bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acceptable short-term outcomes after open heart surgery in kidney transplant recipients: a case control study
Authors: Witczak Bartlomiej Jozef , Svennevig Jan L. , Hartmann Anders , Fiane Arnt E. , Åsberg Anders 
Published: November 2019

Abstract
Background
Cardiovascular disease is common in kidney transplant recipients. They are considered high risk surgery candidates due to comorbidity and immunosuppression. We assessed short-term results of open-heart surgery in kidney transplant recipients and matched controls between 1989 – 2016 at our center.
Methods
Ninety-five patients underwent open heart surgery (48 coronary artery bypass grafting, 27 valve replacements or repairs and 29 combined procedures) after kidney transplantation. Controls (n=95) were matched for age, sex, type and year of surgery. Mean follow-up was 5.6 (4.9) years. Independent two-sample t-test and chi-square test were used to compare continuous variables and frequencies, respectively. Logistic regression was used to identify preoperative risk factors for 30-day mortality.
Results
Included were 76 men and 19 women; mean age 60.3 (11.1) years, 7.1 (5.6) years after transplantation. Kidney transplants had lower renal function, more hypertension, but less pulmonary hypertension than matched controls. Intraoperative data was comparable between kidney transplants and controls. Kidney transplants experienced more frequent acute kidney injury (57% versus 23%, p<0.001), more bleeding (1288 (1081) mL versus 957 (548) mL, p=0.01) and more red cell transfusions (4.9 (5.6) versus 3.2 (5.4) units, p=0.04). Infections were borderline more frequent in kidney transplants (30% versus 20%, p=0.10). Thirty-day mortality was 6.3% in kidney transplants and 2.1% in controls (p=0.14). Independent risk factors for 30-day mortality were acute myocardial infarction last 90 days before surgery (OR 12.5, p=0.02) and current smoking (OR 17.3, p=0.02).
Conclusions
Kidney transplant recipients undergoing cardiac surgery have acceptable short-term results compared with matched controls; 30-day mortality rates were similar. Careful peri- and postoperative management is, however, warranted as kidney transplant recipients experience more bleeding and higher frequency of AKI.
Predictive Value of Admission D-dimer for Contrast-induced Acute Kidney Injury and Poor Outcomes after Primary Percutaneous Coronary Intervention
Authors: Lin Kai-Yang , Chen Han-Chuan , Jiang Hui , Wang Sun-Ying , Chen Hong-mei , Wu Zhi-Yong , Jiang Feng , Guo Yan-Song , ZHU PENG-LI 
Published: November 2019

Abstract
DD was found to be associated with acute myocardial infarction (AMI) and renal insufficiency. However, it is uncertain whether DD is an independent risk factor of CI-AKI in patients undergoing pPCI.Methods We prospectively enrolled 550 consecutive patients undergoing pPCI between January 2012 and December 2016. The predictive value of admission DD for CI-AKI was assessed by receiver operating characteristic(ROC) and multivariable logistic regression analysis. CI-AKI was defined as an absolute serum creatinine increase ≥0.3 mg/dl or a relative increase in serum creatinine ≥50% within 48 h of contrast medium exposure.Results Overall, the incidence of CI-AKI was 13.1%. The ROC analysis showed that the cutoff point of DD was 0.69 ug/ml for predicting CI-AKI with a sensitivity of 77.8% and a specificity of 57.3%. The predictive value of DD was similar to the Mehran score for CI-AKI (AUC DD =0.729 vs AUC Mehran =0.722; p =0.8298). Multivariate logistic regression analysis indicated that DD >0.69 ug/ml was an independent predictor of CI-AKI (odds ratio[OR]=3.37,95%CI:1.80-6.33, p <0.0001). Furthermore, DD >0.69 ug/ml was associated with an increased risk of long-term mortality during during a mean follow-up period of 16 months(hazard ratio=3.41, 95%CI:1.4-8.03, p =0.005).Conclusion admission DD >0.69 ug/ml is a significant and independent predictor of CI-AKI and long-term mortality in patients undergoing pPCI.
The Therapeutic Effect of Corneal Transplantation for Refractory Pseudomonas Aeruginosa Corneal Ulcer
Authors: Li Yan , Wang Ting , Wang Qiang , Jiang Shanhao , Wang Xin 
Published: November 2019

