bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early Percutaneous Tracheostomy in Coronavirus Disease 2019: Association With Hospital Mortality and Factors Associated With Removal of Tracheostomy Tube at ICU Discharge. A Cohort Study on 121 Patients*
Authors: Rosano Antonio , Martinelli Enrico , Fusina Federica , Albani Filippo , Caserta Rosalba , Morandi Alessandro , Dell’Agnolo Piera , Dicembrini Alessandra , Mansouri Leila , Marchini Andrea , Schivalocchi Valeria , Natalini Giuseppe 
Published: November 2020

Objectives:
Early tracheotomy, defined as a procedure performed within 10 days from intubation, is associated with more ventilator free days, shorter ICU stay, and lower mortality than late tracheotomy. During the coronavirus disease 2019 pandemic, it was especially important to save operating room resources and to have a shorter ICU stay for patients, when ICUs had insufficient beds. In this context of limited resources, early percutaneous tracheostomy could be an effective way to manage mechanically ventilated patients. Nevertheless, current recommendations suggest delaying or avoiding the tracheotomy in coronavirus disease 2019 patients. Aim of the study was to analyze the hospital mortality of coronavirus disease 2019 patients who had received early percutaneous tracheostomy and factors associated with removal of tracheostomy cannula at ICU discharge.

Design:
Cohort study.

Setting:
Coronavirus disease 2019 ICU.

Patients:
Adult patients with coronavirus disease 2019 3 days after ICU admission.

Interventions:
None.

Measurements and Main Results:
Three days after ICU admission, 164 patients were present in ICU and included in the analysis. One-hundred and twenty-one patients (74%) were tracheostomized, whereas the other 43 (26%) were managed with translaryngeal intubation only. In multivariable analysis, early percutaneous tracheostomy was associated with lower hospital mortality. Sixty-six of tracheostomized patients (55%) were discharged alive from the hospital. Age and male sex were the only characteristics that were independently associated with mortality in the tracheostomized patients (45.5% and 62.8% in tracheostomized and nontracheostomized patients, respectively; p = 0.009). Tracheostomy tube was removed in 47 of the tracheostomized patients (71%). The only variable independently associated with weaning from tracheostomy at ICU discharge was a faster start of spontaneous breathing after tracheotomy was performed.

Conclusions:
Early percutaneous tracheostomy was safe and effective in coronavirus disease 2019 patients, giving a good chance of survival and of weaning from tracheostomy cannula at ICU discharge.
An update on adult forms of hereditary pheochromocytomas and paragangliomas
Authors: Dariane Charles , Goncalves Judith , Timsit Marc-Olivier , Favier Judith 
Published: November 2020

Purpose of review
Pheochromocytomas and paragangliomas (PPGL) display a strong genetic determinism with 40% of inherited forms. The purpose of this review is to provide an update on current knowledge on adult forms of hereditary PPGL and their management.

Recent findings
PPGL are genetically-driven in 70% of cases, with germline and/or somatic mutations identified in more than 20 genes. Although eight new susceptibility genes have recently emerged, mutations on SDHx genes remain the most frequent. In addition to SDHB, mutations in SLC25A11, FH and MDH2 may predispose to a metastatic disease and somatic alterations including TERT and ATRX mutations, and the differential expression on noncoding RNAs are also associated with the occurrence of metastases.
The biochemical diagnosis remains the mainstay of functional PPGL and does not differ between hereditary PPGL while the choice of the best nuclear imaging approach is dictated by the tumor type and can be influenced by the presence of a germline mutation (18F-DOPA PET/CT for cluster 2 mutation and 68Ga-DOTATATE PET/CT for cluster 1 mutation).

Summary
A systematic genetic testing and counselling is recommended for all PPGL patients and should lead to conservative surgery and an adapted follow up, in case of hereditary form.
Malignant pleural mesothelioma: recent developments
Authors: Sinn Katharina , Mosleh Berta , Hoda M. Alireza 
Published: November 2020

Purpose of review
Malignant pleural mesothelioma (MPM) is a rare, but aggressive tumor with still poor prognosis. In this article, we focus on recent developments in the management of MPM including diagnosis, staging, biomarkers, and treatment strategies.

