bluuebunny/crossref_metadata_2025_split huggingface dataset:
Stabilisation microbiologique des vins par utilisation de champs électriques pulsés
Authors: Davaux F. , Leroy J.-B. , Royant L. 
Published: October 2019

For more than ten years, pulsed electric field (PEF) technology has been the subject of a growing number of publications and patents. The technology previously reserved for laboratories is becoming more and more popular and is now a success in the food industry. Since 2015, with the help of the Occitania region, we have been studying the use of the PEF on the microbiological stability of wines on a semi-industrial scale from 5 to 12 hl/hour. This low thermal and energy consuming physical technology requires no inputs to ensure the destruction of microorganisms and microbial stabilization of wines. These tests are performed with a 7 kV/cm electric field generated between the 2 electrodes of the treatment chambers. The objective is to ensure the microbial stabilisation of wines not exceeding 50 ∘C and to cool the wine immediately after treatment without maintaining it at high temperature. The study of the effectiveness of PEF on yeast destruction is carried out during the mutage of sweet wines. The first results obtained show a very good efficiency of the yeast treatment with an instant cessation of alcoholic fermentation and a decrease in the yeast population ranging from − 3 to − 5 Log. No SO2 addition is then required. On wines contaminated by Brettanomyces, the tests show an almost total elimination (< 1/100 ml) of these yeasts by the PEF treatment. These tests also showed that a higher energy level is required to eliminate all lactic acid bacteria from wine. No effects on the physico-chemical characteristics of the wines were found. The impact on the organoleptic characteristics of wines is ongoing. An optimization of the electrical parameters is still necessary.
Du droit souple au droit dur : quel droit pour la qualité environnementale des vins sous indication géographique ?
Authors: Raffray R. 
Published: October 2019

Le droit du vin accompagne la réception par la filière viticole des valeurs de la Responsabilité Sociale et Environnementale. Les producteurs de vin et les pouvoirs publics recherchent un modèle plus éthique, plus performant sur le plan environnemental, compatible avec le développement durable. Les instruments juridiques utilisés ont beaucoup évolué en vingt ans. Dans un premier temps, les producteurs ont eu recours à des instruments volontaires, non contraignants, caractéristiques du droit souple (chartes éthiques, certification biologique, normes ISO). Une nouvelle règlementation est apparue en droit français. La loi prévoit, d'ici 2030, une certification environnementale, rendue obligatoire par le cahier des charges, pour tout producteur viticole exploitant sous signe de qualité (Appellation d'Origine Protégée ; Indication Géographique Protégée). Ce passage du droit volontaire (souple) au droit imposé (droit dur) est significatif de l'évolution fondamentale de la notion de qualité viticole, qui intègre la qualité environnementale. La qualité environnementale enrichit la qualité liée à l'origine.
Psychopharmaka-induzierte unerwünschte Wirkungen in der Ernährungstherapie
Authors: Schlumm Katharina , Sina Christian , Schröder Torsten , Smollich Martin 
Published: October 2019

ZusammenfassungMetabolische Effekte von Psychopharmaka sind sehr häufig – dies gilt insbesondere für appetitsteigernde Wirkungen und die Zunahme von Körpergewicht. Besonders stark mit einer Gewichtszunahme assoziiert sind Antipsychotika (Neuroleptika) und einige Antidepressiva (Mirtazapin, Lithium, Trizyklika). Resultierende metabolische Veränderungen sind häufig klinisch relevant, da sie sich negativ auf die kardiovaskuläre Morbidität und Mortalität auswirken können. Insbesondere bei Patienten unter Therapie mit Antipsychotika sollten regelmäßig Kontrolluntersuchungen durchgeführt werden (Körpergewicht, Blutdruck, Blutzuckerspiegel, Cholesterin, Leber-/Nierenfunktion). Wirkstoffspezifische metabolische Nebenwirkungen können antizipiert und durch geeignete Ernährungs- und Verhaltensinterventionen abgemildert oder verhindert werden. Alternativ sollte ärztlicherseits auch ein Wirkstoffwechsel erwogen werden, falls die Nebenwirkungen die Lebensqualität des Patienten relevant beeinträchtigen. Bei Unwirksamkeit anderer Maßnahmen zur Gewichtskontrolle kann die Anwendung von Orlistat bzw. Metformin (off-label) versucht werden.
Percutaneous endoscopic versus radiologic gastrostomy for enteral feeding: a retrospective analysis on outcomes and complications
Authors: Strijbos Denise , Keszthelyi Daniel , Gilissen Lennard P. L. , Lacko Martin , Hoeijmakers Janneke G. J. , van der Leij Christiaan , de Ridder Rogier J. J. , de Haan Michiel W. , Masclee Ad A. M. 
Published: October 2019

