bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Uncoventional Technique: Outflow Vein Tributary access for Central Vein and Cephalic Arch Angioplasty in Dysfunctional AVF
Authors: Amullya KR , Muralikrishna N , Vinay K S , Gheewala Umesh Satish , Palanisamy Poornima , Vidyasagar Radhika , Sravan C P S. , Davu Narendra Babu , Sony Jithin , Gupta Veerabhadra 
Published: July 2024

Abstract

Introduction:
Central venous stenosis (CVS) is a significant and frequently encountered problem in managing hemodialysis (HD) patients. Venous hypertension, often accompanied by severe symptoms, undermines the integrity of the HD access circuit. In CVS, dialysis through an arteriovenous (AV) fistula is usually inefficient, with high recirculation rates and prolonged bleeding after dialysis. Interventions for central vein stenosis in patients with AV access are typically performed with a direct puncture of the fistula outflow vein or taking access from the femoral vein, jugular vein, axillary vein, and basilic vein. Commonly encountered complications with taking access from the fistula vein-puncture site bleeding, hematoma, pseudoaneurysm, thrombosis of arteriovenous fistula; complications noted with femoral vein access are groin hematoma, lower limb deep-vein thrombosis, need for patient immobilization, and groin compression. An alternative approach is to use the outflow vein tributary, such as the cephalic vein tributary, as an access to avoid these potential complications.

Aim and Objective:
The objective of this study was to evaluate the feasibility and clinical outcomes of central vein and cephalic vein arch angioplasty, utilizing an outflow vein tributary as access, for managing symptomatic CVS in dialysis patients with upper limb vascular access and significant ipsilateral limb edema.

Methodology:
In a Prospective interventional study conducted at 2 Tertiary care Institutes between 2022 and 2023, a total of 34 patients underwent central vein and cephalic arch angioplasty utilizing an outflow vein tributary as access. Follow-up duration varied among patients.

Results:
During a 1-year period, a total of 34 patients (20 male and 14 female) underwent interventions for central vein stenosis using a tributary of the outflow vein as an access. These interventions encompassed lesions in the SVC, innominate vein, subclavian vein, cephalic arch, and multisegmental disease. The technical success rate for endovascular treatment stood at 88%. However, in four patients, we encountered difficulties in crossing the lesion despite employing additional access from the great saphenous vein (GSV). Notably, in 23 cases, the entire procedure was successfully completed using access from the tributary vein, whereas in seven patients, supplementary access was obtained from the right GSV. Importantly, none of the patients experienced access site complications.

Conclusion:
The use of tributary veins as access allows for the use of wide bore sheaths without encountering complications when addressing central vein pathology. Our findings indicate that employing outflow vein tributaries as access for endovascular treatment is both safe and effective in managing central venous disease.
Management of Ballistic Injuries Affecting the Limbs at the University Hospital of Tengandogo, Burkina Faso, West Africa
Authors: Sawadogo Adama , Bazongo Moussa , Doamba Rodrigue Namekinsba , Sawadogo Youssouf , Tamboura Yacouba , Belem Farid Pingwinde , Nare Youssouf , Sanou Alain , Sanou Adama 
Published: July 2024

Abstract

Introduction:
Limb arterial injuries are serious clinical conditions that can lead to amputation or death. In Burkina Faso, there is a rise in gun shooting since 2016 because of armed conflict. In this study, the authors report the management of limb arterial injuries that occurred in ballistic traumas.

Patients and Methods:
From January 1, 2019, to December 31, 2022, 15 patients (14 males and 1 female) consecutively underwent operative management of limb arterial injuries at the University Hospital of Tengandogo. The mean age was 29.9 years old (17–55). Outcomes were defined according to intensive care unit stay time and postoperative morbidity and mortality.

Results:
Hospital admission after 6 h represented 93.7%. Unstable hemodynamic status was noted in 40%. Upper limbs arteries were more injured (60%) and these included false aneurysms (9) and complete arterial cut (6). Revascularization techniques consisted of direct suture in eight cases and prosthetic grafting in seven cases. Postoperatively, five patients presented complications: two superinfections, two skin necrosis, and one limb paresis. Amputation and mortality were nil.

