bluuebunny/crossref_metadata_2025_split huggingface dataset:
The shifting burden of neurosurgical disease: Vietnam and the middle-income nations
Authors: Carr Christopher , Kahn Lora , Mathkour Mansour , Biro Erin , Bui Cuong J. , Dumont Aaron S. 
Published: October 2018

OBJECTIVEThe Global Burden of Disease (GBD) is an international collaboration and the largest comprehensive investigation of global health disease burden ever conducted. It has been particularly insightful for understanding disease demographics in middle-income nations undergoing rapid development, such as Vietnam, where 6 of the top 10 causes of death are relevant to the neurosurgeon. The burden of stroke—the number one cause of death in Vietnam—is particularly impressive. Likewise, road injuries, with a disproportionate rate of traumatic brain injury, continue to increase in Vietnam following economic development. Low-back and neck pain is the number one cause of disability. Simultaneously, more patients have access to care, and healthcare spending is increased.METHODSIt is imperative that neurosurgical capital and infrastructure keep pace with Vietnam’s growth. The authors searched the existing literature for assessments of neurosurgical infrastructure or initiatives to address neurosurgical disease burden. Using GBD data, the authors also abstracted data for death by cause and prevalence of years of life lost due to disability (YLD) for common neurosurgical pathologies for Vietnam and comparison nations.RESULTSInterventions aimed at primary prevention of risk factors for neurosurgical disease and focused on the transference of self-sustainable technical skills were found to be analogous to those that have been successful in other regions. Efforts toward stroke prevention have been focused on causal risk factors. Multiple investigators have found that interventions aimed at increasing helmet use were successful in preventing traumatic brain injury. Government-led reforms and equipment donation programs have improved technical capacity. Nevertheless, Vietnam lags behind other nations in neurosurgeons per capita; cause-attributable death and YLD attributable to neurosurgical disease are considerably higher in Vietnam and middle-income nations compared to both lower-income nations and upper-income nations.CONCLUSIONSMore than two-thirds of deaths attributable to neurosurgical pathologies in Vietnam and other middle-income nations were due to stroke, and one-fifth of both cause-attributable death and YLD was associated with neurosurgical pathologies. Vietnam and other middle-income nations continue to assume a global burden of disease profile that ever more closely resembles that of developed nations, with particular cerebrovascular, neurotrauma, and spinal disease burdens, leading to exponentially increased demand for neurosurgeons that threatens to outpace the training of neurosurgeons.
Early Complications and Mortality following Radical Cystectomy: Associations with Malnutrition and Obesity
Authors: Arora Karan , Hanson Kristine T. , Habermann Elizabeth B. , Tollefson Matthew K. , Psutka Sarah P. 
Published: September 2018

Background: There are conflicting data regarding the impact of obesity on postoperative outcomes following radical cystectomy (RC) and how obesity and malnutrition interact in patients undergoing RC. Objective: To evaluate associations of body mass index (BMI), significant preoperative weight loss, and hypoalbuminemia with 30-day complications and mortality after RC. Methods: Review of the American College of Surgeons National Surgical Quality Improvement Program database identified 2,055 patients who underwent RC (2006-12). Univariate and multivariable logistic regression models were developed to assess associations between hypoalbuminemia (<3.5 g/dL), >10% preoperative weight loss, obesity as characterized by BMI (class I: 30–34.9, II: 35–39.9, III: ≥40 kg/m2), and 30-day complications and mortality. Results: The median BMI of the study cohort was 27.82 kg/m2 with 22.4% classified as having class I, 7.5% class II, and 4.2% class III obesity, respectively. Hypoalbuminemia and >10% weight loss were present in 16.7% and 3.5%, respectively. Among obese patients, 13.4% had hypoalbuminemia. On multivariable analysis, class I (OR 1.43, p = 0.01), class II (OR 1.92, p < 0.001), and class III (OR 2.32, p < 0.001) obesity and hypoalbuminemia (OR 1.47, p = 0.02) were independently associated with 30-day complications, and class III obesity (OR 2.96, p = 0.02) and hypoalbuminemia (OR 2.33, p = 0.03) were independently associated with 30-day mortality. Conclusion: Increasing class of obesity and hypoalbuminemia were independently associated with increased complications following RC. Hypoalbuminemia and class III obesity were associated with early mortality. This study highlights the fact that malnutrition may coexist in obese patients and underscores the need to identify patients with malnutrition who may be candidates for preoperative nutritional optimization.
