bluuebunny/crossref_metadata_2025_split huggingface dataset:
Esophago-bronchial fistula treated by the Over-The-Scope-Clipping (OTSC) system with argon beam electrocoagulation
Authors: Sonomura Jun , Shimizu Tetsunosuke , Taniguchi Kohei , Lee Sang-Woong , Tanaka Ryo , Imai Yoshiro , Honda Kotaro , Kawai Masaru , Tashiro Keitaro , Uchiyama Kazuhisa 
Published: January 2021

Abstract

Rationale:
An esophago-bronchial fistula is one of the rare postoperative complications of esophageal cancer. There are various medical treatments, including suturing, endoscopic clip, and fibrin glue. However, these treatments often lead to unsatisfactory results, causing physicians to opt for surgical alternatives. The Over-The-Scope-Clipping (OTSC) system offers an alternative method for fistula closure. It can capture a large amount of tissue and is able to compress the lesion until it has fully healed. However, data indicating the efficacy of OTSC for esophago-bronchial fistula are limited.

Patient concerns:
A 64-year-old man presented with an esophago-bronchial fistula after surgery for esophageal cancer. We chose to use a stent as the first line of treatment, but the fistula did not close.

Diagnoses:
Intractable esophago-bronchial fistula associated with esophageal surgery.

Interventions and Outcomes:
On the 94th postoperative day, fistula closure with OTSC was performed, and no leakage of the contrast agent was observed during fluoroscopy. We also attempted to close the fistula by combining OTSC and argon plasma coagulation (APC) to burn off the scar tissue from around the fistula. The fistula gradually shrank after a total of 4 rounds of OTSC, and closure of the fistula was achieved on the 185th postoperative day. There were no adverse events during the treatment of this case.

Lessons:
We demonstrate that OTSC is useful in the management of esophago-bronchial fistulas, and may become a standard procedure for the endoscopic treatment of esophago-bronchial fistulas, replacing the use of stents, clips, or glue.
Seizure-like movements caused by residual sevoflurane inside the anesthesia machine
Authors: Zheng Jianqiao , Du Li , Zhang Lu 
Published: January 2021

Abstract

Rationale:
Sevoflurane-induced seizures are most often caused by high concentrations of sevoflurane during anesthesia induction. However, in this case, we found a rare case of seizure-like movements caused by residual sevoflurane inside the anesthesia machine. Therefore, we propose that the detection of residual anesthesia-inhaled drugs should be included in pre-anesthesia checkout procedures.

Patient concerns:
An 11-year-old girl with a history of epilepsy was scheduled for emergency appendectomy under general anesthesia. The patient presented with seizure-like movements caused by residual sevoflurane inside the anesthesia machine after pre-oxygenation during rapid sequence induction.

Diagnoses:
Based on the clinical presentation and previous history of seizures, sevoflurane-induced seizures were diagnosed.

Interventions:
A washout procedure was performed by turning the oxygen flow up to 10L/min to wash out the residual sevoflurane from the anesthesia machine.

Outcomes:
The seizures ceased spontaneously, and the vital signs of the patient were stable during the washout procedure. Rapid sequence anesthesia induction and total intravenous anesthesia maintenance were uneventful. Surgery was performed as planned, and there were no postoperative problems. The patient was discharged after 4 days without complications and was well on follow-up.

Lessons:
The check-up procedure of residual anesthesia-inhaled drugs inside the anesthesia machine should be included in the checkout design guidelines, or else the washout procedure should be performed in the pre-anesthesia checkout procedures.
Simultaneous cardio-cerebral infarction in the coronavirus disease pandemic era
Authors: Eskandarani Rawan , Sahli Seham , Sawan Shaima , Alsaeed Asim 
Published: January 2021

Abstract

Introduction:
Simultaneous occurrence of acute ischemic stroke and myocardial infarction is reported to have variable precipitating causes. This occurrence has been rarely reported in the literature and described only in very few case reports. During the surge of coronavirus disease (COVID-19) in our region, we noted an increase in the simultaneous occurrence of cardio-cerebral infarction. This led us to explore the possible mechanisms and pathophysiology that could contribute to this increase. The retrospective nature of the study limited us from drawing any conclusion about causation. Rather, we aimed to formulate a hypothesis for future, more rigorous studies.

