bluuebunny/crossref_metadata_2025_split huggingface dataset:
Experience of the management of coronary artery bypass graft only on moderate ischemic mitral regurgitation
Authors: Wang Weitie , Li Bo , Wang Yong , Piao Hulin , Zhu Zhicheng , Xu Rihao , Li Dan , Liu Kexiang 
Published: April 2019

Abstract
To summary the impact of off-pump coronary artery bypass grafting (CABG) only on patients with moderate ischemic mitral regurgitation and survival.
We retrospectively analyzed 109 patients with coronary artery disease (CAD) complicated by moderate mitral regurgitation, from January, 2008 to December, 2014, in the Department of Cardiovascular Surgery at the No. 2 Hospital of Jilin University undergoing off pump CABG only. Preoperative clinical characteristics, complications after surgery, and outcome (survivor or death) were assessed. We observed the degree of mitral valve regurgitation, left ventricular ejection fraction (LVEF), left ventricular and left atrial size, left ventricular end-diastolic volume (LVEDV) preoperative, and New York Heart Association (NYHA) functional class, postoperative 10 days before discharge, and 6 months and longer after surgery. The statistical data were processed by SPSS 19 software with computer; statistical significant difference with P < .05.
Overall in-hospital mortality was 2.75% (3 patients). Patients had lower mean LVEF in the postoperative compared with the preoperative period, but all the patients had higher LVEF since 6 months than preoperative period (P < .001). Compared with the preoperative dates, postoperative valvular regurgitation, left ventricular and atrial size and LVEDV postoperative 10 days before discharge, 6 months and more longer after surgery reduced significantly (P < .001). Rapid atrial fibrillation occurred in 19 cases during perioperative and returned to normal before discharge. The symptom of angina was disappeared in all patients before discharge. The mean follow-up time was 60.16 ± 17.98 months (range 36–96 months). Two patients died of major adverse cardiac events including heart failure and ventricular fibrillation. Three patients died of lung cancer, and 2 patients died of stroke during the longer follow-up.
Off-pump CABG can be performed safely in patients with CAD complicated by moderate mitral regurgitation. The efficacy of CABG only is well demonstrated by the significant improvement of LVEF and NYHA functional class, and by the decrease of left ventricular and atrial size, LVEDV, and mitral regurgitation grade.
Inferior vena cava diameter measurements and BUN/creatinine values to determine dehydration in patients with hip fractures preoperatively
Authors: Kaydu Ayhan , Gokcek Erhan 
Published: April 2019

Abstract
Dehydration is a common problem in patients undergoing hip fracture surgery. Sonographic inferior vena cava (IVC) diameter measurement evaluates to estimate volume status. The aim of the study to evaluate the relationship between IVC measurements (expiratory diameter of IVC, collabsibility index [CI], inspiratory diameter of IVC) and blood urea nitrogen (BUN)/creatinine ratio in patients undergoing hip fracture surgery. Ultrasonography of IVC was performed on 35 patients underwent hip fracture surgery. The end-expiratory diameter of IVC, end-inspiratory diameter of IVC, and CI were assessed preoperatively. The patients were classified as group 1 for BUN/Cr ratio <20, group 2 for BUN/Cr ratio of >20. Sonographic IVC measurement was not successful in 14.2% of patients and 30 patients remained. The mean age was 80.43 ± 11.10 (58–95) years. The IVC diameter values had no discriminatory value for the prediction of dehydration according to BUN/creatinine ratio (P > .05). Receiver operating characteristic curve indicated that area under the curve (AUC) for CI: 49.5%, (95% CI 26.5–72.5) P > .05; for IVC inspiratory diameter: AUC: 43.3%, (95% CI, 19.9–66.6) P > .05; for IVC expiratory diameter: AUC: 45.5%, (95% CI, 26.6–65.4) P > .05. No correlations of BUN/creatinine ratio with CI and IVC expiratory diameter were found (as r = −0.262 [P = .163]; [r = 0.206, P = .274]; respectively). There were not any correlation in linear regression analysis model between BUN/Cr ratio according to independent variables (Age, CI, IVCmax, IVCmin) (P = .108, P = .419, P = .282, P = .257; respectively). No discriminatory relationship was found between the bedside ultrasonographic measurement of IVC parameters and BUN/creatinine ratio in patients underwent hip fracture surgery to predict the preoperative dehydration.
Partial response after treatment with Conversion chemotherapy
Authors: Bu Zhaoting , Lu Cheng , Yang Xu , Lai Hao , Jiang Yuting , Li Yicheng , Lin Yuan , Qin Yuzhou , Xiao Minxi , Cheng Chunfeng , Liu Qi 
Published: April 2019

Abstract

Rationale:
Many studies have reported radical resection for liver metastasis and the primary tumor could represent an important prognostic factor in patients affected by colorectal liver metastases (CRLM). However, resection of huge liver metastases from colon cancer has been seldom reported.