Conclusion:
The management of ballistic arterial trauma to the limbs is late in our context. Circumstances are dominated by combat injuries and the militaries are more affected. However, a good indication for revascularization and rigorously executed technique can save the limbs.
A Rare Case of Painful Thrombosed Great Saphenous Vein Aneurysm in a Young Male
Authors: Aryala Shalini , Madavan Praveena , Singh Devender 
Published: July 2024

Abstract
Primary venous aneurysms are uncommon solitary dilatation of a vein that can occur throughout the venous system. Superficial venous aneurysms of the lower extremities are more often reported as esthetically displeasing bulges or incidental findings and are asymptomatic. A painful primary venous aneurysm is an extremely rare clinical entity. We report a case of painful thrombosed venous aneurysm of the great saphenous vein in a young male and managed surgically.
Comparison of Longitudinal and Transverse Transperitoneal Incisions in Abdominal Aortic Surgery: A Retrospective Analysis
Authors: Gupta Aditya , Pandey Ashutosh Kumar , Manchikanti Sriram , Sun Neelamjingbha , Pitchai Shivanesan 
Published: July 2024

Abstract

Objective:
Patients with abdominal aortic aneurysm (AAA) may be treated with endovascular intervention or open surgical repair. Despite the possibility of a retroperitoneal approach for open surgery, many surgeons prefer a transperitoneal approach. Transperitoneal aortic exposure may be done by longitudinal or transverse incisions. Transverse incisions are thought to be less painful and have less perioperative complications as compared to longitudinal midline incisions, but the reports to this effect are not conclusive. To address the lack of data comparing perioperative outcomes in aortic surgery incisions, our center conducted a retrospective study. Our aim was to generate concrete evidence regarding the choice of incision and its impact on surgical outcomes, filling a crucial gap in existing knowledge.

Materials and Methods:
Fifty-two consecutive cases were selected from our institute’s database who underwent elective open AAA repair, with 26 cases each in longitudinal and transverse incision group. Data were analyzed to compare the effects of type of incision for abdominal aortic surgery on the duration of ventilatory requirements and intensive care unit (ICU) stay, postoperative ileus, perioperative analgesia requirement, and the duration of hospital stay in these patient groups.

Results:
Baseline characteristics and comorbidities of the study population were comparable. Postoperative hospital stays were notably shorter for patients with transverse incisions than those with longitudinal incisions. The transverse incision group also exhibited a statistically significant reduction in postoperative ileus development. However, no significant differences were observed between the two study groups in terms of ventilatory requirements, postoperative analgesia needs, and ICU stays.

Conclusion:
The ongoing discourse in the literature surrounding the incision choices find support in our study, indicative of advantages of transverse incisions that include lower postoperative ileus and shorter hospital stays. However, no clear benefits were observed regarding postoperative ventilation and analgesic requirements. Study limitations underscore the necessity for future prospective research with larger samples and longer follow-ups, yet the findings suggest that transverse incisions may offer improved perioperative outcomes, potentially easing financial strains on patients and health-care systems through reduced hospitalization durations.
Ambulatory Flash Glucose Monitoring Device Detects Hypoglycemia and Time in Range in Children and Adolescents of Type 1 Diabetes Mellitus
Authors: Qamar Tooba , Awasthi Shally , Bhriguvanshi Arpita 
Published: July 2024

Objective:
The mainstay of diabetes control and management is glucose monitoring (GM). Improving glycemic control and decreasing glycemic variability is important to prevent microvascular complications of diabetes. Adherence to GM is a challenge in pediatric type 1 diabetes mellitus (T1DM) patients. Furthermore, nighttime hypoglycemia (NTH) is a common complication of diabetes management; prevention and treatment of which is essential to improve quality of life. We aim to study the impact of flash GM device (FGMD) in detecting NTH and time in range (TIR) in children and adolescents of T1DM.

Materials and Methods:
This was a prospective observational study. Twenty children and adolescents of T1DM from North India, with mean age (range) of 7.15 years (3–13), were enrolled and applied FGMD. Episodes of NTH and average TIR were analyzed during one sensor application, i.e., 14 days.

Results:
The proportion of patients developing NTH after 14 days of insertion of device was 15 (75%) and 5 (25%) patients did not. The mean (standard deviation) duration of NTH in 24 h was 101.35 (136.02) min. The mean (range) percentage of TIR of our study subjects was 32.03% (0–61).

