bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevention of thromboembolism in spinal cord injury -S1 guideline
Authors: Weidner Norbert , Müller Oliver J. , Hach-Wunderle Viola , Schwerdtfeger Karsten , Krauspe Rüdiger , Pauschert Rolf , Waydhas Christian , Baumberger Michael , Göggelmann Christoph , Wittgruber Gabriela , Wildburger Renate , Marcus Oswald 
Published: December 2020

Abstract
Introduction
Traumatic and non-traumatic spinal cord injury bears a high risk for thromboembolism in the first few months after injury. So far, there is no consented guideline regarding diagnostic and prophylactic measures to prevent thromboembolic events in spinal cord injury. Based on a Pubmed research of related original papers and review articles, international guidelines and a survey conducted in German-speaking spinal cord injury centers about best practice prophylactic procedures at each site, a consensus process was initiated, which included spinal cord medicine experts and representatives from medical societies involved in the comprehensive care of spinal cord injury patients. The recommendations comply with the German S3 practice guidelines on prevention of venous thromboembolism.

Recommendations
Specific clinical or instrument-based screening methods are not recommended in asymptomatic SCI patients. Based on the severity of neurological dysfunction (motor completeness, ambulatory function) low dose low molecular weight heparins are recommended to be administered up to 24 weeks after injury. Besides, mechanical methods (compression stockings, intermittent pneumatic compression) can be applied. In chronic SCI patients admitted to the hospital, thromboembolism prophylactic measures need to be based on the reason for admission and the necessity for immobilization.

Conclusions
Recommendations for thromboembolism diagnostic and prophylactic measures follow best practice in most spinal cord injury centers. More research evidence needs to be generated to administer more individually tailored risk-adapted prophylactic strategies in the future, which may help to further prevent thromboembolic events without causing major side effects. The present article is a translation of the guideline recently published online (https://www.awmf.org/uploads/tx_szleitlinien/179-015l_S1_Thromboembolieprophylaxe-bei-Querschnittlaehmung_2020-09.pdf).
Feasibility and outcome of mitral valve repair in patients with infective endocarditis
Authors: Scheggi Valentina , Olivotto Iacopo , Del Pace Stefano , Zoppetti Nicola , Brunetto Alterini , Marchionni Niccolò , Cerillo Alfredo , Stefàno Pier Luigi 
Published: December 2020

Abstract
Background
Valve repair is the treatment of choice for native mitral valve regurgitation. The feasibility of repair when the defect is caused by acute infective endocarditis (IE) is debated. This study aims to compare the outcome of repair and replacement procedures, to report the rate of repair in a single surgical center, and to review the literature on this topic.

Results
We retrospectively analyzed 108 patients with native mitral IE, potentially eligible for surgical repair. Of these 108, 90 (83%) underwent surgery, and 18 were treated conservatively. Among the 90 surgical patients, 57 (63%) underwent valve replacement and 33 valve repair (37%). The mean follow-up duration was 3 years. The two primary endpoints were mortality and freedom from recurrent endocarditis. Secondary endpoints were the post-operative incidence of major adverse events (hospitalization for any cause, pacemaker implantation, new onset of atrial fibrillation, sternal dehiscence), left ventricular systolic function (LVSF), and valvular function at 1-year echocardiographic follow-up. All-cause mortality was lower for valve repair, although not significantly (p = 0.86), as well as nonfatal adverse events (p = 0.92) and relapse rate (p = 0.20) at 3 years. We did not find differences between the two groups at echocardiographic follow-up, neither for left ventricular systolic function (p = 0.22), nor for valvular continence (p = 0.28).

Conclusions
In our experience, the mid-term outcome of repair in IE is comparable to valve replacement and should be considered whenever possible, as in degenerative valve disease. The review of the literature supports this strategy.
Treating patients with severe mental illness with narrative exposure therapy for comorbid post-traumatic stress disorder
Authors: Mauritz Maria W. , van Gaal Betsie G.I. , Goossens Peter J.J. , Jongedijk Ruud A. , Vermeulen Hester 
Published: December 2020

Background
Interpersonal trauma and post-traumatic stress disorder (PTSD) in patients with severe mental illness (SMI) negatively affect illness course. Narrative exposure therapy (NET) is effective in vulnerable patient groups, but its efficacy and applicability has not been studied in out-patients with SMI.

