bluuebunny/crossref_metadata_2025_split huggingface dataset:
Increased risk of appendectomy due to appendicitis after tonsillectomy in women
Authors: Kim So Young , Min Chanyang , Oh Dong Jun , Choi Hyo Geun 
Published: May 2019

Abstract
The purpose of this study was to evaluate the risk of appendectomy due to appendicitis after tonsillectomy in Koreans using national cohort data. Using the national cohort study from the Korean Health Insurance Review and Assessment Service, 1:4 matched tonsillectomy participants (9015) and control participants (36,060) were selected. The Cox-proportional hazard model was used. In this analysis, a crude and adjusted model for age, sex, income, region of residence, and the past medical histories of hypertension, diabetes mellitus, and dyslipidemia were used. For the subgroup analyses, the participants were divided as follows: children (≤14 years old) vs adolescents and adults (≥15 years old) and men vs women. The adjusted hazard ratio (HR) of tonsillectomy for appendectomy was 1.06 (95% confidence interval, CI = 0.89–1.27, P = .517). In the subgroup analysis, the HR was 1.03 (95% CI = 0.82–1.30, P = .804) in children and 1.10 (95% CI = 0.84–1.47, P = .468) in adolescents and adults. In another subgroup analysis, the HR was 0.89 (95% CI = 0.70–1.12, P = .314) in men and 1.39 (95% CI = 1.06–1.83, P = .018) in women. The risk of appendectomy was higher in the tonsillectomy group but only in women.
Outcomes of patients with non-diagnostic bronchoscopy
Authors: Venkatram Sindhaghatta , Pena Damaris , Bajantri Bharat , Diaz-Fuentes Gilda 
Published: May 2019

Abstract
Bronchoscopy is one of the most common diagnostic procedures in pulmonary practice. Data on the outcome of patients following a non-diagnostic bronchoscopy are sparse. Diagnostic yield depends on indication, the characteristics of patients, and the chest imaging. The aim of this study was to evaluate the outcomes of patients with a non-diagnostic bronchoscopy and to compare patients who had a diagnostic with those that had a non-diagnostic bronchoscopy.
Retrospective, single-center study of adult patients who underwent bronchoscopy with transbronchial biopsy (TBBX) and/or endobronchial biopsy (EBBX), endobronchial ultrasound with transbronchial needle aspiration (EBUS-TBNA), or brushing. A strict definition for a “diagnostic” bronchoscopy was used. Univariate and multivariate analyses were performed.
A total of 684 patients were identified, 350 (51%) had a diagnostic procedure. Of the 334 patients with a non-diagnostic bronchoscopy, 196 (58.6%) were followed, but only 172 (88%) completed 1 year of follow-up. Most of the patients (57.8%) had resolution or stabilization of the condition; in the remaining patients, malignancy was most commonly diagnosed after further investigation followed by diffuse lung diseases and infections. Pulmonary tuberculosis was diagnosed in 8 patients. EBUS-TBNA and EBBX were the procedures associated with a diagnostic bronchoscopy. Presence of bilateral interstitial infiltrates predicted a non-diagnostic bronchoscopy.
A significant number of patients with non-diagnostic bronchoscopy may have serious treatable disease that is identified upon further investigation. Close follow up of patients with a non-diagnostic procedure is warranted. Our study found no clear clinical or radiological predictors of diagnostic bronchoscopy.
Herpes zoster involving the abducens and vagus nerves without typical skin rash
Authors: Joo Taesung , Lee Young Chan , Kim Tae Gi 
Published: May 2019

Abstract

Rationale:
Herpes zoster is characterized by unilateral vesicular eruption and it most often affects the trigeminal nerve. We would like to report a rare case of abducens and vagus nerves palsy caused by varicella zoster virus (VZV) without the typical vesicular rash.

Patient concerns:
A 71-year-old woman presented with diplopia. Three days previously, she had experienced sore throat and hoarseness.

Diagnosis:
At presentation, the prism cover test revealed esotropia of 10 prism diopters at primary gaze, and abduction was restricted in the right eye. No vesicular rash was observed on the patient's face, and magnetic resonance imaging of the brain showed no pathology. Flexible fiberoptic laryngoscopy revealed multiple ulcerations on the right side of the larynx—from the epiglottis to the arytenoid. After 1 day of hospitalization, a diffuse skin rash occurred on the patient's trunk, and polymerase chain reaction for VZV DNA was positive at the skin lesion. The patient was diagnosed as having herpes zoster associated with vagus and sixth nerve palsy.

