bluuebunny/crossref_metadata_2025_split huggingface dataset:
Endoscopic transpapillary gallbladder stenting using a newly designed plastic stent for acute cholecystitis
Authors: Nakahara Kazunari , Michikawa Yosuke , Morita Ryo , Suetani Keigo , Morita Nozomi , Sato Junya , Tsuji Kensuke , Ikeda Hiroki , Matsunaga Kotaro , Watanabe Tsunamasa , Matsumoto Nobuyuki , Kobayashi Shinjiro , Otsubo Takehito , Itoh Fumio 
Published: August 2019

Abstract
Background and study aims Biliary plastic stents are generally substituted for gallbladder stents in endoscopic transpapillary gallbladder stenting (EGBS), there is no sufficient evidence about what type of plastic stent is suitable. We examined outcomes of EGBS using standard biliary stents and a novel stent for acute cholecystitis and evaluated the efficacy of the novel stent.
Patients and methods Seventy patients with acute cholecystitis in whom EGBS was performed were evaluated retrospectively. We performed EGBS in 23 patients using the novel stent (novel stent group) and 47 patients using standard biliary stents (pigtail: 35, straight: 12) (control group). In the two groups, we examined outcomes of EGBS.
Results There were no significant differences in patient backgrounds or rates of technical success, clinical success, or early adverse events (AE) between the novel stent group and the control groups. However, rates of late AEs were 4.3 % in the novel stent group (liver abscess: 1) and 40.4 % in the control group (stent migration: 15, recurrence of cholecystitis: 4), indicating a significantly higher rate in the control group (P = 0.004). The rate of stent migration was significantly higher in the control group (P = 0.006). Multivariate analysis identified a straight type stent as the risk factor for stent migration (odds ratio: 8.81, 95 % confidence interval: 1.66 – 46.83).
Conclusions The novel stent had significantly lower rates of late AEs and stent migration. Thus, for long-term stent placement, the novel stent was more effective than traditional biliary stents.
Efficacy of withdrawal time monitoring in adenoma detection with or without the aid of a full-spectrum scope
Authors: Manes Gianpiero , Andreozzi Paolo , Omazzi Barbara , Bezzio Cristina , Redaelli Davide , Devani Massimo , Morganti Daniela , Reati Raffaella , Saibeni Simone , Mandelli Enzo , Arena Ilaria , Hassan Cesare , de Nucci Germana 
Published: August 2019

Abstract
Background and study aims Withdrawal time (WT) monitoring and full-spectrum endoscopy (FUSE) have been suggested to increase adenoma detection rate (ADR) due to more accurate evaluation of the hidden areas of the colon. We aimed to evaluate the efficacy of WT monitoring and FUSE on ADR.
Patients and methods This was a prospective observational study involving consecutive outpatients, aged 18 to 85 years, undergoing colonoscopy with unselected indications. In phase 1, endoscopists performed 660 colonoscopies either with standard forward-viewing endoscope (SFVE) (n = 330) or with FUSE (n = 330). In this phase, WTs were measured without endoscopist awareness of being monitored. In phase 2, endoscopists were informed of being monitored and performed additional 660 colonoscopies either with SFVE (n = 330) or with FUSE (n = 330).
Results WT was lower in phase 1 compared to phase 2 (SFVE: 269 ± 83 vs. 386 ± 60 sec, P < 0.001; FUSE: 289 ± 97 vs. 403 ± 65 sec, P < 0.001). Use of FUSE increased ADR both in phase 1 (33.0 % vs. 27.3 %, P = 0.127) and in phase 2 (41.8 % vs. 33.6 %, P = 0.037). When endoscopists were aware of being monitored, ADR was higher in SFVE (33.6 % vs. 27.3 %; P = 0.090) and FUSE arms (41.8 % vs. 33.0 %; P = 0.024). Improvement in detection of proximal adenomas was associated with WT monitoring [OR 1.577 (95 % C. I. 1.158 – 2.148); P = 0.004], whereas detection of distal adenomas was associated with use of FUSE [OR 1.320 (95 % C. I. 1.022 – 1.705); P = 0.037].
Conclusions Unmonitored endoscopists have suboptimal WT, which increases when they are monitored. WT monitoring and use of FUSE are two reliable and alternative strategies to increase ADR.
Evaluation of a novel low-cost disposable endoscope for visual assessment of the esophagus and stomach in an ex-vivo phantom model
Authors: Garbin Nicolò , Mamunes Alexander P. , Sohn Dennis , Hawkins Ryan W. , Valdastri Pietro , Obstein Keith L. 
Published: August 2019

