bluuebunny/crossref_metadata_2025_split huggingface dataset:
654 Outcome and Complications Following Revision Shoulder Arthroplasty. A Systematic Review and Meta-Analysis
Authors: Ravi V , Murphy R , Moverley R , Derias M , Phadnis J 
Published: October 2021

Abstract

Introduction
It is important to understand the rate of complications associated with the increasing burden of revision shoulder arthroplasty. Currently, this has not been well quantified. This review aims to address that deficiency with a focus on (i) shoulder outcome scores, (ii) complication and reoperation rates and (iii) comparison of anatomic and reverse prostheses when used in revision surgery.

Method
A PRISMA systematic review was performed to identify clinical data for patients undergoing revision shoulder arthroplasty. Data were extracted from the literature and pooled for analysis. Complication and reoperation rates were analysed using a meta-analysis of proportion and continuous variables underwent comparative subgroup analysis.

Results
107 studies (5,010 shoulders) were eligible for inclusion, although complete clinical data was not ubiquitous. Indications for revision included component loosening 20% (n = 584/2872), instability 20% (n = 577/2872), rotator cuff failure 18% (n = 528/2872) and infection 17% (n = 490/2872). Revision surgery resulted in a clinically important improvement in patient-reported outcome measures (PROMs). Intraoperative complication, postoperative complication and reoperation rates were 3% (n = 205/4919), 22% (n = 722/3474) and 15% (n = 533/3474) respectively. Intraoperative and postoperative complications included iatrogenic humeral fractures (n = 134/205, 65%) and instability (n = 209/772, 27%). Revision to reverse TSA, rather than revision to anatomic TSA from any index prosthesis resulted in lower complication rates (22% vs. 29%, p &lt; 0.001 odds ratio 1.5) and superior Constant scores (59.9 vs. 53.8, p &lt; 0.001), although no difference in ASES scores.

Conclusions
Satisfactory improvement in PROMs are reported following revision shoulder arthroplasty; however, revision surgery is associated with high complication rates and better outcomes may be evident following revision to reverse TSA.
843 Annular Closure Device for Disc Herniation: Meta-Analysis of Clinical Outcome and Complications
Authors: Ong C S , Choy W J , Phan K , Diwan A , Mobbs R 
Published: October 2021

Abstract

Aim
To assist surgeons to determine a potential approach to reduce incidences of recurrent lumbar disc herniation and assess the current devices regarding their outcomes and complications.

Method
Four electronic full-text databases were systematically searched through September 2017. All results were pooled utilising meta-analysis with weighted mean difference and odds ratio as summary statistics.

Results
Four studies met inclusion criteria. Three studies reported the use of Barricaid (ACD) while one study reported the use of Anulex (AR). A total of 24 symptomatic reherniation were reported among 811 discectomies with ACD/AR as compared to 51 out of 645 in the control group (OR: 0.34; 95% CI: 0.20,0.56; I2 = 0%; P &lt; 0.0001). Durotomies were lower among the ACD/AR patients with only 3 reported cases compared to 7 in the control group (OR: 0.54; 95% CI: 0.13, 2.23; I2 = 11%; P = 0.39). Similar outcomes for post-operative Oswestry Disability Index and visual analogue scale were obtained when both groups were compared.

Conclusions
Early results showed the use of Barricaid and Anulex devices are beneficial for short term outcomes demonstrating a reduction in symptomatic disc reherniation with low post-operative complication rates. Long-term studies are required to further investigate the efficacy of such devices.
871 Liver Transplant for Colorectal Liver Metastases: A Systematic Review and Meta-Analysis of Proportions
Authors: Varley R , Tarazi M , Davé M , Mobarak S , Stott M , Baltatzis M , Satyadas T 
Published: October 2021

Abstract

Introduction
Colorectal liver metastases were historically considered a contraindication to liver transplantation, but dismal outcomes for those with metastatic colorectal cancer and advancements in liver transplantation (LT) have led to a renewed interest in the topic. We aim to compare the current evidence for liver transplantation for non-resectable colorectal liver metastases (NRCLM) with the current standard treatment of palliative chemotherapy reported in literature – 5-year survival rate &lt;10%.

Method
A systematic review and meta-analysis of proportions was conducted following screening of MEDLINE, EMBASE, SCOPUS and CENTRAL for studies reporting liver transplantation for colorectal liver metastases. Post-operative outcomes measured included 1-, 3- and 5-year survival, overall survival, disease-free survival, and complication rates.

