bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictors of home oxygen duration in chronic neonatal lung disease
Authors: Wong Matthew , Neylan Melissa , Williams Gordon , Zahir Syeda , Chawla Jasneek 
Published: January 2021

Aims: In infants with chronic neonatal lung disease (CNLD), we
aimed to identify predictors of home oxygen duration, predictors of
discharge oxygen flow rates and the association of oxygen flow rates
with respiratory outcomes.
Methods: Retrospective review of infants with CNLD requiring
home oxygen in 2016 and 2017. Hazard ratios (HR) were estimated from
Cox proportional hazards regression models in the cohort. A multinomial
logistic regression model examined the effects of maternal and infant
variables on discharge oxygen flow rates. Kruskal-Wallis test with
univariate linear regression and Fisher’s exact test with binomial
univariate logistic regression were used to examine associations between
oxygen flow groups and post-discharge clinical variables.
Results: 149 infants were included. Median corrected
gestational age (CGA) at oxygen cessation was 6.8 months (IQR 4.4) with
87.2% of infants weaned by 12 months CGA. Shorter initial neonatal
intensive care unit (NICU) stay predicted faster oxygen weaning at 9
months (HR 0.99, 95%CI 0.98-1.00, p=0.02) and 12 months (HR
0.99, 95%CI 0.98-1.00, p=0.02). Infants with hypercarbia at
discharge or discharged from NICU at higher CGA had higher odds of
requiring ≥200mL/min relative to ≤125 mL/min oxygen. Infants discharged
with >250mL/min oxygen were more likely to have a
respiratory related admission before two years chronologic age.
Conclusion: Shorter initial NICU stay was the best predictor
of earlier home oxygen cessation. At NICU discharge, infants with
hypercarbia or a higher CGA may require more home oxygen and experience
more respiratory related hospital admission in the first two years of
chronological age.
Heart Transplantation - Part I: General Considerations
Authors: Givertz Michael M. 
Published: January 2021

Heart failure (HF) is a major public health problem with significant associated morbidity and mortality. In 2001, the American College of Cardiology/American Heart Association (ACC/AHA) guideline committee proposed a new approach to the classification of HF that emphasized both the development and progression of disease. Stage A and B patients are at high risk for developing HF, and include those without structural heart disease (Stage A) and those with structural heart disease, but without signs or symptoms of HF (Stage B). Stage C and D patients have structural heart disease with prior or current symptoms of HF (Stage C) or refractory HF requiring specialized interventions (Stage D). Rregistries suggest that between 5% and 10% of patients with HF have advanced disease, which is associated with 1-year mortality in excess of 50% and a poor quality of life. The Heart Failure Society of America (HFSA) defines Stage D heart failure as “the presence of progressive and/or persistent severe signs and symptoms of heart failure despite optimized medical, surgical, and device therapy…generally accompanied by frequent hospitalization, severely limited exertional tolerance, and poor quality of life.” In this two-part chapter, we focus on heart transplantation, which remains the standard-of-care for highly selected patients with end-stage HF and absence of contraindications to transplant.1-5
This review contains 7 figures, 8 tables, and 46 references.
Key words: heart failure, cardiomyopathy, heart transplant, mechanical circulatory support, prognosis, pulmonary hypertension, diabetes, HLA sensitization, donor
Acute and Chronic Radiation Injury to the Lower Gastrointestinal Tract
Authors: Beard Rachel E. , Nagle Deborah 
Published: January 2021

Radiation is an integral part of therapy for many pelvic cancers, including rectal, prostate, cervical, and uterine cancers, and has been shown to decrease local recurrence and increase patient survival. Radiation injury is a sequela of treatment that manifests different symptoms depending on the organ affected. This review covers disease pathology, risk factors, disease prevention, clinical presentation, medical therapy, endoscopic therapy, and surgical therapy. Tables outline risk factors predisposing patients to the development of radiation injury, investigated prophylactic therapies to prevent radiation injury, reported frequencies of symptoms of chronic radiation proctitis, pharmacologic therapies that have demonstrated clinical benefit in randomized trials, and a scoring system for symptoms and endoscopic and histologic results. A management algorithm details evaluation and treatment of radiation-induced gastrointestinal injury. A microscopic section shows diffuse ulceration and granulation tissue formation. Photographs depict the rectal wall thickened by dense white tissue and severe perianal dermatitis. Endoscopic views of radiation proctitis with ulceration, severe radiation proctitis, mild radiation proctitis, prominent telangiectasia, anal necrosis due to radiation, actively bleeding telangiectasia, and argon plasma coagulation are provided. Other figures include computed tomographic scans of an inflamed rectum and the rectal wall with thin mucosa, and magnetic resonance imaging of the pelvis.
This review contains 13 figures, 5 tables, and 89 references.
Oral Cavity Procedures
Authors: Prince Mark E.P. , Bradford Carol R. , Krause Charles J 
Published: January 2021

