bluuebunny/crossref_metadata_2025_split huggingface dataset:
72153 - Postnatal Evaluation of Prenatally Detected Hydronephrosis - Results of a Swedish regional second trimester screening program 2019-2022
Authors: Bäckstrand Jakob , Evertsson Alva , Öhman Marie Ordéus , Sjöström Sofia , Carlsson Ylva 
Published: August 2024

Abstract

Introduction
Hydronephrosis is a common finding at the second trimester ultrasound. In 2018, a new guideline for antenatally detected hydronephrosis was implemented in Sweden. All fetuses with an anterior posterior diameter of the renal pelvis exceeding six mm at the 2nd trimester ultrasound should have additional follow-up. Aim: To evaluate the new national guideline and compare outcomes of children with hydronephrosis detected during 2nd trimester ultrasound to those diagnosed before the age of two, who went undetected during pregnancy

Method
This prospective cohort study investigated fetuses, with hydronephrosis at the 2nd trimester ultrasound between 2019-11-01 to 2022-10-31 at Sahlgrenska University Hospital. In addition, retrospective data from children, with corresponding ICD-codes at age &lt; 2y, who were not detected antenatally, was collected.

Result
The incidence of hydronephrosis during the 2nd trimester ultrasound was 0.55%(n=171). Of 206 children with hydronephrosis before the age of two, 78.2%(n=161) had antenatal diagnosis. 27.4%(n=32) of those with antenatal hydronephrosis had persisting abnormality at two years, 5.2%(n=8) required surgery, and 8.4%(n=13) were hospitalized for urinary tract infection(UTI). In comparison, among children detected postnatally, 12.8%(n=6) required surgery and 70.2%(n=33) were hospitalized for UTI. Only one patient had an eGFR below normal. The most common diagnoses in the antenatal group were multicystic dysplastic kidney, duplex with or without ureterocele, vesicoureteral reflux and pelviureteric junction obstruction, whereas most children detected postnatally had vesicoureteral reflux.

Discussion
Detection rate of hydronephrosis at 2nd trimester ultrasound is good and children antenatally detected have favorable outcomes. This study contributes to accurate prognostic information.
72242 - Laparoscopy for impalpable undescended testis – do children with syndromes have worse outcome?
Authors: Byström Agnes Raaschou , Selin Caroline Ericsson , Hallabro Nilla , Salö Martin 
Published: August 2024

Abstract

Introduction
Few studies describe the outcome after laparoscopy for impalpable undescended testis (UDT) in children with syndromes. Thus, the aim of the study was to evaluate final diagnosis and outcome after laparoscopy for impalpable UDT with comparison of children with and without a defined syndrome.

Method
An ethically approved retrospective study of boys who underwent laparoscopy for impalpable UDT between 2018 - 2022 was conducted. Variables between children with and without a syndrome were compared using univariate analysis. A syndrome was defined as caused by a chromosomal abnormality or a mutation/genetic polymorphism in a specific gene locus with previously known connected comorbidities/malformations.

Result
A total of 298 boys who underwent laparoscopy for impalpable UDT were included. The median age was 14 months and 32 (10.7%) had a syndrome. Boys with syndromes were significantly older and more often had bilateral disease. Overall, intraabdominal UDT was found in 42%, a testicular nubbin in 22%, vanishing testis in 23% and other miscellaneous findings in the rest. Abdominal UDT was more common in boys with syndrome (66 % vs 39%, p&lt;0.01) and findings of a testicular nubbin was more common in boys without a syndrome (24% vs 3%, p&lt;0,01). Of all boys with completed follow-up after FS2, the atrophy rate was 18% and the re-ascent rate 4%, without differences between boys with and without a syndrome.

Discussion
Boys with syndromes and impalpable UDT have higher rate of true UDT and lower rate of testicular nubbin at time of laparoscopy, but not worse outcome after completed FS2.
72196 - Outcome is not associated with advanced age after CRS and HIPEC for Colorectal peritoneal metastases: a population-based study
Authors: Yacoub Tamara Yousef , Matthiessen Peter , Graf Wilhelm , Cashin Peter , Palmer Gabriella Jansson , Lindskog Elinor Bexe , Syk Ingvar , Ghanipour Lana 
Published: August 2024

Abstract

Introduction
Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) has entailed better prognosis and overall survival for patients with peritoneal metastasis (PM) from colorectal cancer (CRC). However, data on perioperative complications and long-term survival of this procedure in elderly patients (≥75 years) are scarce. The aim of this study was to determine if age ≥75 impacts overall survival (OS) and postoperative morbidity.

