bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long-term Posttraumatic Survival of Spinal Fracture Patients in Northern Finland
Authors: Niemi-Nikkola Ville , Saijets Nelli , Ylipoussu Henriikka , Kinnunen Pietari , Pesälä Juha , Mäkelä Pirkka , Alen Markku , Kallinen Mauri , Vainionpää Aki 
Published: April 2018

Study Design.
A retrospective epidemiological study.

Objective.
To reveal the long-term survival and causes of death after traumatic spinal fracture (TSF) and to determine the possible factors predicting death.

Summary of Background Data.
Increased mortality following osteoporotic spinal fracture has been represented in several studies. Earlier studies concerning mortality after TSF have focused on specific types of fractures, or else only the mortality of the acute phases has been documented. In-hospital mortality has varied between 0.1% and 4.1%.

Methods.
The study sample of 947 patients including all patients with TSF admitted to Oulu University Hospital, Finland, between January 1, 2007 and December 31, 2011. TSFs were identified using International Classification of Diseases 10th revision or Nordic Classification of Surgical Procedures codes and all patient records were manually reviewed. Times and causes of death, obtained from Statistics Finland's Archive of Death Certificates, were available until the end 2016 and 2015, respectively.

Results.
At the end of the follow-up 227 (24.0%) had died. Mortality was 6.8% after the first year and 19.1% after 5 years. Mortality was increased in all age groups compared with the general population, 1-year standardized mortality ratios ranging from 3.1 in over 65-year-olds to 19.8 in under 30-year-olds. In age groups of 50 to 64 years and over 65 years, the most important risk factors for death were males with hazard ratios of 3.0 and 1.6, respectively, and low fall as trauma mechanism with hazard ratios of 9.4 and 10.2, respectively.

Conclusion.
Traumatic spinal fractures are associated with increased mortality compared with the general population, high mortality focusing especially on older people and men. The increase seems to be comparable to the increase following hip fracture. Patients who sustain spinal fracture due to falling need special attention in care, due to the observation that low fall as trauma mechanism increased the risk of death significantly.

Level of Evidence: 3
Development and Validation of Nomograms Predicting Overall and Cancer-Specific Survival of Spinal Chondrosarcoma Patients
Authors: Song Kehan , Song Jian , Shi Xio , Wang Hongli , Ma Xiaosheng , Xia Xinlei , Liang Xin , Lin Kaiyuan , Jiang Jianyuan 
Published: April 2018

Study Design.
Retrospective analysis.

Objective.
To develop and validate nomograms to predict overall survival (OS) and cancer-specific survival (CSS) of spinal chondrosarcoma patients.

Summary of Background Data.
In this era of personalized medicine, data those are available to predict the survival of spinal chondrosarcoma patients are still limited due to the rarity of the disease. Nomogram, which has been widely used in clinical oncology, could conveniently and precisely predict survival outcome for individual patient.

Methods.
We retrospectively collected 450 spinal chondrosarcoma patients from the Surveillance, Epidemiology, and End Results (SEER) database between 1984 and 2013. Univariate log-rank and multivariate Cox analyses were used to identify independent prognostic factors. These prognostic factors were included in the nomograms, which predict 3- and 5-year OS and CSS rate. The nomograms were bootstrap validated internally and externally.

Results.
A total of 450 patients were collected and randomly assigned into the training (n = 225) and validation (n = 225) cohorts. Age, histologic subtype, grade, tumor size, stage, and surgery were identified as independent prognostic factors for OS and CSS (all P < 0.05) and were further incorporated to construct the nomograms. The concordance indices (C-indices) for internal validation of OS and CSS prediction were 0.807 and 0.821, while for external validation of OS and CSS prediction were 0.756 and 0.767. Internal and external calibration plots both revealed an excellent agreement between nomogram prediction and actual survival.

Conclusion.
Nomograms were developed to predict OS and CSS for spinal chondrosarcoma patients. The nomograms could assist clinicians in making more accurate survival evaluation and identifying patients with high risk of mortality.