Abstract
Background and study aims Our academic lab has developed a novel, low-cost, disposable endoscope for assessment of the esophagus and stomach without need for large equipment or complex electronics. Usability and intuitiveness of the platform are unknown.
Methods The novel endoscope (NE) consists of a high-definition camera, LED module, and three bellows. Compressed air actuates the bellows, producing camera/LED articulation. Insufflation and lens cleaning ports are present. Video can be displayed on any monitor. Total material costs less than $ 35 US. Five novices, five fellows, and five attendings performed five trials using a conventional endoscope and the NE on an upper tract phantom with six gastric landmarks marked. Outcomes included successful identification and time to landmarks; and intuitiveness (NASA task load index; user comments).
Results All landmarks were successfully identified with both endoscopes for all trials (n = 900). Attendings and fellows were quicker with the conventional endoscope when compared to the NE (24.48 v 37.13s; P < 0.01). There was no significant time difference between platforms for novices (P = 0.16). All users found the NE intuitive with low mental and physical demand. Novices reported lower temporal demand and effort when using the NE.
Conclusions The NE was easy to maneuver, intuitive, and successful at visualizing gastric landmarks. All users were pleased with the NE drive mechanism and were successful at visualizing the gastric landmarks in a clinically acceptable time. The novel platform has the potential to facilitate rapid, low-cost, diagnostic assessment of the esophagus and stomach in non-traditional settings – facilitating patient management decisions, minimizing encumbrance, and avoiding cross-contamination.
Endoscopic ultrasound-guided placement of coils and cyanoacrylate embolization in refractory gastric variceal bleeding: a pediatric case report
Authors: Olmos Juan I. , Oleas Roberto , Alcívar Juan A. , Baquerizo-Burgos Jorge , Robles-Medranda Carlos 
Published: August 2019

Abstract
Background and study aims Gastric variceal bleeding management is challenging, especially in the pediatric population. Endoscopic cyanoacrylate glue injection is considered the standard for management of gastric varices but it is associated with a high rebleeding rate. Endoscopic ultrasound (EUS)-guided placement of coils with cyanoacrylate is a newly available technique with a lower rebleeding rate but there are no reported cases using this technique in pediatric patients. We report on a 12-year-old child with liver cirrhosis and gastric variceal hemorrhage who was refractory to the endoscopic cyanoacrylate injection and in whom hemostasis was achieved without rebleeding following EUS-guided coiling and cyanoacrylate injection. Neither rebleeding nor varix reappearance was noted on 12-month follow-up. EUS-guided coiling and cyanoacrylate injection is safe and feasible in pediatric patients and could be considered as rescue therapy for treatment of refractory gastric variceal bleeding.
Antacids may increase the appearance of white opaque substance in Helicobacter pylori-eradicated gastric epithelial neoplasia
Authors: Wada Kurato , Ueo Tetsuya , Yonemasu Hirotoshi , Togo Kazumi , Inoue Shotaro , Honda Hideho , Katsuta Makoto , Takahashi Haruhiko , Yao Kenshi , Murakami Kazunari 
Published: August 2019