Method
This population-based study collected data from the National Swedish HIPEC Registry, including patients with PM from CRC operated with CRS-HIPEC. We stratified patients by age (≤74 vs ≥75) with overall survival as primary outcome. Secondary outcomes included PCI-score, N-stage, postoperative morbidity, early mortality and time to relapse.

Result
A total of 592 patients were identified of which 553 were ≤74 year whereas 39 were ≥75. There was no difference in OS (p=0.951, Fig. 1). Factors affecting OS negatively were CC-1 (p=0.004), PCI ≥20 (p=0.009), nodal status N2 (p=0.041), but not age ≥75.
No difference was noted for time to relapse (p=0.525) and in case of recurrent disease, curative intention was offered more frequently to patients ≤69 years (p=0.045). Serious postoperative complication (Clavien-Dindo grade III-IV) rate was 27% in patients ≤74 year and 21% in patients ≥75. The in-hospital mortality rate was 1.3% in patients ≤74 year and zero in patients ≥75year. No difference was observed in in-hospital morbidity (p=0.540) or reoperations (p=0.749).

Discussion
These results support that advanced age is not a contraindication to perform CRS-HIPEC in selected patients with PM from CRC.
72234 - The Loop ileostomy - is it necessary?
Authors: Jonsson Andreas , Xiao Yao 
Published: August 2024

Abstract

Introduction
In Sweden, around 2000 people are diagnosed annually with rectal cancer, with nearly 80 cases in the Halland Region.
Despite improved oncological outcomes, postoperative complications, particularly anastomotic leakage, remain a significant concern, often leading to prolonged hospitalization and sometimes necessitating further interventions.
Matthiessen et al. conducted a study in 2007 comparing anastomotic leakage rates in TME patients with and without a loop ileostomy, finding significantly less leakages in those with the ileostomy. However, subsequent research revealed drawbacks, including longer hospital stays and poorer quality of life.
The study aims to assess loop ileostomy usage in rectal cancer surgeries in Region Halland and compare anastomotic leakage rates between ileostomy and non-ileostomy groups.

Method
A descriptive retrospective study was conducted to assess loop ileostomy usage and anastomotic leakage rates in rectal cancer surgeries in Region Halland between 2017 and 2022. Anastomotic leakage was defined clinically combined with objective signs by imaging and or endoscopic findings.

Result
A total of 157 TME with anastomosis were carried out on patients with rectal cancer in Region Halland. Of these 157 rectum resections, 73 (46.5%) involved a loop ileostomy, showing a decreasing trend over the studied period. In 2017, 61.3% of anastomoses were diverted but in 2022 33.3 %. 37 out of 157 patients (23.6%) experienced leakages. Of these, 21 (56.8%) had a loop ileostomy initially, and 16 had no loop ileostomy, showing no significant difference (p=0.152).

Discussion
This is a small retrospective study, and no clear conclusions can be drawn, further studies are wanted.
72245 - Hospital surgical volumes and outcomes in ileocaecal resection for Crohn’s disease in Sweden 2000 - 2019. A national cohort study
Authors: Soop Mattias , Zuk David , Bryder Nicklas , Myrelid Pär , Thorell Anders , Ludvigsson Jonas F , Olén Ola , Nordenvall Caroline 
Published: August 2024

Abstract

Introduction
Intestinal resection for CD is often complex and remains associated with significant postoperative morbidity. In several other types of complex surgery, increased case volume has been associated with better outcomes. In surgery for CD, such an association has been difficult to assess. ​

Method
In this nationwide cohort study, we used the National Patient Register to identify all CD patients who underwent their first (primary) ileocecal resection in Sweden 2000-2019 at age 15 years or above. Hospitals were grouped into low, middle, and high-volume centres (1-24, 25-36 and ≥37 resections per year).

Result
In the 20-year study period, 3396 patients underwent primary ileocecal resection for CD in Sweden; 2371 (69.8%), 527 (15.5%), and 498 (14.7%) in low-, middle-, and high-volume hospitals, respectively. Laparoscopic surgery was performed in 351 (15%), 126 (24%), and 122 (24%) patients in low-, middle-, and high-volume centers. Surgical reintervention within 100 days was performed in 117 (4.9%), 19 (3.6%) and 13 (2.6%) patients in the three groups (adjusted odds ratios 0.72 (95% confidence interval 0.43-1.15) for middle-volume and 0.52 (0.28-0.89) for high-volume hospitals, compared to low-volume hospitals, Figure 1). There were no differences in the length of index admission hospital stay or mortality. ​