Aims
We aimed to evaluate the efficacy and applicability of NET in SMI on changes in PTSD, dissociation, SMI symptoms, care needs, quality of life, global functioning and care consumption.

Method
The study had a single-group, pre-test–post-test, repeated-measures design and was registered in The Netherlands National Trial Register (identifier TR571). Primary outcomes were assessed at pre-treatment (T0), 1 month post-treatment (T1) and 7 months’ follow-up (T2), with a structured interview for PTSD and dissociation screening. Secondary outcomes followed routinely SMI measurements and medical data. Mixed models were used for data analysis.

Results
The majority of the 23 participants was female (82%). Mean age was 49.9 years (s.d. 9.8) and mean PTSD duration was 24.1 years (s.d. 14.5). Mean PTSD severity decreased from 37.9 at T0 to 31.9 at T1 (−6.0 difference, 95%CI −10.0 to −2.0), and decreased further to 24.5 at T2 (−13.4 difference, 95%CI −17.4 to −9.4). Dissociation, SMI symptoms, duration of contacts, and medication decreased; global functioning increased; and quality of life and perceived needs did not change. Eleven participants were in remission for PTSD at T2, of which five were also in remission for major depression.

Conclusions
NET appeared efficacious and applicable to out-patients with SMI and PTSD, and was well tolerated.
Mental health and well-being of healthcare workers during the COVID-19 pandemic in the UK: contrasting guidelines with experiences in practice
Authors: Vera San Juan Norha , Aceituno David , Djellouli Nehla , Sumray Kirsi , Regenold Nina , Syversen Aron , Mulcahy Symmons Sophie , Dowrick Anna , Mitchinson Lucy , Singleton Georgina , Vindrola-Padros Cecilia 
Published: December 2020

Background
Substantial evidence has highlighted the importance of considering the mental health of healthcare workers during the COVID-19 pandemic, and several organisations have issued guidelines with recommendations. However, the definition of well-being and the evidence base behind such guidelines remain unclear.

Aims
The aims of the study are to assess the applicability of well-being guidelines in practice, identify unaddressed healthcare workers’ needs and provide recommendations for supporting front-line staff during the current and future pandemics.

Method
This paper discusses the findings of a qualitative study based on interviews with front-line healthcare workers in the UK (n = 33), and examines them in relation to a rapid review of well-being guidelines developed in response to the COVID-19 pandemic (n = 14).

Results
The guidelines placed greater emphasis on individual mental health and psychological support, whereas healthcare workers placed greater emphasis on structural conditions at work, responsibilities outside the hospital and the invaluable support of the community. The well-being support interventions proposed in the guidelines did not always respond to the lived experiences of staff, as some reported not being able to participate in these interventions because of understaffing, exhaustion or clashing schedules.

Conclusions
Healthcare workers expressed well-being needs that aligned with socio-ecological conceptualisations of well-being related to quality of life. This approach to well-being has been highlighted in literature on support of healthcare workers in previous health emergencies, but it has not been monitored during this pandemic. Well-being guidelines should explore the needs of healthcare workers, and contextual characteristics affecting the implementation of recommendations.
Appetite-Regulating Hormones Are Reduced After Oral Sucrose vs Glucose: Influence of Obesity, Insulin Resistance, and Sex
Authors: Yunker Alexandra G , Luo Shan , Jones Sabrina , Dorton Hilary M , Alves Jasmin M , Angelo Brendan , DeFendis Alexis , Pickering Trevor A , Monterosso John R , Page Kathleen A 
Published: December 2020

Abstract

Context
Fructose compared to glucose has adverse effects on metabolic function, but endocrine responses to oral sucrose vs glucose is not well understood.

Objective
We investigated how oral sucrose vs glucose affected appetite-regulating hormones, and how biological factors (body mass index [BMI], insulin sensitivity, sex) influence endocrine responses to these 2 types of sugar.

