bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effect of phosphorolcoline-coated cardiopulmonary by-pass circuits on morbidity and mortality in patients with congenital open cardiac surgery
Authors: BOLAT Ali , SURER Suleyman , GÜLBAHAR Özlem , BOLAT Esef , GÜLTEKİN Yıldırım , KUTSAL Ali 
Published: April 2021

Objective: Our aim in this study is to investigate the relationship between mortality and morbidity of phosphorylcholine coated oxygenator circuit used in heart-lung machine in congenital open heart surgery operations.
Materials and Methods: The study was conducted in Dr. Sami Ulus Child Diseases Training and Research Hospital Cardiovascular Surgery Clinic between 2008-2009. 30 congenital heart patients were included. The patients were divided into 2 groups of 15 people. In one of the groups, a phosphorylcholine coated oxygenator circuit was used in the heart lung machine (Group P). In the other group, a standard oxygenator circuit was used (Group C).Congenital heart surgery was performed for 19 Ventricular Septal Defects (VSD), 5 Secundum Atrial Septal Defects (ASD), 3 Primum ASD, 2 Mitral insufficiency and 1 Discret subaortic membrane.
Extubation times, intensive care and discharge times, 24-hour drainage follow-up, inotropic drug use, blood and fresh frozen plasma (FFP) transfusion amount, aspartate aminotransferase, alanine aminotransferase, creatine phosphokinase-MB, urea, blood urea nitrogen, creatinine, white cell number of platelets, lactate dehydrogenase, albumin, total protein, C-reactive protein, prothrombin time, partial thromboplastin time, fibrinogen, D-dimer, C5a and elastase levels were compared perioperatively.
Results: In the study, it was determined that the discharge time was shorter in Group P. It was found that the increase in d-dimer values with fibrinogen was less in Group P. These were found to be statistically significant (p 0.05). There was no mortality in either group.
Conclusion: In this study, phosphorylcholine-coated oxygenator did not significantly reduce the inflammatory response during cardiopulmonary by-pass (CPB). There was no difference between the two groups in terms of morbitidity and mortality.However, the fact that fibrinogen values, which are the acute phase reactants, are lower than the control group and the increase in d-dimer values remain limited may be important in terms of hemocompatibility of the phosphorylcholine coated circuit.
The effectiveness of electroneuromyography in the early diagnosis of diabetic foot development
Authors: KESMEZ CAN Fatma , BİLGE Nuray , ALAY Handan , PARLAK Mehmet 
Published: April 2021

Objective: Diabetic foot is one of the first cause of lower extremity amputation. The aim of this study is to determine which of the nerve conduction disorders may be used predominantly for early diagnosis of diabetic foot development in the follow-up of diabetic patients.
Material and Method: The study consists of 3 different groups (150) of patients diagnosed with type 2 diabetes (DM). 1. Group; 50 patients with diabetic foot complications (DA+), 2. Group; 50 patients without diabetic foot complications and with polyneuropathy (DA-/PNP+), 3. Group; 50 patients without diabetic foot complications and without polyneuropathy (DA-/PNP-). Diabetic foot wounds were grouped by pedis classification.
Findings: Age, sex, diabetes duration, blood glucose, HbA1c values and electroneuromyography (ENMG) for nerve amplitude, velocity and latancy results were compared among the groups. A significant statistical difference was found between three groups when age, sex, HgbA1c, fasting blood glucose, diabetes duration were evaluated (p
Our results of cardiac surgery performed with a right infra axillary mini thoracotomy
Authors: GEMALMAZ Hüseyin , GÜLTEKİN Yıldırım 
Published: April 2021