Discussion
In primary ileocecal resection for Crohn’s disease (CD), high-volume hospitals had lower odds of early surgical reintervention, compared to low-volume hospitals. Hospital groups did not differ in mortality or length of stay. This finding may inform discussions of subspecialization and centralization in surgery for Crohn’s disease.
72298 - High mortality after surgery for perforated diverticulitis Hinchey grade IV was mediated by sepsis
Authors: Samuelsson Andreas , Bock David , Prytz Mattias , Ehrencrona Carolina , Angenete Eva , Haglind Eva 
Published: August 2024

Abstract

Introduction
Studies of perforated diverticulitis have mainly been focused on choice of surgical method and few have included faecal peritonitis, Hinchey grade IV. The aim was to study a national cohort of patients operated for Hinchey IV and to compare with a national cohort Hinchey grade III.

Method
The study cohort consisted of all patients operated for perforated diverticulitis, Hinchey grade III and IV, in Sweden during 2016-2018. The cohort was identified through the Swedish In-Patient registry with a combination of ICD-10 codes for diverticulitis and operation codes (NOMESCO). All medical records were collected to retrieve data on diagnosis, operation and clinical outcomes. Data from the Cause of Death registry and Cancer registry were collected.

Result
Out of 1300 identified patients 669 were operated for perforated diverticulitis Hinchey grade III-IV with 170 Hinchey grade IV. Female sex was more common in Hinchey IV (66% vs 52%) as was immunosuppression. Age, BMI and co-morbidity did not differ. Sepsis was present in 41% among Hinchey IV compared to 18% for Hinchey III. Mortality within 2 years was higher in Hinchey IV (31% vs 21%) largely due to diverticulitis-specific mortality (15.2% vs 6.8%). Risk of death due to diverticulitis was higher for Hinchey IV (HR 1.76 (1.03; 3.00)). Sepsis increased the risk of death due to diverticulitis (HR 2.84 (1.65; 4.93)).

Discussion
Mortality was high after surgery for perforated diverticulitis, especially for Hinchey IV. Although Hinchey grade had an influence independently, sepsis was a strong mediator for death. To reduce mortality emphasis on sepsis care seems warranted.
72321 - Validation of the reporting of local recurrence of rectal cancer in the Swedish ColoRectal Cancer Registry (SCRCR)
Authors: Waldenstedt Sophia , Haglind Eva , Collet Sebastian Klintefelt , Angenete Eva 
Published: August 2024

Abstract

Introduction
The Swedish ColoRectal Cancer Registry (SCRCR) includes data on patients with rectal cancer in Sweden with a coverage rate of 98.5%. While variables on primary diagnosis and treatment have been shown to have good validity, local recurrence has not been validated on a national level previously. As data from the SCRCR is used extensively in research and for clinical evaluation with local recurrence as an important outcome measure, it is essential that this variable in the SCRCR is correct. The aim of this study was to validate the registration of local recurrence of rectal cancer in the SCRCR.

Method
All patients registered with a diagnosis of rectal cancer between 2016 and 2017 and who underwent an abdominal resection were identified in the SCRCR. Medical charts were retrieved and reviewed until end of follow-up June 2022. The retrospectively collected data was compared to the data registered in the SCRCR.

Result
Of a total of 2994 registered patients, 161 were found not to meet the inclusion criteria and 123 had missing charts leaving 2710 patients included in this analysis. A total of 149 patients (5,5%) were found to be diagnosed with local recurrence. Of these 88 (59.1%) were registered in the SCRCR. There were 13 patients registered with local recurrence in the SCRCR with no local recurrence identified in the medical charts.

Discussion
There was a significant under-reporting of local recurrence in the SCRCR.
72306 - Favourable outcomes with a patient-focused treatment approach using open and endovascular techniques for abdominal aortic aneurysms in the modern era
Authors: Smidfelt Kristian , Cervin Anne , Langenskiöld Marcus , Nordanstig Joakim , Perlander Angelica , Strömberg Sofia , Österberg Klas , Skoog Per 
Published: August 2024

Abstract

Introduction
The treatment of abdominal aortic aneurysms is rapidly changing from a tailored treatment approach including both open and endovascular surgery to a total endovascular approach. The evidence for that change of strategy is lacking. This study reports the modern short- and longterm outcome of a tailored treatment regime.

Method
All elective patients, referred to a tertiary aortic center with infra, juxta- and pararenal abdominal aortic aneurysms between 2012 and 2018 were included. 30-day, 90-day, 1-year and 5-year results regarding technical success, complications and survival were reported. The Student t-test or Mann-Whitney U test were used to compare continuous data, Chi-Square test to compare categorical data. Kaplan-Meier curves were used to present data on survival.

