bluuebunny/crossref_metadata_2025_split huggingface dataset:
Music Therapy in Patients Undergoing Ambulatory Surgery: A Single-Blind Randomized Trial
Authors: Mongelli F , Doria T , la Regina G , Cammalleri C A , Sabbatini F , la Regina D 
Published: May 2024

Abstract

Background
Day surgery procedures constitute an essential part of surgical practices in hospitals worldwide. However, outpatients may experience anxiety, fear, and stress negatively impacting patients' ability to follow the established ambulatory surgery pathway. While medications are generally administered to reduce perioperative stress, there are several measures to avoid their use. Music therapy (MT) can be used as a complementary, drug-free, safe, and cost-effective intervention.

Aims
The purpose of our study was to evaluate the impact of MT on perioperative stress and patient satisfaction in patients undergoing ambulatory surgery.

Methods
We conducted a randomized study in patients undergoing ambulatory surgery. The MT group listened to relaxing music for the whole hospital stay, while the control group received the standard treatment. Both groups were managed in the pre- and postoperative periods according to current clinical practice and ultimately received the Leiden Perioperative care Patient Satisfaction (LPPS) questionnaire before hospital discharge.

Results
During the study period, 33 patients were included, 16 randomized to the MT arm and 17 to the control arm. The average age of the patients was 51.1±16.2 years, and 10 (31.2%) patients were women. The postoperative period was uneventful for almost all patients (95.8%), and we observed a high level of satisfaction. No patient required medication for anxiety treatment in the postoperative period. Pre- and postoperative vital signs were similar in both arms. A slightly higher LPPS score was noted in the MT group (179±8 vs. 171±20 pts, p=0.174).

Conclusion
Despite limitations, our study demonstrated that MT in patients undergoing ambulatory surgery might be advantageous in reducing perioperative stress, potentially increasing satisfaction, and enhancing patients' perception of being cared for in a multidisciplinary manner, without neglecting the emotional aspect.
Frailty Assessment for Risk Stratification in Pancreatic Surgery – Results of a Single-Center Cohort Study
Authors: Frey M , Krombholz E , Patalong S , Wirsching A , Nocito A 
Published: May 2024

Abstract

Background
Large cohort studies found an increase in frailty with age. Age is a known risk factor for pancreatic cancer. Seventy percent of new diagnoses are made in patients aged more than 65 years. Pancreatic resections represent the only hope for cure but are associated with high morbidity. The definition “fit for pancreatic surgery”, currently mainly based on age and comorbidities, is continuously challenged.

Aims
The aim of this study is to analyze the impact of frailty on postoperative outcomes after pancreatic resections.

Methods
Data of consecutive patients undergoing pancreatic resections between January 2015 and July 2022 were retrospectively analyzed. Postoperative complications were graded by the Clavien-Dindo Classification, Comprehensive Complication Index (CCI) and complications specific to pancreatic resections as recommended and published by the International Study Group of Pancreatic Surgery. The modified frailty index (mFI) was defined by 11 variables. An mFI score above 0.27 was set to define frailty.

Results
A pancreatic resection was performed in 159 patients, of which 23 (15%) were classified as frail. Pancreatoduodenectomies were similarly distributed in both groups. Frail patients were older (median of 74 vs. 69 years). Male gender was associated with frailty (83%, p=0.001)., Moreover, frailty was associated with an increased rate of preoperative biliary drainage. Although intensive care stay was increased in the frail group (median 3 vs. 0 days; p=0.01), total length of hospital stay was not affected. Frailty was associated with severe complications as defined by a comprehensive complication index &gt;50 (35% vs. 10%; p=0.003), an increased rate of severe type C pancreatic fistula (13% vs. 2%, p=0.04), and a higher 90-day mortality (13% vs. 2%, p=0.04).

Conclusion
Assessment of frailty should be used for preoperative risk stratification since frailty is associated with a higher morbidity and mortality after pancreatic resections.
The PAncreatic Surgery Composite Endpoint PACE – Development and Validation of a Clinically Relevant Endpoint Requiring Lower Sample Sizes
Authors: Kümmerli C , Nickel F , Müller P C , Schmidt M W , Schmidt L P , Wise P , Klotz R , Tjaden C , Diener M , Probst P , Hackert T , Büchler M W 
Published: May 2024

Abstract

Background
Single endpoints in prospective and randomized studies have become impractical due to their low frequency and the marginal benefit of new interventions.