Design
Sixty-nine adults (29 men; 23.22 ± 3.74 years; BMI 27.03 ± 4.96 kg/m2) completed the study. On 2 occasions, participants consumed 300-mL drinks containing 75 g of glucose or sucrose. Blood was sampled at baseline, 10, 35, and 120 minutes post drink for plasma glucose, insulin, glucagon-like peptide (GLP-1)(7–36), peptide YY (PYY)total, and acyl-ghrelin measures. Hormone levels were compared between conditions using a linear mixed model. Interaction models were performed, and results were stratified to assess how biological factors influence endocrine responses.

Results
Sucrose vs glucose ingestion provoked a less robust rise in glucose (P &lt; .001), insulin (P &lt; .001), GLP-1 (P &lt; .001), and PYY (P = .02), whereas acyl-ghrelin suppression was similar between the sugars. We found BMI status by sugar interactions for glucose (P = .01) and PYY (P = .03); obese individuals had smaller increases in glucose and PYY levels after consuming sucrose vs glucose. There were interactions between insulin sensitivity and sugar for glucose (P = .003) and insulin (P = .04), and a sex by sugar interaction for GLP-1 (P = .01); men demonstrated smaller increases in GLP-1 in response to oral sucrose vs glucose.

Conclusion
Sucrose is less efficient at signaling postprandial satiation than glucose, and biological factors influence differential hormone responses to sucrose vs glucose consumption.
Incidence, Mortality, and Characteristics of 18 Pediatric Perioperative Cardiac Arrests: An Observational Trial From 22,650 Pediatric Anesthesias in a German Tertiary Care Hospital
Authors: Jansen Gerrit , Borgstedt Rainer , Irmscher Linda , Popp Jakob , Schmidt Benjamin , Lang Eric , Rehberg Sebastian W. 
Published: December 2020

BACKGROUND:
Recently, a very low incidence of 3 per 10,000 and a mortality of 30% were reported for pediatric perioperative cardiac arrest (POCA). However, high-risk patients, namely children already anesthetized on the intensive care unit (ICU), were excluded. This study investigates the incidence and mortality of POCA in children in whom anesthesia was induced in the ICU or in the operating room using real-world data. In addition, different classifications of POCA were compared with respect to outcome relevance.

METHODS:
This is a retrospective observational study conducted at a German level 1 perinatal center and tertiary care hospital between 2008 and 2018. Children ≤15 years who underwent an anesthetic procedure and suffered from POCA (defined as any condition requiring chest compressions and/or defibrillation) from the beginning of care provided by an anesthesiologist to 60 minutes after anesthesia or sedation were included. Primary end points were incidence and mortality of POCA in children with anesthesia induced in the ICU versus in the operating room. Secondary end points included incidences and outcomes with respect to the pathophysiological cause (respiratory versus circulatory associated).

RESULTS:
There were 18 POCA during 22,650 anesthetic procedures (incidence 7.9 per 10,000; 95% confidence interval [CI], 4.7-12.5). Thirty-day mortality was 3.5 per 10,000 (95% CI, 1.5-6.9). Incidence and mortality were higher in children in whom anesthesia was induced in the ICU versus in the operating room (incidence: 131.6; 95% CI, 57 to 257.6 versus 4.5; 95% CI, 2.2-8.3; P < .001; and mortality: 82.2; 95% CI, 26.7-190.8 versus 1.4; 95% CI, 0.3-3.9; P < .001). Mortality in circulatory-induced POCA (n = 8; 44%) was 100%, in respiratory-induced POCA (n = 9; 50%) 0% (P < .001).

CONCLUSIONS:
Children with anesthesia induction in the ICU represent a high-risk population for POCA and POCA-associated mortality. POCA classification should be based on the individual cause (respiratory versus circulatory) rather than on the perioperative phase or the responsible specialty.
Association Between High Body Mass Index and Mortality Following Myocardial Injury After Noncardiac Surgery
Authors: Lee Seung-Hwa , Yang Kwangmo , Park Jungchan , Lee Jong Hwan , Min Jeong Jin , Kwon Ji-hye , Yeo Junghyun , Kim Jihoon , Hyeon Cheol Won , Choi Jin-ho , Lee Sang-Chol , Gwon Hyeon-Cheol , Kim Kyunga , Ahn Joonghyun , Lee Sangmin Maria 
Published: December 2020

BACKGROUND:
Despite an association between obesity and increased risks for various diseases, obesity has been paradoxically reported to correlate with improved mortality in patients with established cardiovascular disease. However, its effect has not been evaluated to date in patients with myocardial injury after noncardiac surgery (MINS).