Result
429 patients were referred during the time period. 114 patients (26.6%) were treated for complex abdominal aortic aneurysms. 193 (45.0%) patients (mean age 69.8 ± SD5.8) had open repair and 236 (55.0%) patients (mean age 74.9 ± SD6.6) had endovascular repair. In the open repair group, 78 (41.5%) had suprarenal clamp. In the endovascular group 17 (7.2%) received an fenestrated or branched device. Mortality at 30 days were 0.5% and 0.8% for open and EVAR respectively and at 90-days 0.5% and 2.1%, with no difference between groups. 5-year mortality was 15.5% and 31.8% for open and endovascular respectively. The pooled mortality was 24.5% at 5-years.

Discussion
A tailored aneurysm repair approach, where surgical technique is choosed based on patient-related factors as aneurysm-anatomy and physical status, may still be considered the optimal way to treat abdominal aortic aneurysms.
72103 - Undertriage of severely injured patients at one non-trauma center hospital in Stockholm
Authors: Lapidus Oscar , Duran Charlotte , Bredberg Sara , Bäckström Denise , Hammarqvist Folke , Wladis Andreas , Wahlin Rebecka Rubenson 
Published: August 2024

Abstract

Introduction
In a regional trauma system where all severely injured patients are transported to a designated trauma center hospital, trauma triage at non-trauma center hospitals may face additional challenges as patients are assumed to not be severely injured. No recent studies have examined triage accuracy in relation to current guidelines at non-trauma center hospitals the regional trauma system in Stockholm.

Method
Trauma patients treated at Södersjukhuset during 2019-2022 were identified using the Swedish Trauma Registry. Undertriage was defined in accordance with national guidelines as the proportion of patients with NISS ≥16 who did not prompt level 1 trauma team activation (TTA) on arrival to hospital. Triage charts were reviewed to determine whether any TTA criteria were met at the time of arrival. Post-hoc injury severity was not available when evaluating triage charts.

Result
A total of 849 severely injured patients presented to the emergency department during the study period; the rate of level 1 TTA in this cohort was 2.2% (n=19), corresponding to an undertriage of 98% as defined by Swedish national guidelines. Of these patients, 21% (n=188) met at least one of the specified level 1 TTA criteria. The rate of level 2 TTA for severely injured patients was 41% (n=348); the remaining 57% (n=482) prompted no TTA on arrival to the emergency department.

Discussion
In this setting, trauma triage was highly inaccurate; the majority of severely injured patients prompted no TTA on arrival. The specified TTA criteria may be unsuitable for identification of severely injured patients at non-trauma center hospitals.
72222 - Risk for ventral hernia related to parity: A population-based register study
Authors: Katawazai Asmatullah 
Published: August 2024

Abstract

Introduction
The influence of pregnancy on the risk of ventral hernia recurrence is not known. This study aims to assess whether the frequency of pregnancies is associated with an elevated risk of developing ventral hernias.

Method
This nationwide study cohort constitutes women borne 1950-1980 who were registered in the Swedish Birth Register (MBR). Data on pregnancies, distinguishing between vaginal and caesarian sections, were retrieved from the Birth Register. The cohort was cross-matched with the National Patient Register (NPR) to identify subsequent primary hernia repairs.

Result
A total of 1,630,754 women born between 1950 and 1980 were included in the study. Among them, 1,588,609 (92.3%) were registered for at least one birth. The incidence rate for Umbilical Hernia Repair (UHR) and Epigastric Hernia Repair (EHR) was 13.21 per 100,000 person-years and 5.4 per 100,000 person-years, respectively. When compared with women registered for one delivery, the incidence rate ratio for UHR was 1.3 (95% CI: 1.26-1.33, P&lt;0.001) among those registered for two deliveries and 1.6 (95% CI: 1.58-1.68, P&lt;0.001) among those registered for ≥3 deliveries.
The incidence rate ratios were 1.29 (95% CI: 1.20-1.39, P&lt;0.001) and 1.34 (95% CI: 1.24-1.45, P&lt;0.001) for EHR among women with two and ≥3 registered deliveries, respectively.