Patient concerns:
We present an overview of 5 cases of simultaneous cardio-cerebral infarction that we encountered in our emergency department within 1 month.

Diagnosis:
In all cases, diagnosis was confirmed using an electrocardiogram, assessment of laboratory cardiac markers, and imaging.

Interventions:
In all cases, dual antiplatelet therapy was started and thrombolysis was held, as the condition was considered high risk in most of the patients. Cardiac catheterization lab was not activated either because the patient was unstable or the risk of COVID-19 in staff outweighed the benefit added in patient treatment.

Outcomes:
Two out of 5 patients died because of early complications that lasted for few days. The remaining 3 were discharged from the hospital in moderate functionality for extensive therapy and rehabilitation.

Conclusion:
Early recognition and immediate treatment is important in different scenarios leading to thrombosis as the outcome. Additionally, addressing the unknown risks that could contribute to our traditional understanding of these causative mechanisms is important. The hypothesis of exacerbated damage caused by inflammatory and immunological endothelial systemic damage should further be explored to be able to delineate new possibilities in managing these conditions.
Three novel ATG16L1 mutations in a patient with acute myocardial infarction and coronary artery ectasia
Authors: Han Falan , Yan Bo 
Published: January 2021

Abstract

Introduction:
Acute myocardial infarction (AMI) is a specific type of coronary artery disease (CAD) caused by the rupture of coronary atherosclerotic plaques. Coronary artery ectasia (CAE) is a rare phenotype of cardiovascular disease that may promote thrombosis and inflammatory responses leading to myocardial infarction due to abnormal dilatation of blood vessels and coronary blood flow disorders. It is a complicated disease and shows interaction between genetic and environmental factors.

Patient concerns:
A 34-year-old male patient was admitted to our hospital on May 12, 2016, with complaints of chest pain for 1 hour duration.

Diagnosis:
Coronary angiography through the emergency medical service (EMS) system showed 100% occlusion at the first turning point of the right coronary artery (RCA), along with tumor-like expansion of the proximal segment of the RCA and the end of the left main (LM) artery. The patient was diagnosed with AMI and CAE. Three-point mutations in the ATG16L1 gene were identified by direct sequencing.

Interventions:
After admission, the patient underwent emergency green channel coronary angiography and percutaneous coronary intervention (PCI) to assess and unblock the stenosis and occlusion of the RCA lumen, but no stenting was performed because the catheter could not pass the second inflection point of the RCA. Aspirin enteric-coated tablets, clopidogrel sulfate tablets, tirofiban hydrochloride, and low molecular weight heparin calcium were given as anticoagulant and antiplatelet therapy. Atorvastatin calcium tablets were used to regulate blood lipid levels. Perindopril and spironolactone were used to inhibit the renin-angiotensin-aldosterone system (RAAS) to reverse myocardial remodeling. Acetylcholinesterase inhibitors (ACEI) and beta blockers were administered to resist ventricular remodeling and improve cardiac function and prognosis after the patient's blood pressure and heart rhythm were stabilized.

Outcomes:
After active rescue treatment, the patient recovered and was discharged. A coronary angiogram performed 2 years later showed that the RCA blood flow was restored, and the patient had recovered well.

