bluuebunny/crossref_metadata_2025_split huggingface dataset:
1112 Breast Cancer After Breast Augmentation (BCABA): A National Multicentre Collaborative Study of Patient Management and Outcomes
Authors: Manor K , Shah S , Shaker H , Bydder M , Dave R , Harvey J , Kirwan C , Baker B 
Published: July 2024

Abstract

Aim
The incidence of breast cancers diagnosed in patients that have previously had cosmetic breast augmentation is increasing. The presence of an implant at diagnosis poses management challenges. The largest UK series to date reports 49 patients from the iBRA study. We aimed to establish current UK practice encompassing both breast conserving surgery (BCS) and mastectomy +/- reconstruction, and its safety profile.

Method
A national multicentre collaborative model was used, with a steering committee from the NWBRC. Women diagnosed with breast cancer (invasive or non-invasive) from 2012 onwards with pre-existing implant augmentation were identified and data was recorded on REDCapâ. Outcomes were pathology and imaging findings, surgery performed, complications, and recommended adjuvant treatments. Recruitment will end in January 2024.

Results
An interim analysis representing 80% study accrual to date was performed. 24 collaborators from 23 UK units participated, identifying 144 women (median age 51 years, IQR 44-58). 124(86%) presented symptomatically and 20(14%) via screening. 103(72%) underwent BCS with 23(22%) requiring further excision. 84(82%) retained an implant and 98% of these patients were recommended for adjuvant radiotherapy. 41(28%) had mastectomy; 22(54%) had reconstruction (21 implant-based reconstruction, 1 autologous). Of the entire cohort, 6 patients returned to theatre within 90 days for a complication, and 3 lost an implant.

Conclusions
This is the largest reported series of these patients worldwide. There are wide variations in standard of care. Early analysis suggests that re-excision rates for patients undergoing BCS may be higher in this group. Complication rates are comparable to national standards.
297 Exploring Risk Factors for Acute Kidney Injury in Patients Undergoing Cardiac Surgery
Authors: Abelian E , Bhandari M , Purmessur R , Ali J 
Published: July 2024

Abstract

Aim
Acute Kidney Injury (AKI) is an important complication following cardiac surgery that has been associated with adverse outcomes. The aim of this work was to investigate the incidence and risk factors for AKI in patients undergoing cardiac surgery at our centre.

Method
This is a retrospective analysis of 1441 patients who underwent elective or urgent (but not emergency) cardiovascular surgery with use of cardiopulmonary bypass over a 1-year period. Our exclusion criteria were heart transplant, single CABG, congenital repairs or patients on dialysis or renal transplant pre-operatively. Data analysis was performed in R studio.

Results
The mean age of the patients was 67.7 years. Mean creatinine from a 7-day period before surgery was 90µmol/L compared with the mean peak post operative creatinine of 127 µmol/L (95% CI 33-42, p-value &lt;0.05). As defined by the KDIGO AKI stages, 27% developed an AKI stage 1, 11% developed AKI stage 2 and 1% AKI stage 3. The following variables correlated strongly (P-value &lt;0.001) with post-operative risk of AKI: The comorbidities of diabetes, smoking, and peripheral vascular disease; pre-operative medications: diuretics, calcium channel blockers and SGLT-2 inhibitors and receiving FFP or RBC transfusion postoperatively.

Conclusions
AKI is a common complication following cardiac surgery. Having an insight into the risk factors for AKI allows an opportunity for intervention preoperatively and can also highlight patients that may require extra vigilance in the perioperative period to reduce its incidence, which may lead to an improvement in outcomes following surgery.
1011 A Rare Case of Left Sided Hemiparesis Following a Pneumatic Gun-Shot Injury to Left Anterior Chest Wall in a 13-Year-Old Boy
Authors: Wijesundara A , Samarakoon K , Panapitiya N , Aathavan B 
Published: July 2024

Abstract

Introduction
Even though pneumatic weapons rarely cause severe direct trauma, pellet embolisation can lead to unexpected, catastrophic events.