Abstract
Background and study aims Percutaneous endoscopic gastrostomy (PEG) and percutaneous radiologic gastrostomy (PRG) are techniques used for long-term enteral feeding. Our primary aim was to analyze procedure-related and 30-day mortality and complications between PEG and PRG in relation to indications.
Patients and methods A single-center retrospective analysis was performed thath included all adult patients receiving initial PEG (January 2008 until April 2016) and PRG (January 2010 until April 2016). Outcomes were mortality (procedure-related, 30-day), complications (early (≤ 30 days) and late) and success rates.
Results A total of 760 procedures (469 PRG and 291 PEG) were analyzed. Most common indications were head and neck cancer (HNC), cerebrovascular accident (CVA) and amyotrophic lateral sclerosis (ALS). Success rates for placement were 91.2 % for PEG and 97.1 % for PRG (P = 0.001). Procedure-related mortality was 1.7 % in PEG and 0.4 % in PRG (P = 0.113). The 30-day mortality was 10.7 % in PEG and 5.1 % in PRG (P = 0.481 after multivariate logistic regression) CVA was associated with higher 30-day mortality, whereas ALS, higher body weight, and prophylactic placements in HNC were associated with lower rates.Tube-related complications were less frequent in PEG, both early (2.7 % vs. 26.4 %, P ≤ 0.001) and late (8.6 % vs. 31.5 %, P ≤ 0.001). The percentage of major complications and infections did not differ.
Conclusions With respect to procedure-related and 30-day mortality, PEG and PRG compare equally. PRG had a higher procedural success rate. Tube-related complications and pain are less frequent after PEG compared to PRG. The choice for either PEG or PRG therefore should primarily be based on local facilities and expertise.
A novel endoscopic assessment of the gastroesophageal junction for the prediction of gastroesophageal reflux disease: a pilot study
Authors: Inoue Haruhiro , Fujiyoshi Yusuke , Abad Mary Raina Angeli , Rodriguez de Santiago Enrique , Sumi Kazuya , Iwaya Yugo , Ikeda Haruo , Onimaru Manabu , Shimamura Yuto 
Published: October 2019

Abstract
Background and aim Hiatal hernia and lower esophageal sphincter (LES) dysfunction play major roles in gastroesophageal reflux disease (GERD) pathogenesis. We developed a novel endoscopic assessment to evaluate the gastroesophageal junction (GEJ). This study aims to evaluate the feasibility of this method for the diagnostic prediction of GERD.
Methods A retrospective analysis of patients with GERD symptoms who underwent gastroscopy and esophageal pH-impedance monitoring was conducted. The novel assessment evaluated the following in retroflex view: 1) Cardiac Opening (CO): diameter of the opening of the cardia, 2) Sliding Hernia (SH): length from the diaphragmatic crus to the squamocolumnar junction, 3) Scope Holding Time% (SHT%): the percentage of time that the Scope Holding Sign (SHS) was observed out of 30 seconds. The SHS is defined as the lower esophagus holding the endoscope under excessive insufflation. The results of this assessment and that of pH-impedance monitoring were compared.
Results In total, 61 patients (mean age ± SD, 54.1 ± 16.4 years, 32 males) were enrolled. CO and SH were significantly correlated with acid exposure time (AET) (ρ = 0.36, P = 0.005, and ρ = 0.36, P = 0.004). The optimal cutoff of CO for AET > 6 % was 3 cm (Sensitivity = 72.4 %, Specificity = 46.9 %, AUC = 0.64) and that of SH was 2 cm (Sensitivity = 55.2 %, Specificity = 75.0 %, AUC = 0.70). When the population was stratified according to this cutoff, patients with CO > 3 cm and those with SH > 2 cm presented higher AET (15.1 vs 4.1 %, P = 0.037, and 23.0 vs 3.6 %, P = 0.026). Optimal cutoff of SHT% for the number of all reflux episodes > 80 was 75 % (Sensitivity = 81.8 %, Specificity = 54.6%, AUC = 0.67). Patients with SHT% < 75 % presented a higher number of all reflux episodes (88 vs 65, P = 0.014). Sensitivity, specificity, and accuracy of SHT% < 75 % for all reflux episodes > 80 were 81.8 % (95 %CI: 67.7 – 91.8), 54.5% (95 %CI: 40.4 – 64.5), and 68.2 % (95 %CI: 54.0 – 78.1).
Conclusion This novel endoscopic assessment of GEJ significantly predicted the presence of GERD and merits further testing in future studies.
Panzytopenie durch Azathioprin in Kombination mit Allopurinol
Authors: Elsner P. , Meyer J. 
Published: October 2019