Conclusion:
Three-point mutations in the ATG16L1 gene were identified in a patient with AMI and CAE, which extended the mutation spectrum of the ATG16L1 gene. Hence, the etiology of coronary artery aneurysmal dilatation is worthy of further investigation.
Clinical features and outcome of pediatric acute lymphoblastic leukemia with low peripheral blood blast cell count at diagnosis
Authors: Dai Qingkai , Zhang Ge , Yang Hui , Wang Yuefang , Ye Lei , Peng Luyun , Shi Rui , Guo Siqi , He Jiajing , Jiang Yongmei 
Published: January 2021

Abstract
Peripheral blood (PB) blast cell count on day 8 of prednisone therapy has been considered one of the strongest predictors of outcome in children with acute lymphoblastic leukemia (ALL). However, little is known about the clinical features and prognostic impact of PB blast cell count at diagnosis in these patients. The aim of this study was to evaluate the relationship between initial PB blast cell count and clinical prognosis of pediatric ALL.
The study comprised 367 patients with ALL, aged 0 to 14 years, enrolled and treated using the Chinese Children's Leukemia Group-ALL 2008 protocol between 2011 and 2015. The majority (91.6%) of patients were B-cell precursor ALL (BCP ALL), and 8.4% were T-cell ALL (T-ALL).
Patients with BCP ALL in the low PB blast cell count group (<1 × 109/L) had significantly superior survival rates to those in the high count group (≥30 × 109/L). In T-ALL, the low count group showed significantly inferior survival rates compared to both the intermediate count group (1–29.9 × 109/L) and high count group. Multivariate analysis revealed that the initial white blood cell count and minimal residual disease at the end of induction therapy were independently predictive of BCP ALL outcome, while risk stratification was shown to be an independent prognostic factor for T-ALL outcome.
These results indicated that low blast cell count in PB at diagnosis was associated with different clinical outcomes in patients with BCP ALL and T-ALL, although it was not an independent outcome predictor by multivariate analysis.
The gap between overweight and obesity status in children - (STROBE-compliant article)
Authors: Mărginean Cristina Oana , Meliţ Lorena Elena , Huţanu Adina , Ghiga Dana Valentina , Săsăran Maria Oana 
Published: January 2021

Abstract
Overweight might represent only the early stage of obesity or it might act as a trigger of self-awareness turning into an ideal chance for preventing further obesity development.
The aim of this study was to assess the differences between overweight and obese children in terms of anthropometric, low-grade systemic inflammation, liver impairment and atherosclerotic risk.
We performed a study on 132 children aged between 5 and 18 years, divided according to the BMI into 2 groups: group 1 to 76 obese children, and group 2 to 56 overweight children, assessing anthropometric, laboratory and elastography parameters.
We obtained significantly higher values of anthropometric parameters in obese children versus overweight ones. We found higher levels of leukocytes, lymphocytes, AST, ALT, and E median (P = .0345, P = .0103, P < .0001, P = .0008 and P < .0001) in the obese group as compared to the overweight one. BMI was positively correlated with neutrophils, NLR, ESR, glycemia, anthropometric parameters, and E median (P = .0007/<.0001/.0018/.0044/<.0001/<.0001/<.0001/<.0001/<.0001/.0204); and negatively with lymphocytes and HDL-cholesterol (r = −0.2747/−0.2181, P = .0116/.0120).
Our study underlined significant differences between overweight and obese children in terms of inflammatory status and liver impairment suggesting that the risk is directly related to the increase in BMI.
Breast cancer survivors’ perceptions of their partners’ interest in cancer-focused psychosocial interventions
Authors: Cohee Andrea A. , Krueger Ellen F. , Vachon Eric A. , Cottingham Ann H. , Stutz Patrick V. , Alwine Jennifer S. , Johns Shelley A. 
Published: January 2021

Abstract

Background:
Despite that partners of breast cancer survivors (BCS) often experience long-term consequences from the cancer experience, including fear of recurrence and depression, there are rarely psychosocial interventions aimed at mitigating these consequences. Because partners are usually recruited to research studies through BCS, it is important to understand the views of BCS regarding their partners’ involvement in interventions. The aim of this study was to explore perceptions of BCS regarding the advisability of offering a psychosocial intervention to their partners.

Methods:
BCS (N = 22) enrolled in 1 of 3 interventions (acceptance and commitment therapy [ACT], survivorship education [SE], or enhanced usual care [EUC]) were queried about whether they believed their partner would be interested in a psychosocial intervention similar to what they had just completed and asked to provide their opinions about how a partner intervention should be structured and what it should address. Twenty-two BCS (ACT group [n = 5], SE [n = 11], and EUC [n = 6]) completed the interviews.