Aim: The aim of the study is to share the technique and results of heart surgery performed with right infra axillary mini thoracotomy.
Materyal and Method: Between March 2013 and July 2014, 16 heart operations were performed with right infra axillary mini torocotomy incision. Patient data were analyzed retrospectively. These are 6 mitral valve replacement (MVR), 3 aortic valve replacement (AVR), 2 AVR + MVR, 2 atrial septal defect (ASD) repair, 1 myxoma excision. One of them is AVR + tricuspid ring annuloplasty operation and MVR performed due to reoperation. Radiofrequency (RF) ablation was also applied to 1 patient who underwent MVR due to atrial fibrillation.
In these operations, thoracotomy was performed through the right anterior infra axillary line. A parabolic incision of 6-8 cm was made at the 3rd intercostal space (ICA) for aortic valve interventions and at the 4th ICA level for other valve interventions. No special surgical instruments were used in the operations except standard surgical instruments. All cannulation procedures were carried out through the existing thoracotomy incision.
Results: No mortality or morbidity was observed as a result of the operations. The mean extracorporeal circulation (ECC) time was 95±11 minutes, and the mean cross clamp (CC) time was 61±9 minutes. There was an average of 380±35 cc drainage. Extubation time was 7±2.3 hours on average. All patients were taken to the service after 1±0.5 day of intensive care treatment. They were discharged from the hospital in an average of 6±1.5 days. Incision site infection was not observed in any patient. No patients were revised due to bleeding. One patient who was ablated for atrial fibrillation (AF) developed postoperative AF again. He was discharged with medical treatment and speed control.
Conclusion: In this study, we think that heart surgeries with right infraaxillary mini thoracotomy incision may be a good alternative to standard sternotomy and other minimally invasive methods in heart surgery.. With standard surgical instruments and cannulation through a single incision, not only the mitral valve but also the aortic valve, tricuspid valve and other cardiac pathologies can be easily intervened. However, very good results are obtained in patients cosmetically.
Spontaneous hemothorax under rivaroxaban treatment
Authors: DEMİR Mehmet Emin 
Published: April 2021

Rivaroxaban associated spontaneous hemothorax
Rivaroxaban is a highly selective direct thrombin inhibitor indicated in stroke prevention, non-valvular atrial fibrilation, treatment of pulmonary embolism and deep vein thrombosis, prevention of recurrent venous thromboembolism and VTE after elective hip/knee replacement surgery and secondary prevention after acute coronary syndrome. Hemorrhage is the major concern of the drug use. Subdural hematoma, cerebral hemorrhage, GIS hemorrhage, and also intra-articular bleeding has been published in postmarketing reports. Here, we report a case of spontaneous hemothorax under rivaroxaban treatment.
A 73-year-old of man was consulted due to acute dyspnea and palpitation. His x-ray pulmonary images and thorax computed tomography were compatible with hemothorax, consequently, we performed thoracentesis, and macroscopic appearance, cell count revealed hemothorax. There was no sign of any disease, such as low pleural fluid pH and glucose, leucocytic dominance, dysplastic cell, which would indicate an another cause of the bleeding. He was taking rivaroxaban (15 mg Daily) due to chronic atrial fibrillation. Hemorrhage was drained and the drug was cessated. Hemothorax did not relapse in the three month-follow-up periods.
Rivaroxaban (Xarelto) is a member of new anticoagulant drug class and has become favorable in the patient carrying systemic embolism risk with nonvalvular atrial fibrillation. It has predictable pharmacokinetics features, fewer food interactions, bleeding risk, and contrast to warfarin it does not need frequent INR monitoring. Despite promising features, serious hemorrhagic complications have been reported and bleeding risk is still its major challenge in clinical use. Cases of subdural hematoma, cerebral hemorrhage, GIS hemorrhage, and also intra-articular bleeding has been published (1). Hemothorax was assumed as a rare complication until recently published case reports (2, 3). Here, we announce our case to keep in mind that rivaroxaban is a cause of spontaneous hemothorax, as not uncommonly
Profile of Patients with Gaster Perforation at Dr. Moewardi General Hospital Surakarta in The Period of January-December 2018
Authors: Zaini Imam Hafidh , Ida Bagus Budhi  
Published: April 2021

Introduction: A gastric perforation is a form of hollow digestive organ perforation in which the entire thickness of the stomach wall is injured. Perforation of hollow organs can be suspected based upon the clinical picture, and the diagnosis becomes obvious through an image of free air on imaging performed.
Methods: Data of patient characteristics were observed retrospectively from medical records of patients diagnosed with gastric perforation between January and December 2018.
Results: Between January and December 2018, 45 patients with gastric perforation were identified, with data distributed by gender. There were 36 women (80%) and 9 men (20%) in the group. Based on the age group, 32 patients (71%) were distinguished by the age group over 40 years and 13 patients (29 %) under 40 years of age. When viewed from the location of the gastric perforations, it was found that 4 patients (9%) had a perforation in the antrum, 36 patients (80%) in the Prepylorus, and 5 patients (11.2%) in the major curvature. Data on analgesic use revealed 32 patients (71%) had a history of taking analgesics and 13 patients (29%) without a history of taking analgesics.
Conclusion: In 2018, the majority of gastric perforation patients at Dr. Moewardi Hospital were female (80%), with the highest age group being over 40 years (71%) and the most gastric perforations occurring in the pylori (80%). The number of patients with gastric perforation who had previously used herbs and analgesics was higher (70%) than those who had not. Thus, the results of this retrospective study are consistent with previous research findings and can be used to continue research into the relationships (correlations) between the aforementioned variables.
Perbaikan Atap Toilet, Pasang dan Plester Dinding, Pasang Keramik dan Pintu Mushola Al Hidayah, Pondok Manggis Rt 03/04, Bogor
Authors: Swastika Tri Widya , Sarito Sarito , Nurjanah Darul 
Published: April 2021

