bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ocular Conditions Associated With Posterior Vitreous Detachment in Young Patients
Authors: Hikichi Taiichi , Trempe Clement L 
Published: April 2021

* BACKGROUND AND OBJECTIVE: To investigate the ocular conditions associated with posterior vitreous detachment (PVD) in young patients.
* PATIENTS AND METHODS: The vitreous conditions of 861 patients younger than 30 years were studied retrospectively and examined biomicroscopically.
* RESULTS: In the first and second decades of life, retinitis pigmentosa, nondiabetic retinal vascular disorders, and a history of ocular contusion were most commonly associated with PVD. In the third decade of life, proliferative diabetic retinopathy was overwhelmingly the condition most commonly associated with PVD.
* CONCLUSION; This study delineated the ocular pathologic conditions associated with PVD in young patients. These findings may be useful in the management of PVD in patients younger than 30 years.
[Ophthalmic Surg Lasers 1996;27:782-786.]
Computer ergonomics related health problems of Library staff: a case study at the University of Colombo
Authors: Silva Anuja 
Published: April 2021

This paper discusses computer ergonomics related health problems caused by prolonged use of computers in the library staff of the University of Colombo. The heterogeneous population, 60 in total consisted of academic staff, administrative officers and paraprofessional staff including Senior Staff Assistants, Staff Assistants, Management Assistants and Library Information Assistants. A stratified random sampling technique was used to draw the sample (52). A questionnaire was administered to collect data. Data were analysed with descriptive statistics and correlation test using SPSS version 23. It revealed that neck pain was the major (63.8%) musculoskeletal discomfort experienced by the respondents after prolonged period of computer usage followed by shoulder pain (59.6%) and pain in the wrist (53.2%). Pain in the eye (76.6%) was the most persistent visual discomfort experienced by the respondents followed by headaches (72.3%). Major stress-related problem was sleepiness (51.1%) while loss of concentration was identified as the prominent discomfort related to fatigue (27.7%). Prevalence of musculoskeletal discomforts such as pain in the neck and lower arm showed a positive correlation with the height of computer table (r = 0.447, P=0.002 and r = 0.403, P=0.005 respectively), while shoulder pain indicated a weak negative correlation with wrist support (r = -0.317, P=0.03). Data on prevalence of lower arm pain depicted a weak positive correlation with height and distance of the keyboard (r = 0.384, P=0.008) and computer desk height (r = 0.403, P=0.005). As for visual discomfort symptoms developing double vision had a weak positive correlation with glare (r =0.315, P=0.031) and a weak negative correlation with lighting in the workstation (r=- 0.291, P=0.046). Headaches due to extended use of computers showed a significant relationship with view distance (P=0.003) and task breaking (P=0.033). To avoid visual discomforts ergonomic requirement at the computer workstation should be proper lighting, anti-glare filters, and ergonomic positioning of computer monitor and regular work breaks. To reduce health problems, library management should organize workstation ergonomic training sessions to gain knowledge and skills required to optimize the workstation configuration, and provide ergonomically safe working equipment.
Monocyte-Derived Dendritic Cells (moDCs) Differentiate into Bcl6+ Mature moDCs to Promote Cyclic di-GMP Vaccine Adjuvant–Induced Memory TH Cells in the Lung
Authors: Mansouri Samira , Katikaneni Divya S. , Gogoi Himanshu , Jin Lei 
Published: April 2021

Abstract
Induction of lung mucosal immune responses is highly desirable for vaccines against respiratory infections. We recently showed that monocyte-derived dendritic cells (moDCs) are responsible for lung IgA induction. However, the dendritic cell subset inducing lung memory TH cells is unknown. In this study, using conditional knockout mice and adoptive cell transfer, we found that moDCs are essential for lung mucosal responses but are dispensable for systemic vaccine responses. Next, we showed that mucosal adjuvant cyclic di-GMP differentiated lung moDCs into Bcl6+ mature moDCs promoting lung memory TH cells, but they are dispensable for lung IgA production. Mechanistically, soluble TNF mediates the induction of lung Bcl6+ moDCs. Our study reveals the functional heterogeneity of lung moDCs during vaccination and paves the way for an moDC-targeting vaccine strategy to enhance immune responses on lung mucosa.
Plasma Concentrations of Cefazolin in Pediatric Patients Undergoing Cardiac Surgery
Authors: Lapmahapaisan Saowaphak , Maisat Wiriya , Tantiwongkosri Kriangkrai , Jutasompakorn Pinpilai , Sisan Waraphorn 
Published: April 2021

Background:
The guideline for antibiotic prophylaxis in pediatric cardiac surgery is currently unavailable, and the effects of cardiopulmonary bypass (CPB) may result in low plasma cefazolin concentrations and subsequent postoperative surgical site infections (SSIs).