Case Report
A 13-year-old, previously healthy boy was injured by an accidentally fired pneumatic gun, while playing with his twin brother. He sustained a penetrating wound to left anterior chest wall and resultant bleeding was self-limiting.
He was hospitalised within 15minutes. On admission, he was hemodynamically stable with normal Respiratory, Cardiovascular and Neurological system findings. Entry wound measuring 5*5 mm was present at 5th intercostal space just left to the sternum. No exit wound was detected. Initial chest radiograph and ultra-sound abdomen and chest were normal. 2D echocardiogram revealed only a very thin layer(3mm) of pericardial effusion.
Four hours later, He developed a focal seizure followed by left sided hemiparesis. Urgent NCCT brain and carotid artery duplex showed a high dense pellet in right internal carotid artery at the level of petrous temporal bone and hypo-dense Middle Cerebral Artery (MCA) suggestive of right MCA thrombosis.
He was transferred to a tertiary care centre. Interventional radiological and endo-vascular attempts of pellet retrieval have been failed. Ischemic stroke pursued with worsening cerebral oedema; thus decompression craniotomy was performed on day 3. He is currently being rehabilitated in a specialised centre.

Conclusions
High degree of suspicion should be maintained on the possibility of projectile embolisation, in pneumatic gun-shot injuries, especially in the absence of an exit wound. Extensive early investigations should be performed to localise the projectile and retrieval should be planned.
385 Surgical and Oncological Anal Cancer Outcomes at a Regional Tertiary Centre
Authors: Delaney M , Qureshi M 
Published: July 2024

Abstract

Aim
There is little data in the UK about anal cancer outcomes. Our aim was to look at the rates of residual and recurrent disease following surgical or oncological treatment as well as the correspondence with the resection margin.

Method
A retrospective review of those who were diagnosed with anal cancer between 1/1/2017 and 1/1/2022. We reviewed their grade of cancer, the treatment received, the resection margin following surgery, and their outcomes.

Results
95 patients were included. 84 patients received treatment with the aim of cure and 11 patients received palliation from diagnosis. Of those treated with an intent to cure, 61.9% of patients had no residual disease or disease recurrence, 17.9% of patients had residual disease and 20.2% had recurrence (10.7% local; 1.2% regional; 8.3% distant). 29.8% of this patient group have died. 54.1% of those with residual or local recurrence had salvage surgery. 30.8% had a positive margin. 100% of patients with a positive margin at salvage surgery have now died compared to 55.5% of those with a negative margin. 8 patients were treated with local excision for T1 disease. 62.5% had a R1 resection margin. Following further treatment 0% have had disease reoccurrence.

Conclusions
The survival rate of this group of patients is 62.1%. Despite having a negative resection margin at salvage surgery, long-term survival is poor. Compared with local excision of T1 disease, despite a positive or negative margin, survival is 100% in this group.
Rapid synthesis of olivine NaMnPO4
Authors: Xiao Han , Fang Haisheng 
Published: July 2024

Abstract
There are only limited methods available to synthesize metastable olivine NaMnPO4, and these methods all involve a time-consuming process. Herein, we report a rapid synthesis of olivine NaMnPO4, and the results show that the formation of olivine NaMnPO4 highly depends on the Na/Mn/P ratio and the pH of the reaction system, and pure olivine NaMnPO4 can be hydrothermally synthesized for only 1 h under appropriate conditions. This communication provides an efficient process for synthesis of olivine NaMnPO4.
Infective endocarditis and spondylodiscitis—impact of sequence of surgical therapy on survival and recurrence rate
Authors: Weber Carolyn , Misfeld Martin , Diab Mahmoud , Saha Shekhar , Elderia Ahmed , Marin-Cuartas Mateo , Luehr Maximilian , Yagdiran Ayla , Eysel Peer , Jung Norma , Hagl Christian , Doenst Torsten , Borger Michael A , Kernich Nikolaus , Wahlers Thorsten 
Published: July 2024

Abstract

OBJECTIVES
To date, there are no standardized treatment algorithms or recommendations for patients with infective endocarditis (IE) and concomitant spondylodiscitis (SD). Therefore, our aim was to analyse whether the sequence of surgical treatment of IE and SD has an impact on postoperative outcome and to identify risk factors for survival and postoperative recurrence.

METHODS
Patients with IE underwent surgery in 4 German university hospitals between 1994 and 2022. Univariable and multivariable analyses were performed to identify possible predictors of 30-day/1-year mortality and recurrence of IE and/or SD.