Abstract
Purpose To observe the treatment outcome of corneal transplantation for advanced medically uncontrolled culture-proven pseudomonas aeruginosa corneal ulcer.Design Retrospective analysisSubjects and methods 26 patients (eyes) with refractory culture-positive pseudomonas aeruginosa corneal ulcer who failed to respond to drug therapy and underwent consecutive corneal transplant procedures in a hospital (2008.1-2018.8). Etiology, medical history, clinical features, surgical type, vision, recurrence, complications and treatment were recorded, and the relationship between postoperative recovery and selection of surgical method was analyzed.Results Of the 26 patients with pseudomonas aeruginosa corneal ulcer, 9 (34.6%) received penetrating keratoplasty (PKP) and 17 (65.4%) received lamellar keratoplasty (LKP). 22 patients (84.6%) obtained a successful outcome through one corneal transplantation. Of the 9 patients who received PKP, 1 patient having graft rejection 6 months after surgery (endothelial type) obtained successful outcome through adequate drug treatment., while 1 case received success by graft repair combined with amniotic membrane transplantation on the 5 months postoperatively for fungal corneal graft ulcer. In the 17 patients underwent LKP, 2 received a second successful lamellar corneal transplantation for corneal graft melting 2 months after the first surgery. In all the 26 patients, the corneal infection was effectively brought under control by corneal transplantation, and none of them had recurrent ulcers during at least 6months' follow-up. The visual acuity was significantly improved at the last follow-up compared with that before surgery. The postoperative visual acuity of patients underwent LKP was better than that of those who underwent PKP ( p =0.018).Conclusions Corneal transplantation can effectively treat refractory pseudomonas aeruginosa corneal ulcer worsening despite adequate medical treatment and improve eyesight. Compared with PKP, LKP can be the main surgical method to treat refractory pseudomonas aeruginosa corneal ulcer.
Title High Flow Nasal cannula oxygen therapy in a general pediatric (non-intensive care) setting
Authors: Kooiman Louise , Reimink Roelien , Langenhorst Veerle , Brand Paul , Bekhof Jolita 
Published: November 2019

Abstract
Background: High flow nasal cannula therapy (HFNC) is being used increasingly for oxygen delivery in children with impending respiratory failure, however solid evidence of its effectiveness is sparse. Moreover, data on safety regarding its use outside of the Pediatric Intensive Care Unit (PICU), with flowrates exceeding 1 L/kg is lacking. Methods: Retrospective chart review at the pediatric ward of Isala, a general teaching hospital in Zwolle, The Netherlands, 100 km away from the nearest PICU. All children <18 years with impending respiratory failure treated with HFNC between January 2015 and May 2016 were included. A flowrate of 2 L/kg/minute for the first 10 kg was used; with 0.5 L/kg for every kg >10 kg and a maximum of 50 L/min. A pediatric early warning score (PEWS) comprising vital functions and work of breathing (0-28 points) was used to assess severity of respiratory distress. Treatment failure was defined as referral to the PICU. Results: In the 16-month study period HFNC was used during 41 hospital admissions in 39 patients (64.1% male), median age 6.3 months (interquartile range, IQR 3–20.6). Median (IQR) PEWS at the start of HFNC was 8.5 (7–10). Patients were diagnosed with bronchiolitis (70.7%), pneumonia (24.4%) or asthma (4.9%). In 18 cases (43.9%) HFNC failed, with referral to a PICU. No clinical variables (age, comorbidity, PEWS at admission or start of HFNC) nor improvement of the PEWS after 2 hours of HFNC were associated with treatment failure. We found no association between treatment failure and the start of HFNC at an earlier stage or at lower PEWS (odds ratio 1.03; 95% confidence interval 0.82-1.30; p=0.80). There were no safety issues, no cases with air leak or other complications. Conclusions: This small study suggests that HFNC can be safely used and initiated in a general pediatric department. We were unable to find clinical factors that predicted HFNC success. We recommend not to restrict evaluation of the effect of HFNC in studies to short-term (2 hours), but also after longer duration, at least 24 hours.
Weakly-supervised Convolutional Neural Networks of Renal Tumor Segmentation in Abdominal CTA Images
Authors: Yang Guanyu , Wang Chuanxia , Yang Jian , Chen Yang , Tang Lijun , Shao Pengfei , Dillenseger Jean-Louis , Shu Huazhong , Luo Limin 
Published: November 2019