Abstract
Background and study aims White opaque substance (WOS) in gastric epithelial neoplasia is helpful for qualitative diagnosis of neoplasia. We hypothesized that WOS of neoplasia is strongly influenced by acid recovery after Helicobacter pylori eradication, similar to that of gastric intestinal metaplasia. The aim of this study was to investigate whether antacids increase the appearance of the WOS in H. pylori-eradicated neoplasia.
Patients and methods A total of 38 gastric epithelial neoplasias (12 adenomas and 26 adenocarcinomas) detected after H. pylori eradication were retrospectively evaluated. Presence or absence of WOS was evaluated by magnifying endoscopy with narrow band imaging before and after antacid administration. The pH of collected gastric juice was also measured. Study endpoints were (1) prevalence of WOS in the neoplasia before and after antacid administration, and the histological difference (adenoma and adenocarcinoma); and (2) relationship between the prevalence of WOS and gastric juice pH.
Results WOS prevalence increased from 0 % (0/38) to 44.8% (17/38) after antacid administration. WOS prevalence in adenomas was more significantly increased compared to that in adenocarcinomas (83.3 % vs 26.9 %, P = 0.0077). Prevalence of WOS in gastric neoplasias was only observed at neutral levels of gastric juice pH, and WOS was not observed at strong acidic levels.
Conclusions Antacid administration may increase the appearance of WOS in gastric epithelial neoplasia (especially adenomas) detected after H. pylori eradication with acid recovery.
Volumetric laser endomicroscopy and optical coherence tomography in Barrett’s esophagus: a systematic review and meta-analysis
Authors: Rodriguez Maria Auxiliadora Chóez , de Moura Diogo Turiani Hourneaux , Ribeiro Igor Braga , Bernardo Wanderley Marques , Morita Flavio Hiroshi Ananias , Marques Sergio Barbosa , Sakai Paulo , de Moura Eduardo Guimarães Hourneaux 
Published: August 2019

Abstract
Background and study aims Endoscopic imaging of Barrett’s esophagus (BE) with advanced technologies, such as optical coherence tomography (OCT) and volumetric laser endomicroscopy (VLE), allows targeted biopsies and may reduce the number of random biopsies to detect esophageal neoplasia in the early stages during endoscopic BE surveillance. The aim of this study was to evaluate the accuracy of OCT and VLE in diagnosis of intestinal metaplasia, dysplasia, and high-grade dysplasia (HGD), and intramucosal carcinoma (IMC) in BE.
Patients and methods In this systematic review and meta-analysis, the primary outcome measure was diagnostic accuracy of OCT and VLE, in comparison with the gold standard. In the meta-analysis, we calculated sensitivity, specificity, positive likelihood ratio (LR+), negative likelihood ratio (LR-), and diagnostic odds ratio (DOR) for both methods. We performed analyses by patient and by lesion.
Results We evaluated 14 studies involving a collective total of 721 patients and 1565 lesions. In the analysis by lesion, VLE showed a pooled sensitivity, specificity, LR+, LR−, DOR, and SROC AUC of 85 %, 73 %, 3.2, 0.21, 15.0, and 0.87, respectively, for detection of HGD/IMC. In the analysis by lesion for detection of HGD/EAC, OCT showed a pooled sensitivity, specificity, LR+, LR−, DOR, and summary receiver operating characteristic area under the curve of 89 %, 91 %, 9.6, 0.12, 81.0, and 0.95, respectively. The accuracy of OCT in identifying intestinal metaplasia showed a pooled sensitivity, specificity, LR+, LR−, and DOR of 92 %, 81 %, 5.06, 0.091, and 55.58, respectively.
Conclusion OCT- and VLE-guided targeted biopsies could improve detection of dysplasia and neoplasia. Further studies could determine whether the use of such biopsies might replace the current protocol.
Wechselseitige Einflüsse von Beziehungsqualität,
Lebenszufriedenheit und Partnerschaftsstabilität bei Müttern mit
minderjährigen Kindern – eine
Zehn-Jahres-Untersuchung
Authors: Hannighofer Jasmin , Hahlweg Kurt , Zimmermann Tanja 
Published: August 2019