Patient Concerns:
A 58-year-old man presented with huge liver metastases from colon cancer. Laboratory tests revealed elevated tumor markers and a wild-type mutation in the K-RAS gene. A computed tomography scan demonstrated unresectable liver masses with a 16.5-cm maximum diameter and intrahepatic duct dilatation due to compression by the liver metastases.

Diagnosis:
The patient was diagnosed with stage IV descending colon carcinoma with multiple huge hepatic metastases.

Interventions:
He was administered 3 treatment courses, including 9 cycles of combined chemotherapy with mFOLFOX6 plus cetuximab (mFOLFOX6 + Cet), and the liver masses reduced. After a preoperative assessment by a multidisciplinary team when the 9 cycles of systemic chemotherapy had been completed, the patient underwent hepatectomy, followed 4 months later by a laparoscopic colectomy. We used a reverse strategy (liver-first) for the patient.

Outcomes:
In this case, liver-first treatment (systemic chemotherapy of mFOLFOX6 + Cet) was an effective treatment for unresectable CRLM. No postoperative complications occurred. The patient continued to receive postoperative chemotherapy (mFOLFOX6 + Cet) at the latest follow-up. During the 17 months of follow-up, tumor recurrence was un-noted.

Lessons:
Treating colorectal cancer patients with huge hepatic metastases is possible, and surgeons should consider various treatment options in the management of these patients.
Use of Neoveil or TachoSil to prevent pancreatic fistula following pancreaticoduodenectomy
Authors: Kwon Hye Eun , Seo Hyung-Il , Yun Sung Pil 
Published: April 2019

Abstract
The aim of this study was to evaluate the effectiveness of using Neoveil and TachoSil sponges at the pancreaticojejunostomy anastomosis site in reducing the rate and severity of postoperative pancreatic fistula (POPF).
In this study, we retrospectively evaluated data that were prospectively collected on pancreaticoduodenectomy (PD) procedures. Patients were divided into 3 groups: no patch application, Neoveil patch application, and TachoSil patch application. Demographic and surgical data were analyzed.
Around 165 patients with PD were enrolled in this study and were divided into 3 groups. In the standard group (n = 43), no patch was applied, while in the Neoveil and TachoSil groups (n = 84 and n = 38, respectively), the pancreaticojejunostomy anastomosis site was covered with Neoveil and TachoSil patches, respectively. POPF grade B or above occurred in 37.2% (16/43), 14.3% (12/84), and 18.8% (6/38) of patients in the standard, Neoveil and TachoSil groups, respectively, with a significant difference between patients with and without patch application (P = .004). On multivariate logistic analysis of predictive factors for POPF, male sex, patch application, and hospital day were found to be the significant independent predictors of POPF grade B or above.
Significant independent predictors of POPF were male sex and patch application. This study demonstrated that the use of Neoveil or TachoSil patches may reduce the incidence of POPF after PD.
A randomized controlled trial on the impact of moderate-intensity continuous aerobic exercise on the depression status of middle-aged patients with congestive heart failure
Authors: Abdelbasset Walid Kamal , Alqahtani Bader A. 
Published: April 2019

Abstract

Background:
Depression prevalence rates in congestive heart failure (CHF) patients have increased in the last few years. Depression is a leveled and independent risk factor for hospital readmission, decreased function, and patient mortality for patients with CHF. Major depressive disorder can be diagnosed in CHF patients who frequently suffer from sleeplessness, fatigue, and neurovegetative manifestations that extend to depressed patients.

Objectives:
The aim of this study was to investigate the influence of moderate-intensity continuous aerobic exercise (MICAE) on the depression status in patients with CHF.

Methods:
Between June and September 2017, 46 patients with CHF who suffered from depression were selected for this study. These patients aged 40 to 60 years, were medically diagnosed with CHF-related illnesses, and physical disabilities. The participating patients were selected from the psychological medicine unit of the University Hospitals. They were randomly classified into 2 groups, each group included 23 patients. The study group underwent MICAE (MICAE) 3 times weekly for 12 weeks, whereas the control group received traditional intervention without any physical exercise.