Aims:
To demonstrate the calculated-unbound plasma concentrations of cefazolin during uncomplicated pediatric cardiac surgery.

Settings and Design:
A prospective observational study that included 18 patients <seven years of age, undergoing elective cardiac surgery with CPB.

Materials and Methods:
An intravenous infusion of cefazolin (25 mg.kg-1) was administered to patients over 30 minutes within 1 hour before skin incision (first dose). Another 25 mg.kg-1 infusion was administered to the CPB prime volume (second dose). Blood samples were obtained at eight time points: 15 minutes after the first dose (T1); before aortic cannulation (T2); immediately after CPB initiation (T3); 30 (T4), 60 (T5), and 120 (T6) minutes after CPB; 15 minutes after CPB discontinuation (T7), and at skin closure (T8). The total plasma cefazolin concentrations were measured using liquid chromatography tandem mass spectrometry.

Results:
The unbound cefazolin concentrations were calculated assuming 80%-protein binding. The median cefazolin levels were 18.1 (range 4.3-27.0), 11.9 (2.8-24.1), 31.4 (18.3-66.1), 23.4 (13.7-35.9), 20.2 (15.4-24.9), 17.7 (14.8-18.0), 15.6 (9.8-26.2), and 13.3 (8.3-24.6) μg.mL-1 from T1-T8, respectively. The cefazolin levels remained four times above the minimum inhibitory concentrations (MICs) for Methicillin-sensitive S. aureus (MSSA) and S. epidermidis in most patients, but they were inadequate for Enterobacter and E. coli.

Conclusion:
This regimen produced adequate plasma cefazolin concentrations for common organisms that cause SSIs after cardiac surgery.
Validated Tool for Quality Assessment of Anesthesia Services by Cardiac Surgeons
Authors: Guhabiswas Rahul , Chowdhury Saibal Roy , Narayan Pradeep 
Published: April 2021

Background and Aim:
The role of the cardiac anaesthesiologists extends beyond mere patient wellbeing to diagnostic input and active participation in decision making during cardiac surgery. The quality of service provision should therefore be judged not only by patient satisfaction but also by the satisfaction of cardiac surgeons. Unfortunately, quantification of cardiac surgeon satisfaction remains a challenge due to the absence of a reliable and validated tool. We therefore attempted to develop a robust, validated, pilot psychometric questionnaire, to measure satisfaction of cardiac surgeons' to cardiac anesthesia services.

Methods:
The questionnaire was developed with the help of senior cardiac anesthesiologist, cardiac surgeon and statistician with database search in PubMed and the Cochrane Library. The questionnaire was tested for content validity, comprehensibility, and identification of new items. This generated the second version of the questionnaire with nine socio-demographic and professional questions, 46 Likert type questions, an abridged Marlowe Crowne Social Desirability scale and one open ended question. This questionnaire was e-mailed to 100 cardiac surgeons requesting them to participate via a web-based survey application.

Results:
Content validity of the responses was tested by Aiken's content validity coefficient (V). Internal consistency was tested with Chronbach's alpha. Fifty-two cardiac surgeons participated in the survey. Twelve Likert type questions were deleted due to low V values. Excellent Chronbach's alpha (0.94) was obtained in the remaining 34 items.

Conclusions:
We have developed a questionnaire that includes 34 variables and allows quantifying surgeon satisfaction in a reliable fashion and is validated for the purpose.
Venoarterial Extra Corporeal Membrane Oxygenation and Blood Component Usage in Pediatric Patients Undergoing Cardiac Surgery
Authors: Surti Jigar , Jain Imelda , Mishra Amit , Gajjar Trushar , Solanki Atul , Patel Jigar , Shah Jatin , Shah Sapna 
Published: April 2021

Background:
Extra Corporeal Membrane Oxygenation (ECMO) is a well-known tool for providing life-saving support in patients developing post cardiotomy cardiogenic shock in post cardiac surgeries. The current study was designed to evaluate blood transfusion requirements and its relation to mortality in neonate and pediatric cardiac patients requiring venoarterial cardiac ECMO during post-operative period following cardiac surgery.