RESULTS
From the total IE cohort (n = 3991), 150 patients (4.4%) had concomitant SD. Primary surgery for IE was performed in 76.6%, and primary surgery for SD in 23.3%. The median age was 70.0 (64.0–75.6) years and patients were mostly male (79.5%). The most common pathogens detected were enterococci and Staphylococcus aureus followed by streptococci, and coagulase-negative Staphylococci. If SD was operated on first, 30-day mortality was significantly higher than if IE was operated on 1st (25.7% vs 11.4%; P = 0.037) and we observed a tendency for a higher 1-year mortality. If IE was treated 1st, we observed a higher recurrence rate within 1 year (12.2% vs 0%; P = 0.023). Multivariable analysis showed that primary surgery for SD was an independent predictor of 30-day mortality.

CONCLUSIONS
Primary surgical treatment for SD was an independent risk factor for 30-day mortality. When IE was treated surgically 1st, the recurrence rate of IE and/or SD was higher.
O-024 Age affects ultrasound markers of endometrial receptivity in artificial cycles
Authors: Fuentes A , Moliner B , Cirillo P , Castillo J C , Alcaraz B , Martínez M , Moral P , Bernabeu R , Bernabeu A 
Published: July 2024

Abstract

Study question
Are ultrasound markers of endometrial receptivity affected by patient age in artificial cycles?

Summary answer
Maternal age is linked to certain ultrasound markers such as a larger uterus, reduced endometrial compaction and lower uterine peristalsis.

What is known already
The decline in fertility in advanced age women has traditionally been linked to low oocyte quantity and quality. However, recent studies indicate that age may also affect endometrial aspects, influencing implantation and live birth rates. Advanced age can lead to impaired decidualization, increased fibrosis and decreased expression of progesterone and estradiol receptors.
This study aims to investigate the influence of age on ultrasound factors related to implantation in patients undergoing embryo transfer in artificial cycles.

Study design, size, duration
Retrospective study of 452 patients undergoing frozen embryo transfer with artificial cycle, between January 2017 and December 2023.

Participants/materials, setting, methods
Ultrasound markers were evaluated, including assessment of uterine pathology, endometrial thickness before and after the onset of progesterone and uterine peristalsis. Serum progesterone level was also analysed. Spearman correlation and multivariate linear regression were used for analysis, adjusting for uterine factors. Subgroup analysis was performed for patients aged ≥45 years.

Main results and the role of chance
Age correlated inversely with endometrial compaction (S range: 0.3–0.2; p = 0.01) and uterine peristalsis (S range: −0.3–0.1; p &lt; 0.001) and positively with uterus length (S range: 0.2–0.3; p &lt; 0.001) and fibroids. Multivariate linear regression confirmed independent associations (R=.45; p &lt; 0.001). Logistic regression in patients aged ≥45 revealed associations with uterine peristalsis (OR 0.7, 95%CI 0.5–0.9; p = 0.04) and uterus length (OR 1.03; 95%CI 1.01-1.06) but not with endometrial compaction (p = 0.103).

Limitations, reasons for caution
The main limitation of the study is its retrospective nature. Being a study based on daily clinical practice, the group of patients can be heterogeneous, which may have influenced the results. Studies with a homogeneous control group are needed to corroborate our findings.

Wider implications of the findings
Our findings indicate that advanced maternal age affects uterine ultrasound factors, potentially influencing endometrial receptivity in artificial treatments. This may be useful to inform patients of their prognosis and to perform better clinical counseling, as well as to explore different therapeutic strategies in older patients.

Trial registration number
not applicable
O-085 Oocyte cryopreservation: a comprehensive analysis of live birth rate by age and indication of treatment provides reassurance for young cancer patients
Authors: Kirshenbaum M , Wale P , Lantsberg D , Gardner D , Stevens J , Agresta F , Stern K 
Published: July 2024

Abstract

Study question
Does the outcome of oocyte cryopreservation vary across different age groups and treatment indications, i.e. cancer diagnosis, other medical conditions or non medical fertility preservation?

Summary answer
Live birth rate (LBR) is significantly influenced by a woman's age, although not by indication of treatment.

What is known already
OC is increasingly applied in assisted reproduction, although little is about the outcomes, including livebirth according to indication.