Results:
There were no significant differences between the 2 groups regarding baseline characteristics (P
>.05). Patients in both groups had a significant decrease in their depression levels. The study group had a greater reduction of 80.9% (P <.05) when compared to a reduction in the control group 46.46% (P <.05).

Conclusions:
According to the study outcomes, it was concluded that 12 weeks of MICAE has positive effects on the depression status in patients with CHF. The study group who underwent moderate-intensity aerobic exercise had a greater decrease in the depression status of CHF patients when compared to the control group.
Socioeconomic status impacts outcomes following pediatric anterior cruciate ligament reconstruction
Authors: Patel Akash R. , Sarkisova Natalya , Smith Ryan , Gupta Kavish , VandenBerg Curtis D. 
Published: April 2019

Abstract
Previous research has shown that delays in pediatric anterior cruciate ligament (ACL) reconstruction are associated with increased prevalence of concomitant knee injuries and worse outcomes following surgery. However, few studies have described factors that may contribute to these delays and adverse outcomes. This study seeks to determine the effect of socioeconomic status on clinical outcomes following ACL reconstruction.
A retrospective review of patients who underwent primary ACL reconstruction at a tertiary pediatric hospital between 2009 and 2015 was conducted. Variables included chronologic, demographic, and socioeconomic data, and postoperative complications. Socioeconomic status was measured using health insurance type and median household income levels derived from 2009 to 2015 US Census Bureau.
A total of 127 patients (69 male, 58 female) were included. The mean age at time of surgery was 15.0 years. Overall, 68 patients had commercial insurance and 59 patients had government-assisted insurance. The mean household median income for patients with commercial insurance was $87,767 compared to $51,366 for patients with government-assisted insurance. Patients with government-assisted insurance plans demonstrated greater delays in time from injury to initial orthopaedic evaluation (P = .0003), injury to magnetic resonance imaging (MRI) examination (P = .021), injury to surgery (P < .0001), initial orthopaedic evaluation to surgery (P = .0036), and injury to return to play clearance, P = .044. Median household income was significantly related to time from injury to MRI examination (P = .0018), injury to surgery (P = .0017), and initial orthopaedic evaluation to surgery (P = .039). Intraoperatively, 81% of patients with government-assisted insurance had concomitant meniscal injuries compared 65% of patients with commercial insurance, P = .036. Postoperatively, 22% of patients with government-assisted insurance were found to have decreased knee range of motion (“stiffness”) compared to 9% of patients with commercial insurance, P = .034.
Pediatric patients who have government-assisted plans may experience delays in receiving definitive injury management and be at risk for postoperative complications. Our findings suggest a significant discrepancy in time to treatment as well as rates of concomitant knee injuries and postoperative complications between government and commercial insurance types.
Level of Evidence: III
A cohort study of age and sex specific risk of pyogenic liver abscess incidence in patients with type 2 diabetes mellitus
Authors: Ko Ming-Chung , Lin Wei-Hung , Martini Santi , Chang Ya-Hui , Chiu Chang-Ta , Li Chung-Yi 
Published: April 2019

Abstract
To investigate the age-sex-specific incidence and relative risk of pyogenic liver abscess (PLA) in patients with type 2 diabetes mellitus (T2DM), and to assess the joint effects of T2DM and other clinical risk factors for PLA on PLA incidence. We used a population-based cohort design with Taiwan's National Health Insurance claim data. Study subjects included 613,921 T2DM patients and 614,613 controls identified in 2000 and were followed to the end of 2010. Cox regression model was employed to calculate the hazard ratio (HR) and 95% confidence interval (CI) of PLA in relation to T2DM. Over an 11-year follow-up, 5336 T2DM and 1850 controls were admitted for PLA, representing a cumulative incidence of 0.87% and 0.30%, respectively. T2DM was significantly associated with increased hazard of PLA (HR, 2.88; 95% CI, 2.73–3.04). We also found that age and gender may significantly modify the relationship between T2DM and PLA, with a higher HR noted in males patients and those aged <45 years. Biliary tract diseases (HR, 8.60; 95% CI, 7.87–9.40) and liver cirrhosis (HR, 7.52; 95% CI, 6.58–8.59) may add substantially additional risk to the incidence of PLA in T2DM patients. The increased risk of PLA in T2DM was greater in male and younger patients. Careful management of biliary tract diseases and liver cirrhosis may also help reduce the incidence of PLA in T2DM patients.
Pseudo-pseudo Meigs’ syndrome presenting with a combination of polyserositis, elevated serum CA 125 in systemic lupus erythematosus
Authors: Gao Fei , Xu YongMei , Yang GuoWang 
Published: April 2019