Results
Three non-randomised studies met the inclusion criteria, reporting a total of 48 patients receiving LT for NRCLM. Survival at 1-, 3- and 5-years was 83.3-100%, 58.3-80% and 50-80% respectively with no significant difference detected (p = 0.22, p = 0.48, p = 0.26). Disease free survival was 35-56% with the most common site of recurrence being lung. Thirteen out of fourteen deaths were due to disease recurrence.

Conclusions
Although current evidence suggests a survival benefit conferred by LT in NRCLM compared to palliative chemotherapy, the ethical implications of organ availability and allocation demand rigorous justification. Eight registered clinical trials will report on 300 more patients undergoing LT for NRCLM over the next 10 years: concomitant improvements in the management of patients following liver resection and of palliative chemotherapy regimens is paramount.
970 Age-related Differences in Acute Skeletal Muscle Atrophy After Immobilisation: A Systematic Review
Authors: Hodgson H , Wilkinson M , Howard A 
Published: October 2021

Abstract

Introduction
Muscle atrophy is a recognised cause of morbidity and mortality. Whilst the association between loss of muscle mass and age is well established, it is controversial as to whether older adults’ atrophy at a different rate or are more susceptible to atrophy in the acute setting. The aim of this systematic review is to identify if there are any age-related differences in the rate of atrophy between older and younger persons.

Method
A systematic search of Medline, Embase and Cochrane databases in December 2020 was carried out. All studies whose design involved a period of immobilisation and a comparison between older and younger cohorts were included. Studies must have direct pre-and-post immobilisation muscle mass measurements, and the percentage change in muscle mass was extracted from each study.

Results
Searching revealed 1007 records, of which six articles met the inclusion and exclusion criteria. 150 participants were included; 136 (90.7%) were male, and 14 (9.3%) were female. Studies used immobilisation periods between five and 14 days, and measured muscle volume by MRI, DXA or CT. Three studies reported greater atrophy in the older group, and three studies reported greater atrophy in the younger group.

Conclusions
There is no convincing evidence of any differences between the rates of atrophy in older persons in comparison to younger persons. We highlight that the current literature is inconsistent and overall, there is a lack of high-quality research on the topic, with particular concern regarding the significant lack of literature regarding atrophy rates in women.
1044 Impact of Obesity on Complications from Anterior Lumbar Interbody Fusion
Authors: Feeley A , Feeley I , Butler J 
Published: October 2021

Abstract

Aim
Anterior Lumbar Interbody Fusion is a procedure growing in popularity for conditions including degenerative disc disease, and discogenic back pain. Obesity is a significant risk factor in the development of back pain, with patients with raised BMIs at increased of complications using the posterior approach. This review aims to evaluate the risk profile of this patient cohort using the anterior approach for lumbar interbody fusion.

Method
A systematic review of the search databases Pubmed; google scholar; and OVID Medline was carried out between September 2020-November 2020. Studies evaluating the risks associated with obesity during Anterior Lumbar Interbody Fusion (ALIF) were identified and included for review according to PRISMA guidelines. Studies eligible for inclusion were agreed by two independent reviewers. Meta-analysis was used to compare intra- and postoperative complications in patients with increased BMI during ALIF.

Results
Search terms yielded 435 articles for evaluation. 13 studies were included in this review after applying inclusion and exclusion criteria. Meta-analysis of studies demonstrated a significantly increased risk profile for overall complications in the obese patient cohort (CI = 0.04-0.16, p = 0.002) with significant heterogeneity (I2=86%). Patients with increased BMI were not significantly more likely to develop Vascular complications (CI= -.03-0.02, p = 0.62). Simple pooling demonstrated significant association between increased BMI and blood loss.

Conclusions
Obesity was demonstrated to have an impact on overall complication rates in Anterior Lumbar Interbody Fusion procedures, with postoperative complications including wound infections and lower fusion rates more common in patients in increased BMIs.
1046 Anterior Lumbar Interbody Fusion Approaches: A Systematic Review
Authors: Feeley A , Feeley I , Clesham K , Butler J 
Published: October 2021

Abstract

Aim
Anterior lumbar interbody fusion (ALIF) is a well-established alternative to posterior-based interbody fusion techniques, with approach variations, such as retroperitoneal; transperitoneal; open; and laparoscopic well described. Variable rates of complications for each approach have been enumerated in the literature. We aim to elucidate the comparative rates of complications across approach type.