Conclusion:
Flash monitoring is a useful tool to improve adherence to GM, detecting hypoglycemia (diurnal and nocturnal) and TIR in children and adolescents with T1DM.
Socio-demographic Characteristics, Clinical Variables, the Role of Stressor and Phenomenology in Patients with Acute and Transient Psychotic Disorders in One of the Tertiary Care Centre of North India: A Cross-sectional Study
Authors: Singh Mahender , Sharma Dinesh Dutt , Garg Sunny , Sharma Devesh , Chauhan Alka 
Published: July 2024

Background:
Acute and transient psychotic disorders (ATPDs) have benign course and takes place in the existence of noticeable and exceptionally traumatic stressors (direct temporal association between stressors and occurrence of ATPD) which necessitate clinical investigations. Stressors are also known to affect phenomenology and its content.

Aims and Objectives:
This study aims to study the socio-demographic characteristics, clinical variables, the role of stressors and phenomenology in ATPDs patients.

Methodology:
It is a cross-sectional and observational study. This study was done on 150 patients diagnosed on the basis of International Classification of Disease-10 diagnosis criteria of ATPDs after getting an informed consent from them. Patients’ information was recorded on socio-demographic and clinical profile sheet. Thereafter, Presumptive Stressful Life Event Scale and Positive and Negative Syndrome Scale (PANSS) scales were applied to assess the stressors and phenomenology, respectively.

Results:
Most of the patients were female and were between 15 and 35 years of age. Mean age of patients was 32.45 (standard deviation = 11.25) years. Majority of the patients were educated, married, and unemployed. A large amount of the patients belong to nuclear family and were resident of rural areas. Most of the patients presented within 2 weeks of the onset of the illness without any past or family psychiatric history. In 75% patients, stressors precede the onset of the illness. The average value of PANSS was higher in female. Sleep disturbances, delusions, hallucinations, poor rapport, lack of insight, and concrete thinking were the most commonly observed phenomenology in these patients.

Conclusions:
Maximum patients who developed the illness had psychological stressor/s in the past year (mainly before 2 weeks) of the onset of the illness. It helps to consider the person’s life events as a trigger for illness and make decisions regarding treatment accordingly.
Epidemiology of uveitis after tuberculosis in Taiwan – A nationwide population-based cohort study
Authors: Lin Chun-Ju , Hsu Alan Y. , Hsia Ning-Yi , Tien Peng-Tai , Yang Yu-Cih , Lai Chun-Ting , Bair Henry , Chen Huan-Sheng , Tsai Yi-Yu 
Published: July 2024

Abstract:

PURPOSE:
Current reports on the risk of uveitis of all causes after tuberculosis (TB) diagnosis are lacking. Therefore, we sought to investigate the association between the diagnosis of TB and the subsequent risk of uveitis in Taiwan.

MATERIALS AND METHODS:
Data from the Taiwan National Health Insurance system were retrieved and patients with newly diagnosed TB between 2000 and 2012 were recruited. The endpoint of interest was the occurrence of uveitis. Patients without TB were randomly matched 4:1 to TB cases based on age, gender, index date, outpatient clinic visit, and index year. Univariate and multivariable Cox proportional regression analyses were performed to analyze the risk of uveitis among TB patients.

RESULTS:
A total of 6139 patients with TB and corresponding 24,555 matched control participants were recruited. The mean age was 52.9 ± 22.1 years old and 32.1% were male. The medium follow-up period was 5.81 ± 4.37 years and 7.16 ± 3.95 years in the TB and matched control cohorts. Our results showed that patients with TB had no significantly increased incidence of uveitis. After stratification by gender, age, and comorbidities, the relationship between TB and uveitis was found to be not significant. The cumulative incidence of uveitis was also found to be not significantly higher among the TB group (log-rank P = 0.84).