Recent findings
Molecular markers such as programmed death-ligand 1 (PDL-1), Breast Cancer gene 1-associated protein gene, and cyclin-dependent kinase inhibitor 2A (CDKN2A) have prognostic impact and should be considered for assessment in patient samples. In addition to histological subtype and tumor pattern, tumor volumetry plays an increasing important role in staging, assessment of treatment response, and prediction of survival. Several new blood-based biomarkers have been recently reported including peripheral blood DNA methylation, microRNAs, fibulin, and high-mobility group box 1, but have not been established in clinical routine use yet. Regarding treatment, targeted therapies, immunotherapy, and vaccination are considered as new promising strategies. Moreover, extended pleurectomy/decortication is favored over extrapleural pneumonectomy (EPP) and intensity-modulated radiotherapy represents a possible approach in combination with EPP and pleurectomy/decortication. Intracavitary treatment options are promising and deserve further investigations.

Summary
Overall, there has not been a real breakthrough in the treatment of MPM. Further research and clinical trials are needed to evaluate outcome and to identify new potential treatment candidates.
Proximal Nerve Root Involvement in immunoglobulin M Anti–Myelin-Associated Glycoprotein Neuropathy Presenting as Cauda Equina Syndrome
Authors: Fernandes Marco , Calvão-Pires Pedro , Caetano André , Santos Luís 
Published: November 2020

Abstract
Typical distal symptoms in anti–myelin-associated glycoprotein (anti-MAG) neuropathy are believed to be due to the binding of immunoglobulin M to distal nerve terminals. We describe the case of a 56-year-old man diagnosed with immunoglobulin M anti-MAG neuropathy in the setting of Waldenström macroglobulinemia, which developed acute neurological worsening presenting as cauda equina syndrome. Lumbosacral magnetic resonance imaging revealed enlarged nerve roots with diffuse heterogeneous gadolinium enhancement. Treatment with steroids resulted in substantial clinical improvement. Increased recognition of atypical presentations may lead to improved characterization of anti-MAG neuropathy as a more widespread disease.
Polyneuropathy Reveals Origins of Decade-long Gastrointestinal Symptoms in a Patient With Undiagnosed Mitochondrial Neurogastrointestinal Encephalopathy Caused by a Novel Mutation
Authors: Darki Leila , Jalali-Sohi Arash , Beydoun Said R. 
Published: November 2020

Abstract
Mitochondrial neurogastrointestinal encephalopathy (MNGIE) is a rare autosomal recessive disease that manifests with multiorgan presentation characterized by gastrointestinal, extraocular, and both peripheral and central nervous system involvement. MNGIE is caused by mutation in the TYMP (thymidine phosphorylase) gene, resulting in loss of thymidine phosphorylase enzyme activity. This causes its substrates, thymidine and deoxyuridine, to accumulate in tissues and plasma, while also causing secondary alterations in mitochondrial DNA. To date, more than 80 mutations have been reported in this gene. We present herein the clinical, neuroimaging, electrodiagnostic, and molecular findings of a patient with MNGIE caused by a novel homozygous missense mutation (C1175T > G) of the TYMP gene.
What is in the Myopathy Literature?
Authors: Lacomis David 
Published: November 2020

Abstract
This update begins with muscle manifestations of coronavirus 2019. They may include myalgias and elevations in serum creatine kinase. It is unknown whether there is direct muscle invasion and how often the critically ill have muscle sequelae. Regarding autoimmune myopathies, a retrospective study of statin-induced necrotizing myopathy is covered. A relatively large proportion of patients had normal strength at presentation. Examples of dermatomyositis associated with immune checkpoint inhibitors are provided including one with cytokine storm. A report of juvenile dermatomyositis with severe abdominal complications is noteworthy. Two articles address unusual associations with inclusion body myositis, namely, spinocerebellar ataxias and granuloma myositis. In the category of muscular dystrophies, a relatively large single center study of the outcome of scapulothoracic arthrodesis for facioscapulohumeral muscular dystrophy is discussed and a article on anoctaminopathies with pauci- or asymptomatic hyperCKemia.
Regression Discontinuity Designs in Health
Authors: Hilton Boon Michele , Craig Peter , Thomson Hilary , Campbell Mhairi , Moore Laurence 
Published: November 2020

Background:
Regression discontinuity designs are non-randomized study designs that permit strong causal inference with relatively weak assumptions. Interest in these designs is growing but there is limited knowledge of the extent of their application in health. We aimed to conduct a comprehensive systematic review of the use of regression discontinuity designs in health research.

Methods:
We included studies that used regression discontinuity designs to investigate the physical or mental health outcomes of any interventions or exposures in any populations. We searched 32 health, social science, and gray literature databases (1 January 1960 to 1 January 2019). We critically appraised studies using eight criteria adapted from the What Works Clearinghouse Standards for regression discontinuity designs. We conducted a narrative synthesis, analyzing the forcing variables and threshold rules used in each study.

