bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dye chromoendoscopy leads to a higher adenoma detection in the duodenum and stomach in patients with familial adenomatous polyposis
Authors: Strassburg C. P. , Nattermann J. , Hüneburg R. , Heling D. , Kaczmarek D. J. , van Heteren P. , Olthaus M. , Fimmers R. , Berger M. , Coch C. , Lau J. F. , Kristiansen G. , Weismüller T. J. , Spier I. , Aretz S. 
Published: September 2020

Abstract
Backround and study aims Duodenal cancer is the cancer most often seen in patients with familial adenomatous polyposis (FAP) who have undergone risk-reducing colonic surgery. Almost all patients with FAP eventually develop duodenal adenomas and risk for duodenal cancer is up to 12 % with poor prognosis. In addition, there is a rising concern regarding increased gastric cancer risk in patients with FAP. Our aim was to enhance polyp detection by using CE (CE) with the application of indigo carmine dye.
Patient and methods We conducted a prospective, blinded study of patients with FAP undergoing endoscopic examination of the upper gastrointestinal tract. First, a standard white-light examination (WLE) was done followed by an examination performed by an endoscopist who was blinded to the previous examination, using chromoendoscopy (CE) (0.4 % indigo carmine dye).
Results Fifty patients were included in the study. Using WLE, a median number of 13 adenomas (range 0–90) was detected compared to 23 adenomas/patient (range 0–150; P < 0.0001) detected after staining, leading to a higher Spigelman stage in 16 patients (32 %; P = 0.0003). CE detected significantly more larger adenomas (> 10 mm) than WLE (12 vs. 19; P = 0.0391). In the gastric antral region, a median number of 0 adenomas (range 0–6) before and 0.5 adenomas (range 0–7) after staining (P = 0.0025) were detected.
Conclusion This prospective endoscopic trial, to our knowledge the largest in patients with FAP, showed a significant impact of CE on adenoma detection and therapeutic management in the upper gastrointestinal tract. This leads to more intensive surveillance intervals.
Can high-frequency mini-probe endoscopic ultrasonography predict outcome of endoscopic dilation in patients with benign esophageal strictures?
Authors: Daniel Philip , Samanta Jayanta , Gulati Ajay , Gupta Pankaj , Muktesh Gaurav , Sinha Saroj K. , Kochhar Rakesh 
Published: September 2020

Abstract
Background and study aims Endoscopic dilation is first-line management for benign esophageal strictures (ES). Depth of involvement of the esophageal wall on endosonography using high frequency mini-probe (EUS-M) may predict response to dilation. This study evaluated EUS-M characteristics to predict response of ES to endoscopic dilation.
Patients and methods EUS-M was used to measure the total esophageal wall thickness (EWT), involved EWT, percentage of involved wall and layers of wall involved in consecutive patients of benign ES. After a maximum of five sessions of endoscopic dilation, the cohort was divided into responders and refractory strictures. EUS-M characteristics were compared for underlying etiology as also between responders and refractory strictures.
Results Of the 30 strictures (17 females, age: 47.16 ± 15.86 yrs.) 13 were anastomotic, eight corrosive, seven peptic and 2 others. Corrosive strictures had the highest involved EWT and percentage of involved wall (3.51 ± 1.36 mm; 76.38 %) followed by anastomotic (2.73 ± 1.7 mm; 65.54 %) and peptic (1.39 ± 0.62 mm; 40.71 %) (P = 0.026 and 0.021 respectively). After five dilations, 22 were classified as responders and eight as refractory. Wall involvement > 70 % had a greater proportion of refractory strictures (P = 0.019). Strictures with involved EWT of ≥ 2.85 mm required more dilations (P = 0.011). Fewer dilations were required for stricture resolution with only mucosal involvement compared to deeper involvement such as submucosa and muscularis propria (2.14 vs. 5.80; P = 0.001).
Conclusion EUS-M evaluation shows that corrosive and anastomotic strictures have greater depth of involvement compared to peptic strictures. Depth of esophageal wall involvement in a stricture predicts response to dilation.
Physician sentiment toward artificial intelligence (AI) in colonoscopic practice: a survey of US gastroenterologists
Authors: Wadhwa Vaibhav , Alagappan Muthuraman , Gonzalez Adalberto , Gupta Kapil , Brown Jeremy R. Glissen , Cohen Jonah , Sawhney Mandeep , Pleskow Douglas , Berzin Tyler M. 
Published: September 2020