METHODS:
From January 2010 to June 2019, of a total of 35,269 adult patients with postoperative cardiac troponin level data, 5633 (16.0%) patients had MINS as diagnosed by postoperative cardiac troponin I above the 99th-percentile upper reference of 40 ng·L−1 using the TnI-Ultra immunoassay. Patients with MINS were divided into 3 groups according to body mass index (BMI), with 3246 (57.6%) were in the normal (18.5–25 kg·m−2), 425 (7.5%) in the low BMI (<18.5 kg·m−2), and 1962 (34.8%) in the high BMI (≥25 kg·m−2) groups, respectively. The primary outcome was mortality during the first year after surgery, and the mortality during 30 days was also compared.

RESULTS:
Following adjustment for confounding with inverse probability of treatment weighting, mortality within the first year appeared to be significantly lower in the high BMI group compared with the normal (14.8% vs 20.9%; hazard ratio [HR], 0.75; 95% confidence interval [CI], 0.66-0.85; P < .001) and the low BMI (14.8% vs 25.6%; HR: 0.56; 95% CI, 0.48-0.66; P < .001) groups.

CONCLUSIONS:
High BMI may be associated with decreased mortality following MINS. Further investigations are needed to support this finding.
Clinician Well-being during a Pandemic: Practices to Boost Resilience and Life Satisfaction
Authors: Wiederman Michael W. , Toresdahl Brett , Asif Irfan M. 
Published: December 2020

Abstract
The role of the sports medicine physician has been challenged in several ways during the COVID-19 pandemic, potentially eroding a sense of well-being. Four universal human needs related to flourishing and a sense of life satisfaction are the framework we use to examine the effects of a pandemic on sports medicine clinicians. We offer two evidence-based practices to promote well-being and resilience within each of the four universal needs.
A comparative study of Lumbar Decompression and Fusion with Internal Fixation versus Simple Decompression in elderly patients with two-segment Lumbar Spinal Stenosis
Authors: Tu Pengfa , Cao Shuo , Jiang Chenyang , Yan Chong-chao 
Published: December 2020

Objective: To investigate and compare the effect of decompression and fusion with internal fixation vs. simple decompression in the treatment of elderly patients with two-segment lumbar spinal stenosis (LSS) in perioperative and postoperative follow-up periods.
Methods: Twenty-eight elderly patients with two-segment LSS admitted in Baoding First Hospital between Mar. 2017 and Jan. 2018 were retrospectively analyzed. Fifteen patients who underwent simple decompression were included in the simple decompression group, and 13 who underwent decompression and fusion with internal fixation were included in the decompression-fixation group. The general data and perioperative conditions including wound complications, operation time, blood loss, and VAS (legs) and JOA score were analyzed and compared between the two groups.
Results: There was no significant difference in postoperative leg pain (VAS) between the two groups, and a statistically significant difference in JOA score was found between the two groups one month after the operation. The operation time, length of stay, and blood loss in the decompression-fixation group were significantly different from those in the simple decompression group and no significant difference in wound complications was observed between the two groups.
Conclusion: There is no significant difference in leg pain relief in elderly patients with two-segment LSS when treated with decompression and fusion with internal fixation or simple decompression. Simple decompression is associated with less intraoperative injuries, better postoperative functional recovery, and reduced hospital stay.
doi: https://doi.org/10.12669/pjms.37.1.2287
How to cite this:Tu P, Cao S, Jiang C, Yan CC. A comparative study of Lumbar Decompression and Fusion with Internal Fixation versus Simple Decompression in elderly patients with two-segment Lumbar Spinal Stenosis. Pak J Med Sci. 2021;37(1):256-260. doi: https://doi.org/10.12669/pjms.37.1.2287
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Clinical correlation and prognostic significance of immunofluorescence in renal biopsies of patients having Glomerulonephritis
Authors: Zafar Fauzia , Mehar M. Faisal , Khan Afsheen Asghar , Safdar Rabia Saleem 
Published: December 2020