CONCLUSION:
Our nationwide population-based cohort retrospective study showed that the incidence of uveitis was not significantly higher among patients with TB. Future prospective and multicenter studies are warranted to confirm our findings.
Diagnostic significance of serum levels of serum amyloid A, procalcitonin, and high-mobility group box 1 in identifying necrotising enterocolitis in newborns
Authors: Guo Li-Ming , Jiang Zhi-Hui , Liu Hong-Zhen , Zhang Lei 
Published: July 2024

BACKGROUND
Necrotising enterocolitis (NEC) is a critical gastrointestinal emergency affecting premature and low-birth-weight neonates. Serum amyloid A (SAA), procalcitonin (PCT), and high-mobility group box 1 (HMGB1) have emerged as potential biomarkers for NEC due to their roles in inflammatory response, tissue damage, and immune regulation.
AIM
To evaluate the diagnostic value of SAA, PCT, and HMGB1 in the context of NEC in newborns.
METHODS
The study retrospectively analysed the clinical data of 48 newborns diagnosed with NEC and 50 healthy newborns admitted to the hospital. Clinical, radiological, and laboratory findings, including serum SAA, PCT, and HMGB1 Levels, were collected, and specific detection methods were used. The diagnostic value of the biomarkers was evaluated through statistical analysis, which was performed using chi-square test, t -test, correlation analysis, and receiver operating characteristic (ROC) analysis.
RESULTS
The study demonstrated significantly elevated levels of serum SAA, PCT, and HMGB1 Levels in newborns diagnosed with NEC compared with healthy controls. The correlation analysis indicated strong positive correlations among serum SAA, PCT, and HMGB1 Levels and the presence of NEC. ROC analysis revealed promising sensitivity and specificity for serum SAA, PCT, and HMGB1 Levels as potential diagnostic markers. The combined model of the three biomarkers demonstrating an extremely high area under the curve (0.908).
CONCLUSION
The diagnostic value of serum SAA, PCT, and HMGB1 Levels in NEC was highlighted. These biomarkers potentially improve the early detection, risk stratification, and clinical management of critical conditions. The findings suggest that these biomarkers may aid in timely intervention and the enhancement of outcomes for neonates affected by NEC.
Evaluation of the clinical effects of atropine in combination with remifentanil in children undergoing surgery for acute appendicitis
Authors: Li Yu-Juan , Chen Yong-Yan , Lin Xia-Lan , Zhang Wei-Zhi 
Published: July 2024

BACKGROUND
Acute appendicitis (AA) is the most common cause of acute abdomen in children. Anesthesia significantly influences the surgical treatment of AA in children, making the scientific and effective selection of anesthetics crucial.
AIM
To assess the clinical effect of atropine (ATR) in combination with remifentanil (REMI) in children undergoing surgery for AA.
METHODS
In total, 108 cases of pediatric AA treated between May 2020 and May 2023 were selected, 58 of which received ATR + REMI [research group (RG)] and 50 who received REMI [control group (CG)]. Comparative analyses were conducted on the time to loss of eyelash reflex, pain resolution time, recovery time from anesthesia, incidence of adverse events (AEs; respiratory depression, hypoxemia, bradycardia, nausea and vomiting, and hypotension), intraoperative responses (head shaking, limb activity, orientation recovery, safe departure time from the operating room), hemodynamic parameters [oxygen saturation (SPO2), mean arterial pressure, heart rate, and respiratory rate], postoperative sedation score (Ramsay score), and pain level [the Face, Legs, Activity, Cry, Consolability (FLACC) Behavioral Scale].
RESULTS
Compared with the CG, the RG showed significantly shorter time to loss of eyelash reflex, pain resolution, recovery from anesthesia, and safe departure from the operating room. Furthermore, the incidence rates of overall AEs (head shaking, limb activity, etc. ) were lower, and influences on intraoperative hemodynamic parameters and stress response indexes were fewer. The Ramsay score at 30 min after extubation and the FLACC score at 60 min after extubation were significantly lower in the RG than in the CG.
CONCLUSION
ATR + REMI is superior to REMI alone in children undergoing AA surgery, with a lower incidence of AEs, fewer influences on hemodynamics and stress responses, and better post-anesthesia recovery.
Effectiveness of magnetic resonance imaging and spiral computed tomography in the staging and treatment prognosis of colorectal cancer
Authors: Bai Lu-Na , Zhang Lu-Xian 
Published: July 2024