Level of Evidence: 4
Randomized Controlled Trial of Extended Perioperative Counseling in Enhanced Recovery After Colorectal Surgery
Authors: Forsmo Håvard Mjørud , Erichsen Christian , Rasdal Anne , Tvinnereim Jon Meyer , Körner Hartwig , Pfeffer Frank 
Published: April 2018

BACKGROUND:
Enhanced recovery after surgery programs reduce the length of hospital stay in patients who undergo elective colorectal resection, but the reasons for this reduction are not well understood.

OBJECTIVE:
The aim of this randomized controlled trial was to assess the impact of extended perioperative counseling in treatment groups that were otherwise the same with respect to enhanced recovery after surgery criteria.

DESIGN:
Patients eligible for open or laparoscopic colorectal resection were randomly assigned to extended counseling (repeated information and guidance by a dedicated nurse) or standard counseling.

SETTINGS:
This study was conducted at a single institution.

PATIENTS:
Patients (n = 164) were randomly assigned to enhanced recovery after surgery plus extended counseling (n = 80) or enhanced recovery after surgery with standard counseling (n = 84).

MAIN OUTCOME MEASURES:
The primary end point was the total length of hospital stay. Discharge criteria were defined. Secondary end points were postoperative complications, postoperative length of hospital stay, readmission rate, and mortality.

RESULTS:
Total hospital stay was significantly shorter among patients randomly assigned to enhanced recovery after surgery plus extended counseling (median 5 (range 2–29) days vs 7 (range 2–39) days, p < 0.001). The 2 treatment groups differed in adherence to the elements of postoperative enhanced recovery after surgery such as mobilization and total oral intake. The 2 treatment groups did not differ in overall, major, and minor morbidity; reoperation rate; readmission rate; and 30-day mortality.

LIMITATIONS:
The main limitation of this study was the absence of blinding.

CONCLUSIONS:
Perioperative information and guidance were important factors in enhanced recovery after surgery care and were associated with a significantly shorter length of hospital stay. Our findings suggest that perioperative counseling enables patients to comply with the elements of postoperative enhanced recovery after surgery and thereby reduces the length of hospital stay. This study was registered with ClinicalTrials.gov (NCT01610726). See Video Abstract at http://links.lww.com/DCR/A505.
Functional Outcomes After Rectal Resection for Deep Infiltrating Pelvic Endometriosis: Long-term Results
Authors: Erdem Suna , Imboden Sara , Papadia Andrea , Lanz Susanne , Mueller Michael D. , Gloor Beat , Worni Mathias 
Published: April 2018

BACKGROUND:
Curative management of deep infiltrating endometriosis requires complete removal of all endometriotic implants. Surgical approach to rectal involvement has become a topic of debate given potential postoperative bowel dysfunction and complications.

OBJECTIVE:
This study aims to assess long-term postoperative evacuation and incontinence outcomes after laparoscopic segmental rectal resection for deep infiltrating endometriosis involving the rectal wall.

DESIGN:
This is a retrospective study of prospectively collected data.

SETTINGS:
This single-center study was conducted at the University Hospital of Bern, Switzerland.

PATIENTS:
Patients with deep infiltrating endometriosis involving the rectum undergoing rectal resection from June 2002 to May 2011 with at least 24 months follow-up were included.

MAIN OUTCOME MEASURES:
Aside from endometriosis-related symptoms, detailed symptoms on evacuation (points: 0 (best) to 21 (worst)) and incontinence (0–24) were evaluated by using a standardized questionnaire before and at least 24 months after surgery.

RESULTS:
Of 66 women who underwent rectal resection, 51 were available for analyses with a median follow-up period of 86 months (range: 26–168). Forty-eight patients (94%) underwent laparoscopic resection (4% converted, 2% primary open), with end-to-end anastomosis in 41 patients (82%). Two patients (4%) had an anastomotic insufficiency; 1 case was complicated by rectovaginal fistula. Dysmenorrhea, nonmenstrual pain, and dyspareunia substantially improved (p < 0.001 for all comparisons). Overall evacuation score increased from a median of 0 (range: 0–11) to 2 points (0–15), p = 0.002. Overall incontinence also increased from 0 (range: 0–9) to 2 points (0–9), p = 0.003.