Abstract
Background: Renal cancer is one of ten most common cancers in human beings. The laparoscopic partial nephrectomy (LPN) is an effective way to treat renal cancer. Localization and delineation of the renal tumor from pre-operative CT Angiography (CTA) is an important step for LPN surgery planning. Recently, with the development of deep neural networks in medical images, fully supervised deep neural networks can provide accurate pixel-wise organ and lesion segmentation. However, constructing the training dataset with manual labels consumes a lot of time. Methods: Therefore, in this work, we proposed a novel weakly-supervised convolutional neural network for renal tumor segmentation. A new three-stage training strategy was introduced to train a convolutional neural network, which includes group and weighted training phases. Results: We evaluated the proposed method on abdominal CT angiographic images of 200 patients. Extensive experimental results show that the proposed method achieves higher dice coefficient of 0.826 than the other two existing weakly-supervised deep neural networks. Furthermore, the segmentation performance is close to the fully supervised deep convolutional neural networks. Conclusions: The proposed strategy improves not only the efficiency of network training but also the precision of the segmentation.
The Effect of Supplemental High Fidelity Simulation Training in Preclinical Medical Students
Authors: Meyers Lori , Mahoney Bryan , Schaffernocker Troy , Way David , Winfield Scott , Uribe Alberto , Mavarez-Martinez Ana , Palettas Marilly , Lipps Jonathan 
Published: November 2019

Abstract
Introduction : Simulation-based education (SBE) with high-fidelity simulation (HFS) offers medical students early exposure to the clinical environment, allowing development of clinical scenarios, management, and teamwork skills. We hypothesized that supplementation of standard pulmonary physiology curriculum with HFS would improve the performance of first-year medical students on written tests of pulmonary physiology. Methods : This pilot study included SBE with three HFS scenarios of patient care that highlighted basic pulmonary physiology. First-year medical students’ test scores of their cardio-pulmonary curriculum were compared between students who participated in SBE versus only lecture-based education (LBE). A survey was administered to the SBE group to assess their perception of the HFS. Results : From a class of 188 first-year medical students, 89 (47%) participated in the SBE and the remaining 99 were considered as the LBE group. On their cardio-pulmonary curriculum test, the SBE group had a median score of 106 [IQR: 97,110] and LBE group of 99 [IQR: 89,105] (p<0.001). For the pulmonary physiology subsection, scores were also significantly different between groups (p=0.014). Conclusion : Implementation of supplemental SBE with HFS could be an adequate technique to improve learning enhancement and knowledge retention in preclinical medical students.
Intravenous administration of tranexamic acid to reduce blood loss during perioperative period in acetabular fracture surgery
Authors: Wang ZhiDong , Wang ZhenHeng , Yang Huilin , Zhu RuoFu , Chen GuangDong , Zhu Xu , Shi WeiDong 
Published: November 2019

Abstract
Backgroud:Literature have reported that topical use of TXA can reduce perioperative blood loss in acetabular fracture surgery.We aim to investigate the effect of intravenous administration of tranexamic acid (TXA) on perioperative blood loss during acetabular fracture surgery Methods:From January 2016 to October 2019, 85 patients undergoing surgical treatment with intravenous TXA administration for acetabular fractures at our department were retrospectively analyzed. The patients were divided into three groups according to dosage of TXA: Single treatment group: patients receiving intravenous infusion of TXA (15 mg/kg) 20 min before surgery (n = 33), repeated treatment group: patients receiving intravenous infusion of TXA (15 mg/kg) 20 min before surgery and intravenous infusion of TXA (10 mg/kg) at 3 h (n = 26), and multiple treatment group: patients receiving intravenous infusion of TXA (15 mg/kg) 20 min before surgery and intravenous infusion of TXA (10 mg/kg) at 3 and 6 h (n = 26). Total blood loss, intraoperative blood loss, postoperative hemoglobin drop, surgery-related transfusion rate, postoperative thrombosis rate, and operation time were compared among these three groups Results:Total blood loss, intraoperative blood loss, postoperative hemoglobin drop, and drainage volume in the single treatment group, repeated treatment group, and multiple treatment group were 932.7.0 ± 181.8 ml, 624.2 ± 138.7 ml, 32.2 ± 5.3 g/l, and 100.1 ± 30.1ml; 843.4 ± 153.0 ml, 567.3 ± 144.1ml, 27.6±3.8 g/l, and 86.1± 42.2 ml; and 748.0 ± 145.2ml, 521.1 ± 98.1ml, 24.4 ± 4.4g/l, and 64.8 ± 29.0 ml, respectively; the values were significantly different between groups (P <0.05). The surgery-related blood transfusion rates in the single treatment, repeated treatment, and multiple treatment groups were 51.5% (17/33), 23.0% (6/26), 19.2% (5/26), respectively. There was no statistically significant difference in surgery-related blood transfusion rates between groups Conclusions:Intravenous administration of TXA in acetabular fracture surgery can reduce total blood loss, intraoperative blood loss, and postoperative hemoglobin drop without increasing the risk of venous thrombosis. Multiple administrations before surgery, and at 3 h and 6 h during surgery are more effective than single and repeated administration
Functional versus functional and anatomical criteria-guided ranibizumab treatment in patients with neovascular age-related macular degeneration – results from the randomized, phase IIIb OCTAVE study
Authors: Staurenghi Giovanni , Garweg Justus G. , Gerendas Bianca S. , Macfadden Wayne , Gekkiev Boris , Margaron Philippe , Dunger-Baldauf Cornelia , Kolář Petr 
Published: November 2019

