bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Effects of Fasting Status on the Relative Risk of Pulmonary Aspiration in Acute Care Surgery Patients
Authors: Reed LaSala V. , Morgan Madison E. , Bradburn Eric H. , Vernon Tawnya M. , Maish George O. 
Published: July 2020

Background Acute care surgery patients are often unfasted at the time of surgery, presenting a unique opportunity to study the effects of fasting on the risk of pulmonary aspiration. We aimed to determine the relative risk of aspiration in patients who were fasted at the time of surgery according to guidelines versus those in an unfasted state. Methods A retrospective chart review of 100 patients who underwent appendectomy (n = 76) or exploratory laparotomy (n = 24) was conducted at a single institution in 2016-2017. Using the American Society of Anesthesiologists (ASA) Practice Guidelines for Preoperative Fasting, patients were stratified into study and control groups according to whether they were unfasted (nothing by mouth for <8 hours prior to surgery) or fasted (nothing by mouth for >8 hours prior to surgery). Data controlled for patients’ age, sex, body mass index (BMI), most recent hemoglobin A1c, presence of gastroesophageal reflux disease (GERD), and presence of hiatal hernia. Results Of the 76 patients who underwent appendectomy, 15% were unfasted with a total of 0 aspiration events ( P < .001). Of the 24 patients who underwent exploratory laparotomy, 42% were unfasted with a total of 0 aspiration events ( P < .001). This yields a relative risk of pulmonary aspiration of 1.0 (absolute risk of 0) in both the study and control groups. Discussion In an acute care surgery population including patients who were not fasted according to guidelines, there was no increase in the risk of pulmonary aspiration. Level of Evidence Epidemiological study; Level III.
The prominent value of apparent diffusion coefficient in assessing high-risk factors and prognosis for patients with endometrial carcinoma before treatment
Authors: Quan Quan , Lu Yunfeng , Xuan Beibei , Wu Jingxian , Yin Wanchun , Hua Yi , Chen Rongsheng , Ren Siling , Zhou Shuwei , Zhang Fenfen , Meng Yu , Rao Kunying , Mu Xiaoling 
Published: July 2020

Background To date, there are no consensus methods to evaluate the high-risk factors and prognosis for managing the personalized treatment schedule of patients with endometrial carcinoma (EC) before treatment. Apparent diffusion coefficient (ADC) is regarded as a kind of technique to assess heterogeneity of malignant tumor. Purpose To explore the role of ADC value in assessing the high-risk factors and prognosis of EC. Material and Methods A retrospective analysis was made on 185 patients with EC who underwent 1.5-T magnetic resonance imaging (MRI). Mean ADC (mADC), minimum ADC (minADC), and maximum ADC (maxADC) were measured and compared in different groups. Results Among the 185 patients with EC, the mADC and maxADC values in those with high-risk factors (type 2, deep myometrial invasion, and lymph node metastasis) were significantly lower than in those without. According to receiver operating characteristic (ROC) curve analysis, the areas under the curve (AUC) were significant for mADC, minADC, and maxADC predicting high-risk factors. Furthermore, the AUCs were significant for mADC and maxADC predicting lymph node metastasis but were not significant for minADC. Patients with lower mADC were associated with worse overall survival and disease-free survival; the opposite was true for patients with higher mADC. Conclusion Our study showed that ADC values could be applied to assess the high-risk factors of EC before treatment and might significantly relate to the prognosis of EC. It might contribute to managing initial individualized treatment schedule and improve outcome in patients with EC.
Treating patients with cancer amidst the COVID-19 pandemic: experience of a regional hospital in the Piedmont region in northern Italy
Authors: Garrone Ornella , Denaro Nerina , Ruatta Fiorella , Vanella Paola , Granetto Cristina , Vandone Anna Maria , Occelli Marcella , Cauchi Carolina , Ricci Vincenzo , Fea Elena , Di Costanzo Gianna , Colantonio Ida , Crosetto Nicola , Merlano Marco C. 
Published: July 2020