Results:
The participants identified 3 unmet partner needs that they thought could be addressed by a psychosocial intervention: problems with coping, communication breakdowns, and lack of information. They also provided 3 recommendations regarding the development of a partner intervention: the use of a group format, the provision of separate sessions for partners and BCS, and the inclusion of intervention components that provide practical or factual information related to breast cancer.

Conclusions:
BCS can provide valuable insights that can inform the development of psychosocial interventions for partners of survivors. The development of such partner interventions is critical to address the negative and often hidden health and social effects experienced by partners of BCS.
Current practices in clinical supervision in psychosocial oncology
Authors: Taylor-Irwin Nicole E. , Kracen Amanda 
Published: January 2021

Abstract

Purpose:
Clinical supervision is a common pedagogical practice, but one that has received little scrutiny. This descriptive study examined the state of supervision in psycho-oncology in the United States. We were interested in learning more about how supervision is being conducted to better understand how training and clinical supervision can be improved in psycho-oncology.

Design/Sample:
Fifty-three psychosocial oncology mental health professionals completed an electronic survey.

Methods:
Participants were asked about their training in supervision, how they practice, what is unique about supervising in an oncology setting, and whether participants viewed their training as sufficient.

Findings:
Most respondents (50; 94.3%) had received some training in supervision; however, about half (28, 52.8%) reported that they had not received enough training to be an effective supervisor of trainees working with cancer patients. The majority (49, 92.5%) believed it is necessary to gain specific training to be an effective supervisor in oncology settings. In open-ended responses, participants shared what they found unique about supervising in psychosocial oncology; 4 themes emerged. These were the considerations of working in a medical setting, differences in the process and structure of therapy, deeper relationships with colleagues and patients, and the effect of clinical work on the therapist/supervisee.

Conclusions/Implications:
More than half of our sample of psychosocial oncology practitioners in the United States felt that they were inadequately prepared to supervise and believed it is necessary to pursue specific training in this area. Enhanced training in supervision should be offered because of the specialized demands of practicing in oncology settings.
Invasive Mechanical Ventilation for Acute Viral Bronchiolitis: Retrospective Multicenter Cohort Study*
Authors: Mitting Rebecca B. , Peshimam Niha , Lillie Jon , Donnelly Peter , Ghazaly Marwa , Nadel Simon , Ray Samiran , Tibby Shane M. 
Published: January 2021

Objectives:
Bronchiolitis is a leading cause of PICU admission and a major contributor to resource utilization during the winter season. Management in mechanically ventilated patients with bronchiolitis is not standardized. We aimed to assess whether variations exist in management between the centers and then to assess if differences in PICU outcomes are found.

Design:
Retrospective cohort study.

Setting:
Three tertiary PICUs (Centers A, B, and C) in London, United Kingdom.

PATIENTS:
Patients under 1 year of age (n = 462) who received invasive mechanical ventilation for acute viral bronchiolitis from 2012-2016.

INTERVENTIONS:
None.

Design:
Retrospective cohort study.

MEASUREMENTS AND MAIN RESULTS:
Data collected include all sedative agents administered, 48 hour cumulative fluid balance and location of endotracheal tube (oral or nasal). Primary outcome was duration of invasive mechanical ventilation. A generalized linear model was used to test for differences in duration of invasive mechanical ventilation between centers after adjustment for confounders: corrected gestational age, oxygen saturation index, bacterial coinfection, prematurity, respiratory syncytial virus status, risk of mortality score and comorbidity. Baseline characteristics were similar, other than a higher risk of mortality score at center A and higher admission oxygen saturation index at center C. Center A was associated with utilization of the most benzodiazepine and opiate sedation, the fewest nasal endotracheal tubes, and the highest mean cumulative fluid balance at 48 hours.
Center A had an adjusted mean duration of invasive mechanical ventilation that was 44% longer than center C (95% CI, 25–66%; p < 0.001).
The majority of confounders had an association with the duration of invasive mechanical ventilation; all were biologically plausible. Corrected gestational age was negatively associated with the duration of invasive mechanical ventilation for preterm infants less than 32 weeks, but not for term or 32–37 week infants (interaction effect). This meant that at a corrected age of 0 months, a less than 32-week infant had a mean duration that was 55% greater than a term infant: this effect had disappeared by 8 months old.