Method
A systematic review of the search databases Pubmed; google scholar; and OVID Medline was made in November 2020 to identify studies related to complications associated with anterior lumbar interbody fusion. PRISMA guidelines were utilised for this review. Studies eligible for inclusion were agreed by two independent reviewers. Meta-analysis was used to compare intra- and postoperative complications with ALIF for each approach.

Results
4575 studies were identified, with 5728 patients across 31 studies included for review following application of inclusion and exclusion criteria. Meta-analysis demonstrated the transperitoneal approach resulted in higher rates of Retrograde Ejaculation (RE) (p &lt; 0.001; CI = 0.05-0.21) and overall rates of complications (p = 0.05; CI = 0.00-0.23). Rates of RE were higher at the L5/S1 intervertebral level. Rates of vessel injury were not significantly higher in either approach method (p = 0.89; CI=-0.04-0.07). Laparoscopic approaches resulted in shorter inpatient stays (p = 0.01).

Conclusions
Despite the transperitoneal approach being comparatively underpowered, its use appears to result in a significantly higher rate of intra- and postoperative complications, although confounders including use of BMP and spinal level should be considered. Laparoscopic approaches resulted in shorter hospital stays, however its steep learning curve and longer operative time have deterred surgeons from its widespread adaptation.
1510 Percutaneous Coronary Intervention vs Coronary Artery Bypass Grafting in Left Main Coronary Artery Disease. A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Authors: Hennessy C , Henry J A 
Published: October 2021

Abstract

Aim
There is still no consensus whether percutaneous coronary intervention (PCI) is as safe and effective as coronary artery bypass grafting (CABG) for left main coronary artery (LMCA) disease. Recent updates from key clinical trials necessitated an updated examination of the literature on this topic.

Method
A systematic search was performed of the MEDLINE (via PubMed), EMBASE, Cochrane and clinicaltrials.gov databases from inception to December 20th, 2020. Selected studies were analysed using the random effects model. Outcomes measured included all-cause mortality, MACCE, myocardial infarction (MI), stroke and revascularization. Follow up points were 30 days, 1 year, 5 years and 10 years.

Results
Six RCTs with a total population of 4700 were included in the analysis. For all-cause mortality PCI was non-inferior to CABG at all time points. MACCE favoured PCI at 30 days, and CABG at 5 years. No difference was seen at 1 year and 10 years. MI favoured CABG at 5 years follow up, with no difference seen at 30 days, 1 year or five years. For stroke, PCI was favourable to CABG at 30 days and 1 year, with no difference at 5 years and 10 years. Revascularisation favoured CABG at 1 year and 5 years, with no difference at other time-points.

Conclusions
PCI may be considered as an alternative to CABG for uncomplicated LMCA disease. More complex lesions may still benefit from CABG. CABG may be of benefit where future revascularisation would rather be avoided. Further clinical trials examining this research question are needed.
Pannexin 1: a novel regulator of acute hypoxic pulmonary vasoconstriction
Authors: Grimmer Benjamin , Krauszman Adrienn , Hu Xudong , Kabir Golam , Connelly Kim A , Li Mei , Grune Jana , Madry Christian , Isakson Brant E , Kuebler Wolfgang M 
Published: October 2021

Abstract

Aims
Hypoxic pulmonary vasoconstriction (HPV) is a physiological response to alveolar hypoxia that diverts blood flow from poorly ventilated to better aerated lung areas to optimize ventilation-perfusion matching. Yet, the exact sensory and signalling mechanisms by which hypoxia triggers pulmonary vasoconstriction remain incompletely understood. Recently, ATP release via pannexin 1 (Panx1) and subsequent signalling via purinergic P2Y receptors has been identified as regulator of vasoconstriction in systemic arterioles. Here, we probed for the role of Panx1-mediated ATP release in HPV and chronic hypoxic pulmonary hypertension (PH).

Methods and results
Pharmacological inhibition of Panx1 by probenecid, spironolactone, the Panx1 specific inhibitory peptide (10Panx1), and genetic deletion of Panx1 specifically in smooth muscle attenuated HPV in isolated perfused mouse lungs. In pulmonary artery smooth muscle cells (PASMCs), both spironolactone and 10Panx1 attenuated the increase in intracellular Ca2+ concentration ([Ca2+]i) in response to hypoxia. Yet, genetic deletion of Panx1 in either endothelial or smooth muscle cells did not prevent the development of PH in mice. Unexpectedly, ATP release in response to hypoxia was not detectable in PASMC, and inhibition of purinergic receptors or ATP degradation by ATPase failed to attenuate HPV. Rather, transient receptor potential vanilloid 4 (TRPV4) antagonism and Panx1 inhibition inhibited the hypoxia-induced [Ca2+]i increase in PASMC in an additive manner, suggesting that Panx1 regulates [Ca2+]i independently of the ATP-P2Y-TRPV4 pathway. In line with this notion, Panx1 overexpression increased the [Ca2+]i response to hypoxia in HeLa cells.