Background: The coronavirus disease 2019 (COVID-19) pandemic is posing an unprecedented dilemma to oncologists worldwide, forcing them to decide whether to continue or suspend treatments in order to protect their most vulnerable patients from infection. After the first report from China, the outbreak spread rapidly worldwide. To, date no clear indications on how to treat patients with cancer with COVID-19 infection are available. Methods: We report data on 21 patients with cancer referred to a single medical oncology unit of a general hospital from mid-March to April 23, 2020. Results: Nine patients were on active cancer therapy during the infection and all stopped medical treatments. Overall 8 patients developed pneumonia and 6 patients died of COVID-19. Conclusion: The management of patients with cancer during the pandemic should be carefully balanced and discussed among oncologists and other key professionals involved in the treatment of this vulnerable group of patients, in order to balance the risk of treatment and the risk of infection.
Cluster analysis for the identification of clinical phenotypes among antiphospholipid antibody-positive patients from the APS ACTION Registry
Authors: Zuily Stéphane , Clerc-Urmès Isabelle , Bauman Cédric , Andrade Danieli , Sciascia Savino , Pengo Vittorio , Tektonidou Maria G , Ugarte Amaia , Gerosa Maria , Michael Belmont H , Zamorano Maria Angeles Aguirre , Fortin Paul , Ji Lanlan , Efthymiou Maria , Cohen Hannah , Branch D Ware , Jesus Guilherme Ramires de , Nalli Cecilia , Petri Michelle , Rodriguez Esther , Cervera Ricard , Knight Jason S , Atsumi Tatsuya , Willis Rohan , Bertolaccini Maria Laura , Vega Joann , Wahl Denis , Erkan Doruk ,   APS ACTION Investigators
Published: July 2020

Objective This study aimed to use cluster analysis (CA) to identify different clinical phenotypes among antiphospholipid antibodies (aPL)-positive patients. Methods The Alliance for Clinical Trials and International Networking (APS ACTION) Registry includes persistently positive aPL of any isotype based on the Sydney antiphospholipid syndrome (APS) classification criteria. We performed CA on the baseline characteristics collected retrospectively at the time of the registry entry of the first 500 patients included in the registry. A total of 30 clinical data points were included in the primary CA to cover the broad spectrum of aPL-positive patients. Results A total of 497 patients from international centres were analysed, resulting in three main exclusive clusters: (a) female patients with no other autoimmune diseases but with venous thromboembolism (VTE) and triple-aPL positivity; (b) female patients with systemic lupus erythematosus, VTE, aPL nephropathy, thrombocytopaenia, haemolytic anaemia and a positive lupus anticoagulant test; and (c) older men with arterial thrombosis, heart valve disease, livedo, skin ulcers, neurological manifestations and cardiovascular disease (CVD) risk factors. Conclusions Based on our hierarchical cluster analysis, we identified different clinical phenotypes of aPL-positive patients discriminated by aPL profile, lupus or CVD risk factors. Our results, while supporting the heterogeneity of aPL-positive patients, also provide a foundation to understand disease mechanisms, create new approaches for APS classification and ultimately develop new management approaches.
Anti-recoverin antibodies indicate fundus abnormalities in systemic lupus erythematosus
Authors: Li Min , Cheng Gong , Wang Zongyi , Liu Wen , Jin Yuebo , Huang Bo , Wang Yifan , Qu Jinfeng , Shi Guixiu , Su Yin , He Jing , Li Zhanguo 
Published: July 2020

Objectives Lupus fundus abnormalities are a sight-threatening complication of systemic lupus erythematosus (SLE) and its pathogenesis remains to be studied. The aim of this study was to assess the clinical characteristics associated with the presence of anti-recoverin antibodies in patients with SLE, especially those with fundus abnormalities. Methods Seventy-six participants were enrolled, including 21 patients with fundus abnormalities (fundus group), 30 patients without fundus abnormalities (non-fundus group) and 25 healthy individuals. Serum anti-recoverin antibody levels were measured using enzyme-linked immunosorbent assay, and clinical and laboratory data were obtained from medical records. Results Compared with the non-fundus group, the fundus group had a higher incidence of hematuria ( p < 0.05). The Systemic Erythematosus Disease Activity Index (SLEDAI) score in the fundus group was significantly higher than the non-fundus group (21.48 ± 8.06 versus 10.80 ± 5.74, p < 0.001). The levels of serum anti-recoverin antibodies in the fundus group were significantly higher than the non-fundus group ( p = 0.029) or the healthy control group ( p = 0.011). Anti-recoverin-negative and -positive patients differed on a number of clinical parameters, including incidence of fever, rash, antinuclear antibody, anti-dsDNA antibody, erythrocyte sedimentation rate, immunoglobulin G, complement C3 and complement C4. The average SLEDAI score of anti-recoverin-positive patients was significantly higher than anti-recoverin-negative patients (17.73 ± 8.11 versus 12.56 ± 8.37, p < 0.05). Conclusions Anti-recoverin antibodies were related to higher disease activities in SLE, especially those with fundus abnormalities, suggesting that anti-recoverin antibodies may play an important role in the pathogenesis of fundus abnormalities in SLE.
Topography-based customized trans-epithelial phototherapeutic keratectomy for anterior corneal scar removal
Authors: Shetty Rohit , Shroff Rushad , Chhabra Aishwarya , Arora Ritu , Lalgudi Vaitheeswaran Ganesan 
Published: July 2020