Materials and Methods:
Overall 24 pediatric patients (including neonates) who underwent VA ECMO in post cardiac surgery at our institute from January 2016 to October 2017 were included in the study. The details of demographics, blood transfusion, ECMO, and morbidity and mortality were collected for all the patients.

Objective of the Study:
The primary objective of our study was to assess the outcome of patients on ECMO in post pediatric cardiac surgery. The secondary objective of the study was to assess the effect of blood transfusion on the outcome of the patients.

Results:
Overall mortality rate was 50% (n = 12). The overall transfusion rate of packed red blood cells was higher in patients who did not survive even after institution of VA ECMO. The transfusion of other blood products like platelets, cryoprecipitate, and fresh frozen plasma were also higher in this group of patients though it was statistically non-significant except for packed red cell transfusion. Though statistically non-significant, the patients who didn't survive even after institution of VA ECMO post-surgery had relatively higher mean age (703.88 ± 998.94 days) as compared to their counterparts (510.63 ± 384.36 days).

Conclusion:
The use of ECMO is associated with considerable morbidity and mortality. Packed red cell transfusion is definitely higher in expired patients, indicative of deteriorated status of the patient. However, considering non-significant association of other blood components, except packed red cell it is recommended that patients' overall clinical condition should be taken into consideration for transfusion of blood products and not only targeting the transfusion triggers.
Effect of Perioperative Acetaminophen on Body Temperature after Cardiovascular Surgery with Cardiopulmonary Bypass
Authors: Kaneko Shohei , Ichinomiya Taiga , Sato Shuntaro , Sekino Motohiro , Murata Hiroaki , Hara Tetsuya 
Published: April 2021

Context:
Postoperative hyperthermia, which may lead to cognitive decline, is a common complication of cardiovascular surgery with cardiopulmonary bypass (CPB).

Aims:
The aim of this study was to examine the effectiveness of perioperative intravenous acetaminophen on body temperature in adult patients after cardiovascular surgery with CPB.

Settings and Design:
This was a single-center retrospective study focusing on adult patients who underwent elective cardiovascular surgery with CPB at a university hospital in Japan.

Subjects and Methods:
Patients were divided into two groups based on whether they received acetaminophen perioperatively. In the acetaminophen group, 15 mg/kg intravenous acetaminophen solution was infused at 30 min after discontinuation of CPB and every 6 h after intensive care unit (ICU) admission.

Statistical Analysis Used:
The primary outcome was the maximum axillary temperature within 12 h after ICU admission. The effects of acetaminophen on postoperative body temperature were estimated by the standardization and inverse probability weighting using propensity scores.

Results:
A total of 201 patients were included in the final analysis (acetaminophen group, n = 101; non-acetaminophen group, n = 100). The maximum axillary temperature within 12 h after ICU admission was 37.20 ± 0.54°C in the acetaminophen group and 37.78 ± 0.59°C in the non-acetaminophen group. Acetaminophen lowered the standardized mean of primary endpoint (−0.54°C, 95% confidence interval, −0.69 to −0.38) compared to non-acetaminophen.

Conclusions:
Perioperative intravenous acetaminophen inhibited body temperature elevation after cardiovascular surgery with CPB, compared with the non-acetaminophen group.
Clinical Efficacy of Levosimendan vs Milrinone in Preventing Low Cardiac Output Syndrome Following Pediatric Cardiac Surgery
Authors: Jothinath Kaushik , Balakrishnan Soundaravalli , Raju Vijayakumar , Menon Shoba , Osborn Jenit 
Published: April 2021

Background:
Prophylactic milrinone is commonly used to prevent Low Cardiac Output Syndrome (LCOS) after pediatric cardiac surgery. This study compares the use of levosimendan with milrinone when used as the primary inotrope following pediatric cardiac surgery.

Subjects and Methods:
Forty infants undergoing corrective surgery for congenital heart disease were recruited during the study and randomized into two groups (group L and group M). During rewarming, a loading dose of levosimendan or milrinone was administered followed by a 24-hour infusion of the chosen inotrope. Echocardiographic variables were measured postoperatively. Statistical analysis was done with SPSS-20 computer package. Association between the variables was found by independent t test. P < 0.05 was considered statistically significant.