Conclusion
In the present study, we identify Panx1 as novel regulator of HPV. Yet, the role of Panx1 in HPV was not attributable to ATP release and downstream signalling via P2Y receptors or TRPV4 activation, but relates to a role of Panx1 as direct or indirect modulator of the PASMC Ca2+ response to hypoxia. Panx1 did not affect the development of chronic hypoxic PH.
Paradoxical cardiac conduction during exercise stress testing in myotonic dystrophy type 1: a case report
Authors: Ahmad Suliman , Kabunga Peter 
Published: October 2021

Abstract

Background
Exercise stress testing (EST) identifies functional abnormalities that may manifest only during physiologic stress to the heart. This may have significant prognostic value in identifying latent conduction abnormalities in asymptomatic patients with myotonic dystrophy type 1 (MD1), who may benefit from prophylactic permanent pacemaker (PPM) implantation.

Case report
We report the case of a patient with MD1 with a 5-month history of atypical left-sided chest pain. Her baseline electrocardiogram (ECG) showed sinus rhythm and variable PR interval prolongation (206–220 ms) without symptoms of cardiac conduction disease. Routine blood tests and cardiac investigations including a 24-h ECG monitoring, echocardiogram, and a cardiac magnetic resonance imaging scan, revealed no abnormalities. To investigate her chest pain and to determine the need for prophylactic PPM implantation, EST and an electrophysiological study were performed. Exercise testing revealed minimal PR shortening (PR = 200 ms) at peak exercise and paradoxical PR prolongation (PR = 280 ms) during the early recovery period. A prophylactic DDDR PPM was implanted following an electrophysiological study that revealed a prolonged His-ventricle (HV) interval of 84 ms.

Discussion
The current use of annual ECG and 24 Holter monitoring may not adequately detect abnormal cardiac conduction in asymptomatic patients with MD1. The invasive nature of electrophysiology studies limits its use as a screening tool for conduction abnormalities in asymptomatic patients. Thus, EST could be used to identify underlying conduction abnormalities in MD1 patients without any specific symptoms of bradycardia, which warrant further invasive electrophysiological studies (EPS).
An engineered, orthogonal auxin analog/AtTIR1(F79G) pairing improves both specificity and efficacy of the auxin degradation system inCaenorhabditis elegans
Authors: Hills-Muckey Kelly , Martinez Michael A Q , Stec Natalia , Hebbar Shilpa , Saldanha Joanne , Medwig-Kinney Taylor N , Moore Frances E Q , Ivanova Maria , Morao Ana , Ward J D , Moss Eric G , Ercan Sevinc , Zinovyeva Anna Y , Matus David Q , Hammell Christopher M 
Published: October 2021

AbstractThe auxin-inducible degradation system in C. elegans allows for spatial and temporal control of protein degradation via heterologous expression of a single Arabidopsis thaliana F-box protein, transport inhibitor response 1 (AtTIR1). In this system, exogenous auxin (Indole-3-acetic acid; IAA) enhances the ability of AtTIR1 to function as a substrate recognition component that adapts engineered degron-tagged proteins to the endogenous C. elegans E3 ubiquitin ligases complex [SKR-1/2-CUL-1-F-box (SCF)], targeting them for degradation by the proteosome. While this system has been employed to dissect the developmental functions of many C. elegans proteins, we have found that several auxin-inducible degron (AID)-tagged proteins are constitutively degraded by AtTIR1 in the absence of auxin, leading to undesired loss-of-function phenotypes. In this manuscript, we adapt an orthogonal auxin derivative/mutant AtTIR1 pair [C. elegans AID version 2 (C.e.AIDv2)] that transforms the specificity of allosteric regulation of TIR1 from IAA to one that is dependent on an auxin derivative harboring a bulky aryl group (5-Ph-IAA). We find that a mutant AtTIR1(F79G) allele that alters the ligand-binding interface of TIR1 dramatically reduces ligand-independent degradation of multiple AID*-tagged proteins. In addition to solving the ectopic degradation problem for some AID-targets, the addition of 5-Ph-IAA to culture media of animals expressing AtTIR1(F79G) leads to more penetrant loss-of-function phenotypes for AID*-tagged proteins than those elicited by the AtTIR1-IAA pairing at similar auxin analog concentrations. The improved specificity and efficacy afforded by the mutant AtTIR1(F79G) allele expand the utility of the AID system and broaden the number of proteins that can be effectively targeted with it.
IBD Disability Index Is Associated With Both Direct and Indirect Costs of Inflammatory Bowel Disease
Authors: Shafer Leigh Anne , Shaffer Seth , Witt Julia , Nugent Zoann , Bernstein Charles N 
Published: October 2021