The surgical management of lesions of the oral cavity is complex and requires the surgeon to consider multiple factors. Frequently a multidisciplinary team should be included in the decision-making process, particularly when a malignant lesion is being treated. Preoperative evaluation is critical in determining the optimal therapy and often will include radiologic evaluation and flexible endoscopy in addition to physical examination. Surgical decision making includes determining when a transoral approach is possible and appropriate versus a more extensive surgical approach such as a lip split and mandibulotomy. For small lesions, with a cooperative patient, local anesthesia might be adequate, but often, general anesthesia will be required. For malignant lesions, management of possible cervical node metastasis must be included in the treatment plan. Management of the airway during surgery and postoperatively must also be carefully considered. When there is concern for significant postoperative swelling or trismus, which might make reintubation difficult, tracheostomy should be considered. Primary closure can be effective for small defects. In some circumstances, a skin graft or local flaps can be successfully employed. When surgical excision results in larger defects, reconstruction must be included in the surgical plan.

This review contains 13 figures, 7 tables and 32 references
Key Words: glossectomy, lip split, oral cancer, mandibulectomy, mandibulotomy, maxillectomy, ranula, sialendoscopy
Lymphatic Mapping and Sentinel Node Biopsy
Authors: Ollila David W. , Stitzenberg Karyn B. , Gallagher Kristalyn 
Published: January 2021

With an estimated 232,670 new cases in the United States in 2014, breast cancer is among the most common malignancies treated by US surgeons. Meanwhile, the incidence of melanoma is rising faster than for all other solid malignancies, with an estimated 76,100 new cases of invasive melanoma in the United States in 2014. Over the past 20 years, significant strides have been made in the management of these two diseases from the standpoint of both surgical and adjuvant therapy. For both diseases, the presence or absence of lymph node metastases is highly predictive of patient outcome and is the most important prognostic factor for disease recurrence and cancer-related mortality. This review covers lymphatic mapping and sentinel node biopsy for melanoma, special circumstances associated with sentinel node biopsy in melanoma, lymphatic mapping and sentinel node biopsy in breast cancer, and radiation exposure guidelines and policies. The figures show lymphatic mapping and sentinel lymph node biopsy for melanoma, lymphatic mapping and sentinel node biopsy for breast cancer, and touch-imprint cytology from lymphatic mapping and sentinel node biopsy for breast cancer.

This review contains 3 highly rendered figures and 89 references.
Open Esophageal Procedures
Authors: Wright Cameron D 
Published: January 2021

The growing stature of minimally invasive approaches to esophageal diseases does not diminish the importance of the equivalent open approaches. This chapter describes common open operations performed to excise Zenker diverticulum, to manage complex gastroesophageal reflux disease, and to resect esophageal and proximal gastric tumors. For each of these open procedures, the preoperative evaluation, operative planning, steps of the operative techniques, postoperative care, complications, and outcome evaluation are described. Over two dozen figures show many of the operative steps for a cricopharyngeal myotomy and excision of Zenker diverticulum, a transthoracic hiatal hernia repair, a transhiatal esophagectomy, Ivor-Lewis esophagectomy, and a left thoracoabdominal esophagogastrectomy.