Intervention and outcomes:
She received famciclovir at a dose of 500 mg 3 times daily for 7 days and coadministered methylprednisolone. At the 4-month follow-up, her diplopia and eye movement had resolved completely.

Lessons:
In patients with abducens nerve palsy without typical vesicular lesion, herpes zoster may not be detected early. In that case, systemic examination is very important for diagnosing herpes zoster.
Structural and functional connectivity of ascending reticular activating system in a patient with impaired consciousness after a cardiac arrest
Authors: Parra-Morales Alejandra M. , Rudas Jorge , Vargas Jorge A. , Gómez Francisco , Enciso-Olivera Cesar O. , Trujillo-Rodriguez Diana , Martínez Darwin , Hernandez José , Ordóñez-Rubiano Edgar G. , Marín-Muñoz Jorge H. 
Published: May 2019

Abstract

Rationale:
Diffusion tensor imaging (DTI), diffusion tensor tractography (DTT), as well as resting-state-functional magnetic resonance imaging (rsfMRI) are promising methods for assessing patients with disorders of consciousness (DOCs).

Patient concerns:
This work describes the main findings using DTI, DTT, and rsfMRI in a patient with a DOC secondary to an anoxic encephalopathy who had a fatal outcome. She was an 85-year-old woman who presented a cardiac arrest and underwent cardiopulmonary resuscitation for 20 minutes then returning to spontaneous circulation. After sedation withdrawal, 2 days after the event, she remained with a Glasgow Coma Scale score of 3/15 and with an absence of brainstem reflexes.

Diagnoses:
DOC secondary to an anoxic encephalopathy after cardiovascular resuscitation.

Interventions:
A complete brain MRI scan was performed 72 hours after the initial event, including DTI, DTT, and rsfMRI. DTT demonstrated disruption of both ventral and dorsal tegmental tracts bilaterally. DTI showed a reduction of fractional anisotropic level in the mesencephalic nuclei. Moreover, changes in the number of fiber tracts were not evidenced in any portions of the ascending reticular activating system (ARAS). Finally, an increase in the anticorrelated and correlated association among the nuclei in the ARAS and the cortex was evidenced.

Outcomes:
Patient deceased.

Lessons:
Neuroimaging demonstrated low FA values in the ARAS, destruction of dorsal and ventral tegmental tracts, as well as hyper-connective (highly correlated or anti-correlated) association among ARAS and cortical nuclei compared with 3 healthy control subjects.
The effect of meditative movement for glucose control in patients with type 2 diabetes
Authors: Xia Tingwei , Yang Yue , Li Weihong , Tang Zhaohui , Li Zongrun , Guo Yongsong 
Published: May 2019

Abstract

Background:
Type 2 diabetes is one of the most common and complex chronic disease. A lot of clinical researches have focused on meditative movement for type 2 diabetes. However, there is no systematic review and meta-analysis has been conducted. We aim to systematically review the effect of meditative movement on the type 2 diabetes care.

Methods:
The databases including PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, Ovid LWW, EMBASE will be searched. Studies published from the time when the database establishment to December 2018 will be retrieved. RCTs study on meditative movement for glucose control in patients with type 2 diabetes will be included. The primary outcomes are HbA1c, fasting blood glucose, and postprandial blood glucose (PPBG). RevMan V.5.3 software will be used to perform the analyses.

Results:
This study will provide high-quality synthesis of effectiveness and safety of meditation movement for type 2 diabetes.

Conclusion:
This systematic review will provide high-quality evidence to judge whether the meditative movement is beneficial to glucose control in patients with type 2 diabetes.