Aims
To provide a composite endpoint in pancreatic surgery.

Methods
Data from prospective studies were used to develop (n=1273) and validate (n=544) a composite endpoint based on postoperative pancreatic fistula, post-pancreatectomy hemorrhage as well as reoperation and reinterventions. All patients had pancreatectomies of different extents. The association of the developed PAncreatic surgery Composite Endpoint (PACE) with prolonged length of hospital stay (LOS) &gt;75th percentile and mortality were assessed. A single-institution database was used for external validation (n = 2666). Sample size calculations were made for single outcomes and the composite endpoint.

Results
In the internal validation cohort, the PACE demonstrated an AUC of 78.0%, a sensitivity of 90.4% and a specificity of 67.6% in predicting a prolonged LOS. In the external cohort, the AUC was 76.9%, the sensitivity 73.8% and the specificity 80.1%. The 90-day mortality rate was significantly different for patients with a positive versus a negative PACE both in the development and internal validation cohort (5.1% vs 0.9%; P&lt; 0.001), as well as in the external validation cohort (8.5% vs 1.2%, P&lt; 0.001). The PACE enabled sample size reductions of up to 80.5% compared to single outcomes.

Conclusion
The PACE performed well in predicting prolonged hospital stays and can be used as a standardized and clinically relevant endpoint for future prospective trials enabling lower sample sizes and therefore improved feasibility compared to single outcome parameters.
Concomitant Cervical and Anal Screening for Human Papillomavirus (HPV) – Worth the effort or waste of time?
Authors: Espirito Santo I , Kefleyesus A , Pache B , Chilou C , Hübner M , Hahnloser D , Grass F 
Published: May 2024

Abstract

Background
Human papilloma virus (HPV) infection represents the most common sexually transmitted disease and a major risk factor for disease progression to anal cancer.

Aims
This study aimed to analyze the rate of concomitant anal dysplasia in a prospectively surveilled cohort of sexually active women.

Methods
This study represents a follow-up analysis of the AnusGynecology (ANGY) study (doi.org/10.3390/cancers14205096). This prospective, cross-sectional single-center study recruited women for concomitant cervical and anal screening of HPV genotypes and cytology during a single appointment. Cervical / anal smears +/- biopsies if deemed necessary were performed by board-certified specialists during a single outpatient visit. All women with findings of either HPV or any type of dysplastic lesions on anal smears were offered follow-up in a specialized high-resolution anoscopy (HRA) outpatient clinic.

Results
Overall, 275 patients (mean age 42±12) were included. Among them, 102 (37%) had cervical high risk (HR)-HPV. Anal smear cytology was performed in 255 patients (93%), while 19 patients (7%) underwent anal biopsy during the combined visit. In total, HPV was (incidentally) revealed in 91 patients (33%) on anal smears, while any degree of anal dysplasia was found in 30 patients (11%), 6 if which were high-grade squamous intraepithelial lesions (H-SIL). Furthermore, 10 out of 19 biopsies were positive (3 H-SIL lesions).
Only half (48/93, 52%) of women agreed to undergo the recommended specialized follow-up evaluation. Of them, 18 (38%) were diagnosed with dysplastic lesions (9 L-SIL and H-SIL, respectively) on biopsies, while the remaining visits revealed no abnormalities.

Conclusion
The present study revealed a significant number of dysplastic lesions in women willing to undergo specialized proctologic evaluation after abnormal findings on initial screening. Close follow-up of these women is hence strongly recommended.
Snapshot Audit Early Onset Colorectal Cancer (EOCC) – What is the Current Situation in Switzerland?
Authors: Gros H , Taha-Mehlitz S , Erdem-Sanchez S , Klasen J M , Friedrich U , Steinemann D , Huber A K , Gass M , Rodjakovic D , Galli R , Nebiker C , Hartel M , Müller A , Viehl C , Di Pietro Martinelli C , Holzgang M , Happ S , Simon T , Stimpfle D , Zingg U , Teixeira Da Cunha S , Eisner L , Studer P , Worni M , von Strauss Und Torney M 
Published: May 2024

Abstract

Background
Early onset colorectal cancer (EOCC), defined as colorectal cancer (CRC) ≤ 50 years, has seen an alarming rising incidence in western countries.