This review contains 27 figures, 21 tables, 14 references
Keywords: Zenker diverticulum, esophageal cancer, gastroesophageal reflux disease, gastric tumor, cricopharyngeal myotomy, transthoracic hiatal hernia repair, transhiatal esophagectomy, Ivor-Lewis esophagectomy, left thoracoabdominal esophagogastrectomy
Fecal Incontinence
Authors: Madoff Robert D. , Vogler Sarah A. 
Published: January 2021

Fecal incontinence, defined as the involuntary loss of gas, liquid, or solid stool through the anal canal, occurs in an estimated 18 million adults in the United States. Fecal incontinence causes social isolation and confines patients to their homes; additionally, it contributes to medical morbidity, including urinary tract infections, perianal skin breakdown, and decubitus ulcers. Causes for fecal incontinence can be broken down into three broad categories: neurologic disease; functional gastrointestinal diseases or abnormalities; and structural injuries or abnormalities in the pelvic floor, rectum, or anal sphincter. This review describes the clinical evaluation of, investigative studies related to, and management of fecal incontinence. Tables review common causes of sphincter injury, the Fecal Incontinence Severity Index, and daily life factors measured by the Fecal Incontinence Quality of Life questionnaire. Figures show an obstetric sphincter injury, an algorithm outlining the workup and management of fecal incontinence, ultrasonograms of a normal anal sphincter and a sphincter defect, the steps involved in sphincteroplasty, sacral nerve stimulation, and an artificial anal sphincter.
This review contains 6 figures, 3 tables, and 54 references.
Lower Extremity Amputation for Ischemia
Authors: Pevec William C. 
Published: January 2021

Major amputations (proximal to the ankle) of the lower extremity are the manifestations of end-stage, nonreconstructable chronic arterial occlusive disease. A well-performed amputation provides the patient with the best prognosis for return to functional mobility. However, an amputation that fails to heal primarily may cause substantial physical and psychological harm to an already chronically ill patient. Minor amputations (at the toe or forefoot level) are not technically complex, but poor patient selection or technical imperfection can result in major amputation and loss of independent ambulation. In this chapter, selection of the level of amputation is reviewed; the methods to perform digital, forefoot, transtibial, and transfemoral amputations are presented; and postoperative management and potential complications are discussed.

Key Words: above-the-knee amputation, below-the-knee amputation, Guillotine amputation, ray amputation, transmetatarsal amputation, transphalangeal amputation
This review contains 10 figures, 1 table and 22 references
Substance Use Disorders in the Surgical Patient
Authors: Alarhayem Abdul Q , Keric Natasha , Dent Daniel L. 
Published: January 2021

Large bodies of evidence link alcohol consumption and substance use disorders (SUDs) with motor vehicle collisions, as well as life-threatening intentional injury. According to the substance use and mental health estimates from the 2013 National Survey on Drug Use and Health, 24.6 million individuals age 12 or older were current illicit drug users in 2013, including 2.2 million adolescents age 12 to 17, and 60.1 million individuals age 12 or older were binge drinkers in the past month. Many people with SUDs become patients; therefore, the surgeon must be able to recognize and manage many of the related issues that can ensue. This review details the definition of SUDs, basic principles of toxicology, acute management of the patient with suspected substance use intoxication or withdrawal, managing life-threatening syndromes in patients with SUDs, overdose and withdrawal syndromes of opioids, stimulants, and depressants, surgical complications of SUDs, perioperative and postoperative considerations in patients with SUDs, and consultation and referral to a toxicologist and poison control center. Figures show first- and zero-order kinetics; pupillary examination, laboratory and radiographic findings in SUDs; polymorphic ventricular tachycardia; consciousness as an interplay between arousal and awareness, an algorithm for the management of seizures, sine, mechanism of cocaine’s cardiac toxicity and hemorrhagic stroke in a cocaine abuser, necrotizing soft tissue infection, digit necrosis associated with intra-arterial injection of cocaine, scars from skin popping, nonocclusive thrombus in the left internal jugular vein, needle fracture with soft tissue dislodgment, oral contrast-enhanced computed tomographic scan showing rounded foreign bodies in the stomach, and fecal impaction associated with heroin. Tables list criteria for substance use disorders according to the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-V), frequently misused drugs, causes of death in SUD, cardiac, neurologic, and metabolic signs and symptoms caused by commonly abused substances , anion and osmolar gap equations, life-threatening manifestations of cocaine toxicity, and alcohol-related disorders.
This review contains 15 figures, 8 tables, and 85 references.
Trauma Imaging
Authors: Gross Joel A. , Gunn Martin L. , Fink Kathleen R. 
Published: January 2021