Results:
Mean age and weight of the patient in Group L was 8.55 ± 5.83 months and 6.05 ± 2.09 kgs, while that in group M was 6.85 ± 3.57 months and 5.26 ± 2.11 kgs. 4 patients (20%) treated with levosimendan had LCOS in comparison with 6 (30%) patients in those treated with milrinone. Echocardiographic parameters in both groups L and M were comparable (cardiac index 3.47 ± 0.76 vs 3.72 ± 1.05 L/min/m2, EF 66.10 ± 7.82% vs 59.34 ± 10.74%, stroke volume index 25.4 ± 6.3 vs 27.74 ± 10.35 mL/m2). The duration of ventilation, ICU stay and hospital stay were lesser in group L (12.75 ± 9.69, 35.95 ± 12.11, 119.10 ± 46.397 vs 23.60 ± 22.03, 51.20 ± 29.92, 140.20 ± 52.65 hours).

Conclusions:
The incidence of LCOS was lesser in those patients treated with levosimendan, when compared with those treated with milrinone. Cardiac index and stroke volume index were comparable between the two groups. Thus, levosimendan provides a non-inferior alternative to milrinone when used as the primary inotrope following pediatric cardiac surgery.
Intraoperative Comparison of 2D versus 3D Transesophageal Echocardiography for Quantitative Assessment of Mitral Regurgitation
Authors: Lovhale Pravin S. , Gadhinglajkar Shrinivas , Sreedhar Rupa , Sukesan Subin , Pillai Vivek 
Published: April 2021

Background:
Effective regurgitant orifice area (EROA) can be represented by 3D echocardiographic vena contracta cross-sectional area (3D-VCA) as a reference method for the quantification of mitral regurgitation (MR) without making any geometrical assumptions. EROA can also be derived from 3D PISA technique with a hemispherical (HS) or hemielliptical (HE) assumption of the proximal flow convergence. However, it is not clear whether HS-PISA and HE-PISA has better agreement with 3D-VCA.

Aims:
This study was conducted to compare the EROA and Rvol obtained from 3D-VCA with those obtained from 2D-VC, 2D-HS-PISA, 3D-HS-PISA, and 3D-HE-PISA.

Setting:
Tertiary care hospital.

Design:
Prospective observational study.

Materials and Methods:
After anesthesia induction, 43 consecutive patients were evaluated with RT-3D-TEE after acquiring images from midesophegeal views and performing the offline analysis of volume dataset. 3D-VCA was measured using multiplanar reconstruction mode and EROA and regurgitant volume were estimated using HS-PISA and HE-PISA methods. The HE-PISA was calculated by using the Knud Thomsen formula.

Statistical Analysis:
Agreement between methods to estimate EROA and regurgitant volumes were tested using Bland–Altman analysis. The interobserver variability and intraobserver variability were assessed using an intraclass correlation coefficient.

Results:
The EROA estimated by 3D-VCA was larger than EROA obtained by 2D-HS-PISA and 3D-HS-PISA, which were significantly greater than 3D-HE-PISA. 3D-HS-PISA-EROA showed the best agreement with 3D-VCA (bias: 0.21; limits of agreement: −0.01 to 0.41; SD: 0.1). Correlation between various methods as compared to 3D-VCA was better in the organic MR group than functional MR group.

Conclusion:
3D-HS-PISA showed the best agreement with 3D-VCA compared to other PISA methods. Better correlation between PISA-EROA and 3D-VCA was observed in patients with organic MR than functional MR.
Evaluation of High-Dose Atorvastatin Pretreatment Influence in Patients Preconditioning of Post Coronary Artery Bypass Graft Surgery
Authors: Bastani Misagh , Khosravi Mohammad Bagher , Shafa Masih , Azemati Simin , Maghsoodi Behzad , Asadpour Elham 
Published: April 2021

Context:
Atorvastatin is considered as lipid reductive drugs with anti-inflammatory and pleotherapic effects in coronary artery bypass graph (CABG).

Aim:
This study is conducted to evaluate the effects of atorvastatin in CABG.

Setting and Design:
Patients with a coronary bypass graph procedure in Nemazee hospital in Shiraz were divided into two 50-groups receiving high-dose (80 mg) and low-dose (20 mg) atorvastatin.

Materials and Methods:
Troponin I, creatinine kinase-MB (CK-MB), atrial fibrillation (AF) after CABG, duration of mechanical ventilation, inotrope duration of consumption, blood sugar profile, liver and renal function, death during 30 days of CABG, MACE (major advance cardiac events) during admission in ICU, and 1 month follow up were surveyed.