Purpose: To report a case of management of a post-LASIK superficial corneal scar using a novel single-step topography-based customized phototherapeutic keratectomy (PTK). Methods: Surgical technique description. Results: Ablation was planned using Schwind Amaris® 1050RS excimer laser as decentered trans-epithelial PTK of 5 mm × 3.5 mm of 75 µm depth exactly over the area of the scar. UDVA, CDVA improved from 20/60 and 20/40 pre-operatively to 20/30 and 20/20p post-operatively. Refractive error improved from −2.5 DC @135 to +0.25 DS/−0.25 DC @75. Regularization of topography and stromal surface on ASOCT was noted with minimal hyperopic shift. Another step of ablation to address induced hyperopia was not required. Conclusion: Topography-based customized PTK appears to be an effective novel technique for the management of superficial corneal scars with minimal induced refractive change. This technique holds promise as an alternative in the targeted management of superficial corneal scars, traditionally treated by conventional PTK, without significant ablation of normal tissue.
Conjunctivitis as sole symptom of COVID-19: A case report and review of literature
Authors: Ozturker Zeynep Kayaarasi 
Published: July 2020

Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel virus causing an ongoing pandemic in 2020. Although the symptomatic patients infected by SARS-CoV-2 generally show respiratory distress, atypical manifestations such as conjunctivitis are also observed. A series of cases are reported in which reverse transcriptase polymerase chain reaction (RT-PCR) testing on tears had demonstrated the presence of the virus. However, the transmission of the virus through ocular fluids remains unknown. Case description: In this case report, the development of conjunctivitis is presented as the sole symptom of a new coronavirus disease 2019 (COVID-19) in an emergency health care worker. The patient’s first application was to the ophthalmology clinic due to redness, stinging, tearing, and photophobia for one day in the right eye. The patient had no symptoms of fever, cough, shortness of breath, or fatigue. Two days later, the RT-PCR test, blood analysis, and chest computed tomography (CT) were applied to the patient for being in contact with a COVID positive patient. Conjunctival swabs did not identify SARS-CoV-2 by RT-PCR. However, nasopharyngeal swab and blood test confirmed the diagnosis of COVID-19. Chest CT did not show pneumonia. Conclusion: This phenomenon shows that conjunctivitis may occur as a sole manifestation of COVID-19 which needs to be carefully evaluated by health care workers and eye care professionals during the pandemic.
Outcomes after anatomic reconstruction of the radioulnar ligaments for distal radioulnar joint instability
Authors: Frantz Lisa M. , Helsper Elizabeth A. , Morris Harry A. , Hearon Bernard F. 
Published: July 2020

This retrospective study investigated the clinical outcomes of patients treated for chronic distal radioulnar joint instability with open anatomic reconstruction of the palmar and dorsal radioulnar ligaments. After the midpoint of a tendon graft is anchored at the ulnar fovea, the two graft limbs traverse the distal radioulnar joint. One limb is woven into the palmar wrist capsule and the other is secured to the dorsal wrist capsule and retinaculum to stabilize the joint. Of 30 patients (31 wrists) treated with this technique, 19 were followed longitudinally for a mean of 10 years (range 3–21). In this long-term cohort, there were statistically significant improvements in ulnar-sided wrist pain on the visual analogue scale and in distal radioulnar joint stability on the dorsopalmar stress test. The modified Mayo Wrist Scores were classified as three excellent, 12 good, three fair and one poor. Of the 30 patients studied, failure occurred in four patients, two from graft rupture and two from distal radioulnar joint arthrosis. We conclude that anatomic reconstruction of the palmar and dorsal radioulnar ligaments is an effective treatment for distal radioulnar joint instability and is associated with high satisfaction and durable outcomes. Level of evidence: IV
Effect of Preoperative Frozen Shoulder on Clinical Outcomes After Arthroscopic Rotator Cuff Repair
Authors: Jeong Jeung Yeol , Shim Seung Bo , Hong Jin Ho , Im Wooyoung , Lee Sang Min , Yoo Jae Chul 
Published: July 2020