Objective: To correlate the immunofluorescence (IF) findings on renal biopsies of patients of glomerulonephritis (GN) with the clinical course of the disease.
Methods: This retrospective descriptive study was done at the Department of Pediatrics Medicine Unit-I, Nishtar Hospital Multan, from January 2008 to January 2019. A total of 387 cases of both gender, aged up to 16 years, diagnosed having GN on the basis of renal biopsies by light microscopy (LM) and IF findings, were included. Outcome as remission, partial remission, no remission with stable kidney disease, no remission with progressive kidney disease and end-stage kidney disease (ESKD) were computed. Chi square test was applied to see the correlation of IF findings and outcome by taking p value less than 0.05 as statistically significant.
Results: Focal segmental glomerulosclerosis (FSGS) was found to be the commonest histopathology finding noted in 158 (40.8%) followed by mesangioproliferative GN 74 (19.1%) and membranous nephropathy 42 (10.9%). Complete remission was observed in 145 (37.5%) cases whereas ESKD was seen in 26 (6.7%). Distinct pattern of IF findings were shown when distribution of IF findings were seen with respect to all study variables (p value < 0.001). For outcome, 134 (51.3%) IF negative cases had complete remission while 93 (35.6%) negative IF findings also had partial remission. ESKD was seen among 14 (25.9%) IgM positive and three (33.3%) IgA positive cases.
Conclusion: Immunofluorescence proved an important diagnostic tool in reaching the exact diagnosis in various types of GN. Distinct correlation between IF findings and clinical course of various types of GN was observed. IF negative cases had better outcome and was not having progressive course of disease so prognosis remained better than IF positive cases in this study.
doi: https://doi.org/10.12669/pjms.37.1.2497
How to cite this:Zafar F, Mehar MF, Khan AA, Safdar RS. Clinical correlation and prognostic significance of immunofluorescence in renal biopsies of patients having Glomerulonephritis. Pak J Med Sci. 2021;37(1):76-80. doi: https://doi.org/10.12669/pjms.37.1.2497
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Loss of expression of Syndecan-1 is associated with Tumor Recurrence, Metastatic Potential, and Poor Survival in patients with Colorectal carcinoma
Authors: Al-Maghrabi Jaudah Ahmed 
Published: December 2020

Objective: The loss of expression of syndecansyndecan-1 is associated with poor prognosis in many types of human cancer. The objective of this study was to evaluate the relation between syndecan-1 immunoexpression and several clinicopathological parameters in a subset of colorectal carcinoma (CRC) patients.
Methods: Pathology tissue blocks of 202 primary tumors, 41 adenomas, and 37 normal colonic mucosae were used in this study. The cases diagnosed in the period 1995–2015 was included in the study. Immunohistochemistry analysis was performed using anti-CD138/syndecan-1 (B-A38) mouse monoclonal antibody. A semiquantitative method was used to score the syndecan-1 expression based on an evaluation of the percentage and intensity of the membranous and cytoplasmic expression. The data collected from Pathology Department at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. This is a retrospective cohort study that was conducted from July 2018 until August 2019.
Results: Loss of syndecan-1 immunoexpression was observed in 72 (42.6%), 5 (12.2%), and 3 (8.1%) cases of CRC, adenomas, and normal mucosae, respectively. Low expression of syndecan-1 showed an association with nodal (p=0.003) and distant (p=0.001) metastasis, lymphovascular invasion (p=0.001), and tumor recurrence (p=0.006). Low syndecan-1 expression were associated with short overall survival (OS) (log rank 4.019, p=0.045) and disease-free survival (DFS) probabilities (log rank 4.748, p=0.029).
Conclusion: Loss of syndecan-1 immunoexpression is associated with metastatic potential, tumor recurrence and shorter survival in CRC and is considered a potential biomarker of poor prognosis in CRC patients.
doi: https://doi.org/10.12669/pjms.37.1.2592
How to cite this:Al-Maghrabi J. Loss of expression of Syndecan-1 is associated with Tumor Recurrence, Metastatic Potential, and Poor Survival in patients with Colorectal carcinoma. Pak J Med Sci. 2021;37(1):114-120. doi: https://doi.org/10.12669/pjms.37.1.2592
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.