Evaluation of Intraoperative Versus Postoperative Adjuvant Mitomycin C with Nephroureterectomy for Urothelial Carcinoma of the Upper Urinary Tract
Authors: Noennig Blake , Bozorgmehri Shahab , Terry Russell , Otto Brandon , Su Li-Ming , Crispen Paul L. 
Published: September 2018

Background: Results of randomized trials support a single dose of intravesical chemotherapy following radical nephroureterectomy (RNU) for urothelial carcinoma. Objective: To evaluate the impact of the timing of intravesical mitomycin C (MMC) administration on the rate of bladder tumor recurrence (BTR) following RNU. Methods: We performed a retrospective review of patients who underwent RNU for upper tract urothelial carcinoma (UTUC) and received intravesical MMC between 2008 and 2016. Patients were categorized into two separate groups based on the timing of MMC administration: patients who received MMC intraoperatively (IO) and patients who received MMC on post-operative day 1 or later (PO). Our primary endpoint was BTR rate within the first year after surgery. Results: Fifty-one patients met our inclusion criteria: (IO: n = 30; PO: n = 21). There were no statistically significant differences in baseline characteristics of age, gender, race, surgical approach, tumor grade, tumor stage, surgical margins, nodal status, concomitant CIS, or history of bladder cancer. The median length of follow-up for each group was 22 months for IO and 12 months for PO ( P = 0.10). The estimated probability of 1-year BTR rates for the IO and PO groups were 16% and 33%, respectively ( p = 0.09). Cox analysis noted that the IO patients had a significantly lower rate of BTR in the first year postoperatively (HR = 0.113, 95% CI = 0.28–0.63, p = 0.01). Conclusions: The use of intraoperative MMC at the time of RNU was associated with a decrease in the risk of 1-year recurrence within the bladder.
Urinary Biomarkers in the Evaluation of Primary Hematuria: A Systematic Review and Meta-Analysis
Authors: Sathianathen Niranjan J. , Butaney Mohit , Weight Christopher J. , Kumar Raj , Konety Badrinath R. 
Published: September 2018

Introduction: Urinary biomarkers are entering the clinical landscape as a non-invasive method to evaluate patients for bladder cancer, however it is currently predominantly used in the surveillance setting. The use of biomarkers in the setting of primary hematuria is not widespread despite initial promising results. This study comprehensively reviews the literature on the diagnostic performance of FDA-approved biomarkers in the evaluation of primary hematuria. Methods: According to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement, MEDLINE, EMBASE, ScienceDirect, Cochrane Libraries, HTA database, Google Scholar and Web of Science were searched up to June 2017 for studies assessing the diagnostic accuracy of FDA-approved urinary biomarkers amongst patients presenting with primary hematuria. The quality of included studies was assessed using the QUADAS-2 tool. Results: Fourteen studies met the pre-specified eligibility criteria and were included for analysis. The biomarkers assessed in these studies were AssureMDx, Bladder tumor antigen, CxBladder, NMP22, UroVysion and uCyt+. Across these four biomarkers, the sensitivity ranged from 0.67 to 0.95, and specificity from 0.68 to 0.93, respectively. There was significant heterogeneity between the included studies. Limited head-to-head comparison with urine cytology demonstrated that in general, the biomarkers have superior sensitivity but inferior specificity. Overall, the quality of evidence was graded as moderate primarily because of inadequate blinding. Conclusion: The current diagnostic performance of biomarkers are inadequate to replace cystoscopy in the primary hematuria setting. However, AssureMDx in particular may have a role as a triage test for cystoscopy but further prospective data is required to validate these findings. Given the current evidence, the use of these markers as an adjunct to cystoscopy for the evaluation of hematuria should be considered investigational.