Berdasarkan hasil wawancara dan pengamatan tim Pengabdian Kepada Masyarakat, ditemukan beberapa permasalahan yang sangat krudensial mengenai keberadaan Mushola Al Hidayah Kampung Pondok Manggis yang sudah tidak layak digunakan sebagai prasarana beribadah umat muslim di lingkungan RT.03/RW.04, Desa Bojong Baru, Kecamatan Bojong Gede, Kabupaten Bogor. Diantaranya yaitu belum terlaksananya pengecoran atap, pemasangan dinding pembatas, plesteran dinding dan pemasangan keramik dinding serta lantai tempat wudhu. Untuk itu perlu dilakukan perbaikan Mushola Al Hidayah, terutama perbaikan pada atap toilet, plester dinding toilet, mengganti pintu toilet, pemasangan keramik dinding dan lantai tempat wudhu, serta pemasangan dan plester dinding penyekat. Dalam mencapai tujuan diatas maka tim Pengabdian Kepada Masyarakat Program Studi Konstruksi Gedung, Jurusan Teknik Sipil, Politeknik Negeri Jakarta, bekerjasama dengan warga secara bergotong royong melakukan perbaikan Mushola tersebut yang dilaksanakan pada tanggal 6 dan 13 Oktober 2018. Dimana target khusus dari kegiatan ini adalah menyempurnakan kondisi fisik Mushola Al Hidayah Kampung Pondok Manggis, RT.03/RW.04, Desa Bojong Baru, Kecamatan Bojong Gede, Kabupaten Bogor. Dengan selesainya pekerjaan tersebut maka tersedia prasarana Mushola yang memadai guna meningkatkan ketakwaan serta keimanan kepada Tuhan Yang Maha Esa.
An Overview of Earthquake Science in Malaysia
Authors: Tongkul Felix 
Published: April 2021

This paper highlights the level of earthquake hazard in Malaysia, the challenges in mitigating earthquake hazard and the way forward on how to strengthen earthquake science in Malaysia. Earthquake hazard is regarded as low throughout Malaysia, with the exception of Sabah where it is considered moderate. This elevated level of a hazard was reinforced during the 2015 Ranau Earthquake, which killed 18 people. Despite this and other recent sizeable earthquakes, the earthquake hazard in Malaysia is poorly understood, yet the population has increased, and growth in buildings and infrastructure has risen. While much progress has been made since the 2015 Ranau earthquake in terms of the development of (i) national seismic hazard map; (ii) national seismic building code; and (iii) planning guideline in a high-risk earthquake area, there are still many challenges faced in mitigating earthquake hazard in Malaysia. There is still a lack of seismic, geological, geodetic and engineering data; insufficient seismic and geodetic monitoring network system; lack of trained human resources; and lack of public awareness. To ensure that earthquake hazard is properly quantified and mitigated some steps have to be taken, which includes (i) comprehensive geological, geotechnical and engineering studies; (ii) coordinated seismic and geodetic monitoring; (iii) human resource capacity building; (iv) coordinated public education; (v) allocation of special research and development grant; and (vi) setting up of a National Earthquake Research Centre.
Cost-effectiveness analysis of caplacizumab in the new standard of care for immune Thrombotic Thrombocytopenic Purpura in Italy
Authors: Di Minno Giovanni , Ravasio Roberto 
Published: April 2021