ZusammenfassungEin 55-jähriger Patient mit einem seit Jahrzehnten vorbekannten systemischen Lupus erythematodes (SLE) und zahlreichen medikamentös behandelten Komorbiditäten (arterielle Hypertonie, Diabetes mellitus Typ 2, Hyperurikämie, Niereninsuffizienz, Antiphospholipid-Syndrom, venöse Thromboembolien und periphere arterielle Verschlusskrankheit) stellte sich zur Abklärung von Ulcera crurum bei einem Hautarzt vor. Der Dermatologe diagnostizierte eine Immunvaskulitis und verordnete Azathioprin (100 mg/Tag). In der Folge kam es zu einer deutlichen Verschlechterung des Allgemeinbefindens sowie zu einem Abszess am Oberschenkel; als Ursache stellte sich eine schwere Panzytopenie heraus. Während des nachfolgenden stationären Aufenthaltes wurde der Patient dialysepflichtig, entwickelte eine Pneumonie, Gerinnungsstörungen und zerebrale Infarkte mit Entwicklung einer kortikalen Blindheit. In zeitlichem Abstand traten eine akute Cholecystitis bei Cholelithiasis, eine Sepsis und zunehmende Ischämien im Bereich der hirnzuführenden Arterien mit motorischen Ausfällen, Sprachstörungen und rezidivierenden Krampfanfällen auf, die schließlich zum Tode führten.Gutachterlich festgestellt und von der Schlichtungsstelle bestätigt wurde als Ursache der Panzytopenie die behandlungsfehlerhafte Komedikation von Azathioprin mit der vorbestehenden Medikation mit Allopurinol ohne Dosisanpassung. Xanthinoxidasehemmer wie Allopurinol können die Myelotoxizität von Azathioprin erhöhen; sollte im Einzelfall eine entsprechende Kombination unvermeidbar sein, ist laut Fachinformation eine Dosisreduktion von Azathioprin auf 25 % erforderlich sowie eine engmaschige Kontrolle von Blutbild und Thrombozyten.Gerade bei multimorbiden, multimedikamentös vorbehandelten Patienten sollten bei Neuansetzen einer medikamentösen Therapie mögliche Arzneimittelinteraktionen sorgfältig überprüft werden.
Risk Factors for Impaired Patient-Reported Satisfaction and Increased Length of Hospital Stay Following Hysterectomy on Benign Indications in Premenopausal Women: a Study From the Swedish National Register for Gynecological Surgery
Authors: Borendal Wodlin Ninnie 
Published: October 2019

Abstract
Introduction The aims of the study were to evaluate the impact of intra- and postoperative complications on satisfaction one year after hysterectomy for benign conditions, to determine risk factors for low patient satisfaction and to analyze whether complications were associated with the length of hospital stay.
Material and Methods A retrospective study of 27 938 women from the Swedish National Register for Gynecological Surgery undergoing hysterectomy for benign conditions between January 2004 and June 2016. Data were obtained from prospectively collected pre-, peri- and postoperative forms. Statistical analyses were performed using multivariable logistic regression models. Crude and adjusted odds ratios and 95% confidence intervals are presented.
Results More than 90% were satisfied with the hysterectomy. Dissatisfaction was associated with complications. Pelvic pain as indication, preoperatively having less expectations to get rid of symptoms or being alleviated from surgery, and current smoking were also risk factors for low patient satisfaction. Vaginal and abdominal subtotal hysterectomies were associated with high satisfaction. Occurrence of complications intra- and postoperatively before discharge was associated with increased length of hospital stay, as well as occurrence and severity of complications reported after discharge from hospital.
Conclusions Complications were strongly associated with lower patient satisfaction. Preoperative expectations of surgery, indication, mode of surgery and life-style factors had impact on the satisfaction. Patient-centered information to ensure realistic expectations and prevention of complications seem to be essential to gain optimal patient satisfaction with surgery.
Concomitant Overlapping Acute Extradural and Subdural Hematoma
Authors: Agrawal Amit , Kumar VA Kiran , Kiran NA Sai , Kumar V Anil , Raj Busetty Prithvi 
Published: October 2019