Abstract
Background: To evaluate the efficacy and safety of two individualized ranibizumab retreatment schemes in neovascular age-related macular degeneration.
Methods: Patients (N=671) were randomized (1:1) to receive three initial monthly ranibizumab 0.5 mg injections, then retreatment guided by either best-corrected visual acuity (BCVA) loss (Group I) or BCVA loss and/or signs of disease activity on optical coherence tomography (OCT; Group II). The study was terminated prematurely and the decision to discontinue the study was made by the sponsor. Efficacy analyses were performed on patients who completed 12 months of the originally planned 24-month study. Safety analyses are presented for all safety analyzable patients.
Results: Of 671 randomized patients, 305 completed 12 months of the study. For the 12-month completers, baseline mean (standard deviation) BCVA and reading-center evaluated central subfield thickness (CSFT) were comparable [Group I: 60.9 (13.10) letters and 517.7(201.79) µm; Group II: 60.2 (12.21) letters and 515.3 (198.37) µm]. The change from baseline at Month 12 in BCVA was 6.7 (13.48) letters in Group I and 8.3 (13.53) letters in Group II and the change in CSFT was −161.3 (163.48) µm and −175.3 (170.45) µm, respectively. The mean number of ranibizumab injections was 8.2 in Group I and 8.4 in Group II.
Conclusion: Ranibizumab treatment resulted in visual and anatomic gains at 12 months for both retreatment strategies, with a trend in favor of OCT-guided vs BCVA loss guided retreatment. No new safety signals were seen.
Analysis of the respiratory therapy in newborns with extremely low body weight at birth
Authors: Bayalieva A. Zh. , Ziganshin I. M. , Babintseva A. A. 
Published: November 2019

Respiratory therapy is the main component of intensive care for premature newborns, it has a great influence on nursing outcomes.Characteristics of children and research methods. The authors carried put a retrospective analysis of the intensive care effectiveness in 44 infants with extremely low body mass at birth.Results. They found the cases of bronchopulmonary dysplasia and evaluated the treatment effectiveness depending on the weight and gestational age. The children with birth weight of 500–699 grams demonstrated low efficiency of intensive care and adverse course of bronchopulmonary dysplasia. This group of premature infants was characterized by a prolonged stay in the intensive care unit, mechanical ventilation, low body mass dynamics, and, as a result, had a high mortality rate in the late neonatal period compared to the group of children born with a birth weight of more than 700 g (p <0.05).Conclusion. Effective nursing of preterm infants with a birth weight less than 700g requires a combination of an individual approach to the auxiliary ventilation methods and a non-invasive ventilation regimen along with pharmacotherapy that stimulates the respiratory center of the newborn and promotes the maturation of surfactant to prevent complications of respiratory therapy.
Evaluation of anthropometric parameters and body composition in children with cerebral palsy
Authors: Rakhmaeva R. F. , Kamalova A. A. , Ayupova V. A. 
Published: November 2019