Due to increased use of computed tomography (CT) and ultrasonography, technological advances in equipment design, and increased availability of imaging equipment in the emergency department, imaging studies have revolutionized the assessment of the trauma patient in the past three decades. This review examines commonly used imaging modalities in trauma evaluation, initial and additional imaging, brief introduction to CT, and an overview of CT image processing and reviewing a CT scan. Head imaging, spine imaging, chest imaging, and abdominal and pelvic imaging are presented, along with injury grading, solid-organ injury appearances and specific abdominal solid-organ injuries, urinary system injury, penetrating trauma, unexplained intraperitoneal fluid, vascular injury and musculoskeletal injury. Figures show lateral view of the cervical spine; volume rendering of the pelvis; CT windows; CT imaging of acute intracranial bleeding, herniation in acute subdural hemorrhage, post-traumatic pseudoaneurysm of descending thoracic aorta, subscapular hematoma of the liver, liver laceration, pseudoaneurysm of the liver, shattered kidney and the nonperfused right kidney attributable to a traumatic renal artery injury, tigroid spleen, a focus of gas and stranding adjacent to the lateral wall of the ascending colon, extravasated urinary contrast (white material) surrounding the proximal right indicating ureteral laceration or transection, intraperitoneal bladder rupture, and contrast extravasation in the liver; magnetic resonance imaging versus CT of shear injuries; and magnetic resonance imaging in the setting of cervical spine trauma.
This review contains 18 highly rendered figures, 23 tables, and 83 references.
Keywords:Trauma, computed tomography, radiography, magnetic resonance imaging, ultrasonography, imaging study
Perioperative Management of Patients on Steroids Requiring Surgery
Authors: Reiher Alexandra , Sippel Rebecca S. , Elfenbein Dawn M. 
Published: January 2021

Patients with chronic lung disease, inflammatory bowel disease, rheumatoid arthritis, and solid-organ transplantations are often on steroid supplementation either intermittently or chronically. Endogenous steroid use results in decreased adrenocorticotropic hormone secretion by the pituitary gland through negative feedback mechanisms. Over several weeks, this can result in adrenal gland atrophy, eventually leading to secondary adrenal insufficiency. Appropriate management of perioperative glucocorticoid replacement therapy can be challenging, but appropriate replacement is essential to optimize patient outcomes. Insufficient dosing of glucocorticoids during the perioperative period can result in hypotension and even death. Excessive treatment with glucocorticoids decreases wound healing, increases the risk of hyperglycemia, and increases susceptibility to infection. This review covers the historical perspective, the hypothalamic-pituitary-adrenal (HPA) axis, when to suspect an impaired HPA axis, an argument against supraphysiologic glucocorticoid treatment in the perioperative period, the rationale for treating patients with impaired renal function, guidelines for dosing glucocorticoids in the perioperative period, and consulting a specialist. Figures show a clinical algorithm for evaluation and treatment of adrenal insufficiency in the perioperative period and the HPA axis. Tables list steroid conversions and perioperative glucocorticoid treatment recommendations.

This review contains 2 highly rendered figures, 2 tables, and 22 references.
Transplant Immunology: Basic Immunology and Clinical Practice
Authors: Foley David P , Lee Lung-Yi 
Published: January 2021

Engraftment of a transplanted organ into an allogeneic host triggers a cascade of immunologic responses in the host that are designed to facilitate graft rejection. Modern donor-to-host matching techniques and immunosuppression protocols have successfully tempered this natural immune response so that graft survival has dramatically improved. However, optimizing graft survival by precisely downregulating the host response to graft rejection while preserving host immune defenses against pathologic and infectious agents remains poorly understood and elusive in current clinical practice. This review discusses transplant immunology with respect to host versus graft and the basis of allorecognition, as well as clinical management of the transplanted allograft. Figures show human leukocyte antigen (HLA), direct allorecognition, T cell receptor and CD3, T cell–associated second messenger signaling pathway, CD8 molecules directly ligating class I HLAs and CD4 molecules directly binding HLA class II, detection of alloantibodies by enzyme-linked immunosorbent assay or flow cytometry, recipient-donor crossmatch, histopathology of kidney allograft with antibody-mediated rejection, and an algorithm for assessment and management of renal allograft rejection.
This review contains 9 figures, 6 tables and 61 references.
Keywords: Transplantation, immunology, human leukocyte antigen, crossmatch, donor, acute rejection, chronic rejection
The Diabetic Surgical Patient
Authors: Layba Cathline , Griffin Lance 
Published: January 2021