Statistical Analysis:
Collected data were analyzed by independent and paired t-test and Chi square.

Results:
AST was increased, ALT, ALK-P after CABG were decreased, and urine volume in the second day of admission in ICU was increased in the high-dose group. There was an increase and following decrease in blood sugar of patients in the high-dose after CABG. An inflammatory marker after CABG was raised in both groups, ck-mb had an increase, and then followed by a reduction. Troporin had no significant differences between groups. Patients with high-dose atorvastatin had better glomerular filtration rate and renal performance. Along with decreasing AF in the case group, hemodynamics' disorder reduced and there was less bleeding.

Conclusion:
According to the above, it seems that a short-time prescription of high dose of atorvastatin in CABG can lead to better renal function, decreasing of arrhythmia and AF.
Effect of metformin therapy on thyroid-stimulating hormone levels in women with polycystic ovarian syndrome
Authors: Dhanpal Vinay , Dharmalingam Mala , Kalra Pramila 
Published: April 2021

Introduction:
Metformin has been shown to decrease thyroid-stimulating hormone (TSH) levels without effect on total T4 and total T3 levels, especially in patients with underlying thyroid dysfunction.

The Aim of the Study:
To evaluate the effect of metformin therapy on TSH levels in polycystic ovarian syndrome (PCOS) patients who were euthyroid with or without treatment.

Design of the Study
Nonrandomized prospective intervention trial.

Materials and Methods:
The study included all euthyroid PCOS patients of the reproductive age group diagnosed according to the modified Rotterdam criteria and the patients were divided into two groups. The first group was put on lifestyle modification alone (Group-I), whereas the second group was put on lifestyle modification and metformin therapy (Group-II). In both groups of patients, TSH, total T4, and total T3 levels were done at baseline and after 3 months of follow-up.

Results:
A total of 105 patients with PCOS were nonrandomly assigned to Group I (n = 53) and Group II (n = 52). The baseline parameters (age, body mass index, TSH, and Homeostatic Model Assessment for Insulin Resistance) were similar. Thirty-six patients in Group I and 39 in Group II were followed up for 3 months. The change in TSH levels in both groups was not significant at follow-up (Group I [2.56 ± 0.87 vs. 3.01 ± 1.54; P = 0.102] and Group II [2.90 ± 0.81 vs. 2.76 ± 1.26;P = 0.503]). In a subgroup analysis in patients who had thyroid dysfunction, there was a significant decrease in TSH levels in Group II (3.10 ± 0.54 vs. 2.57 ± 0.50;P = 0.031).

Conclusion:
Metformin significantly decreased TSH levels in women with PCOS with underlying thyroid dysfunction, while it did not show any effect on women without underlying thyroid dysfunction.
Primary hypothyroidism on follow-up in a cohort of Indian patients with subacute thyroiditis
Authors: Kalra Pramila , Prasanna Kumar K. M. 
Published: April 2021

Objectives:
Subacute thyroiditis (SAT) is a temporary dysfunction of the thyroid gland and is commonly due to its viral infection. Permanent hypothyroidism after recovery from SAT has been reported in various studies.

Methodology:
This was a prospective study conducted in two tertiary care centers in South India to follow-up these cases for the development of permanent primary hypothyroidism at 1-year follow-up after recovery from SAT.

Results:
The total number of cases followed up was 146, including 103 females (70.5%) and 43 males (29.5%). Females' mean age was 33.03 ± 11.7 years, and males' mean age was 40.17 ± 11.84 years. Seven patients reported the second attack of thyroiditis. The mean thyroid-stimulating hormone (TSH) recorded at baseline was 0.042 ± 0.056 µIU/ml. Permanent hypothyroidism was seen in 19.86% of the cases at a 1-year follow-up and was found to be higher in patients with lower TSH at baseline. The females and males were affected at a younger age as compared to other studies. The incidence of permanent hypothyroidism was found to be higher as compared to some but lesser compared to a few others. The iodine supplementation could also be one of the postulates for this higher incidence of hypothyroidism. The severity of thyrotoxicosis was a significant determinant of the future development of hypothyroidism.

Conclusions:
The patients with SAT need to be followed up for the development of permanent hypothyroidism. The prevalence of hypothyroidism at 1 year was 19.86% after an attack of thyroiditis.