Conclusions:
Between-center variations exist in both practices and outcomes. The relationship between these two findings could be further tested through implementation science with “optimal care bundles.”
The Role of Health Informatics in Facilitating Communication Strategies for Community Health Workers in Clinical Settings: A Scoping Review
Authors: Kolla Avani , Lim Sahnah , Zanowiak Jennifer , Islam Nadia 
Published: January 2021

Background:
Community health workers (CHWs) have been identified as effective members of health care teams in improving health outcomes and reducing health disparities, especially among racial and ethnic minorities. There is a growing interest in integrating CHWs into clinical settings using health informatics–based strategies to help provide coordinated patient care and foster health-promoting behaviors.

Objective:
In this scoping review, we outline health informatics–based strategies for CHW-provider communication that aim to improve integration of CHWs into clinical settings.

Design:
A scoping review was conducted.

Eligibility Criteria:
US-based sources between 2013 and 2018 were eligible.

Study Selection:
Literature was identified through PubMed and Google queries and hand searching key reference lists. Articles were screened by title, abstract, and then full-text.

Main Outcome Measures:
Health informatics–based strategies for CHW-provider communication and their impacts on patient care were documented and analyzed.

Results:
Thirty-one articles discussed health informatics–based strategies for CHW-provider communication and/or integration of CHWs into clinical settings. These strategies include direct CHW documentation of patient encounters in electronic health records (EHRs) and other Web-based applications. The technologies were used to document patient encounters and patient barriers to health care providers but were additionally used for secure messaging and referral systems. These strategies were found to meet the needs of providers and CHWs while facilitating CHW-provider communication, CHW integration, and coordinated care.

Conclusions:
Health informatics–based strategies for CHW-provider communication are important for facilitating CHW integration and potentially improving patient outcomes and improving disparities among minority populations. This integration can support the development of future disease prevention programs and health care policies in which CHWs are an established part of the public health workforce. However, further investigation must be done on overcoming implementation challenges (eg, lack of time or funding), especially in smaller resource-challenged community-based clinics that serve minority patients.
What Drives Patients’ Complaints About Adverse Events in Their Hospital Care? A Data Linkage Study of Australian Adults 45 Years and Older
Authors: Case Jennifer , Walton Merrilyn , Harrison Reema , Manias Elizabeth , Iedema Rick , Smith-Merry Jennifer 
Published: January 2021

Objective
The aim of the study was to determine from patient-reported data the relationships between patients’ experiences of adverse events (AEs), the disclosure of the events, and patients propensity for complaints or legal action.

Methods
A cross-sectional survey was administered to 20,000 participants randomly chosen from the 45 and Up Study. The surveyed participants were older than 45 years and hospitalized in New South Wales, Australia, between January and June 2014. They were identified using data linkage to capture experiences of AEs.

Results
Of the 7661 respondents, 474 participants (7%) reported experiencing an AE. Those who did not receive an apology or expression of regret in the incident disclosure process were significantly more likely to make a complaint (P < 0.05). Those who found out about the event from hospital staff but did not receive a formal open disclosure process were found to be significantly more likely to seek legal advice (P < 0.05). Patients who made a complaint generally perceived that they experienced more problems in their hospital care, with significant differences identified between those who did and did not make a complaint on 13 of the 15-item Picker Patient Experience Questionnaire.

Conclusions
Although incident disclosure was not associated with whether a complaint was made or legal action pursued, significant associations between key aspects of the disclosure process and these outcomes were noted. Significant differences between those who did and did not make a complaint were noted in relation to the timing and apology components of open disclosure. The critical role of overall patient experience in the context of optimal AE management was evident from these data.