Why MICAS?
Authors: Menzies David , Murphy Anna Marie 
Published: October 2018

<p><strong>Introduction</strong></p><p>The Mobile Intensive Care Ambulance Service (MICAS) was initiated in 1996 to assess, stabilise and transfer critically ill patients from a referring hospital to a receiving hospital to meet their clinical needs. </p><p>Critically ill patients are transferred throughout Ireland to an increased level of care, repatriation for continuity of care following specialist treatment, specialist critical care services or in some instances, are considered too unstable to be transported by local staff. In 2015, it was estimated that approximately 1000 ICU patients are transported per annum (Murphy, Dwyer). These numbers are likely to increase as a result of the reorganisation of health services, the development of hospital groups, the establishment of the hub and spoke critical care services and introduction of trauma centres. This increases the requirement of inter hospital transfers throughout the country.</p><p><strong>Aims</strong></p><p>The aim of this audit was to establish the rationale for a critical care retrieval service and to evaluate the adverse events for inter hospital transport of critically ill patients in Ireland over a 3 year period</p><p><strong>Methods</strong></p><p>A retrospective chart review of all patients transported by MICAS between January 2015 and December 2017 was undertaken. Clinical records were reviewed for acuity and for adverse events. </p><p><strong>Results</strong></p><p>339 patients were transported in this timeframe with 7% experiencing an adverse event overall.</p><p><strong>Conclusion</strong></p><p>The MICAS data shows an increasing number of critically ill patients transferred by MICAS within the timeframe. </p><p>The rationale for MICAS includes the provision by a specialist team with transport specific equipment with reduced adverse events. </p><p> </p><p> </p><p> </p><p> </p><p> </p><p> </p>
Perbandingan efektivitas flutikason furoat intranasal dengan dan tanpa loratadin oral pada penderita rinitis alergi
Authors: Talango Rita , Aminuddin Aminuddin , Punagi Abdul Qadar , Djufri Nani Iriani 
Published: September 2018

Background: Allergic rhinitis (RA) is a symptomatic disorder of the nose induced by IgE mediatedinflamation. Corticosteroid alone or in combination with antihistamine have been recommended bythe ARIA-WHO and is often used in the management of RA. Purpose: To compare the effectiveness ofa combination therapy of intranasal fluticasone furoate (IFF) and oral loratadine (LO) with a singletherapy of IFF, based on the levels of eosinophils and clinical symptoms patients with RA. Method: Openclinical trial with 40 of patients divided into two groups 20 patients was given a combination therapyand 20 patients was given only IFF. The level of eosinophils and clinical symptoms were examinedbefore and after therapy. Data were analyzed using the Wilcoxon, Friedman and Mann Whitney tests.Results: Showed decrease in eosinophils level and clinical symptoms were significant (p<0.05) in bothtreatment groups, but there was no significant difference (p>0.05) in the effectiveness between bothtreatments. Conclusion: Therapy with IFF, alone or combined with LO were effective to decrease thelevel of eosinophils and clinical symptoms and there was no difference in efficacy, but still combinationtherapy is better than single therapy. Keywords: allergic rhinitis, intranasal fluticasone furoate, oral loratadine Abstrak : Latar belakang: Rinitis alergi (RA) merupakan gangguan fungsi hidung, terjadi setelah pajananalergen melalui inflamasi mukosa hidung yang diperantarai IgE0. Penggunaan kortikosteroid baik tunggalmaupun kombinasi dengan antihistamin telah direkomendasikan oleh ARIA-WHO dan sering digunakandalam penatalaksanaan