PROSPERO registration number: CRD42019128495
Low serum bilirubin, albumin, and uric acid levels in patients with Crohn's disease
Authors: Su Qisheng , Li Xiaohong , Mo Wuning , Yang Zheng 
Published: May 2019

AbstractSerum concentrations of bilirubin, albumin, and uric acid (UA) play important roles in controlling oxidative stress. Until now, there are few researches related to the relationship between oxidative stress and Crohn's disease (CD); furthermore, no such study has been reported from China. Our aim was to evaluate serum bilirubin, albumin, and UA levels in CD patients and relate them to disease activity.Seventy-one patients diagnosed with CD and 125 sex- and age-matched healthy individuals were retrospectively analyzed during the same period. Clinical characteristics and laboratory parameters were analyzed in CD patients and healthy control groups.Serum levels of bilirubin, albumin, and UA in patients with CD were significantly lower than those in the healthy control group. Correlation analysis demonstrated that serum concentrations of total bilirubin, direct bilirubin, indirect bilirubin, albumin, and UA were negatively related to disease activity in patients with CD (r = −0.620,P < .001;r = −0.304,P < .05;r = −0.623,P < .001;r = −0.408,P < .01; andr = −0.296,P < .05; respectively).Serum bilirubin, albumin and UA levels were significantly lower in CD patients, suggesting potential correlations between serum bilirubin, albumin, and UA levels and disease activity in CD patients. In addition, the noninvasive biochemical index may be potential markers for assessing the disease activity of patients with CD.
Anesthetic management for a patient with bronchobiliary fistula after pancreaticoduodenectomy
Authors: Lee Jungwon , Jung Sung Mee , Lee Yongbae , Kim Sae-Yeon 
Published: May 2019

Abstract

Rationale:
Perioperative management of patients with bronchobiliary fistula (BBF) is an anesthetic challenge because they typically exhibit poor lung function preoperatively, require meticulous lung isolation intraoperatively and need postoperative respiratory support.

Patient concerns:
A 44-year-old man with a past surgical history of pancreaticoduodenectomy presented fluctuating fever, jaundice, dyspnea and yellowish sputum. Despite intravenous antibiotic treatment and repeated percutaneous drainage, patient showed gradual deterioration with hypoxemia, and uncontrolled pneumonia.

Diagnoses:
The patient was diagnosed with BBF based on the clinical manifestation such as biloptysis with pneumonia, and imaging studies.

Interventions:
Resection of the fistula and bilobectomy was performed under general anesthesia. Avoidance of positive pressure ventilation before lung isolation and precise lung isolation are essential for patients with BBF to protect the unaffected lung. Therefore, rapid sequence induction was performed. Left-sided double-lumen tube was inserted for lung isolation and position of the tube was confirmed by visualization with fiberoptic bronchoscopy. Bile-stained secretion was repeatedly suctioned in trachea and both bronchi during surgery.

Outcomes:
In spite of decrease in SpO2 with institution of one-lung ventilation, the patient's oxygenation was gradually improved as surgery progressed without hemodynamic instability. At the end of surgery, the double-lumen tube was replaced with a single-lumen endotracheal tube for postoperative mechanical ventilation.

Lessons:
Absolute lung isolation using double-lumen tube for one-lung ventilation and bronchial toilet during surgery and replacement of single-lumen tube for postoperative respiratory support at the end of surgery are effective to improve oxygenation in patients with BBF.
Rib cartilage in Asian rhinoplasty: new trends
Authors: Yoo Shin Hyuk , Jang Yong Ju 
Published: May 2019

Purpose of review
Costal cartilage has many advantages over other grafting materials because of its large quantity and high biocompatibility. As a result, it has been considered as a good option for Asian rhinoplasty. However, costal cartilage is difficult to use and is associated with a high complication rate. To avoid the disadvantages and complications of costal cartilage graft, several techniques have been proposed in the literature. This review addresses the conventional uses of costal cartilage in Asian rhinoplasty and recent updates.

Recent findings
Different techniques have been reported for Asian rhinoplasty using costal cartilage. Solid-block costal cartilage and diced cartilage with or without wrapping materials are widely used for dorsal augmentation. Many different grafting techniques for the tip and septal reconstruction have been reported by numerous surgeons. When using costal cartilage graft, surgeons should pay attention to both graft complications, such as warping or infection, and donor-site morbidity. Several strategies have recently been developed to avoid these complications.

Summary
This article summarises grafting options for Asian rhinoplasty using costal cartilage and possible complications. This information may assist with proper selection of appropriate techniques for harvesting, carving and grafting costal cartilage.
Diagnosis and management of hypopituitarism
Authors: Yeliosof Olga , Gangat Mariam 
Published: May 2019

Purpose of review
This review summarizes pituitary function, and the clinical presentation and treatment of hypopituitarism.