Abstract
Background and study aims Early studies have shown that artificial intelligence (AI) has the potential to augment the performance of gastroenterologists during endoscopy. Our aim was to determine how gastroenterologists view the potential role of AI in gastrointestinal endoscopy.
Methods In this cross-sectional study, an online survey was sent to US gastroenterologists. The survey included questions about physician level of training, experience, and practice characteristics and physician perception of AI. Descriptive statistics were used to summarize sentiment about AI. Univariate and multivariate analyses were used to assess whether background information about physicians correlated to their sentiment.
Results Surveys were emailed to 330 gastroenterologists nationwide. Between December 2018 and January 2019, 124 physicians (38 %) completed the survey. Eighty-six percent of physicians reported interest in AI-assisted colonoscopy; 84.7 % agreed that computer-assisted polyp detection (CADe) would improve their endoscopic performance. Of the respondents, 57.2 % felt comfortable using computer-aided diagnosis (CADx) to support a “diagnose and leave” strategy for hyperplastic polyps. Multivariate analysis showed that post-fellowship experience of fewer than 15 years was the most important factor in determining whether physicians were likely to believe that CADe would lead to more removed polyps (odds ratio = 5.09; P = .01). The most common concerns about implementation of AI were cost (75.2 %), operator dependence (62.8 %), and increased procedural time (60.3 %).
Conclusions Gastroenterologists have strong interest in the application of AI to colonoscopy, particularly with regard to CADe for polyp detection. The primary concerns were its cost, potential to increase procedural time, and potential to develop operator dependence. Future developments in AI should prioritize mitigation of these concerns.
The Art of Detecting Antibodies against Factor VIII
Authors: Tiede Andreas , Alberio Lorenzo 
Published: September 2020

AbstractAntibodies against factor VIII (FVIII) can be detected based on their ability to neutralize the procoagulant activity of FVIII (neutralizing antibodies, inhibitors), or based on their specific binding capacity to FVIII protein. This article reviews the available assays and their clinical interpretation in patients with congenital and acquired hemophilia.
Translating Laboratory Tests into Clinical Practice: A Conceptual Framework
Authors: Nagler Michael 
Published: September 2020

AbstractThe use of laboratory biomarkers in clinical practice is rapidly increasing. Laboratory tests are, however, rarely evaluated adequately before implementation, and the utility of many tests is essentially unclear. An important reason for this knowledge gap is that a comprehensive and generally accepted methodological framework supporting evaluation studies is essentially lacking. Researchers, clinicians, and decision-makers are often not aware of the methodological tools available and face problems with the appraisal of a test's utility. With the present article, I aim to summarize current concepts and methodological tools and propose a framework for a phased approach that could be used in future evaluation projects. Future research will refine this suggested framework by identifying problems in current evaluation projects, specifying methodological criteria for all phases, as well as developing advanced methodological tools.
An international survey on recognition and characterization of atrophic gastritis and intestinal metaplasia
Authors: Yip Hon Chi , Uedo Noriya , Chan Shannon M. , Teoh Anthony Yuen Bun , Wong Simon Kin Hung , Chiu Philip W. , Ng Enders Kwok Wai 
Published: September 2020

Abstract
Background and study aims Atrophic gastritis (AG) and intestinal metaplasia (IM) are premalignant conditions of gastric cancer and endoscopic recognition and characterization may help in stratifying the gastric cancer risk for screening and surveillance. However, there is currently lack of consensus in defining the severity of AG and IM. We aimed to conduct an international survey to understand the current practice of endoscopists worldwide.
Methods An online survey was designed to collect data regarding participants’ practice in endoscopic assessment of AG & IM. A test using images was conducted to evaluate the difference in accuracy of characterization of AG & IM.
Results From July to October 2017, 249 endoscopists responded to the survey. Around 70 % of participants received some form of training on recognition of AG & IM. There was significant variety in the training received across different continents. One hundred seventy-six participants (70 %) would document the presence of both AG and IM, but the classification systems used were inconsistent between endoscopists. Overall accuracy in diagnosis of AG & IM in the image test was 84.5 % and 80.7 % respectively. The diagnostic accuracy was significantly higher among Japanese and Korean endoscopists compared to the rest of the world.
Conclusion Training regarding endoscopic recognition of AG & IM differs significantly in different parts of the world. The difference in diagnostic accuracy for these premalignant gastric conditions may also explain the discrepancy in the early cancer detection rates among different countries. A simple unified classification system may be beneficial for better stratification of cancer risks.
Manual für Methoden und Nutzung versorgungsnaher Daten zur
Wissensgenerierung
Authors: Klinkhammer-Schalke Monika , Kaiser Thomas , Apfelbacher Christian , Benz Stefan , Dreinhöfer Karsten E. , Geraedts Max , Hauptmann Michael , Hoffmann Falk , Hoffmann Wolfgang , Koller Michael , Kostuj Tanja , Kowalski Christoph , Mugele Katrin , Ortmann Olaf , Schmitt Jochen , Schünemann Holger , Veit Christof , Wesselmann Simone , Bierbaum Thomas 
Published: September 2020