Abstract

Rationale:
Combination of polyserositis and elevated serum CA 125 is common in tumor or infectious disease, but this clinical combination is also found in other diseases. It could be the initial manifestation of pseudo-pseudo Meigs’ syndrome (PPMS), which is characterized by the presence of polyserositis and raised CA-125 level in systemic lupus erythematosus (SLE).

Patient's concerns:
A 44-year-old Chinese female was admitted with three months history of painless abdominal distension accompanied by watery diarrhea 5–6 times daily, shortness of breath, fatigue, lower limb swelling, and 10 kg weight loss. The test results showed peripheral cytopenias, hypoproteinemia, renal dysfunction and elevated CA 125, antidouble-stranded DNA antibodies, and anti-Sjogren's syndrome A antigen antibody was positive. There is no evidence for the diagnosis of solid tumor according to the results of imaging modality and pathological examination.

Diagnosis:
The patient was diagnosed as pseudo-pseudo Meigs syndrome.

Intervention:
The patient received hormone, leflunomide, and Plaquenil therapy.

Outcomes:
The patient's symptoms were relieved and the laboratory index was improved after the treatment of hormone and immunosuppressant.

Lessons subsections as per style:
PPMS is characterized by the combination of serous effusion and elevated serum CA 125 with no evidence of tumor among SLE patients. Clinicians should be aware of the diagnosis of PPMS avoiding unnecessary anxiety or surgical interventions.
Differentiated Care Preferences of Stable Patients on Antiretroviral Therapy in Zambia: A Discrete Choice Experiment
Authors: Eshun-Wilson Ingrid , Mukumbwa-Mwenechanya Mpande , Kim Hae-Young , Zannolini Arianna , Mwamba Chanda P. , Dowdy David , Kalunkumya Estella , Lumpa Mwansa , Beres Laura K. , Roy Monika , Sharma Anjali , Topp Steph M. , Glidden Dave V. , Padian Nancy , Ehrenkranz Peter , Sikazwe Izukanji , Holmes Charles B. , Bolton-Moore Carolyn , Geng Elvin H. 
Published: April 2019

Background:
Although differentiated service delivery (DSD) models for stable patients on antiretroviral therapy (ART) offer a range of health systems innovations, their comparative desirability to patients remains unknown. We conducted a discrete choice experiment to quantify service attributes most desired by patients to inform model prioritization.

Methods:
Between July and December 2016, a sample of HIV-positive adults on ART at 12 clinics in Zambia were asked to choose between 2 hypothetical facilities that differed across 6 DSD attributes. We used mixed logit models to explore preferences, heterogeneity, and trade-offs.

Results:
Of 486 respondents, 59% were female and 85% resided in urban locations. Patients strongly preferred infrequent clinic visits [3- vs. 1-month visits: β (ie, relative utility) = 2.84; P < 0.001]. Milder preferences were observed for waiting time for ART pick-up (1 vs. 6 hours.; β = −0.67; P < 0.001) or provider (1 vs. 3 hours.; β = −0.41; P = 0.002); “buddy” ART collection (β = 0.84; P < 0.001); and ART pick-up location (clinic vs. community: β = 0.35; P = 0.028). Urban patients demonstrated a preference for collecting ART at a clinic (β = 1.32, P < 0.001), and although most rural patients preferred community ART pick-up (β = −0.74, P = 0.049), 40% of rural patients still preferred facility ART collection.

Conclusions:
Stable patients on ART primarily want to attend clinic infrequently, supporting a focus in Zambia on optimizing multimonth prescribing over other DSD features—particularly in urban areas. Substantial preference heterogeneity highlights the need for DSD models to be flexible, and accommodate both setting features and patient choice in their design.
Cartilage Trap-Door Flap Technique for Correction of High Nasal Septum Deflection
Authors: Kim Jooyeon , Choi Gwan , Kwon Jae Hwan 
Published: April 2019

Objective:
To introduce a novel cartilage trap-door flap technique in endonasal septoplasty to correct high dorsal deviation of the cartilaginous septum, and confirm its effectiveness.

Design:
Prospective observational study.

Setting:
Medical center.