Recent findings
Updates in the field include new guidelines and meta-analyses on the diagnosis and treatment of select hormone deficiencies, novel treatment options, and advances in next generation sequencing technology.

Summary
Hypopituitarism is defined as partial or complete loss of a single or multiple pituitary hormones. The clinical presentation of hypopituitarism varies depending on the number and severity of hormone deficiencies. Treatment involves the physiologic replacement of the individual end-organ hormone deficiencies and requires close lifelong monitoring.
The Gray Degeneration of the Brain and Spinal Cord
Authors: Ganesh Aravind , Stahnisch Frank W. 
Published: May 2019

Abstract
In 1857, French-Austrian psychiatrist Bénédict Augustin Morel (1809–1873) published his infamous though highly successful Traité des dégénérescences physiques, intellectuelles et morales de l'espèce humaine, which was fully dedicated to the social problem of “degeneration” and its psychiatric and neurological underpinnings. European psychiatrists, neurologists, and pathologists integrated Morel's approach into their neuropsychiatric theories and searched for the somatic and morphological alterations in the human brain, as did the versatile pupil of Rudolph Virchow (1821–1902), Georg Eduard von Rindfleisch (1836–1908), in his Lehrbuch der pathologischen Gewebelehre (1867). This can be seen as a starting point of research into the vascular genesis of “multiple sclerosis” by observing that the changes of blood vessels and nerve elements could be the result of inflammation and increased blood flow. We examine the waxing and waning of a 19th century diagnostic condition, which fell out of favor and resurfaced during the 20th century.
Surgical Excision Versus Ablation for Superficial Endometriosis-Associated Pain: A Randomized Controlled Trial
Authors: Riley Kristin A. , Benton Andrea S. , Deimling Timothy A. , Kunselman Allen R. , Harkins Gerald J. 
Published: May 2019

(Abstracted from J Minim Invasive Gynecol 2019;26:71–77)
The primary sequelae of endometriosis are infertility and chronic pelvic pain (CPP). Nearly 40% of women with endometriosis are infertile, and 71% to 87% have CPP.
The Effectiveness of Regular Exercise Programs in the Prevention of Gestational Diabetes Mellitus—A Systematic Review
Authors: Makaruk Beata , Galczak-Kondraciuk Anna , Forczek Wanda , Grantham Weronika , Charmas Małgorzata 
Published: May 2019

Importance
Physical activity is recognized as one of the most important tools in the management of gestational diabetes mellitus (GDM).

Objective
The aim of this review was to compare and analyze regular prenatal exercise programs and examine their effectiveness in the prevention of GDM.

Evidence Acquisition
The following databases were used: Academic Search Complete, Health Source–Consumer Edition, Health Source–Nursing/Academic Edition, Master File Premier, MEDLINE, and SportDiscus with full text. The inclusion criteria were as follows: a randomized study, regular training program throughout pregnancy, and supervised by a prenatal activity specialist.

Results
The 10 articles selected for the review were divided into 2 groups. The first group comprised 2 studies presenting successful interventions in the prevention of GDM, whereas the second group included 8 articles with no statistically significant effects of the training programs in GDM prevention. Beginning an exercise program at early stages of the pregnancy and high adherence were common features of the effective programs.

Conclusions
When designing and carrying out the program, the beginning of the intervention and adherence should be considered. To increase adherence, the program should be attractive and it should meet the participants' needs.

Relevance
This review might be used for identifying factors deciding whether an exercise program is an effective intervention to prevent the development of GDM. Moreover, it might also prove useful in the preparation of future guidelines for designing and implementing regular exercise programs effective in preventing GDM in pregnant women by gynecologists, obstetricians, midwives, trainers, and prenatal specialists.

Target Audience
Obstetricians and gynecologists, family physicians.