ZusammenfassungFür die Nutzung vorhandener Versorgungsdaten gibt es immer mehr gute
Gründe, wobei v. a. die Nutzung von Registerdaten im Fokus
steht. Das zugehörige, klar strukturierte methodische Vorgehen ist
bisher noch unzureichend zusammengeführt, aufbereitet und
transparent dargestellt. Das Deutsche Netzwerk Versorgungsforschung (DNVF)
hat deswegen eine Ad hoc Kommission zur Nutzung versorgungsnaher Daten
(RWE/RWD) ins Leben gerufen. Der vom IQWiG erstellte Rapid Report
über die wissenschaftliche Ausarbeitung von Konzepten zur
„Generierung versorgungsnaher Daten und deren Auswertung zum Zwecke
der Nutzenbewertung von Arzneimitteln nach § 35a SGB V“ ist
ein wesentlicher Schritt für die Nutzung von Registerdaten zur
Evidenzgenerierung. Das vom DNVF 2020 veröffentlichte
„Memorandum Register – Update 2019“ beschreibt
Anforderungen und methodische Grundlagen von Registern. Best Practice
Beispiele aus der Onkologie, die auf dem einheitlichen onkologischen
Basisdatensatz für die Klinische Krebsregistrierung (§ 65c
SGB V) beruhen, zeigen z. B., dass im Sinne einer
wissensgenerierenden Versorgungsforschung mithilfe von Registerdaten
Leitlinien überprüft sowie Empfehlungen für
Leitlinien und notwendige Interventionen abgeleitet werden können.
Gleichzeitig fehlen jedoch klare Qualitätsanforderungen und
strukturierte formale und inhaltliche Vorgehensweisen in den Bereichen
Datenzusammenführung, Datenprüfung und Nutzung spezifischer
Methoden je nach vorhandener Fragestellung. Die bisher uneinheitlichen
Vorgaben sollen aufgearbeitet und ein Methoden-Leitfaden zur Nutzung
versorgungsnaher Daten entwickelt und veröffentlicht werden. Das
erste Kapitel des Manuals zu Methoden versorgungsnaher Daten
erläutert Zielstellung und Struktur des Manuals. Es wird dargelegt,
warum die Verwendung des Begriffes „Versorgungsnahe Daten
(VeDa)“ zielführender ist als die Nutzung der Begriffe Real
Word Data (RWD) und Real World Evidence (RWE). Mit der Vermeidung des
Begriffes „Real World“ soll insbesondere unterstrichen
werden, dass auch qualitativ hochwertige Forschung auf Versorgungsdaten
aufsetzen kann (z. B. registerbasierte vergleichende Studien).
Impacto subespinhal do quadril: Resultados clínicos e radiográficos do tratamento artroscópico
Authors: Roos Bruno Dutra , Roos Milton Valdomiro , Camisa Júnior Antero , Lima Ezequiel Moreno Ungaretti , Fontana Mariano Feraboli , Okamoto Roger Pires 
Published: September 2020

ResumoObjetivo Avaliar os resultados clínicos e radiográficos assim como as complicações relacionadas a pacientes submetidos ao tratamento artroscópico do impacto subespinhal do quadril.Métodos Foram avaliados retrospectivamente 25 pacientes (28 quadris) submetidos ao tratamento artroscópico de impacto subespinhal entre janeiro de 2012 e junho de 2018. O seguimento médio foi de 29,5 meses, e os pacientes foram avaliados clinicamente pelo Harris hip score modificado por Byrd (MHHS), o non-arthritic hip score (NAHS), e quanto à rotação interna e flexão do quadril. Além disso, foram avaliados por exames de imagem: o ângulo center-edge (CE) acetabular, o ângulo alfa, a presença de sinal da parede posterior, o grau de artrose, a presença de ossificação heterotópica do quadril e a classificação de Hetsroni para Impacto Subespinhal.Resultados Observou-se aumento médio pós-operatório de 26,9 pontos para o MHHS, 25,4 para o NAHS (p < 0,0001), 10,5° na rotação interna (p < 0,0024) e 7,9° para flexão do quadril (p < 0,0001). Quanto à avaliação radiográfica, observou-se redução média de 3,3° no ângulo CE e de 31,6° para o ângulo alfa (p < 0,0001). Foram classificados 18 casos (64,3%) como artrose grau 0 de Tönnis e 10 (35,7%) como Tönnis 1. Dois casos (7,1%) apresentaram ossificação grau 1 de Brooker. A maioria dos quadris (n = 15; 53,6%) foi classificada como tipo II de Hetsroni et al.Conclusão No presente estudo, os pacientes submetidos a tratamento artroscópico de impacto subespinhal apresentaram melhora nos aspectos clínicos e nos padrões radiográficos aferidos pós-operatoriamente, com seguimento médio de 29,5 meses.
How to Design and Harvest a Propeller Flap
Authors: Pignatti Marco , Pinto Valentina , Docherty Skogh Ann-Charlott , Giorgini Federico Armando , Cipriani Riccardo , De Santis Giorgio , Hallock Geoffrey G. 
Published: September 2020