Diabetes mellitus is the seventh leading cause of death in the United States; diabetic patients have a 50% chance of undergoing a surgical procedure during their lifetime, and operations in this patient population have been associated with a reported mortality of 4% to 13%. Careful planning of operative management and perioperative care must be taken into account when scheduling surgery for diabetic patients, especially patients taking insulin or oral hypoglycemic agents. Debate continues and inconsistencies remain regarding the management of both diabetes and hyperglycemia in the surgical setting. The review covers the evaluation of the diabetic patient, preoperative management, intraoperative management, postoperative management, total parenteral nutrition and blood glucose, cardiovascular and renal assessment, infection, and special populations.
This review contains 2 figures, 5 tables, and 21 references
Keywords: Glucose, Hyperglycemia, perioperative period, surgery, diabetes mellitus, surgical site infection, preoperative management, postoperative management, wound healing
Gallbladder and Biliary Tree
Authors: Gray Stephen 
Published: January 2021

Understanding gallbladder and biliary anatomy is paramount to the surgeon. A comprehensive understanding of the gallbladder and biliary tree is necessary to properly treat a variety of surgical pathologies. Understanding the usual anatomy and the variations will help prevent iatrogenic biliary injuries. Moreover, anatomic consideration dictates oncologic therapies for gallbladder and biliary tract malignancies.
Key words: bile duct, bile salts, biliary tree, cholecystectomy, gallbladder
The Duodenum
Authors: Ronnekleiv-Kelly Sean , Burkhart Richard A 
Published: January 2021

The duodenum is the first part of the small intestine that arises from the embryologic foregut and midgut. With maturation, it lies mostly retroperitoneal and is intimately associated with nearby structures such as the pancreas, hepatoduodenal ligament, and transverse colon mesentery. It is well vascularized with a rich lymphatic network and supports digestive, absorptive, immune, and endocrine functions. The duodenum receives food bolus from the stomach and releases various hormones important for regulating motility and gastric acid secretion. In the duodenum, food content mixes with bile and pancreatic enzymes to continue digestion of and initiate absorption for fats, carbohydrates, proteins, and vitamins and minerals. The duodenum experiences substantial exposure to the external environment and therefore contains an extensive immune barrier, including mucosa-associated lymphoid tissue. Additionally, there is a significant neuroendocrine network within the duodenum and small intestine that possesses a variety of endocrine functions, including regulation of acid secretion, motility, pancreatic function, bile flow, and mucosal cell growth. These enterochromaffin cells are the source duodenal neuroendocrine tumors (carcinoid) and can be classified according to subtype or grade. The duodenum is a diverse component of the small intestine that is uniquely suited to its numerous functions.
Key words: absorption, acid secretion, anatomy, digestion, duodenum, intestinal immune system, microstructure, motility, mucosa-associated lymphoid tissue, neuroendocrine
Endovascular Procedures For Lower Extremity Vascular Disease: Specifics of Endovascular Treatment
Authors: Jayakumar Lalithapriya , Davies Mark 
Published: January 2021

The application of endovascular procedures to lower-extremity vascular disease is well established for many common vascular diseases and has often supplanted conventional open surgical approaches. Endovascular therapy for arterial disease in the lower extremity encompasses treatment of acute ischemia, chronic ischemia, and aneurysmal disease. The fundamental skill set and techniques employed are common to all these processes. This chapter details the management of chronic ischemia, acute lower-extremity arterial ischemia, pseudoaneurysms and aneurysms, and arteriovenous malformations.
Key words: access closure, access complications, acute limb ischemia, aneurysm endovascular treatment, chronic limb ischemia, intravascular ultrasonography, lower-extremity angiogram, lower limb ischemia, percutaneous transluminal angioplasty, transcollateral access, transpopliteal access