Learning Objectives
After participating in this activity, physicians should be better able to compare and analyze regular prenatal exercise programs; identify the most effective exercise programs in the prevention of GDM; distinguish factors decisive in gravid participants' involvement in regular physical activity sessions; and prepare for preparation of the future guidelines regarding regular exercise programs effective in preventing GDM.
Intravaginal Diazepam for the Treatment of Pelvic Floor Hypertonic Disorder: A Double-blind, Randomized, Placebo-Controlled Trial
Authors: Holland Michael A. , Joyce John S. , Brennaman Lisa M. , Drobnis Erma Z. , Starr Julie A. , Foster Raymond T. 
Published: May 2019

(Abstracted from Female Pelvic Med Reconstr Surg 2019;25:76–81)
Pelvic floor hypertonic disorder is a neuromuscular condition that causes involuntary spasms of the levator ani muscles, resulting in reproducible pelvic pain during vaginal intercourse or internal pelvic examination. It may act as a primary pain generator, a singular component of pelvic pain, or cause bladder or bowel dysfunction.
Clinical Practice Guidelines for the Rehabilitation of Lower Limb Amputation
Authors: Webster Joseph B. , Crunkhorn Andrea , Sall James , Highsmith M. Jason , Pruziner Alison , Randolph Billie J. 
Published: May 2019

Abstract
Between 2015 and 2017, the US Department of Veterans Affairs and the US Department of Defense developed a clinical practice guideline for rehabilitation of lower limb amputation to address key clinical questions. A multidisciplinary workgroup of US Department of Veterans Affairs and US Department of Defense amputation care subject matter experts was formed, and an extensive literature search was performed which identified 3685 citations published from January 2007 to July 2016. Articles were excluded based on established review criteria resulting in 74 studies being considered as evidence addressing one or more of the identified key issues. The identified literature was evaluated and graded using the National Academies of Science GRADE criteria. Recommendations were formulated after extensive review. Eighteen recommendations were confirmed with four having strong evidence and workgroup confidence in the recommendation. Key recommendations address patient and caregiver education, consideration for the use of rigid and semirigid dressings, consideration for the use of microprocessor knees, and managed lifetime care that includes annual transdisciplinary assessments. In conclusion, this clinical practice guideline used the best available evidence from the past 10 yrs to provide key management recommendations to enhance the quality and consistency of rehabilitation care for persons with lower limb amputation.
Blended Collaborative Care to Treat Heart Failure and Comorbid Depression: Rationale and Study Design of the Hopeful Heart Trial
Authors: Herbeck Belnap Bea , Anderson Amy , Abebe Kaleab Z. , Ramani Ravi , Muldoon Matthew F. , Karp Jordan F. , Rollman Bruce L. 
Published: May 2019

ABSTRACT

Objective
Despite numerous improvements in care, morbidity from heart failure (HF) has remained essentially unchanged in recent years. One potential reason is that depression, which is comorbid in approximately 40% of hospitalized HF patients and associated with adverse HF outcomes, often goes unrecognized and untreated. The Hopeful Heart Trial is the first study to evaluate whether a widely generalizable telephone-delivered collaborative care program for treating depression in HF patients improves clinical outcomes.

Methods
The Hopeful Heart Trial aimed to enroll 750 patients with reduced ejection fraction (HFrEF) (ejection fraction ≤ 45%) including the following: (A) 625 patients who screened positive for depression both during their hospitalization (Patient Health Questionnaire [PHQ-2]) and two weeks following discharge (PHQ-9 ≥ 10); and (B) 125 non-depressed control patients (PHQ-2(−)/PHQ-9 < 5). We randomized depressed patients to either their primary care physician's “usual care” (UC) or to one of two nurse-delivered 12-month collaborative care programs for (a) depression and HFrEF (“blended”) or (b) HrEFF alone (enhanced UC). Our co-primary hypotheses will test whether “blended” care can improve mental health–related quality of life versus UC and versus enhanced UC, respectively, on the Mental Component Summary of the Short-Form 12 Health Survey. Secondary hypotheses will evaluate the effectiveness of our interventions on mood, functional status, hospital readmissions, deaths, provision of evidence-based care for HFrEF, and treatment costs.

Results
Not applicable.

Conclusions
The Hopeful Heart Trial will determine whether “blended” collaborative care for depression and HFrEF is more effective at improving patient-relevant outcomes than collaborative care for HFrEF alone or doctors' UC for HFrEF.

Trial registration:
ClinicalTrials.gov identifier NCT02044211.