AbstractPropeller flaps are local flaps based either on a subcutaneous pedicle, a single perforator, or vessels entering the flap in such a way so as to allow the flap to rotate on their axis. Depending on the kind of pedicle and the anatomical area, the preoperative investigation and the harvesting techniques may vary.An adequate knowledge of skin and subcutaneous tissue perfusion in the different areas of the body is very important to plan a propeller flap to be successful.The surgeon should begin by finding the most suitable perforators in the area surrounding the defect using available technology. The position, size, and shape of the flap are planned about this point.For perforator-pedicled propeller flaps, the procedure starts with an exploration from the margins of the defect or through a dedicated incision to visualize any perforators in the surroundings. The most suitable perforator is selected and isolated, the skin island is replanned, and the flap is harvested and rotated into the defect. The variations in surgical technique for other types of propellers and in specific anatomical areas are also described.Compared with free flaps, propeller flaps have the advantage of a simpler, shorter operation, without the need for a recipient vessel for microanastomosis.Yet, from a technical point of view, an adequate experience in dissecting perforators and the use of magnifying glasses are almost always required.
Rectovaginal Fistulas Secondary to Obstetrical Injury
Authors: Dawes Aaron J. , Jensen Christine C. 
Published: September 2020

AbstractRectovaginal fistula (RVF), defined as any abnormal connection between the rectum and the vagina, is a complex and debilitating condition. RVF can occur for a variety of reasons, but frequently develops following obstetric injury. Patients with suspected RVF require thorough evaluation, including history and physical examination, imaging, and objective evaluation of the anal sphincter complex. Prior to attempting repair, sepsis must be controlled and the tract allowed to mature over a period of 3 to 6 months. All repair techniques involve reestablishing a healthy, well-vascularized rectovaginal septum, either through reconstruction with local tissue or tissue transfer via a pedicled flap. The selection of a specific repair technique is determined by the level of the fistula tract and the status of the anal sphincter. Despite best efforts, recurrence is common and should be discussed with patients prior to repair. As the ultimate goal of RVF repair is to minimize symptoms and maximize quality of life, patients should help to direct their own care based on the risks and benefits of available treatment options.
Conversion Total Hip Arthroplasty with a Direct Anterior Approach for Failed Treatment of Acetabular Fractures
Authors: Yun Andrew G. , Qutami Marilena , Dylan Pasko Kory B. 
Published: September 2020

AbstractTotal hip arthroplasty (THA) is a salvage procedure after failed treatment of acetabular fractures. Technical challenges increase the risk of perioperative complications, specifically nerve palsy and dislocation. The direct anterior approach (DAA) was evaluated to mitigate these risks. Clinical and radiographic outcomes were reviewed retrospectively. Thirteen patients underwent conversion THA. Of the 13, nine had been treated with open reduction internal fixation (ORIF), one with traction, and three conservatively. When possible, retained hardware was deliberately left in place. At a mean follow-up of 4 years, there were no major complications, readmissions, revisions, or deaths. Two nonunions managed with autografting went on to union. The mean HOOS (hip disability and osteoarthritis outcome) Jr score at follow-up was 89. These data suggest that the DAA may be a reasonable alternative to the posterior approach in this high-risk population.
Partial Anomalous Pulmonary Venous Return Diagnosed by Central Catheter Misplacement
Authors: Reichert Lena , Bougioukas Ioannis , Seipelt Ralf , Huwer Hanno 
Published: September 2020