Results:
The literature search retrieved 7658 records, producing 325 studies that met the inclusion criteria. A broad range of health topics was represented. The forcing variables used to implement the design were age, socioeconomic measures, date or time of exposure or implementation, environmental measures such as air quality, geographic location, and clinical measures that act as a threshold for treatment. Twelve percent of the studies fully met the eight quality appraisal criteria. Fifteen percent of studies reported a prespecified primary outcome or study protocol.

Conclusions:
This systematic review demonstrates that regression discontinuity designs have been widely applied in health research and could be used more widely still. Shortcomings in study quality and reporting suggest that the potential benefits of this method have not yet been fully realized.
Which is good for pre-operative anxiety? Midazolam, video games or teaching with cartoons
Authors: Sakızcı Uyar Bahar , Polat Reyhan , Bolat Merve , Donmez Aslı 
Published: November 2020

BACKGROUND
Pre-operative anxiety in children has been associated with adverse clinical outcomes such as difficulty in anaesthesia induction, emergence delirium and negative postoperative behavioural changes. Therefore, pre-operative anxiety should be alleviated in both children and clinicians.

OBJECTIVE
We investigated the effect on pre-operative anxiety of premedication with midazolam, playing video games or watching a cartoon about anaesthesia.

DESIGN
A prospective randomised trial.

SETTING
Single-centre study performed between August 2018 and June 2019.

PATIENTS
We enrolled 138 patients aged 5 to 8 years undergoing elective surgery.

INTERVENTIONS
After evaluating baseline (T0) anxiety levels using the modified Yale Pre-operative Anxiety Scale (mYPAS) in the pre-operative holding area, 0.5 mg kg−1 oral midazolam was given to Group M, a tablet with videogame applications was given to Group T, and Group S watched the cartoon ‘Şüko Is Being Operated’. mYPAS values were recorded a further three times: 20 min after the intervention (T1), while entering the operating room (T2), and during mask induction of anaesthesia (T3).

MAIN OUTCOME MEASURES
The primary endpoint was the change in children's anxiety levels from baseline. The secondary endpoint was cooperation during mask induction.

RESULTS
The baseline mYPAS scores were comparable (40.7, 42.6 and 40.7 in groups M, S and T respectively). The mean mYPAS scores at T1 were 32.6, 34.7, 26.8 and at T2 were 38.6, 42.7, 35 in groups M, S and T, respectively. There were significant differences between groups S and T at T1 and T2 (P < 0.001, P = 0.010). A significant decrease was found in Group T compared with both groups M and S from T0 to T1 (P = 0.002). mYPAS values at T3 were 38.3, 43.7, 39.5 in groups M, S and T, respectively, with no difference between the groups (P = 0.224). Mask acceptance scores were similar in all groups (P = 0.912).

CONCLUSIONS
The passive teaching technique of watching a video for reducing anxiety levels was not effective. However, active distraction with videogames was found to be a valuable method to reduce pre-operative anxiety.

TRIAL REGISTRATION
ClinicalTrials.gov identifier: NCT03530670.
Clinical and laboratory signs of haemophagocytic lymphohistiocytosis associated with pandemic influenza A (H1N1) infection in patients needing extracorporeal membrane oxygenation
Authors: von Bahr Greenwood Tatiana , Holzgraefe Bernhard , Chiang Samuel C.C. , Wang Yini , Tesi Bianca , Bryceson Yenan T. , Henter Jan-Inge 
Published: November 2020

BACKGROUND
Severe pandemic influenza has been associated with the hyperinflammatory condition secondary haemophagocytic lymphohistiocytosis (HLH).

OBJECTIVES
To determine the frequency, degree, character and possible cause of influenza-associated HLH in critically ill patients with severe acute respiratory distress syndrome due to influenza A (H1N1) infection requiring extracorporeal membrane oxygenation (ECMO) support at our hospital.

DESIGN
A retrospective observational study.

PATIENTS AND SETTING
Medical data were retrieved retrospectively from 11 consenting patients of thirteen adults infected with pandemic influenza A (H1N1) 2009 requiring ECMO between July 2009 and January 2010 at the ECMO Centre of Karolinska University Hospital, Stockholm, Sweden. All patients were evaluated for HLH using HLH-2004 criteria and HScore.