Aims
This research aims to determine the current state of incidence, symptoms, diagnostic methods, and treatment approach in EOCC compared to late onset CRC (LOCRC) in the extended Northwestern Switzerland.

Methods
Patients seeking care for CRC between April-November 2023 were enrolled in a prospective multicenter (11 hospitals within extended Northwestern Switzerland) observational cohort study. Information was collected using questionnaires and patient charts.

Results
We included 315 patients, thereof 38 (10.8%) EOCC. In total 211 (58.9%) patients were male, mean age was 42.5 and 71.2 years, respectively. Rectal bleeding was the main symptom in both groups (60.5% vs 37.0%), followed by change in bowel habits in EOCC and fatigue in LOCRC without reaching significance. Rectal bleeding and mucous, abdominal pain, change of bowel habits and bloating were significantly more often in EOCC. Significantly more LOCRC patients stated that their physical condition affected sexual erection and social interaction, whereas in EOCC, family life was significantly affected. For both groups, endoscopy was the leading diagnostic tool. EOCC had a diagnostic delay of 6.5 weeks compared to their counterparts. No difference in frequency of neoadjuvant treatment, surgical approach or need for emergency surgery was observed. In EOCC, a trend to more lymph node retrieval was observed and significantly more EOCC received an ostomy. Postoperatively, significantly more EOCC than LOCRC patients received adjuvant chemotherapy (55.6 % vs 28.6 %).

Conclusion
Our analysis illustrates the current standard-of-care of EOCC in the extended Northwestern Switzerland. EOCC compared to LOCRC patients present themselves differently to the medical community, leading to a different approach to their symptoms, which eventually results in a delayed diagnosis. Based on these results, it is time to foster awareness and start redefining national screening criteria.
Analysis of Eligibility of the S1 Corridor for the Trans-Sacral Screw Placement in Geriatric Patients
Authors: Polt M , Zindel-Geisseler C , Sommer C , Stillhard P , Müller D A , Acklin Y P , Michelitsch C 
Published: May 2024

Abstract

Background
Minimal-invasive placement of a trans-sacral screw represents an increasingly popular method of fixation for Fragility Fractures of the Pelvis (FFP), with variable upper sacral anatomy representing the main challenge. Little is known about the variability of sacral anatomy in the geriatric population and the potential effect of osteoporosis on the upper sacral anatomy and thus S1 corridor morphology.

Aims
To examine the eligibility (&gt;12 mm) of the S1 corridor for the trans-sacral screw placement in a geriatric population and to analyse what pelvic dysmorphism signs might serve as predictors for an ineligible S1 corridor.

Methods
We analysed S1 corridor in pelvic CT scans of 107 geriatric patients without history of fracture or other pelvic pathology. First, the eligibility for the trans-sacral screw placement was determined by measuring the width and the height of the central portion of the S1 corridor. Then, pelvises were examined for signs of dysmorphism. The correlation of these signs with the ineligible S1 corridor was analysed.

Results
In our geriatric population with average age of 79,55 ± 8.79 years (male : female 0.88) 44% of S1 corridors were not eligible for a trans-sacral screw. In this ineligible group the height was shown to be a more significant limiting dimension (90,9%), compared to the width in 68,2% (p&lt;0.05). Mamillary processes, not recessed sacrum and dysmorphic sacral foramina were present in 38,3%, 34,6%, and 26,2% respectively, with not recessed sacrum demonstrating a significant correlation with a too narrow S1 corridor (p&lt;0.05).

Conclusion
The analysed geriatric population demonstrates a high prevalence of a too narrow S1 corridor, which makes a placement of a trans-sacral screw risky or even impossible. The height of the S1 corridor represents the main limiting factor with a dysmorphism sign of a not recessed sacrum being a significant predictor for the ineligible S1 corridor.
Cement Augmentation for Proximal Humerus Fractures: A Meta-Analysis of Randomized Trials and Observational Studies
Authors: Lecoultre Y , Beeres F , van de Wall B , Link B C , Tillmann F , Pretz F , Babst R 
Published: May 2024

Abstract

Background
It is unclear if elderly patients treated with plate osteosynthesis for proximal humerus fractures benefit from cement augmentation.