Background: A concomitant rotator cuff tear (RCT) with frozen shoulder is a common but challenging clinical scenario. The effect of frozen shoulder on clinical outcomes is open to discussion. Purpose/Hypothesis: This study aimed to evaluate the effect of preoperative frozen shoulder on postoperative clinical outcomes of an RCT. We hypothesized that the treatment results of an RCT concomitant with preoperative frozen shoulder would be comparable with those of an isolated RCT. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 212 patients were divided into 2 groups: 154 in the non–frozen shoulder (NFS) group and 58 in the preoperative frozen shoulder (FS) group. All patients underwent a thorough preoperative evaluation that included range of motion (ROM) and the pain visual analog scale, functional visual analog scale, Constant score, and American Shoulder and Elbow Surgeons (ASES) score. The same evaluation was performed at 6 months and 1 and 2 years postoperatively. The healing status of the repaired RCT of all patients was evaluated by postoperative magnetic resonance imaging. Results: The FS group showed statistically significantly worse functional outcomes than the NFS group at 6 months and 1 year postoperatively ( P < .05). At 2 years postoperatively, active assisted ROM was equivalent between the groups, although the ASES and Constant scores were significantly lower for the FS group ( P < .033 and P < .001, respectively). The retear rates were 5.3% and 12.3% for the FS and NFS groups, respectively ( P = .013). Conclusion: Preoperative frozen shoulder positively affected rotator cuff healing but negatively affected most functional outcomes, including ROM, at 6 months and 1 year postoperatively. At 2 years after surgery, there was no significant difference in active motion, but outcome scores remained lower in the FS group. For patients with preoperative frozen shoulder, a delay in surgery for additional physical therapy might not be necessary. The retear rate for the NFS group was more than double that for the FS group in the current study, which indicates that surgery for an RCT combined with frozen shoulder might provide better results in the long term because of an intact, healed rotator cuff.
Pneumonia Hospitalization Coding Changes Associated With Transition From the 9th to 10th Revision of International Classification of Diseases
Authors: Smithee Ryan B. , Markus Tiffanie M. , Soda Elizabeth , Grijalva Carlos G. , Xing Wei , Shang Nong , Griffin Marie R. , Lessa Fernanda C. 
Published: July 2020

Objectives: To evaluate the impact of International Classification of Disease, 10th revision, Clinical Modification ( ICD-10-CM) implementation on pneumonia hospitalizations rates, which had declined following pneumococcal conjugate vaccine introduction for infants in 2000. Methods: We randomly selected records from a single hospital 1 year before (n = 500) and after (n = 500) October 2015 implementation of ICD-10-CM coding. We used a validated ICD-9-CM algorithm and translation of that algorithm to ICD-10-CM to identify pneumonia hospitalizations pre- and post-implementation, respectively. We recoded ICD-10-CM records to ICD-9-CM and vice versa. We calculated sensitivity and positive predictive value (PPV) of the ICD-10-CM algorithm using ICD-9-CM coding as the reference. We used sensitivity and PPV values to calculate an adjustment factor to apply to ICD-10 era rates to enable comparison with ICD-9-CM rates. We reviewed primary diagnoses of charts not meeting the pneumonia definition when recoded. Results: Sensitivity and PPV of the ICD-10-CM algorithm were 94% and 92%, respectively, for young children and 74% and 79% for older adults. The estimated adjustment factor for ICD-10-CM period rates was −2.09% (95% credible region [CR], −7.71% to +3.0%) for children and +6.76% (95% CR, −3.06% to +16.7%) for older adults. We identified a change in coding adult charts that met the ICD-9-CM pneumonia definition that led to recoding in ICD-10-CM as chronic obstructive pulmonary disease (COPD) exacerbation. Conclusions: The ICD-10-CM algorithm derived from a validated ICD-9-CM algorithm should not introduce substantial bias for evaluating pneumonia trends in children. However, changes in coding of pneumonia associated with COPD in adults warrant further study.
Clinical value of measurable residual disease testing for assessing depth, duration, and direction of response in multiple myeloma
Authors: Martinez-Lopez Joaquin , Wong Sandy W. , Shah Nina , Bahri Natasha , Zhou Kaili , Sheng Ying , Huang Chiung-Yu , Martin Thomas , Wolf Jeffrey 
Published: July 2020