Zusammenfassung
Hintergrund Obwohl eine beständige und zufriedenstellende
Partnerschaft ein wichtiges Lebensziel darstellt, wird derzeit jede dritte Ehe
geschieden. Lebenszufriedenheit sowie der Übergang in die Elternschaft
scheinen bedeutsame Faktoren darzustellen. Diese Langzeitstudie untersucht den
Zusammenhang zwischen Beziehungsqualität, -stabilität und
Lebenszufriedenheit von Müttern unter Einbezug weiterer Familienmerkmale
über einen Zeitraum von zehn Jahren.
Methode Längsschnittliche Daten von N=249 Müttern
wurden mittels Regressionsanalysen hinsichtlich Beziehungsqualität,
Lebenszufriedenheit und Partnerschaftsstabilität sowie weiterer
Variablen ausgewertet.
Ergebnisse Die Lebenszufriedenheit der Mütter blieb über
den gesamten Erhebungszeitraum von 10 Jahren relativ stabil, wohingegen ein
signifikanter Abfall der Beziehungsqualität zu verzeichnen war. Vor
allem die interindividuelle Lebenszufriedenheit stellte einen signifikanten
Prädiktor für die langfristige Beziehungsqualität als
auch für die psychische Gesundheit von Mutter und Kind, die
Schichtzugehörigkeit und die Anzahl kritischer Lebensereignisse dar. Die
anfängliche Beziehungsqualität schien sich ebenfalls langfristig
auf die wahrgenommene Lebenszufriedenheit als auch die psychische Gesundheit der
Mutter auszuwirken. Der Zusammenhang zwischen Lebenszufriedenheit und
Partnerschaftsstabilität fiel hingegen nur marginal aus.
Schlussfolgerung Die Studie zeigt bidirektionale Zusammenhänge
zwischen Partnerschaftsqualität und Lebenszufriedenheit über den
Verlauf von 10 Jahren. Vor allem die Lebenszufriedenheit schien langfristigen
Einfluss auf diverse Familienfaktoren zu nehmen. Die Erkenntnisse sollten dazu
genutzt werden, neue oder bestehende partnerschaftliche Präventions- und
Interventionsprogramme weiterzuentwickeln, dabei sollte v. a. die
Förderung der Zufriedenheit und Lebensqualität des einzelnen
Partners im Vordergrund stehen.
Wirksamkeit, Moderatoren und Mediatoren manualisierter
familienbasierter Therapie bei Jugendlichen mit Essstörungen: Eine
systematische Übersichtsarbeit
Authors: Schlegl Sandra , Voderholzer Ulrich , Maier Julia , Naab Silke , Lock James 
Published: August 2019

ZusammenfassungFamilienbasierte Therapie (FBT) ist derzeit die Therapie bei Jugendlichen mit
Essstörungen mit der höchsten Evidenz. Ziel der
Übersichtsarbeit ist es, die bisherigen Forschungsergebnisse
hinsichtlich der Wirksamkeit der manualisierten FBT nach Lock und Le Grange
zusammenzufassen sowie Moderatoren und Mediatoren darzustellen. In 5
randomisiert-kontrollierten Studien (engl. randomised controlled trial, RCT) bei
Anorexia nervosa (N=560) zeigten sich Remissionsraten zwischen
21,2–42% am Ende der Behandlung, zwischen
21,8–40% bei der 6-Monats-Katamnese und zwischen
29–49% bei der 12-Monats-Katamnese. Die Remissionsraten bei
Bulimia nervosa (2 RCTs, N=210) lagen bei 39% bzw.
29–44% bzw. 49%. Wünschenswert wären
Replikationen der Ergebnisse durch unabhängige Arbeitsgruppen und in
anderen Ländern. Es wäre zudem interessant, FBT im Vergleich zur
Kognitiven Verhaltenstherapie sowie zur tiefenpsychologisch fundierten Therapie
zu untersuchen und weitere Strategien für Non-Responder zu
explorieren.
C-Reactive Protein Serum Levels as an Internal Load Indicator of Sprints in Competitive Football Matches
Authors: Jatene Pedro , dos Santos Gustavo Silva , Portella Daniel Leite 
Published: August 2019