Aims
This meta-analysis aims to compare cement augmentation to no augmentation regarding healing, complications, and functional results.

Methods
PubMed, Embase and Cochrane Central Register of Controlled Trials were searched for randomized clinical trials and observational studies. Effect estimates were pooled across studies using random effects models. The primary outcome is overall complication rate. Stratified analyses were performed for types of complication (implant related or systemic). Secondary outcomes include re-interventions, hospital stay, operation time, functional scores, and general quality of life.

Results
Five observational studies and one randomized controlled trial with a total of 541 patients were included. The overall complication rate was significantly lower in the augmented group (15.6% versus 25.4%, OR 0.54 (95%CI 0.33–0.87)). This was caused by a reduction of implant related complications (10.4% vs 19.9%, OR 0.49 (95%CI 0.28, 0.88)). No difference in humeral head necrosis was found. Data on re-intervention, hospital stay, and operation time was limited but did not show significant differences. No impact on functional scores and general quality of life was detected.

Conclusion
This meta-analysis shows that cement augmentation may reduce overall complications, mainly by preventing implant related complications. No difference was detected regarding need for reintervention, functional scores, general quality of life and hospital stay. This is the first meta-analysis on this topic. It remains to be seen whether conclusions will hold when more and better-quality data becomes available.
Bridging Stent-Graft Implantation in the Renal Artery During Complex Endovascular Aortic Procedures does not alter the Renal Sonographic Resistance Index
Authors: Reitnauer D , Stadlbauer T H W , Zimmermann A 
Published: May 2024

Abstract

Background
Ultrasound examination of the resistance index (RI) of both kidneys can provide evidence of renal artery stenosis. The extent to which the RI is changed after bridging stent-graft implantation due to altered flow characteristics is not known.

Aims
The aim of the study was to investigate the influence of renal bridging stent-grafts on the RI of the kidneys after fenestrated endovascular aortic repair (FEVAR).

Methods
Ultrasound examinations of the kidneys were conducted using a GE LOGIQ S7 XDclear ultrasound system (GE Medical Systems AG, Glattburg, Switzerland). The evaluation was performed according to SGUM 2D standard criteria. The RI was determined in all consecutive patients on the day before and after renal bridging stent-graft implantation. For this purpose, the kidneys were divided into 3 areas according to the standard protocol and 2 RI values were recorded per area by evaluating intrarenal arterial Doppler signals. Mean values were calculated and compared for each kidney.

Results
For 64 kidneys in 32 consecutive patients (73.9±7.8 years, 4 female, 28 male) treated with FEVAR and renal bridging stent–graft implantation pre- and postinterventional examinations were carried out. Sono-morphologically, the kidneys examined were inconspicuous (pre: size at least 107.1x52.4 mm, parenchymal margin 18.3 mm versus post: size at least 107.9x52.9 mm, parenchymal margin 18.6 mm, p&gt;0.4). The arborization of the renal perfusion was preserved pre and post implantation. The RI did not differ before and after implantation (0.66±0.06 versus 0.67±0.07; p=0.10). None of the patients experienced severe impairment of renal function.

Conclusion
After successful implantation of a bridging stent-graft in a non-stenosed renal artery, there is no relevant change in the RI of the kidney. The RI seems therefore to be suitable for assessing renal perfusion after complex endovascular aortic therapy.
Perioperative and Mid-Term Outcomes of Bovine Xenografts in Infected Aortic/Iliac Surgery
Authors: Celi de la Torre J A , Hakimi M 
Published: May 2024

Abstract

Background
Various methods of open-surgical treatment of infected aortic and iliac pathologies are available. The use of surgeon-made bovine pericardium grafts in infected aortic/iliac context has been associated with a low re-infection rate as well as high feasibility. Prefabricated (factory pre-sewn) bovine pericardium prostheses have been available for a few years. Studies reporting clinical results are rare.

Aims
Present the perioperative and mid-term outcomes of a bifurcated and straight bovine pericardium prostheses (BioModiVasc®) in infected aortic and iliac pathologies.

Methods
Retrospective database analysis of all vascular surgery operations between 2021 and 2023 at our centre.