BACKGROUND
Colorectal cancer (CRC) is a prevalent cancer type in clinical settings; its early signs can be difficult to detect, which often results in late-stage diagnoses in many patients. The early detection and diagnosis of CRC are crucial for improving treatment success and patient survival rates. Recently, imaging techniques have been hypothesized to be essential in managing CRC, with magnetic resonance imaging (MRI) and spiral computed tomography (SCT) playing a significant role in enhancing diagnostic and treatment approaches.
AIM
To explore the effectiveness of MRI and SCT in the preoperative staging of CRC and the prognosis of laparoscopic treatment.
METHODS
Ninety-five individuals admitted to Zhongshan Hospital Xiamen University underwent MRI and SCT and were diagnosed with CRC. The precision of MRI and SCT for the presurgical classification of CRC was assessed, and pathological staging was used as a reference. Receiver operating characteristic curves were used to evaluate the diagnostic efficacy of blood volume, blood flow, time to peak, permeability surface, blood reflux constant, volume transfer constant, and extracellular extravascular space volume fraction on the prognosis of patients with CRC.
RESULTS
Pathological biopsies confirmed the following CRC stages: 23, 23, 32, and 17 at T1, T2, T3, and T4, respectively. There were 39 cases at the N0 stage, 22 at N1, 34 at N2, 44 at M0 stage, and 51 at M1. Using pathological findings as the benchmark, the combined use of MRI and SCT for preoperative TNM staging in patients with CRC demonstrated superior sensitivity, specificity, and accuracy compared with either modality alone, with a statistically significant difference in accuracy (P < 0.05). Receiver operating characteristic curve analysis revealed the predictive values for laparoscopic treatment prognosis, as indicated by the areas under the curve for blood volume, blood flow, time to peak, and permeability surface, blood reflux constant, volume transfer constant, and extracellular extravascular space volume fraction were 0.750, 0.683, 0.772, 0.761, 0.709, 0.719, and 0.910, respectively. The corresponding sensitivity and specificity values were also obtained (P < 0.05).
CONCLUSION
MRI with SCT is effective in the clinical diagnosis of patients with CRC and is worthy of clinical promotion.
Correlation between abdominal computed tomography signs and postoperative prognosis for patients with colorectal cancer
Authors: Yang Shao-Min , Liu Jie-Mei , Wen Rui-Ping , Qian Yu-Dong , He Jing-Bo , Sun Jing-Song 
Published: July 2024

BACKGROUND
Patients with different stages of colorectal cancer (CRC) exhibit different abdominal computed tomography (CT) signs. Therefore, the influence of CT signs on CRC prognosis must be determined.
AIM
To observe abdominal CT signs in patients with CRC and analyze the correlation between the CT signs and postoperative prognosis.
METHODS
The clinical history and CT imaging results of 88 patients with CRC who underwent radical surgery at Xingtan Hospital Affiliated to Shunde Hospital of Southern Medical University were retrospectively analyzed. Univariate and multivariate Cox regression analyses were used to explore the independent risk factors for postoperative death in patients with CRC. The three-year survival rate was analyzed using the Kaplan-Meier curve, and the correlation between postoperative survival time and abdominal CT signs in patients with CRC was analyzed using Spearman correlation analysis.
RESULTS
For patients with CRC, the three-year survival rate was 73.86%. The death group exhibited more severe characteristics than the survival group. A multivariate Cox regression model analysis showed that body mass index (BMI), degree of periintestinal infiltration, tumor size, and lymph node CT value were independent factors influencing postoperative death (P < 0.05 for all). Patients with characteristics typical to the death group had a low three-year survival rate (log-rank χ 2 = 66.487, 11.346, 12.500, and 27.672, respectively, P < 0.05 for all). The survival time of CRC patients was negatively correlated with BMI, degree of periintestinal infiltration, tumor size, lymph node CT value, mean tumor long-axis diameter, and mean tumor short-axis diameter (r = -0.559, 0.679, -0.430, -0.585, -0.425, and -0.385, respectively, P < 0.05 for all). BMI was positively correlated with the degree of periintestinal invasion, lymph node CT value, and mean tumor short-axis diameter (r = 0.303, 0.431, and 0.437, respectively, P < 0.05 for all).
CONCLUSION
The degree of periintestinal infiltration, tumor size, and lymph node CT value are crucial for evaluating the prognosis of patients with CRC.