RA. Tujuan: Untuk membandingkan efektivitas terapi kombinasi flutikason furoatintranasal (FFI) dan loratadin oral (LO) dengan terapi tunggal FFI berdasarkan kadar eosinofil dan gejalaklinis penderita RA. Metode: Uji klinik terbuka pada 40 penderita RA, dibagi menjadi 20 penderita padakelompok pertama diberikan terapi kombinasi FFI dengan LO dan 20 penderita kelompok kedua diberikanterapi tunggal FFI. Pemeriksaan eosinofil dan gejala klinis dilakukan sebelum dan sesudah terapi. Datadianalisis menggunakan uji Wilcoxon, Friedman dan Mann Whitney. Hasil: Terjadi penurunan kadareosinofil dan gejala klinis secara signifikan (p<0,05) pada kedua kelompok terapi, namun tidak adaperbedaan efektivitas secara signifikan (p>0,05) antara kedua kelompok terapi. Kesimpulan: Terapi FFItunggal maupun dikombinasikan dengan LO efektif menurunkan kadar eosinofil dan gejala klinis sertatidak ada perbedaan efektivitas, namun terapi kombinasi masih lebih baik dibanding terapi tunggal. Kata kunci: rinitis alergi, flutikason furoat intranasal, loratadin oral
Penyakit kelenjar saliva dan peran sialoendoskopi untuk diagnostik dan terapi
Authors: Tamin Susyana , Yassi Duhita 
Published: September 2018

Background: Human salivary glands could be prone to diseases. Special tools have been createdto diagnose the disease of the glands and with the advancement of technology, better instruments weredeveloped. Purpose: We present this literature review to share the knowledge of diagnostic and therapyin today’s management of salivary gland disease. Literature Review: Human salivary glands consistedof major and minor salivary glands which produce saliva. Salivary gland secretion is a process that involves cell synthesis and active transport. Salivary gland diseases are also associated with secretion process. Sialoendosopy can be use as diagnostic and therapeutics tool in salivary glands disease. As atherapeutic tool, sialoendoscopy has a role in stone fragmentation and extraction and also dilatation ofstenosis and stricture. Conclusion: Sialoendscopy has many advantages in diagnosis and treatment ofsalivary gland disease, but its employment is still limited because of the high price and required skilledand experienced operator. Key words: salivary gland, salivary gland disease, sialoendoscopy Abstrak : Latar belakang: Kelenjar saliva manusia tidak lepas dari gangguan penyakit. Beberapa alat telahditemukan untuk diagnosis penyakit ini dan dengan semakin berkembangnya teknologi, sangat diharapkanberkembang pula alat diagnosis yang lebih baik. Tujuan: dengan tulisan ini diharapkan dapat memperluaswawasan terhadap perangkat diagnostik dan terapi pada penyakit kelenjar saliva. Tinjauan Pustaka:Kelenjar saliva manusia terdiri dari kelenjar saliva mayor dan minor yang berperan untuk memroduksisaliva. Sekresi kelenjar saliva merupakan suatu proses yang melibatkan sintesis sel dan transpor aktif.Penyakit kelenjar saliva juga berhubungan dengan proses sekresi. Sialoendoskopi dapat digunakansebagai alat diagnostik maupun terapi pada penyakit kelenjar saliva. Sebagai alat terapi, sialoendoskopidapat berperan pada fragmentasi dan ekstraksi batu serta dilatasi stenosis dan striktur. Kesimpulan:Sialoendoskopi memiliki keunggulan dalam diagnosis dan terapi penyakit kelenjar saliva, namunpenggunaannya masih terbatas karena harganya yang mahal dan diperlukan operator yang trampil danberpengalaman. Kata kunci: kelenjar saliva, penyakit kelenjar saliva, sialoendoskopi
Hubungan ekspresi RANKL dengan derajat destruksi tulang akibat kolesteatoma pada otitis media supuratif kronik
Authors: Yarisman Lilia , Asroel Harry Agustaf , Aboet Askaroellah , Zaluchu Fotarisman 
Published: September 2018