RESULTS
Eleven patients (median age 31 years) were included in the study and all survived. All patients showed signs of multiple organ dysfunction and pronounced inflammation, more severe in the four patients with HLH who had significantly higher peak serum concentrations of ferritin (P = 0.024), alkaline phosphatase (P = 0.012) and gamma-glutamyl transferase (P = 0.024), lower concentration of albumin (P = 0.0086) and more frequently hepatomegaly (P = 0.048). Abnormal lymphocyte cytotoxicity (lytic units <10) and a low proportion of natural killer (NK) cells were observed in three of four patients with HLH. Notably, we found a significant inverse correlation between serum ferritin concentration and NK cell and cytotoxic T lymphocyte percentages (r

s
= −0.74, P = 0.0013 and r

s
= −0.79, P = 0.0025, respectively). One HLH patient received HLH-directed cytotoxic therapy, another intravenous immunoglobulin and the other two no specific HLH-directed therapy.

CONCLUSION
Critically ill patients, including healthy young adults, with pandemic influenza may develop HLH and should be monitored for signs of hyperinflammation and increasing organ dysfunction, and evaluated promptly for HLH because HLH-directed therapy may then be beneficial. The association of low NK percentages with hyperferritinaemia may suggest a role for reduced NK cell numbers, possibly also cytotoxic T lymphocytes, and subsequently reduced lymphocyte cytotoxicity, in the pathogenesis of hyperinflammation and secondary HLH.
Comparative validity and reliability of the WeChat-based electronic and paper-and-pencil versions of the PISQ-12 for collecting participant-reported data in Chinese
Authors: Zhang Chenyu , Sun Zhijing , Yang Jun , Xu Tao , Zhu Lan , Lang Jinghe 
Published: November 2020

Abstract

Objective:
The objective of this study is to assess the consistency between the WeChat-based Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire short form (PISQ-12) in Chinese and the paper version and to determine the test–retest reliability of the WeChat questionnaire.

Methods:
A total of 120 women aged between 24 and 69 years were recruited from the outpatient clinic at Peking Union Medical College Hospital and randomly assigned to two groups. All participants completed the WeChat and paper questionnaires twice. Group A completed the paper questionnaire before the WeChat version; Group B completed the WeChat questionnaire before the paper version. Two weeks later, all participants completed the questionnaires in the opposite order. Then, the reliability and validity of the two versions were assessed using Pearson correlation coefficients, intraclass correlation coefficients, and Bland-Altman graphs.

Results:
No significant difference in completion time was found between the two versions of the Chinese PISQ-12 (P = 0.67). Half of the participants (60/120) preferred the WeChat questionnaire, 15% (18/120) preferred the paper form (P < 0.01), and 35% had no preference (42/120). The response time was positively correlated with age (P < 0.01) and negatively correlated with the degree of education (P < 0.01). A Pearson correlation coefficient of 0.92 and an intraclass correlation coefficient of 0.94 indicated strong consistency between the two versions. The WeChat form exhibited strong test–retest reliability (Pearson correlation coefficient, 0.86; intraclass correlation coefficient, 0.86). The Bland-Altman plots supported these results.

Conclusions:
The WeChat questionnaire was preferred over the paper version in a Chinese sample and had excellent consistency with the paper version and high test–retest reliability for collecting data on private topics.
Predictors and prognostic role of low myocardial mechano-energetic efficiency in chronic inflammatory arthritis
Authors: Cioffi Giovanni , Mancusi Costantino , de Simone Giovanni , Ognibeni Federica , Orsolini Giovanni , Dalbeni Andrea , Gatti Davide , Fassio Angelo , Adami Giovanni , Rossini Maurizio , Viapiana Ombretta , Giollo Alessandro 
Published: November 2020

Objective:
To assess the variables associated with the status of low myocardial mechano-energetic efficiency (MEE) [the ratio between myocardial left ventricular (LV) work and magnitude of myocardial oxygen consumption] and whether low-MEE is a prognosticator of adverse cardiovascular outcome in patients with chronic inflammatory arthritis.

Methods:
A total of 432 outpatients with established chronic inflammatory arthritis without overt cardiac disease were recruited from March 2014–March 2016; 216 participants were used as comparison group. Low-MEE status was a priori identified by standard echocardiography at rest as less than 0.32 ml/s per g (5th percentile of MEE calculated in 145 healthy individuals). The pre-specified primary end-point of the study was a composite of cardiovascular death/hospitalization. Follow-up ended September 2019.