AbstractIntroductionWe aimed to determine both direct (medical) and indirect (lost wages) costs of IBD and the association between the degree of IBD-related disability and extent of IBD-related costs.MethodsPersons age 18-65 from the population-based University of Manitoba IBD Research Registry completed a survey including the IBD Disability Index (IBDDI) and questions related to employment, missed work (absenteeism), and reduced productivity at work (presenteeism). Administrative health data including surgeries, hospitalizations, physician claims, and prescriptions were linked to the survey and assessed. To calculate annual wage loss, number of days of missed work was multiplied by the average wage in Manitoba for the given occupation per Statistics Canada. Costs were adjusted to 2016-17 Canadian dollars. Using descriptive and regression analysis, we explored the association between IBDDI and annual direct and indirect costs associated with IBD.ResultsAverage annual medical costs rose from $1918 among those with IBDDI 0-4 to $9,993 among those with IBDDI 80-86. Average annual cost of lost work rose from $0 among those with IBDDI 0-4 to $30,101 among those with IBDDI 80-86. Using linear regression, each additional unit of IBDDI was associated with an increase of $77 in annual medical cost (95% CI, $52-102; P &lt; .001) and an increase of $341 in annual cost of lost wages (95% CI, $288-395; P &lt; .001).ConclusionsCosts related to IBD are significantly associated with the degree of IBD-related disability. Among the approximate 30% of the IBD population with IBDDI scores ≥40, the indirect costs of absenteeism and presenteeism accounts for ~75% of the total IBD-related costs.
Bariatric Surgery in Patients With Inflammatory Bowel Disease: A Case-Control Study from the GETAID
Authors: Reenaers Catherine , de Roover Arnaud , Kohnen Laurent , Nachury Maria , Simon Marion , Pourcher Guillaume , Trang-Poisson Caroline , Rajca Sylvie , Msika Simon , Viennot Stéphanie , Alttwegg Romain , Serrero Mélanie , Seksik Philippe , Peyrin-Biroulet Laurent , Picon Laurence , Bourbao Tournois Céline , Gontier Renaud , Gilletta Cyrielle , Stefanescu Carmen , Laharie David , Roblin Xavier , Nahon Stéphane , Bouguen Guillaume , Carbonnel Franck , Attar Alain , Louis Edouard , Coffin Benoît 
Published: October 2021

Abstract

Background
The prevalence of obesity and the number of bariatric surgeries in both the general population and in patients with inflammatory bowel disease (IBD) have increased significantly in recent years. Due to small sample sizes and the lack of adequate controls, no definite conclusions can be drawn from the available studies on the safety and efficacy of bariatric surgery (BS) in patients with IBD. Our aim was to assess safety, weight loss, and deficiencies in patients with IBD and obesity who underwent BS and compare findings to a control group.

Methods
Patients with IBD and a history of BS were retrospectively recruited to centers belonging to the Groupe d’Etude Thérapeutique des Affections Inflammatoires du Tube Digestif (GETAID). Patients were matched 1:2 for age, sex, body mass index (BMI), hospital of surgery, and type of BS with non-IBD patients who underwent BS. Complications, rehospitalizations, weight, and deficiencies after BS were collected in cases and controls.

Results
We included 88 procedures in 85 patients (64 Crohn’s disease, 20 ulcerative colitis, 1 unclassified IBD) with a mean BMI of 41.6 ± 5.9 kg/m2. Bariatric surgery included Roux-en-Y gastric bypass (n = 3), sleeve gastrectomy (n = 73), and gastric banding (n = 12). Eight (9%) complications were reported, including 4 (5%) requiring surgery. At a mean follow-up of 34 months, mean weight was 88.6 ± 22.4 kg. No difference was observed between cases and controls for postoperative complications (P = .31), proportion of weight loss (P = .27), or postoperative deficiencies (P = .99).

Conclusions
Bariatric surgery is a safe and effective procedure in patients with IBD and obesity; outcomes in this patient group were similar to those observed in a control population.