Latar belakang: Otitis media supuratif kronik (OMSK) dengan kolesteatoma merupakan penyakitpada telinga tengah dengan salah satu komplikasi berupa destruksi tulang, yang dapat menyebabkankematian. Receptor Activator of Nuclear Factor Kβ-Ligand (RANKL) merupakan salah satu sitokinyang berperan dalam proses destruksi tulang.Tujuan: Mengetahui hubungan ekspresi RANKL denganderajat destruksi tulang akibat kolesteatoma pada penderita OMSK tipe bahaya.Metode: Penelitian inibersifat analitik dengan desain cross sectional. Sebanyak 40 sampel kolesteatoma dilakukan pemeriksaanimunohistokimia untuk dinilai ekspresi RANKL pada kolesteatoma.Hasil: Terdapat hubungan yangsignifikan antara ekspresi RANKL dengan derajat destruksi tulang dan komplikasi yang terjadi (p<0,05).Tidak terdapat hubungan antara ekspresi RANKL dengan kelompok umur dan jenis kelamin (p>0,05).Kesimpulan: Terdapat hubungan yang signifikan antara derajat destruksi tulang dengan ekspresi RANKLmelalui pemeriksaan imunohistokimia.Kata kunci: RANKL, destruksi tulang, kolesteatoma, OMSK ABSTRACTBackground: Chronic suppurative otitis media (CSOM) with cholesteatoma is a middle ear disease,leading to bone structure destruction which can cause fatal case. Receptor Activator of Nuclear FactorKβ-Ligand (RANKL) is known as one of the cytokine that has important role in the process of bonedestruction.Purpose: To identify an association between RANKL expression with bone destruction leveldue to cholesteatoma in malignant CSOM patients. Method: This was an analytical study with crosssectional design. About 40 cholesteatoma sample was examinated by using immunohistochemistry tomeasure its RANKL expression. Result: There was a significant relationship (p<0.05) between RANKLexpression with bone destruction level and complication. There was no significant relationship betweenRANKL expression with age and sex (p>0.05). Conclusion: There was a significant relationship betweenbone destruction level with the RANKL expression by immunohistochemistry examination.Keywords: RANKL, bone destruction, cholesteatoma, CSOM
Pemeriksaan EBER sebagai identifikasi infeksi virus Epstein-Barr pada karsinoma nasofaring
Authors: Romdhoni Achmad Chusnu , Shoffi Muhammad Noer 
Published: September 2018

Latar belakang: Protein Epstein-Barr Virus Encoded Small RNA (EBER) ditemukan pada sebagian besar jaringan karsinoma nasofaring (KNF). Hal ini merupakan bukti bahwa infeksi virus Epstein-Barr (VEB) menjadi salah satu penyebab terjadinya KNF. Penurunan ekspresi EBER dipengaruhi oleh maturasi sel dan diferensiasi sel karsinoma. Tujuan: Mengidentifikasi hubungan ekspresi EBER dengan stadium dan jenis histopatologi pada penderita KNF. Metode: Penelitian observasional analitik dengan pendekatan cross sectional. Penelitian dilakukan di Unit Rawat Jalan Telinga Hidung Tenggorok - Bedah Kepala Leher Rumah Sakit Umum Daerah Doktorr. Soetomo Surabaya mulai bulan November 2015 hingga Oktober 2016 dengan consecutive sampling. Fisher exact test untuk melihat hubungan ekspresi EBER dengan stadium KNF. Hasil: Ekspresi EBER dari seluruh sampel didapati negatif sebanyak 23,33%, positif lemah sebanyak 10%, positif sedang sebanyak 33,33%, dan positif kuat sebanyak sebanyak 33,33%. Berdasarkan hasil uji statistik menunjukkan hubungan antara ekspresi EBER dengan stadium KNF didapatkan p=0,623, sedangkan ekspresi EBER dengan jenis histopatologi KNF diketahui p=0,204. Kesimpulan: Tidak terdapat hubungan antara ekspresi EBER dengan stadium KNF, maupun antara ekspresi EBER dengan jenis histopatologi KNF. Kata kunci: Karsinoma nasofaring, ekspresi EBER, stadium dan jenis histopatologi ABSTRACT Background: Protein of Epstein Barr Virus Encoded Small RNA (EBER) have found in most of the nasopharyngeal carcinoma (NPC) tissue which prove that NPC was caused by Epstein Barr Virus Infection (EBV). EBER expression decreased was triggered by maturation and differentiation cell EBER expression in NPC patients. Purpose: To identify