Study design, size, duration
Retrospective cohort study analyzing all OC and subsequent warmed oocyte cycles in two fertility centers - Melbourne IVF and the Royal Women’s Hospital, Melbourne, Australia, between the years 2014 to 2022.

Participants/materials, setting, methods
Women undergoing autologous IVF treatment using vitrified and warmed oocytes. Outcome of stimulation cycles and warmed oocyte cycles were assessed according to women’s age at OCP (≤ 35 years, 35-40 years and ≥ 40 years) and treatment indication- cancer diagnosis, other medical conditions and non medical.

Main results and the role of chance
2689 women underwent a total of 3801 cycles of OC, comprising 702 cycles for cancer diagnosis (18.6%), 1146 cycles for other medical (30.5%), and 1953 cycles for non-medical (50.9%). Regardless of indication, younger age groups exhibited a higher median number of mature oocytes: &lt;35 (11, 8-17), 35-40 (9, 6-11), and &gt;40 (6, 3-9) (H(2)=15.1, p &lt; 0.05).
Among 582 warmed oocytes cycles, the &gt;40 group demonstrated lower rate cycles with at least one good-quality blastocyst (76.7%) compared to 35-40 (87.1%) and &lt;35 (87.2%), p &lt; 0.05. Cumulative live birth rates (cLBR) were also lower in the &gt;40 age group (14.9%) compared to 35-40 (34.9%) and &lt;35 (46.5%), p &lt; 0.01.
When analyzing cycles by indication, patients with cancer had lower oocyte survival rate (80.8% vs 84.8% in other medical and 82.1% in non medical, p &lt; 0.01). Nonetheless, no differences in rate of cycles with at least one good quality embryo rates (cancer diagnosis 87.2%, other medical 82.1% and non medical 89.3%, p = 0.06). Patients with cancer diagnosis had higher clinical miscarriage rate (25%) compared with other medical (7%) and non medical (10.5%), p &lt; 0.01. However, cLBR did not differ between the indication groups (29.7% in cancer diagnosis, 35% in other medical and 38.1% in non medical, p = 0.5.

Limitations, reasons for caution
Retrospective data collection.

Wider implications of the findings
Our study offers comprehensive data that may assist patients desiring OC, and provides reassurance that even with a cancer diagnosis, outcomes are as favorable as those having non-medical OC. Given the substantial impact of age, health care providers should, when possible, advise to complete this procedure at a young age.

Trial registration number
Not applicable
P-762 Discovery and quantification of microplastics in human cumulus granulosa cells
Authors: Weina L , Yena H , Liang H , Huan Z , Gang L , Ge L 
Published: July 2024

Abstract

Study question
The impact of microplastics (MPs) on human health has received increasing attention; their accumulation in female reproductive system and possible harms have not been quantified.

Summary answer
This study firstly reveals the contamination of human cumulus granulosa cells and follicular fluid by MPs and the effects of these contaminants on ART outcomes.

What is known already
MPs are ubiquitous in soil, sea, air, fresh water, and other environments. MPs are ingested by humans through the food chain, air and direct contact, resulting in various health problems, such as endocrine disruption, immune disturbance and reproductive toxicity. MPs exposure has been found to have a great impact on females, as MPs may accumulate in the ovaries and reduce the number of follicles, ovarian size, pregnancy rate, embryo production and fertility. To date, one study has found evidence of MPs in human placentas for the first time, but MPs contamination in other human reproductive systems has not been identified.

Study design, size, duration
The inclusion criteria comprised female patients of infertile couples excluding male factors who visited the outpatient department of the Reproductive and Genetic Hospital of CITIC-Xiangya between January 2019 and January 2021.We randomly selected 16 women who met the criteria and assessed their CCs and follicular fluid samples for the presence of MPs.

Participants/materials, setting, methods
In the present study, 16 cumulus granulosa cell samples and 2 follicular fluid samples were collected, and MPs were detected via pyrolysis-gas chromatography/mass spectrometry (Py-GC/MS).

Main results and the role of chance
MPs were detected in both cumulus granulosa cells and follicular fluid, with an average abundance of 313.14±246.69 mg/kg in cumulus granulosa cellsand 12.88±15.54 mg/kg in follicular fluid. Polyethylene terephthalate was the predominant polymer in cumulus granulosa cells. There were no significant differences in the IVF fertilization rates, ICSI fertilization rates, IVF good-quality embryo rates, or ICSI good-quality embryo rates between the high-MP group and low-MP group. However, embryos in the high-MP group exhibited a lower normal cleavage rate than did those in the low-MP group, while the embryos in the high-MP group exhibited a greater proportion of noncleavage than did those in the low-MP group.