Discussion
A history of more than one pregnancy is associated with an increased incidence of umbilical and epigastric hernias.
72258 - Inguinal hernia repair during the COVID-19 pandemic – a nationwide, retrospective cohort study from Swedish Hernia Register
Authors: Stolt Ramia , Rogmark Peder , Ruiz Fernando , Ticehurst Kristina , Österberg Johanna , De la Croix Hanna 
Published: August 2024

Abstract

Introduction
Over 16 000 inguinal hernia repairs (IHR) are annually performed in Sweden, mainly in elective daycare setting. During COVID-19 pandemic all elective surgeries in Sweden were initially postponed to reallocate sources and reduce the spreading. Our aim is to study the impact of the COVID-19 pandemic on IHR in Sweden based on a nationwide, retrospective cohort.

Method
A retrospective, observational cohort based upon data from the Swedish Hernia Register (SHR) to compare the quality of IHR in Sweden before and during the Coivd-19-pandemic. The results are presented according to STROBE checklist after using multivariate logistic regression analysis to calculate the complication risks in short- and long-term.

Result
109461 hernia repairs were registered in SHR between 2015-2021. The elective IHRs decreased by 22,3% in 2020. Subsequently, the percentage of acute IHRs increased only by 0.9% during the pandemic. However, the risk of getting an acute IHR was slightly increased in the later cohort (OR 1.24) and main risk factors were female gender (OR=3.28, p&lt;0,001), age &gt;70 years (p&lt;0.001) and ASA class &gt;3 (p&lt;0.001). Acute IHR was also highly associated with severe postoperative complications (Clavien-Dindo 3b-5) and 30-days mortality in both cohorts (OR 3.94, p&lt;0.001).

Discussion
The number of acute hernia repairs seems to be independent of number of elective hernia surgery. The risk of emergency surgery increased slightly during the Covid-pandemic (R 1.24), but despite that no significant differences could be shown in mortality rates or risk of severe complication between the cohorts. Further time is needed to study risk of reoperation.
Transatrial repair of a giant left ventricular pseudoaneurysm and ischaemic mitral regurgitation after myocardial infarction: case report
Authors: Monden Yuki , Une Dai , Furuta Megumi , Yoshida Kenji , Nakai Mikizo 
Published: August 2024

Abstract

Background
Left ventricular pseudoaneurysm (LVPA) is an infrequent but highly lethal complication of myocardial infarction. Early surgical repair with a resection of pseudoaneurysm is often performed, given that medical therapy alone is associated with a high risk of mortality. This report describes a case of a giant LVPA on the lateral wall post-infarction and mitral valve regurgitation that was successfully treated by surgical transatrial closure and mitral valve replacement.

Case summary
A 77-year-old man with chronic kidney disease and a history of percutaneous coronary interventions for acute myocardial infarction was referred to the cardiac surgeons because of a spontaneous finding of an abnormal mass adjacent to the heart on imaging studies, which was missed on a chest radiograph obtained 3 months earlier. Cardiac studies revealed LVPA and severe mitral regurgitation with poor ejection fraction. Early repair of LVPA and concurrent mitral valve surgery were recommended. Transatrial patch closure and mitral valve replacement were performed using an interatrial approach via median sternotomy. Although the patient’s post-operative course was complicated by congestive heart failure and irreversible renal failure, he was discharged with good functional status after 1 month of intermittent renal replacement therapy with haemodialysis.

Discussion
Transatrial repair of LVPA and concurrent mitral valve replacement can be a treatment of choice for reducing surgical trauma to the left ventricle and protecting the sealing structure from rupture.
Genetics, transcriptomics, metagenomics, and metabolomics in the pathogenesis and prediction of atrial fibrillation
Authors: Linna-Kuosmanen Suvi , Vuori Matti , Kiviniemi Tuomas , Palmu Joonatan , Niiranen Teemu 
Published: August 2024

Abstract
The primary cellular substrates of atrial fibrillation (AF) and the mechanisms underlying AF onset remain poorly characterized and therefore, its risk assessment lacks precision. While the use of omics may enable discovery of novel AF risk factors and narrow down the cellular pathways involved in AF pathogenesis, the work is far from complete. Large-scale genome-wide association studies and transcriptomic analyses that allow an unbiased, non-candidate-gene-based delineation of molecular changes associated with AF in humans have identified at least 150 genetic loci associated with AF. However, only few of these loci have been thoroughly mechanistically dissected, indicating that much remains to be discovered for targeted diagnostics and therapeutics. Metabolomics and metagenomics, on the other hand, add to the understanding of AF downstream of the primary substrate and integrate the signalling of environmental and host factors, respectively. These two rapidly developing fields have already provided several correlates of prevalent and incident AF that require additional validation in external cohorts and experimental studies. In this review, we take a look at the recent developments in genetics, transcriptomics, metagenomics, and metabolomics and how they may aid in improving the discovery of AF risk factors and shed light into the molecular mechanisms leading to AF onset.