Methods:
46 patients who had underwent septoplasty using the cartilage island flap technique to correct the high dorsal deviation from November 2014 to November 2015. The subjective symptoms were measured using the Nasal Obstruction Symptom Evaluation scale. The objective evaluations of the surgical results were analyzed using acoustic rhinometry. Post-operative status of the nasal septum was estimated by nasal endoscopic examination.

Results:
Among 46 patients, 32 cases (69.57%) were “complete correction”, 14cases (30.43%) were “improved” with residual deviation and there was not “no-change” or “even worse” case based on endoscopic examination. Minimal cross-sectional area in convex side of nasal cavity was significantly changed from 0.22cm2 to 0.56cm2 after the surgery, and nasal volume in narrower side of nasal cavity was significantly changed from 2.44mL to 6.22 mL. The patients’ nasal obstruction symptoms significantly reduced from 10.43 before the surgery to 1.45 after the surgery. During the follow-up period, the authors have not experienced any obvious complications such as saddle nose, septal perforation, and bleeding.

Conclusion:
The proposed cartilage trap-door flap technique provides easy and effective results for dorsal deviations of the cartilaginous septum in selected cases without significant complications.
Comparing Outcomes in Orthognathic Surgery Using Clear Aligners Versus Conventional Fixed Appliances
Authors: Kankam Hadyn , Madari Sarika , Sawh-Martinez Rajendra , Bruckman Karl C. , Steinbacher Derek M. 
Published: April 2019

Purpose:
Orthognathic surgery for dentofacial deformities is typically preceded and followed by orthodontic treatment. Traditionally, orthodontic hardware is secured to the dentition to allow dental movement and stabilization. Clear-aligner therapy (eg, Invisalign) provides an aesthetic alternative, consisting of a series of transparent trays. Its use has not been described in complex triple-jaw orthognathic surgery. The purpose of this study is to evaluate perioperative outcomes and 3-dimensionally quantify postoperative edema in Invisalign patients undergoing triple-jaw orthognathic procedures, comparing this to patients treated with conventional fixed appliances. The surgical approach to patients with clear-aligners is also outlined.

Methods:
The authors conducted a retrospective chart review and 3-dimensional morphometric study of Invisalign patients undergoing triple-jaw surgery (LeFort I osteotomy, bilateral sagittal split osteotomy, and genioplasty). An identical assessment of demographically matched patients treated with conventional fixed appliances was performed and compared with the Invisalign group.

Results:
Thirty-three patients, with a mean age of 19.99 years, were included: 13 with Invisalign and 20 with conventional fixed appliances. No significant difference was observed in operating time, concurrent extraction of teeth, fat grafting, duration of hospital stay, diet advancement, and use of narcotic analgesics between the 2 groups. Nine patients had sufficient 3-dimensional images for volumetric analysis (4 with Invisalign and 5 with conventional fixed appliances). Postoperative edema was not significantly different (P = 0.712) when comparing conventional fixed appliances (44.29 ± 23.16 cm3) to Invisalign (37.36 ± 31.19 cm3).

Conclusion:
The present study demonstrates that complex multiple-jaw orthognathic procedures can be successfully performed in Invisalign patients. Perioperative and short-term clinical outcomes are not compromised.
Delayed Dural Arteriovenous Fistula at the Transverse-Sigmoid Sinus Secondary to Petroclival Meningioma Surgery Via Far Lateral Approach
Authors: Xue Xiying , Hou Yunxia , Chen Jingming , Yuan Xunhui , Sun Gaoling , Guo Liemei 
Published: April 2019

Abstract
Intracranial dural arteriovenous fistulas (DAVFs) are typified by pathological anastomoses between meningeal arteries and dural venous sinuses or cortical veins. There are many causes contributing to the etiology of DAVFs. Among the variable causes, acquired DAVFs secondary to craniotomy had rarely been reported, especially for delayed DAVFs at the transverse-sigmoid sinus. Till now, there are only 12 published cases of delayed DAVFs at the transverse-sigmoid sinus secondary to craniotomy. Herein, the authors describe such an extraordinary rare case secondary to petroclival meningioma resection via far lateral approach, and to the best knowledge of us, this is the first well-documented case of delayed DAVF at the transverse-sigmoid sinus following far lateral craniotomy. Furthermore, cases of delayed DAVFs at the transverse-sigmoid sinus secondary to craniotomy were reviewed and investigated, and the clinical characteristics and treatment were also broadly discussed.