Results
28 BioModiVasc® grafts were implanted in 27 patients due to INAA (40,7%), VGEI (51,9%), trauma (3,7%) or Leriche-Syndrome (3,7%). Patients were predominantly male (85,2%) and often presented arterial hypertension (88,9%). Significant risk factors were infection in a remote site (29,6%), emergency/urgent operations in the past 12 months (22,2%) and previous vascular procedures (44,4%). Elevated CRP (88,9%) and soreness at site (81,5%) were the most common findings at presentation. CT-scan showed infection-typical findings in 96,3%. Pathogen was isolated in 77,8% of the cases. Median operation time was 300 minutes. 88,9% of the operations were emergency/urgent ones. 96,3% of the reconstructions were orthotopic, access was mostly transperitoneal (59,3%). Median hospital/ICU days were 19 and 2 respectively. Infection a/o operation-associated 30-day mortality was 11,1%. 3-deaths occurred at follow-up (median 12 months), non-infection a/o operation related. 1 patient required a re-do due to a duodenal erosion caused by the prosthetic anastomosis.

Conclusion
Open surgical treatment of aortic/iliac septic pathologies with the BioModiVasc® prosthesis yields good results, which are similar to the reported results of the use of surgeon-made bovine pericardial reconstructions.
Italian Association of Hospital Cardiologists position paper—obesity in adults: a clinical primer
Authors: Di Fusco Stefania Angela , Mocini Edoardo , Gori Mauro , Iacoviello Massimo , Bilato Claudio , Corda Marco , De Luca Leonardo , Di Marco Massimo , Geraci Giovanna , Iacovoni Attilio , Milli Massimo , Navazio Alessandro , Pascale Vittorio , Riccio Carmine , Scicchitano Pietro , Tizzani Emanuele , Gabrielli Domenico , Grimaldi Massimo , Colivicchi Furio , Oliva Fabrizio 
Published: May 2024

Abstract
Obesity is a chronic and relapsing disease characterized by the interaction between individual predispositions and an obesogenic environment. Recent advances in understanding the mechanisms of energetic homoeostasis paved the way to more effective therapeutic approaches compared with traditional treatments. Since obesity is a complex disease, it necessitates a multi-disciplinary approach whose implementation remains challenging. Nonetheless, emerging pharmacological interventions appear promising. Currently, therapeutic success is discreet in the short term but often fails to maintain long-term weight loss due to a high likelihood of weight regain. Cardiologists play a key role in managing patients with obesity, yet often lack familiarity with its comprehensive management. The aim of this document is to summarize knowledge to consolidate essential knowledge for clinicians to effectively treat patients living with obesity. The paper emphasizes the pivotal role of a strong patient–clinician relationship in navigating successful treatment. We analyse the criteria commonly used to diagnose obesity and point out the strengths and limitations of different criteria. Furthermore, we discuss the role of obesiologists and the contributions of cardiologists. In addition, we detail key components of effective therapeutic strategies, including educational aspects and pharmacological options.
Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO) scientific statement on the simplification of the drug regimen for secondary cardiovascular prevention
Authors: De Luca Leonardo , Di Fusco Stefania Angela , Iannopollo Gianmarco , Mistrulli Raffaella , Rizzello Vittoria , Aimo Alberto , Navazio Alessandro , Bilato Claudio , Corda Marco , Di Marco Massimo , Geraci Giovanna , Iacovoni Attilio , Milli Massimo , Pascale Vittorio , Riccio Carmine , Scicchitano Pietro , Tizzani Emanuele , Gabrielli Domenico , Grimaldi Massimo , Colivicchi Furio , Oliva Fabrizio 
Published: May 2024

Abstract
The issue of suboptimal drug regimen adherence in secondary cardiovascular prevention presents a significant barrier to improving patient outcomes. To address this, the utilization of drug combinations, specifically single pill combinations (SPCs) and polypills, was proposed as a strategy to simplify treatment regimens. This approach aims to enhance treatment accessibility, affordability, and adherence, thereby reducing healthcare costs and improving patient health. The document is an Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO) scientific statement on simplifying drug regimens for secondary cardiovascular prevention. It discusses the underuse of treatments despite available, effective, and accessible options, highlighting a significant gap in secondary prevention across different socio-economic statuses and countries. The statement explores barriers to implementing evidence-based treatments, including patient, healthcare provider, and system-related challenges. The paper also reviews international guidelines, the role of SPCs and polypills in clinical practice, and their economic impact, advocating for their use in secondary prevention to improve patient outcomes and adherence.