Objectives: To evaluate the cost-effectiveness analysis (CEA) of caplacizumab in combination with plasmapheresis (PEX) and immunosuppression compared to PEX and immunosuppression in the treatment of acute episodes of iTTP.
Methods: A Markov model was used to conduct the CEA from the perspective of the hospital, over a lifetime horizon. Clinical data derived from HERCULES trial and a systematic literature review. Economic input included direct costs only. Utility and disutility values were obtained from literature. Data on healthcare resources and costs were retrieved from HERCULES trial, literature, TTP guidelines and Italian tariffs. A sensitivity analysis was conducted. The cost-effectiveness probability was tested for several options of discount levels considering a suggested willingness to pay (WTP) threshold of € 60,000 in Italy.
Results: The use of caplacizumab in combination with PEX and immunosuppression is associated with a positive difference in survival of 3.27 life years (24.53 vs 21.26) and in quality of life of 3.06 QALY (22.01 vs 18.96) when compared to PEX and immunosuppression. Caplacizumab leads to an ICER per life years of € 41,653 and an ICER per QALY of € 44,572. For the suggested WTP threshold, the probability of caplacizumab being cost-effective is 82.4% (no discount), 92.8% (15% discount), 95.3% (20% discount), 96.9% (25% discount) and 98.2% (30% discount).
Conclusions: Caplacizumab in addition to PEX and immunosuppression is cost-effective, allowing the hospital to achieve greater efficiency in managing the burden of a life-threatening disease such as iTTP.
Analysis of the Phenotypic Variability as Well as Impact of Early Diagnosis and Treatment in Six Affected Families With ALDH7A1 Deficiency
Authors: Jiao Xianru , Gong Pan , Wu Ye , Zhang Yuehua , Yang Zhixian 
Published: April 2021

ObjectiveTo describe the clinical characteristics of 12 patients from six families with pyridoxine-dependent epilepsy (PDE) carryingALDH7A1mutations, and analyze the impact of early diagnosis and treatment, as well as possible genotype–phenotype relationship.MethodsClinical and genetics data of 12 patients were collected.ResultsFamily 1–3 presented with symptoms in the neonatal period, while family 4-6 presented during early infancy. In the same family, the age of onset was similar. The focal motor seizure appeared in all patients. The affected identical twins from family 4 were diagnosed with infantile spasms. Mutation analysis identified nine differentALDH7A1mutations among six families. The neurodevelopment of siblings in family 1 was mild delay and normal separately due to the minor difference of delayed diagnosis time. Siblings in family 2 showed severely delayed and normal development respectively due to the significant difference of a delayed diagnosis for 4 years. In family 5, although the difference of the delayed diagnosis time is up to 7 years, the nearly normal psychomotor development in both patients might be due to infrequent seizures before the delayed diagnosis. A severe phenotype exhibited in family 3, 4, and 6. The survived affected patients presented with severe developmental delay or refractory seizures and their twins or older sisters presented a similar clinical history and died in the early days of life. Mutation analysis showed D511N and IVS11 + 1G &gt; A in family 3, V188A and exon1 deletion in family 4, and Y354C and exon 8–13 deletion in family 6.ConclusionPatients from the same family often have the same phenotype, including onset age and seizure type. Early treatment with pyridoxine and infrequent seizures showed positive relationship with prognosis. The deletion of exon 1 and exon 8–13 might be associated with the severe phenotype.
Alteration of the Gut Microbiome in Chronic Kidney Disease Patients and Its Association With Serum Free Immunoglobulin Light Chains
Authors: Liu Fengping , Xu Xuefang , Chao Lin , Chen Ke , Shao Amo , Sun Danqin , Hong Yan , Hu Renjing , Jiang Peng , Zhang Nan , Xiao Yonghong , Yan Feng , Feng Ninghan 
Published: April 2021