Limitations, reasons for caution
It is not clear how long these particles may persist in the human body. The method we used can detect only the concentration of MPs but not the size of MP particles. Moreover, our method cannot be used to quantify smaller-diameter nanoplastics, which are considered to pose greater risks.

Wider implications of the findings
This is the first study in which MPs were identified and characterized in human ovarian granulosa cells, providing reference data for evaluating their toxicity to the human female reproductive system.

Trial registration number
Not applicable
O-100 Chronic endometritis - research and practice
Authors: McQueen D 
Published: July 2024

Abstract
Chronic endometritis is an inflammation of the endometrium characterized by the presence of plasma cells. Plasma cells can be identified on H&E and CD138 immunohistochemical staining by their characteristic appearance. There is a large body of evidence supporting the association between chronic endometritis and recurrent pregnancy loss (RPL), with a prevalence of approximately 30% among women with RPL (McQueen 2021). A limitation of the current literature, however, is heterogeneity of diagnostic criteria utilized and there is no consensus on the exact definition or number of plasma cells required. The treatment of chronic endometritis is oral antibiotic therapy and removal of any associated uterine pathology such as retained pregnancy tissue. Studies show that a single course of antibiotics has a cure rate of 60-94% when endometrial biopsies are repeated following treatment (Johnson 2010, McQueen 2014). Following antibiotic treatment, if resolution of chronic endometritis confirmed, women with RPL have improved live birth rates (Kimura 2019; Pirtea 2021).
P-471 Anxiety, depression, and body image among infertile women with and without polycystic ovary syndrome
Authors: Jannink T 
Published: July 2024

Abstract

Study question
Do women with PCOS undergoing fertility treatment experience higher anxiety and depression symptoms, along with lower body appreciation, compared to those without PCOS?

Summary answer
Having PCOS was not associated with symptoms of anxiety and depression, but was associated with somewhat lower body appreciation.

What is known already
PCOS has been associated with a higher chance to develop mental health problems, like anxiety, and body image concerns. The International Guidelines on PCOS recommend that all women with PCOS should routinely be screened for anxiety and depressive disorders. In most studies in this field, the comparison group included healthy women without fertility problems.

Study design, size, duration
We conducted a cross-sectional survey study between May 2021 and July 2023, using an online questionnaire. We informed women about this study at fertility clinics in the Netherlands through posters and leaflets and on the websites of the Dutch patient organizations Freya and Stichting PCOS.

Participants/materials, setting, methods
This study included women with infertility, with and without PCOS, undergoing fertility treatment. Women completed the Hospital Anxiety and Depression Scale and the Body Appreciation Scale-2. Primary outcomes were clinically relevant symptoms of anxiety and depression (scores&gt;11), and BAS-2 scores. Secondary outcomes were mean anxiety and depression scores, along with scores of 8 and higher. Dichotomous and continuous outcomes were analysed using logistic and linear regression analyses adjusted for age, BMI, and duration of infertility.

Main results and the role of chance
A total of 1025 women currently undergoing infertility treatment participated, of whom 502 (49.0%) had PCOS and 523 (51.0%) had other infertility diagnoses. We found self-reported clinically relevant symptoms of anxiety in 33.1% of women with PCOS and in 31.0% of women with other infertility diagnoses (adjusted OR: 0.99, 95% CI 0.74 – 1.31). Clinically relevant symptoms of depression were reported in 15.5% of women with PCOS versus 14.5% of women with other infertility diagnoses (adjusted OR: 1.04, 95% CI 0.71 – 1.50). Women with PCOS reported slightly less body appreciation (adjusted mean difference: -1.34, 95% CI -2.32 to -0.36).

Limitations, reasons for caution
Results are based on self-report and may have been affected by sampling bias.

Wider implications of the findings
Although guidelines recommend screening women with PCOS, feelings of anxiety and depression can be present in any woman undergoing fertility treatments. We advise fertility clinics to be aware of women’s mental health issues and to offer support accordingly, as a part of routine care.

Trial registration number
not applicable