Children with cerebral palsy (CP) often develop nutritional disorders, their incidence reaches 80% (according to the literature data).Purpose. To analyze the frequency of nutritional disorders and features of nutritional status in children with CP.Characteristics of children and research methods. We studied the anthropometric indicators (weight, height, body mass index, triceps and subscapular skin fold thickness), physical development characteristics depending on the motor abilities of the child according to the Gross Motor Function Classification System scale and body composition by bioelectrical impedance.Results. Nutritional status disorders were detected in 88.8% of patients, while the diagnostic was based on a reduced physical development in 55.5% of patients. 22.2% of patients had protein-energy deficiency of the first degree, 15.5% of patients had protein-energy deficiency of the second degree, 6.7% of patients had protein-energy deficiency of the third degree, 11.1% of patients suffered from overweight. Besides, nutritional disorders were diagnosed in 33.3% of patients with normal physical development, but with altered body composition, namely, with the imbalance of fat and lean body weight, the isolated increase of the percentage of fat mass, the decrease of active cellular and musculoskeletal weight. These patients also require nutritional correction.Conclusion. These data confirm the dependence of physical development and body composition on the patient’s motor activity and demonstrate the need for complex comprehensive study of nutritional status in children with CP.
The health of children born to mothers who have had a threat of abortion
Authors: Smirnova A. V. , Borzova N. Yu. , Sotnikova N. Yu. , Malyshkina A. I. , Kharlamova N. V. 
Published: November 2019

The risk of preterm labor is one of the leading complications of gestation which determines the high level of perinatal morbidity and mortality. Receptor for advanced glycation end product RAGE is considered to be an important participant of congenital and adaptive immunity and it can regulate the production of pro-inflammatory cytokines and chemokines. TNFa is a leading pro-inflammatory cytokine, it is produced in response to endotoxin. TGFß1 is the main mediator providing anti-inflammatory effect.Purpose. To identify the features of the health status of newborns after the threat of termination of pregnancy in 22–27 weeks, the content of sRAGE and cytokines in women at risk of preterm labor depending on perinatal pathology in children.Materials and methods. We examined 120 pregnant women at 22–27 weeks of gestation, they were divided into 2 groups: the main group (80 women at risk of preterm labor) and the control group (40 women with uncomplicated pregnancy). We determined the content of sRAGE, TGFβ1 и TNFα cytokines, and antibodies to Chlamydia trachomatis, Mycoplasma hominis и Ureaplasma urealyticum, simple herpes virus, cytomegalovirus, the virus of Epstein–Barr in the venous blood serum by ELISA.Results. The threat of preterm labor at 22–27 weeks increases the risk of perinatal hypoxic lesions of the CNS in newborn 1,5 times (relative risk (RR) 1.43; 95% confidence interval – CI 1.14–1.78). A premature birth, after the threat of preterm labor at 22–27 weeks, increases the risk of perinatal damage to the CNS more than five times (RR 5.13; 95% CI 2.47–10,69), and the risk of intrauterine infection is increased four times (RR 4.08; 95% CI 2.54–6.54). Low content of sRAGE in patients with threat of premature labor at 22–27 weeks is a predictor of development of perinatal hypoxic lesions of the CNS.Conclusion. Low content of sRAGE in the blood serum of patients at risk of premature labor at 22–27 weeks is a predictor of development of perinatal hypoxic lesions of the CNS. A decreased concentration of TGFβ1 cytokine in the blood of women at risk of premature birth is associated with intrauterine infection in newborns.
Experience in using povidone-iodine to treat superficial and full-thickness burns
Authors: Vladimirova O. V. , Lavreshin P. M. , Vladimirov V. I. , Rybalko A. E. , Zybinskiy I. A. 
Published: November 2019

Thermal injuries are now ranked number one among injuries, and incidence of injury-related complications, especially infectious and purulent, does not decrease in surgical practice, despite the modern methods for treatment and prevention. Purulent complications depress the speed and quality of wound healing and increase the number of bed-days and treatment costs. Moreover, infection spreading complicates treatment and increases mortality and disability of patients with burn injuries. Choosing the most effective antiseptic agent for burn injuries is crutial both from the perspective of effective local treatment of wounds and wound complications and from the perspective of pharmacoeconomic aspects. At the current time, povidone iodine solution and ointment are one of the leading antiseptics used at all stages of care for burn patients. Its efficacy has been proven by clinical trials and many years’ experience of use by specialists and patients. We have also gained extensive positive experience in using this drug to treat 269 patients with burns of 5 to 35% total body surface area (TBSA) and various thickness without development of resistance and pain in patients and with a pronounced antiseptic effect during its use on the basis of City Clinical Hospital No. 2 of Stavropol, which once again proved high efficacy and feasibility of the widespread use of povidone-iodine in practice due to antimicrobial activity, high bioavailability, ease of use and economic benefits.