LIMITATIONS:
This study was limited by its retrospective nature and moderate number of patients.

CONCLUSIONS:
Laparoscopic segmental rectal resection for the treatment of deep infiltrating endometriosis including the rectal wall is associated with good results in endometriotic-related symptoms, although patients should be informed about possible postoperative impairments in evacuation and incontinence. However, its clinical impact does not outweigh the benefit that can be achieved through this approach. See Video Abstract at http://links.lww.com/DCR/A547.
Added value today of hormonal measurements in ovarian stimulation in gonadotropin-releasing hormone antagonist treatment cycle
Authors: Popovic-Todorovic Biljana , Racca Annalisa , Blockeel Christophe 
Published: April 2018

Purpose of review
Traditional approach of ovarian stimulation monitoring for in-vitro fertilization involves transvaginal sonography and serum estradiol measurements. Accumulating evidence has shown that hormonal evaluations during ovarian stimulation allow individual cycle optimization, moving away from only predicting the risk of ovarian hyperstimulation syndrome, but in addition assessing the impact of ovarian stimulation on endometrial receptivity, quality of oocytes, and subsequently embryos. The purpose of this review is to discuss the relevance and added value of hormonal monitoring during ovarian stimulation in gonadotropin-releasing hormone antagonist cycles where most of the advances have occurred.

Recent findings
Basal hormonal status, particularly estradiol, progesterone, and luteinizing hormone are instrumental in prediction of the patients with poor prognosis. Estradiol levels on the day of trigger are less sensitive in predicting ovarian hyperstimulation syndrome then the number of follicles more than 11 mm in diameter. Progesterone elevation on the day of trigger is associated with lower pregnancy rates. The gold standard treatment for progesterone elevation is to adopt a freeze-all strategy when the threshold of 1.50 ng/ml is exceeded. The effect of progesterone elevation on embryo quality remains to be confirmed by more trials.

Summary
Endocrine monitoring during ovarian stimulation allows fine-tuning of the physiology of the stimulated cycle and thereby increases the chances of successful treatment outcome.
Crowdsourcing Public Perceptions of Plastic Surgeons: Is There a Gender Bias?
Authors: Bucknor Alexandra , Christensen Joani , Kamali Parisa , Egeler Sabine , van Veldhuisen Charlotte , Rakhorst Hinne , Mathijssen Irene , Lin Samuel J. , Furnas Heather 
Published: April 2018

Background:
Implicit gender bias may result in lower wages for women, fewer leadership positions, and lower perceived competence. Understanding public and patient gender preferences for plastic surgeons may enable opportunities to address public perceptions. This investigation evaluates public preferences for a plastic surgeon’s gender or demeanor.

Methods:
Members of the Amazon Mechanical Turk crowdsourcing platform read 1 of the 8 randomly assigned scenarios describing a hypothetical situation requiring a plastic surgeon to operate on their mother. The scenarios differed only by surgeon gender, surgeon demeanor (“agentic,” traditionally more masculine versus “communal,” traditionally more feminine), or type of surgery. Using a Likert scale, respondents indicated their agreement with 7 statements on surgeon competence, skills, leadership qualities, likeability, respect, trustworthiness, and, ultimately, preference as a surgeon. Independent t tests were used to compare scores. Lower scores indicated a more negative response.

Results:
Overall, 341 responses were received: 55.7% were male and 45.5% white. There were no significant differences in any of the 7 characteristics assessed when examining by surgeon gender, only. However, female surgeons with a communal demeanor were perceived as less competent (4.32 versus 4.51, P = 0.018) and less skilled (4.36 versus 4.56, P = 0.019) than agentic female surgeons. Male respondents rated female surgeons lower than male surgeons in terms of competence (P = 0.018), skills (P = 0.034), likeability (P = 0.042), and preferred choice as a surgeon (P = 0.033).