AbstractThis study compared internal load variable dynamics across three consecutive football matches and investigated its relationship with the number of sprints performed by players. Twenty-three male players had blood and salivary samples collected for hormonal concentration (testosterone, cortisol, and testosterone-cortisol ratio), and serum analysis (interleukin-6, interleukin-1-beta, and c-reactive-protein), respectively. Sprints were measured through Global Position System devices. Testosterone and testosterone-cortisol-ratio presented a decreasing behavior up to the second match, and all other indicators presented an increasing behavior during the same period, c-reactive-protein was the only indicator observed to significantly rise up to the third match as well (0.38±0.02 mg/L; 0.49±0.05 mg/L; 0.69±0.05 mg/L; 0.89±0.08 mg/L). C-reactive-protein showed strong correlations with sprints in the second and third matches (p<0.01, r=0.71 and 0.79), and weak-to-moderate in the first one (p<0.05, r=0.59). Interleukin-6 and interleukin-1-beta presented weak-to-moderate correlation in every match (p<0.05, r=0.48 to 0.51; r=0.51 to 0.55) while testosterone-cortisol ratio presented weak-to-moderate correlation only in the third one (p<0.05, r=0.42). Multilevel linear regression showed that c-reactive-protein had a higher R2 than other biomarker in any regression model (R2=0.624; p<0.001). Therefore, c-reactive-protein can be a valid and reliable indicator of sprinting in competitive football. Future research should explore longer periods of monitoring and/or others external load variables so that other behaviors may arise to knowledge.
Suspended Push-up Training Augments Size of not only Upper Limb but also Abdominal Muscles
Authors: Kohiruimaki Ren , Maeo Sumiaki , Kanehisa Hiroaki 
Published: August 2019

AbstractWe investigated the effects of sling-based, suspended push-up training on muscle size and function of upper limb and abdominal muscles. Eight men conducted suspended push-ups to failure 3 sets/session, 3 sessions/week, for 8 weeks. The maximum number of push-ups during training gradually and significantly increased from the first to last training session (+92%), suggesting improved muscle endurance. After the training, muscle thickness of the elbow extensors (+16%) and flexors (+3%), as well as abdominal muscles (rectus abdominis: RA,+27%; external oblique: EO,+14%) significantly increased. No changes occurred in maximum isometric strength of elbow extension or flexion, nor in 1-repetition maximum bench press. In a follow-up experiment, electromyograms (EMGs) of RA, EO and internal oblique (IO) during suspended push-ups to failure were measured and normalized to those during maximum voluntary contraction of each muscle (% EMGmvc) in six men. EMG significantly increased when reaching failure in all muscles (RA: 46–88%, EO: 32–50%, IO: 19–52%, start-end), and was particularly high in RA. These results suggest that suspended push-up training can augment size of not only upper limb but also abdominal muscles, likely attributable to high muscle activities during exercise; however, this does not necessarily improve maximum strength after training thus warrants careful interpretation/application.
Intracranial Acute Subdural Hematoma Following Spinal Anesthesia: Our Experience with Six Patients
Authors: Elshanawany Ahmed M. , Wahab Amani Hassan Abdel 
Published: August 2019

Abstract
Objective To describe our experience with the occurrence of intracranial acute subdural hematoma (ASDH) following spinal anesthesia.
Patients and Methods We reviewed our records from 2010 to 2017 to detect cases of nontraumatic ASDH following spinal anesthesia. All cases were analyzed for the etiological factors, time lag between the procedure and hematoma diagnosis, treatment, and outcome.
Results Of 329 cases of nontraumatic ASDH, we identified 6 patients whose spontaneous ASDH developed following spinal anesthesia. All our patients were obstetrical and received spinal anesthesia for delivery. Patient ages ranged from 21 to 34 years. Two patients presented with deterioration of consciousness a few hours after delivery. Three patients presented with persistent headache and lethargy days after delivery. One patient presented 3 days after delivery with severe deterioration of consciousness. All patients had undergone surgical evacuation of a hematoma. Five patients recovered and one patient died 2 days after surgery. Records showed none of the six patients had coagulopathy or any other blood disorder.
Conclusion Although uncommon, intracranial ASDH should be considered in patients following spinal anesthesia, especially those with a prolonged headache after the procedure.
Uma comparação entre incisões oblíquas e verticais na coleta do tendão dos isquiotibiais na reconstrução do LCA e na lesão do ramo infrapatelar do nervo safeno
Authors: Keyhani Sohrab , Kazemi Seyyed Morteza , Sajjadi Mohammadreza Minator , Elmi Asghar 
Published: August 2019