Results:
MEE was significantly lower in chronic inflammatory arthritis patients than controls (0.35 ± 0.11 vs. 0.45 ± 0.10 ml/s per g; P < 0.001). Low-MEE was detected in 164 patients (38%). Independent predictors of low-MEE were older age, higher SBP, diabetes mellitus, LV concentric geometry and lower LV systolic function. During a follow-up of 36 (21–48) months, a primary end-point occurred in 37 patients (8.6%): 22/164 patients with low-MEE (13.4%) and 15/268 (5.6%) without low-MEE (P = 0.004). Low-MEE predicted primary end-points in multivariate Cox regression analysis [heart rate 2.23 (confidence interval 1.13–4.38), P = 0.02] together with older age, lower renal function and higher LV mass.

Conclusion
: Low-MEE is detectable in more than one-third of patients with chronic inflammatory arthritis and is associated with traditional cardiovascular risk factors and abnormalities in LV geometry and systolic function. In these patients low-MEE is a powerful prognosticator of adverse cardiovascular events.
Endophthalmitis after cataract surgery: an update on recent advances
Authors: Peck Travis J. , Patel Samir N. , Ho Allen C. 
Published: November 2020

Purpose of review
Prevention and management of postcataract endophthalmitis remain quite relevant for anterior segment and vitreoretinal surgeons. Although the Endophthalmitis Vitrectomy Study, published in 1996, remains the only level 1 evidence for the management of postcataract endophthalmitis, recent advances have resulted in an evolution of practice patterns. The aim of this review is to summarize the literature regarding postcataract endophthalmitis with a focus on the last 18 months.

Recent findings
The IRIS registry indicates the rates of endophthalmitis are decreasing in the United States, and the outcomes appear to be improving. Intracameral moxifloxacin has become more widely accepted and intracameral vancomycin has been shown to be associated with retinal vasculitis. The role of systemic antibiotics and vitrectomy is unclear and practice patterns vary widely.

Summary
Although practice patterns vary, prevention and treatment of endophthalmitis after cataract surgery continues to improve. More uniform guidelines regarding surgical and medical therapy are necessary but the standard of prompt referral to a vitreoretinal specialist for immediate intravitreal antibiotics remains the most important intervention in the management of postcataract endophthalmitis.
Choroidal thickness after phacoemulsification: nonrandomized comparison of postoperative topical ketorolac vs dexamethasone vs combination of ketorolac–dexamethasone eyedrops
Authors: Ghiasian Leila , Abri Aghdam Kaveh , Azizi Ehsan , Abdolalizadeh Parya , Janani Leila , Grzybowski Andrzej , Ghasemi Falavarjani Khalil 
Published: November 2020

Purpose:
To compare the effect of topical dexamethasone vs ketorolac vs combined dexamethasone–ketorolac after phacoemulsification on choroidal thickness (CT).

Setting:
Tertiary university-based hospital.

Design:
Prospective nonrandomized comparative case series.

Methods:
Ninety-two eyes of 92 patients were assigned to the 3 groups after uneventful phacoemulsification: Group 1, dexamethasone; Group 2, ketorolac; Group 3, combined dexamethasone–ketorolac applied topically. CT at subfoveal (SFCT), nasal, and temporal as primary and central retinal thickness (CRT) as secondary outcomes were measured preoperatively and at 1 month, 3 months, and 6 months postoperatively using enhanced depth-imaging optical coherence tomography.

Results:
Preoperative CT was similar between the groups (all P > .05). The groups differed in pattern of changes in nasal and temporal CT (both P < .001) although their changes of CRT (P = .13) and SFCT (P = .55) over time were similar. The mean of SFCT at 1 month, 3 months, and 6 months was significantly higher than baseline in dexamethasone (P < .001 for all follow-ups) and combined (P < .001 for both 1 month and 3 months and P = .03 for 6 months) groups, whereas it was not statistically significant in the ketorolac group (P = .07). There was an increase in the nasal and temporal CT in 3 groups, persisted at 6 months in dexamethasone (both P < .001) and ketorolac (both P < .001) groups, whereas the change was not statistically significant at 6 months in the combined group. Choroidal thickness measurements were performed in 31 eyes of 31 patients in group 1, 29 eyes of 29 patients in group 2, and 32 eyes of 32 patients in group 3.

Conclusions:
Dexamethasone and combined groups had statistically significant changes of SFCT after phacoemulsification; however, the ketorolac group did not. The pattern of SFCT changes was similar between 3 groups.