AbstractAnomalous venous connections of the left lung can either affect all of the veins or only the upper lobe. They mostly drain into the innominate vein. We present the case of a patient who underwent a coronary bypass operation and was prepared with insertion of central lines including Swan-Ganz catheter through both the internal jugular veins. Blood gas analysis obtained from these catheters suggested the presence of a left-to-right shunt. CT (computed tomography) imaging confirmed a pulmonary venous anomaly with misplacement of the left-sided catheter in an abnormal pulmonary vein. Such a rare condition can be suspected by obtaining arterialized blood samples and measuring the mean pressure through central catheters.
Cisto ósseo simples do acrômio: Relato de caso
Authors: Öztürk Recep , Bulut Emin Kürşat , Ateş Ömer Faruk , Güngör Bedii Şafak 
Published: September 2020

ResumoCistos ósseos simples são raros na escápula, e, pelo que sabemos, não foram relatados no acrômio. Aqui, apresentamos uma paciente do sexo feminino, de 24 anos, submetida com sucesso ao tratamento composto por curetagem e xenoenxerto. Não foram observados achados de recidiva no acompanhamento pós-operatório de seis meses, quando a paciente apresentou amplitude total de movimento e foi capaz de realizar todas as atividades rotineiras de maneira satisfatória.
Intrathrombus Fibrin Attenuates Spatial Sorting of Phosphatidylserine Exposing Platelets during Clotting Under Flow
Authors: Trigani Kevin T. , Diamond Scott L. 
Published: September 2020

AbstractBackground As thrombosis proceeds, certain platelets in a clot expose phosphatidylserine (PS) on their outer membrane. These PS+ platelets subsequently sort to the perimeter of the mass via platelet contraction. It remains unclear how thrombin and fibrin may alter PS+ platelet sorting within a clot.Objective We investigated the role of fibrin in PS+ platelet sorting.Methods We used an 8-channel microfluidic assay of clotting over collagen (±tissue factor) at 100 s−1 initial wall shear rate. Temporal PS+ platelet sorting was measured using a Pearson's correlation coefficient between the annexin V distribution in a clot at 9 versus 15 minutes. Spatial PS+ platelet sorting was measured using an autocorrelation metric of the final annexin V distribution.Results By 6 minutes, PS+ platelets were distributed throughout the platelet deposits and became highly spatially sorted by 15 minutes when thrombin and fibrin were blocked with Phe-Pro-Arg-chloromethylketone (PPACK). Fibrin polymerization (no PPACK) attenuated temporal and spatial PS sorting and clot contraction. With Gly-Pro-Arg-Pro (GPRP) added to block fibrin polymerization, PS sorting was prominent as was clot contraction. Exogenously added tissue plasminogen activator drove fibrinolysis that in turn promoted clot contraction and PS sorting, albeit to a lesser degree than the PPACK or GPRP conditions. Clots lacking fibrin displayed 3.6 times greater contraction than clots with fibrin.Conclusion PS sorting correlated with clot contraction, as previously reported. However, fibrin inversely correlated with both percent contraction and PS sorting. Fibrin attenuated clot contraction and PS sorting relative to clots without fibrin.
Evaluation of Efficacy of Coenzyme Q10 as an Adjunct to Nonsurgical Periodontal Therapy and Its Effect on Crevicular Superoxide Dismutase in Patients with Chronic Periodontitis
Authors: Pranam Swagat , Palwankar Pooja , Pandey Ruchi , Goyal Anjana 
Published: September 2020

AbstractObjectives To assess the efficacy of coenzyme Q10 (CoQ10) as an adjunct to nonsurgical periodontal therapy and its effect on superoxide dismutase (SOD) in gingival crevicular fluid (GCF) in patients with chronic periodontitis (CP).Materials and Methods A total of 16 patients aged between 30 and 50 years having mild to moderate CP of both sexes having pocket depth of 5 to 7 mm in four nonadjacent interproximal sites were selected. The sites were randomized and divided into treatment and control groups. CoQ10 and a placebo gel were administered in the treatment and control sites, respectively, at baseline after scaling and root planing (SRP). GCF was collected using microcapillary method at baseline and 3 months and was assessed for SOD using enzyme-linked immunosorbent assay reader at 450 nm wavelength. Probing pocket depth, gingival index, and plaque index were assessed at baseline, 1 month, and 3 months, respectively.Statistical analysis For each assessment point, data were statistically analyzed using Student’s t-test and paired t-test. Level of significance was set at p < 0.05.Results On intergroup comparison, there was no statistically significant difference between the clinical parameters of both the groups at all the time intervals (p > 0.05), but there was a significant increase in the level of SOD in the test group (p > 0.05) compared with the control group at 3 months.Conclusions Adjunctive use of CoQ10 with SRP can boost the antioxidant concentration, but it is not superior to SRP in the treatment of CP.