AbstractUsually following traumatic brain injury, extradural hematoma (EDH) and subdural hematoma (SDH) appear in opposite locations, with EDH being a coup injury and SDH being a contrecoup injury. We present a case of 24-year-old male patient who had concomitant overlapping acute EDH and SDH requiring neurosurgical intervention and discuss the clinical relevance of these coexisting lesions. Concomitant overlapping EDH and SDH are uncommon lesions and need close observation and planned follow-up imaging.
Demonstration of Brain Expansion in Cases of Chronic SDH during Admission Leads to Decreased Rates of Recurrence
Authors: Yagnick Nishant S. , Moolchandani Sandeep , Sinha Sumit , Mehta V. S. 
Published: October 2019

AbstractWhile being considered a simple procedure among the wide spectrum of neurosurgical procedures, the surgical management of chronic subdural hematoma (SDH) still possesses a degree of variability. Present concepts of production versus absorption of chronic SDH fluid has led to practitioners differing in the use of drains, the treatment of inner membrane, the flushing of the subdural cavity, and the perioperative decision making for cases with comorbidities and a history of anticoagulant/antiplatelet usage. In this article, we present the management of chronic SDH over a period of 15 months using the principles followed at our center. In 60 patients of chronic SDH, with the use of drains, we waited for radiological demonstration of brain expansion before drain removal and discharge. In our experience, this has led to better prognostication and very low recurrence rates, particularly in patients with comorbidities and on anticoagulant/ antiplatelet medication.
Role of Anthropometric Nutritional Assessment in Severe Head Injury
Authors: Dhandapani Manju , Dhandapani Sivashanmugam , Agarwal Meena , Chutani Alka , Sharma Bhawani S. , Mahapatra Ashok K. 
Published: October 2019

Abstract
Aim Nutritional demand after traumatic brain injury is increased due to hypermetabolic response. The present study was undertaken to assess nutritional status with anthropometric indices, factors associated, and their prognostic role following severe head injury (SHI).
Method A total of 114 patients in age group 20 to 60 years, admitted within 24 hours of SHI, with Glasgow Coma Scale of 4 to 8, and with no serious systemic disorder were enrolled for the study. Of these, 67 were prospectively assessed weekly till 21 days for changes in mid arm circumference (MAC), mid arm muscle circumference (MAMC), and triceps skin fold thickness (TSF). They were studied in relation to other factors and outcome was assessed at 3 months.
Results The percentage fall at 3 weeks for MAC, MAMC, and TSF were 14, 10, and 37%, respectively. The percentage of fall in MAMC was the earliest, and was significantly greater in patients with surgical intervention, tracheostomy, prolonged fever, delayed enteral feeding, and greater caloric deficit. Admission MAMC < 90% of standard was significantly associated with unfavorable outcome (odds ratio 5.9 [95% confidence interval 1.3–27.8], p = 0.01). Unfavorable outcome was significantly more frequent in patients who had at least 15% fall in MAC (85.7 vs. 41.9%, p = 0.03), or 10% fall in MAMC (68.8 vs. 38.2%, p = 0.04) at 2 weeks, compared with others. Fall in TSF had no significant association with outcome at 3 months. In multivariate analysis, MAMC fall had significant independent association with unfavorable outcome.
Conclusion Bedside anthropometry (especially MAMC) is efficient in identifying patients with nutrition depletion with significant influence on outcome at 3 months.
Manipulation under Anesthesia after Knee Arthroplasty Is Associated with Worse Long-Term Clinical Outcomes and Survivorship
Authors: Crawford David A. , Adams Joanne B. , Morris Michael J. , Berend Keith R. , Lombardi Adolph V. 
Published: October 2019

