported in the oral cavity.