Abstract
Few clinical studies have reported results of measurable residual disease (MRD) assessments performed as part of routine practice. Herein we present our single-institution experience assessing MRD in 234 multiple myeloma (MM) patients (newly diagnosed [NDMM = 159] and relapsed [RRMM = 75]). We describe the impact of depth, duration, and direction of response on prognosis. MRD assessments were performed by next-generation sequencing of immunoglobulin genes with a sensitivity of 10−6. Those achieving MRD negativity at 10−6, as well as 10−5, had superior median progression-free survival (PFS). In the NDMM cohort, 40% of the patients achieved MRD negativity at 10−6 and 59% at 10−5. Median PFS in the NDMM cohort was superior in those achieving MRD at 10−5 vs &lt;10−5 (PFS: 87 months vs 32 months; P &lt; .001). In the RRMM cohort, 36% achieved MRD negativity at 10−6 and 47% at 10−5. Median PFS was superior for the RRMM achieving MRD at 10−5 vs &lt;10−5 (PFS: 42 months vs 17 months; P &lt; .01). Serial MRD monitoring identified 3 categories of NDMM patients: (A) patients with ≥3 MRD 10−6 negative samples, (B) patients with detectable but continuously declining clonal numbers, and (C) patients with stable or increasing clonal number (≥1 log). PFS was superior in groups A and B vs C (median PFS not reached [NR], NR, 55 respectively; P &lt; .001). This retrospective evaluation of MRD used as part of clinical care validates MRD as an important prognostic marker in NDMM and RRMM and supports its use as an endpoint in future clinical trials as well as for clinical decision making.
Treosulfan-based conditioning is feasible and effective for cord blood recipients: a phase 2 multicenter study
Authors: Milano Filippo , Gutman Jonathan A. , Deeg H. Joachim , Nemecek Eneida R. , Baumgart Joachim , Thur Laurel , Dahlberg Ann , Salit Rachel B. , Summers Corinne , Appelbaum Frederick R. , Delaney Colleen 
Published: July 2020

AbstractAlthough the use of treosulfan (TREO) in conventional donor hematopoietic cell transplantation (HCT) has been extensively evaluated, its use in cord blood transplantation (CBT) for hematologic malignancies has not been reported. Between March 2009 and October 2019, 130 CBT recipients were enrolled in this prospective multicenter phase 2 study. The conditioning regimen consisted of TREO, fludarabine, and a single fraction of 2 Gy total-body irradiation. Cyclosporine and mycophenolate mofetil were used for graft-versus-host disease prophylaxis. The primary end point was incidence of graft failure (GF), and based on risk of GF, patients were classified as low risk (arm 1, n = 66) and high risk (arm 2, n = 64). The median age was 45 years (range, 0.6-65 years). Disease status included acute leukemias in first complete remission (CR; n = 56), in ≥2 CRs (n = 46), and myelodysplastic (n = 25) and myeloproliferative syndromes (n = 3). Thirty-five patients (27%) had received a prior HCT. One hundred twenty-three patients (95%) engrafted, with neutrophil recovery occurring at a median of 19 days for patients on arm 1 and 20 days for patients on arm 2. The 3-year overall survival, relapse-free survival (RFS), transplant-related mortality, and relapse for the combined groups were 66%, 57%, 18%, and 24%, respectively. Among patients who had a prior HCT, RFS at 3 years was 48%. No significant differences in clinical outcomes were seen between the 2 arms. Our results demonstrate that TREO-based conditioning for CBT recipients is safe and effective in promoting CB engraftment with favorable clinical outcomes. This trial was registered at www.clinicaltrials.gov as #NCT00796068.