Conclusions:
Women plastic surgeons’ demeanor and respondent gender affected perception of certain characteristics. Women plastic surgeons may consider ways to engage with the public to address possible gender role stereotypes.
Buried Versus Exposed Kirschner Wires Following Fixation of Hand Fractures: l Clinician and Patient Surveys
Authors:   WIRE Research Collaborative
Published: April 2018

Background:Fractures of the metacarpals and phalanges are common. Placement of Kirschner wires (K-wires) is the most common form of surgical fixation. After placement, a key decision is whether to bury the end of a K-wire or leave it protruding from the skin (exposed). A recent systematic review found no evidence to support either approach. The aim of study was to investigate current clinical practice, understand the key factors influencing clinician decision-making, and explore patient preferences to inform the design of a randomized clinical trial.Methods:The steering group developed surveys for hand surgeons, hand therapists, and patients. Following piloting, they were distributed across the United Kingdom hand surgery units using the Reconstructive Surgery Trials Network.Results:A total of 423 hand surgeons, 187 hand therapists, and 187 patients completed the surveys. Plastic surgeons and junior surgical trainees preferred to leave K-wires not buried. Ease of removal correlated with a decision to leave wires exposed, whereas perceived risk of infection correlated with burying wires. Cost did not affect the decision. Hand therapists were primarily concerned about infection and patient-related outcomes. Patients were most concerned about wire-related problems and pain.Conclusion:This national survey provides a new understanding of the use of K-wires to manage hand fractures in the United Kingdom. A number of nonevidence-based factors seem to influence the decision to bury or leave K-wires exposed. The choice has important clinical and health economic implications that justify a randomized controlled trial.
Mucinous Adenocarcinoma of the Scalp: Primary Cutaneous Neoplasm Versus Underlying Metastatic Disease
Authors: Brown Ciara A. , Lynch Michael C. , Ueno Cristiane M. 
Published: April 2018

Summary:
Primary cutaneous mucinous carcinoma (PCMC) is a rare mucin-producing malignancy derived from epithelial glandular structures. The literature regarding this topic is mostly in the form of case reports and case series. PCMC tends to present in the elderly with predilection for the head and neck and on initial assessment it can be easily mistaken for a simple inclusion cyst. Although PCMC is often indolent in nature, in rare instances it can metastasize and should remain a differential diagnosis in a selected population. The significance in identifying PCMC is reliably differentiating it from metastatic mucinous adenocarcinoma. We present a review of literature and case of PCMC on the scalp of a 67-year-old female.
Adenovirus Ocular Infections: Prevalence, Pathology, Pitfalls, and Practical Pointers
Authors: Garcia-Zalisnak Debora , Rapuano Christopher , Sheppard John D. , Davis Andrew R. 
Published: April 2018

Abstract:
Adenoviral conjunctivitis comprises a large number of physician office visits in the United States and places a great financial burden on health care. It is estimated that the incidence of adenovirus infection to be as high as 20 million cases per year in the United States. There are multiple adenovirus serotypes, each associated with different types and severity of infection. Ocular manifestations of adenovirus include epidemic keratoconjunctivitis, pharyngoconjunctival fever, and nonspecific conjunctivitis. Adenoviral conjunctivitis is primarily a clinical diagnosis. Laboratory diagnosis is available although until recently rarely used. At present, there is no established or approved specific effective drug against adenovirus. Treatment is primarily supportive and includes artificial tears and cool compresses. Topical antibiotics are only indicated if a bacterial coinfection is suspected or in high-risk patients such as children. Prevention against this extremely contagious disease is of utmost importance. Although most cases are self-limited and have a relatively benign course, permanent visual disability can occur. For this reason, it is imperative that all eye care providers are capable of diagnosing and effectively treating these patients, and also preventing the spread of this contagious disease to others.
Scleral Patch Graft With a Suture Reinforcement Technique in Surgical Management of Necrotizing Scleritis With Ectasia
Authors: Wen Joanne C. , Lam Jocelyn , Banitt Michael R. 
Published: April 2018

Purpose:
To describe a technique for reducing and reinforcing scleral thinning in cases of necrotizing scleritis with ectasia.