ObjectivesGut dysbiosis is associated with chronic kidney disease (CKD), and serum free immunoglobulin light chains (FLCs) are biomarkers for CKD. This study aims to assess the CKD gut microbiome and to determine its impact on serum FLC levels.MethodsTo control for confounders, 100 patients and sex- and age-matched healthy controls (HCs) were recruited. The gut microbiome was assessed by sequencing 16S rRNA gene V3-V4 hypervariable regions. Phylogenetic Investigation of Communities by Reconstruction of Unobserved States was applied to infer functional metabolic pathways. When observing group differences in the microbiome and predicted metabolic pathways, demographic confounders were adjusted using binary logistic regression; when examining impacts of the gut microbiome and metabolic pathways on serum FLCs, factors influencing FLC levels were adjusted using multiple regression.ResultsPrincipal coordinate analysis revealed a significantly different bacterial community between the CKD and HC groups (P &lt; 0.05). After adjusting for confounders, lower Chao 1, observed species and Shannon indices based on binary logistic regression predicted CKD prevalence. Actinobacteria, Alistipes, Bifidobacterium and Bifidobacterium longum enrichment, upregulation of metabolic pathways of bacterial toxin, chloroalkane and chloroalkene degradation, and Staphylococcus aureus infection also predicted CKD prevalence (P &lt; 0.05). Furthermore, depletion of Actinobacteria and Bifidobacterium and reduced chloroalkane and chloroalkene degradation predicted high levels of FLC λ (P &lt; 0.05).ConclusionsGut dysbiosis in CKD patients was confirmed by controlling for confounders in the present study. Additionally, the association between gut dysbiosis and FLC λ levels demonstrates the existence of crosstalk between the microbiome and immune response in CKD.
Identification of Epithelial-Mesenchymal Transition-Related lncRNAs that Associated With the Prognosis and Immune Microenvironment in Colorectal Cancer
Authors: Liu Chuan , Hu Chuan , Li Jianyi , Jiang Liqing , Zhao Chengliang 
Published: April 2021

Background: The expression of long non-coding RNA (lncRNA) is associated with the epithelial-mesenchymal transition (EMT) in tumorigenicity, but the role of EMT-related lncRNA in colorectal cancer (CRC) remains unclear.Methods: The clinical data and gene expression profile of CRC patients were obtained from The Cancer Genome Atlas database. Differential expression analysis, Cox regression model, and Kaplan-Meier analysis were used to study the relationship between EMT-related lncRNAs and the prognosis of CRC. Functional analysis and unsupervised clustering analysis were performed to explore the influence of certain lncRNAs on CRC. Finally, Cytoscape was used to construct mRNA-lncRNA networks.Results: Two signatures incorporating six and ten EMT-related lncRNAs were constructed for predicting the overall survival (OS) and disease-free survival (DFS), respectively. Kaplan-Meier survival curves indicated that patients in the high-risk group had a poorer prognosis than those in the low-risk group. The results of the functional analysis suggested that the P53 and ECM-receptor pathways affect the prognosis of CRC, and AL591178.1 is a key prognostic EMT-related lncRNA, which is negatively related to immune cells, P53 pathway, and ECM-receptor pathway.Conclusion: Six OS-related and ten DFS-related EMT-related lncRNAs were correlated with the prognosis of CRC by potentially affecting the immune microenvironment, and AL591178.1 plays a key role as a prognostic factor.
Radiographic Features and Clinical Factor for Preoperative Prediction in the Bulging Duodenal Papilla With Malignancy
Authors: Wang Xiao-Jie , Ke Jun-Li , Xu Jian-Xia , Zhou Jia-Ping , Lu Yuan-Fei , Zhou Qiao-Mei , Shi Dan , Yu Ri-Sheng 
Published: April 2021

BackgroundTo investigate characteristic clinical and imaging features and establish a scoring system for preoperative prediction of malignancy in the bulging duodenal papilla.MethodsA total of 147 patients with bulging duodenal papilla (Benign enlargement n = 67; malignant enlargement n = 80) from our hospital between 2010 and 2020 were retrospectively analyzed. We investigated meaningful clinical and CT imaging features and established the score model through logistic regression and weighted. The calibration test, the ROC, AUC, and cut-off points were performed in score model. The model was also divided into three score ranges for convenient clinical evaluation.ResultsThree clinical and CT imaging features were finally included in the score model including direct bilirubin (DBil) increase &gt;7 umol/L (3 points), pancreatic duct (PD) dilation &gt;5 mm (2 points), and irregular shape (2 points). The AUCs of the primary predictive model and score model were 0.896 (95% CI, 0.835–0.940) and 0.896 (95% CI, 0.835–0.940), respectively. This scoring system presented with a sensitivity of 78.8% and a specificity of 88.1% when using 2.5 points as cutoff value. Three score ranges were also proposed for convenient clinical use as follows: 0–2 points; 3–4 points; 5–7 points. The number of patients with malignant duodenal papillary enlargement increased with the increasing scores.ConclusionsWe proposed a convenient scoring system to preoperative predict malignancy in the bulging duodenal papilla.