AbstractThe literature is mixed on the long-term fate of knees that undergo manipulation under anesthesia (MUA). The purpose of this study is to evaluate the long-term outcomes and survivorship of patients who required a MUA after primary total knee arthroplasty (TKA) compared with a cohort of patients who did not undergo a MUA. Between 2003 and 2007, 2,193 patients (2,783 knees) underwent primary TKA with 2-year minimum follow-up; 182 knees (6.5%) had a MUA. Patients who had a manipulation were younger (p < 0.001) and had worse preoperative range of motion (ROM) (p < 0.001). Postoperative ROM, Knee Society clinical (KSC), functional, and pain (KSP) scores, revisions, and survivorship were compared between MUA and no MUA. Mean follow-up was 9.7 years. MUA patients had lower postoperative ROM (p < 0.001), change in ROM (p < 0.001), KSC (p < 0.001), KSP (p < 0.001), and change in KSP scores (0.013). Revisions occurred in 18 knees (9.9%) in the MUA group compared with 77 knees (3%) without a MUA (p < 0.001). Most common reason for revision after MUA was continued stiffness (50%). Relative risk for revision after one MUA was 2.01 (95% confidence interval [CI], 1.1–3.8, p < 0.001) and after three or more MUAs were 27.02 (95% CI, 16.5–44.1, p < 0.001). Ten-year survival after MUA was 89.4% (95% CI, 87.1–91.7%) compared with 97.2% (95% CI, 96.9–97.5%) without a MUA (p < 0.001). Patients who undergo a MUA after primary TKA may have a knee at risk with higher revision rates, worse long-term clinical scores, ROM and survivorship.
Cervicothoracic Junction Fractures Management: An Overview of Literature
Authors: Dash Chinmaya 
Published: October 2019

AbstractThe cervicothoracic junction (CTJ) is a unique area of spine and is the junction between the mobile lordotic cervical spine and the rigid kyphotic thoracic spine. It extends from C6 through T4. The fractures of the CTJ are uncommon and not well known. The article focuses on biomechanics of cervicothoracic region, management strategies of fractures of cervicothoracic region, and reviews pertinent literature.
The Intersection of Intimate Partner Violence and Substance use among Women with Opioid use Disorder
Authors: Pallatino Chelsea , Chang Judy C. , Krans Elizabeth E. 
Published: October 2019

Background Women with opioid use disorder (OUD) report high rates of intimate partner violence (IPV) and there is limited understanding of how IPV influences substance use behaviors among women with OUD. Methods Semi-structured qualitative interviews were conducted with a sample of 40 women with OUD participating in an ongoing clinical trial evaluating postpartum contraceptive utilization patterns for this population. Interviews were audio-recorded, transcribed verbatim and lasted approximately 45 min. Interview questions focused on women's perceptions and experiences with IPV and how these experiences impacted their substance use behaviors. Transcripts were coded independently in Atlas.ti and qualitatively analyzed using a general qualitative inquiry approach for emerging themes. Results Participants were aged 24–29, and the majority were white, single, unemployed, had Medicaid insurance and a high school degree. Although personal IPV experiences were not necessary to be selected for this qualitative sub-study, all participants reported some lifetime experience with IPV. Four overarching themes emerged: (1) women attributed physical IPV to their partner's substance use; (2) emotional abuse prevented women from fully engaging in their recovery; (3) financial abuse prevented women from gaining independence from abusive partners; and (4) women coped with IPV experiences through substance use. Conclusions IPV had a significant influence on women's substance use behaviors including their perceived risk of relapse and treatment discontinuation. These findings demonstrate the need to integrate assessment, evaluation and management of IPV into substance use treatment settings.
Behavioral Economic Demand for Alcohol among Young Adults who Engage in Simultaneous Alcohol and Marijuana Use
Authors: Ramirez Jason J. , Cadigan Jennifer M. , Lee Christine M. 
Published: October 2019

Background: Young adults (YAs) who engage in simultaneous alcohol and marijuana use (SAM) may combine substances due to enhanced subjective effects, and as a result, may place greater value (e.g., spend more resources) on alcohol relative to YAs who consume alcohol but do not engage in SAM. The aim of the current study was to evaluate behavioral economic demand for alcohol among YAs who reported SAM ( n = 101) relative to alcohol use only ( n = 316), and concurrent alcohol and marijuana use (CAM; n = 63). Methods: YAs (18–25 years old) recruited from the community completed an online assessment that included the Alcohol Purchase Task as well as past month alcohol, marijuana, and SAM use. Results: Analyses of covariance demonstrated that YAs who reported SAM had significantly higher Omax values (maximum overall expenditures on alcohol) than those who reported CAM, and both YAs who reported SAM and alcohol-only had significantly higher Pmax values (maximum inelastic price per drink) than YAs who reported CAM. Conclusions: YAs that engage in SAM show an increased willingness to spend resources on alcohol. Elevated demand is not associated with concurrent use of multiple substances, but rather the combined (i.e., overlapping) use of substances.