Methods:
Descriptive report of a surgical technique in 2 surgical cases with a video.

Results:
Successful repair and reduction in uveal prolapse from scleral thinning in 2 cases of necrotizing scleritis with ectasia with a suturing technique using overlapping (weave) compressive suturing over a scleral patch.

Conclusions:
In cases of necrotizing scleritis with ectasia in which there is perforation or prolapsing uvea, this technique should be considered.
Transcatheter Aortic Valve Replacement
Authors: Aalaei-Andabili Seyed Hossein , Anderson R. David , Bavry Anthony A. , Lee Teng C. , Wayangankar Siddharth , Arnaoutakis George J. , Beaver Thomas M. 
Published: April 2018

Objective Transcatheter aortic valve replacement is now commercially available for intermediate-risk, high-risk, or inoperable patients with severe aortic stenosis. In this study, we investigated change in the safety and efficiency of the transcatheter aortic valve replacement procedure at our institution and patient outcomes comparing our first 100, second 100, and last 100 patients. Methods From March 2012 to June 2016, 544 patients underwent transcatheter aortic valve replacement at our center. Three hundred patients were selected for this study and were categorized in the following three groups: group A, first to 100th patient; group B, 101st to 200th patient; and group C, 444th to 544th patient. Preoperative, intraoperative, and postoperative data were collected. Results Three hundred patients, 162 male (54%) male and 138 female (46%) with a mean ± SD age of 79.10 ± 8.93 years and mean ± SD society of thoracic surgeons’ risk score of 7.47 ± 0.76 were included. Fluoroscopy time, operation time, and incision time significantly decreased form group A to group C (all P < 0.05). Mean of contrast volume was also the highest in group A and the lowest in group C ( P < 0.001). Acute kidney injury rate was 26% (n = 26) in group A versus 23% (n = 23) in group B ( P = 0.743), and only one patient in group C (group C vs. group B, P < 0.001). Strokes declined over time: five (5%) stroke in group A; two (2%) stroke in group B, and no patient in group C (group C vs. group B, P = 0.1, and group C vs. group A, P = 0.059). In-hospital mortality was 5% (n = 5) in group A, 4% (n = 4) in group B, and 1% in group C ( P = 0.21). Conclusions Progressive experience and technology advances with transcatheter aortic valve replacement procedures improved operators’ expertise, making the transcatheter aortic valve replacement more efficient and safer over time.
Initial Clinical Experience With a Flexible Peripheral 21-G Needle Device
Authors: Tremblay Alain , Myers Renelle , Beaudoin Eve-Lea , Bonifazi Martina , Delage Antoine , Fortin Marc , Hergott Christopher A. , MacEachern Paul R. , Shaipanich Tawimas , Shieh Benjamin , Gasparini Stefano , Lam Stephen 
Published: April 2018

Background:
Bronchoscopic techniques can be used to safely sample peripheral lung nodules (PLN), and transbronchial needle aspiration (TBNA) can further increase the diagnostic yield. Current needle devices not necessarily designed for this indication have limitations. We report our initial experience with a new flexible nitinol peripheral TBNA needle specifically designed for such sampling.

Methods:
Retrospective case review describing the first clinical cases performed with a commercially available 21-G peripheral TBNA device in 4 centers.

Results:
Eleven different operators performed 40 procedures for PLNs of a mean size of 35.1 mm (±18), and located 18.8 mm (±18.8) from the pleural surface, with 50% of them being present in the upper lobes. Bronchoscopists rated the use of the needle as good or excellent for reaching the PLN in 27/30 (90%) of cases. The TBNA sample was diagnostic in 18/40 cases (45%) overall and in 18/28 (64.3%) of cases where a diagnosis on bronchoscopy was possible. No episode of pneumothorax, significant bleeding, hypoxemia, escalation of care, or other complications were noted.

Conclusion:
Our initial experience with a novel peripheral TBNA device appears safe and effective, and may offer technical advantages over other available devices. Additional studies will be required to confirm the role of this device in the approach to bronchoscopic sampling of parenchymal lung nodules.