Resumo
Objetivo O presente estudo teve como objetivo comparar as incisões oblíquas e verticais na coleta dos tendões dos isquiotibiais na reconstrução do ligamento cruzado anterior (LCA) e na lesão do ramo infrapatelar do nervo safeno.
Métodos O presente estudo foi realizado em um centro de referência terciário por 12 meses. Pacientes com indicação de reconstrução de uma ruptura do LCA foram incluídos no estudo, os quais foram randomizados em dois grupos (vertical [GV] e oblíquo [GO]). Após a exclusão de alguns casos, 92 pacientes foram elegíveis para análise posterior (GV: n= 44; GO: n = 48). Eles foram acompanhados por 9 meses após a cirurgia, e a perda de sensibilidade sobre o joelho e sobre o aspecto proximal da perna operada foi registrado.
Resultados Os comprimentos médios da incisão foram de 27 mm e 38 mm para os grupos GO e GV, respectivamente. A taxa total de hipoestesia foi de 40% (27 pacientes). Um total de 12 (25%) e de 25 pacientes (56,8%) dos grupos GO e GV, respectivamente, relataram sintomas de hipoestesia. A presença de hipoestesia em pacientes no grupo GV foi duas vezes maior do que no grupo GO. Não foi observada correlação estatística entre a lesão do nervo e idade, gênero, escolaridade e demora entre a lesão e a reconstrução.
Conclusão A incisão oblíqua, que apresentou menor risco de lesão nervosa, pode ser mais recomendada para a coleta do enxerto. Pacientes submetidos à reconstrução do LCA no grupo GO tiveram menor incidência de hipoestesia peri-incisional quando comparados aos pacientes do grupo GV.
Inhalational Isoflurane Sedation in Patients with Decompressive Craniectomy Suffering from Severe Subarachnoid Hemorrhage: A Case Series
Authors: Lehmann Felix , Müller Marcus , Zimmermann Julian , Güresir Ági , Lehmann Victoria , Putensen Christian , Vatter Hartmut , Güresir Erdem 
Published: August 2019

Abstract
Background Severe aneurysmal subarachnoid hemorrhage (SAH) may lead to the necessity of decompressive craniectomy (DC) to treat refractory elevated intracranial pressure (ICP). In some patients, adequate deep sedation, as one part of conservative treatment, cannot be achieved. Recent investigations suggest that inhalative sedation might not be as detrimental as considered before, and therefore a treatment option.
Materials and Methods A retrospective analysis of seven patients was performed who suffered from aneurysmal SAH (Hunt-Hess grade 3–5, Fisher's score 3) and underwent DC due to a critically elevated ICP. In these patients, the target sedation level could not be achieved even with high doses of intravenous sedatives. Thus, the sedative regimen was switched to inhaled anesthesia with isoflurane. Mean arterial pressure (MAP), ICP, cerebral perfusion pressure (CPP), levels of vasopressors, and respiratory parameters were analyzed.
Results Deep sedation (Richmond Agitation-Sedation Scale [RASS] −5, mean–fractional end-expiratory gas concentration [mean-Fet] 0.78%) was rapidly achieved in all patients after commencing general anesthesia with isoflurane. ICP remained stable when comparing 1 hour before the onset of isoflurane sedation (1) with 6 (2), and 12 hours (3) after commencing isoflurane anesthesia (mean ICP [1] 13.83 mm Hg; [2] 12.57 mm Hg; [3] 11.14 mm Hg). The mean duration of application was 9 (± 4) days. CPP could be maintained above 70 mm Hg without the need for extended vasopressor usage.
Conclusion In a setting of severe SAH and critically elevated ICP with the need for aggressive multimodal therapy, isoflurane was safely applied in those patients. Our sedation goal was rapidly achieved and critical rise in ICP was not observed. Further investigations are required to demonstrate that inhaled anesthesia with isoflurane can be a promising alternative option, as this drug has better controllable pharmacokinetics, no clinically relevant accumulation of the drug itself, and potential neuroprotective effects (so far reported in different animal models).