association between EBER expression and histopathological type of NPC. Method: This study was an observational analytic with cross-sectional design. This study occured at Inpatients Unit of Otorhinolaryngology - Head and Neck Surgery of Dr. Soetomo Hospital Surabaya, November 2015 - October 2016. Samples were collected by consecutive sampling. Statistical analysis was using Fisher’s exact test. Result: The EBER expression from all sample there were 23.33% negative, 10.00% weak positive, 33.33% moderate positive, and 33.33% strong positive. Statistical analysis was obtained p=0.623 and the association between EBER expression with stage of NPC was obtained p=0.204. Conclusion: There was no association between EBER expression and stage NPC, nor histopathological type of nasopharyngeal carcinoma. Keywords: Nasopharyngeal carcinoma, EBER expression, stage and histopathological type
Patogenesis dan diagnosis gangguan napas saat tidur dengan Drug Induce Sleep Endoscopy (DISE)
Authors: Rachmawati Elvie Zulka Kautzia , Arief Wresty , Tamin Susyana , Yunizaf Rahmanofa , Fardizza Fauziah 
Published: September 2018

Latar belakang: Obstructive sleep apnea (OSA) ialah penyakit kronis yang terjadi akibat episode intermiten sumbatan jalan napas komplit atau sebagian saat tidur. OSA dapat menimbulkan komplikasi seperti hipertensi, diabetes melitus, stroke dan excessive daytime sleepiness yang dapat berakibat fatal. OSA merupakan bagian dari gangguan napas saat tidur. Tujuan: Mengindentifikasi letak atau level dan konfigurasi sumbatan pada saat tidur. Tinjauan pustaka: Cara untuk mendiagnosis OSA adalah nasofaringolaringoskopi dengan Muller`s maneuver, pemeriksaan polisomnography (PSG), dan drug induce sleep endoscopy (DISE). Pemeriksaan PSG merupakan standar baku emas untuk mendapakan nilai apnea-hipopnea index (AHI) yang menentukan derajat OSA. Pemeriksaan untuk mengidentifikasi lokasi sumbatan jalan napas yang menyebabkan peningkatan resistensi aliran udara adalah Muller`s maneuver dan DISE. Pada pemeriksaan DISE, digunakan propofol atau midazolam secara intravena untuk menstimulasi keadaan sumbatan pada saat tidur, dilanjutkan dengan pemeriksaan nasofaringolaringoskopi. Kesimpulan: Pemeriksaan ini merupakan cara yang sangat terpercaya untuk menentukan level sumbatan pada keadaan tidur, sehingga jenis tindakan operasi yang dilakukan menjadi lebih tepat. Kata kunci: Drug induced sleep endoscopy, midazolam, propofol, manuver Muller’s, obstructive sleep apnea, polisomnografi ABSTRACT Background: Obstructive sleep apnea (OSA) is a common chronic disorder caused by intermittent episodes of complete or partial upper airway obstruction during sleep. It may lead to complications such as hypertension, diabetes mellitus, stroke, as well as excessive daytime sleepiness which can be fatal. OSA is a part of sleep disorder breathing. Purpose: To identify the sites or the levels of obstruction and its configuration. Literature review: Muller’s maneuver upon nasopharyngoscopy, polysomnography (PSG), and drug-induced sleep endoscopy (DISE) are the modalities for diagnosing OSA. Polysomnography is the gold standard examination for OSA, one of the variables; the apnea-hipopnea index (AHI) is used to determine the presence and severity of OSA. Muller’s maneuver and DISE are the examination to identify the sites responsible for increase in airflow resistance. DISE technique uses intravena injection of propofol or midazolam to produce obstruction in a “natural sleep” condition followed by nasopharyngolaryngoscopy examination. Conclusion: DISE is considered as a very reliable means to define the level of obstruction during sleeping, thus could help to determine appropriate surgery. Keywords: Drug induced sleep endoscopy, midazolam, propofol, Muller’s maneuver, obstructive sleep apnea, polisomnography