bluuebunny/crossref_metadata_2025_split huggingface dataset:
Die neue Struktur und Konzeption der ICD-11 im Bereich psychischer Störungen
Authors: Husemann Ronja , Wiegand Hauke F. , Hölzel Lars P. 
Published: April 2024

ZUSAMMENFASSUNGDie Diagnostik psychischer Störungen ist komplex und umfangreich. Die ICD (International Statistical Classification of Diseases and Related Health Problems) erlaubte bislang nicht, wichtige Informationen bzgl. Verlauf (z. B. Chronische Depression) oder Symptomatik (z. B. Angstsymptome bei affektiven Episoden) zu kodieren. Auch erschwerte die bisherige Codestruktur das Hinzufügen weiterer, neuer Störungsbilder. Häufig gibt es keine Unterscheidung des Schweregrades, und wenn doch, beruht diese Einstufung auf der Anzahl der erfüllten Symptome und nicht den Funktionseinschränkungen, die sich als Folge der Symptomatik für den Betroffenen ergeben. Aus diesen Gründen wurde die ICD grundlegend in Struktur und Konzept überarbeitet.Der vorliegende Artikel beschreibt und diskutiert die wichtigsten Anpassungen. Dazu gehören die Umsetzung der ICD-11 als Onlineversion, die Gruppierung von Störungsbildern auf Basis gemeinsamer Ätiologie, Pathophysiologie und Phänomenologie, die Anpassung und Erweiterung der Anwendung von Diagnosecodes, der verstärkte Einbezug dimensionaler Phänomene innerhalb des kategorialen Systems und die Reduktion der diagnostischen Kriterien auf die wesentlichen Merkmale. Diese Änderungen sollen im Rahmen der Steigerung der Nutzerfreundlichkeit und stärkeren Individualisierung in der Beschreibung von klinischen Phänomenen unter Einbezug wissenschaftlicher Evidenz eine möglichst flächendeckende Anwendung des Klassifikationssystems gewährleisten und so die internationale Vergleichbarkeit verbessern.
Is Appendectomy During Late Stages of Pregnancy Associated with an Increased Cesarean Delivery Rate? – a Retrospective Analysis of One Center During 10 Years
Authors: Kummer Julia , Koenigbauer Josefine , Peters Falko Stephan Joachim , Rickert Christian , Hellmeyer Lars 
Published: April 2024

AbstractAbout one in 500 pregnant women requires a surgical intervention that is not pregnancy-related. One of the most common surgical interventions during pregnancy is appendectomy. The primary aim of this study was to assess surgical access of appendectomy during pregnancy and pregnancy outcome. Secondary outcomes were clinical symptoms and diagnostics as well as histopathological analysis.This is a single-center retrospective data analysis conducted at a tertiary perinatal center. A digital search of the hospital record archive was conducted focusing on pregnant women beyond 24 0/7 weeks of pregnancy encoding appendectomy. Descriptive statistical analysis was performed.Between January 2013 and January 2023, a total of 20 appendectomies were performed during pregnancy with gestational age beyond 24 0/7 weeks of pregnancy. All of them were performed as lower midline laparotomy. The rate of appendix perforation was 3/20 (15.0%). 19/20 patients (95.0%) delivered via cesarean. In 7/20 patients (35.0%) appendectomy was performed during cesarean delivery due to incidental finding of irritated or abnormal vermiform appendix. In the pathological work-up, only 2/7 (28.6%) of these subjects had inflammation.In this small monocentric cohort, only open appendectomies were performed. Our data indicate that it is safe to perform open appendectomy during pregnancy if necessary. In this small patient group, there was an increase in simultaneous cesarean deliveries.
Komplementärmedizinische Basisgenetik: der
Histaminabbau
Authors: Kramer Michael , Welt Thomas , Fux Vilmos 
Published: April 2024

ZusammenfassungHistamin wirkt in der Peripherie als Gewebshormon und im zentralen Nervensystem
(ZNS) als Neurotransmitter. Eine verstärkte Histaminwirkung manifestiert sich
als Histaminintoleranz mit Symptomen wie Urtikaria, Magen-Darm-Problemen und
Asthma. Im ZNS kann sie zu Schlafstörungen, Hyperaktivität und Neigung zu
psychischen Erkrankungen führen. In der vorliegenden Arbeit wird die Rolle
genetischer Varianten der histaminabbauenden Enzyme behandelt, die einen
Einfluss auf die Funktion von Histamin haben. Histamin wird in der Peripherie
extrazellulär durch das Enzym Diaminoxidase (DAO) abgebaut, und intrazellulär
durch Histamin-N-Methyl-Transferase (HNMT) und Monoaminoxidase-B (MAO-B). Im ZNS
dagegen fungieren nur die intrazellulären Abbauenzyme HNMT und die MAO-B.
Genetische Varianten dieser Enzyme mit verminderter Funktion prädisponieren zur
verstärkten Wirkung des Histamins.
A 10-Year Study of the Trend of Accidental Falls in the Elderly in a Japanese Hospital
Authors: Takekawa Toru , Obuchi Kei , Watanabe Shu , Yamada Naoki , Abo Masahiro 
Published: April 2024

AbstractElderly people are prone to falls. We established the Falls Prevention Working Group
(FPWG) at our hospital in 2015 to reduce the number of falls during hospitalization. This
study compared the trend of in-hospital falls in the elderly in two time periods (2008/9 and
2018/9) and determined the effects of FPWG-implemented measures. Using medical records, we
counted the monthly number of falls suffered by patients during hospitalization in April
2008-March 2009 and April 2018-March 2019. We also categorized the falls according to the
severity of fall-related complications.A total of 3609 hospital falls were recorded during the 2008–2019 period (2008/9:
n = 433, 2018/9: n = 324). Falls were more common in patients aged 70–79 in 2008/9 but were
noted in those aged ≥ 80 in 2018/9. The mean number of falls/month (27.3 ± 6.4, range:
12–45) was stable throughout the year. The incidence of falls in 2018/9 (1.90/1000 per
persons per day) was significantly lower than in 2008/9 (2.30/1000, p = 0.006). Level ≥ 3b
accidents, reflecting serious accidents with complications, were encountered in 12 of 433
accidents in 2008/9 compared with significantly fewer accidents (2 of the same severity
among 324 accidents) in 2018/9 (p = 0.030).Our results showed a decrease in in-hospital falls in 2018/9 and that the sufferers were
older relative to 10 years earlier. A multidisciplinary team should recommend measures to
prevent falls and an environment “resilient” to falls, and encourage patients to be aware of
possible falls.
ERAS-Implementierung in der Thoraxchirurgie
Authors: Neudecker Jens , Andreas Marco Nicolas , Lask Aina , Strauchmann Julia , Elsner Aron , Rückert Jens-Carsten , Dziodzio Tomasz 
Published: April 2024

ZusammenfassungDieses Manuskript gibt einen Überblick über die Prinzipien und Voraussetzungen zur Implementierung eines ERAS-Programms in der Thoraxchirurgie.Basierend auf den ERAS-Guidelines für Thorachirurgie der ERAS Society wird das ERAS-Programm mit seinen einzelnen Maßnahmen bei elektiven Lungenoperationen dargestellt. Mit besonderem Augenmerk auf das postoperative Outcome werden die klinischen Maßnahmen anhand einer aktuellen Literaturübersicht beschrieben. Das ERAS-Programm zum optimierten perioperativen Management für elektive lungenresezierende Eingriffe besteht derzeit aus 45 Maßnahmen, die sich auf 4 perioperative Phasen verteilen. Diese Maßnahmen umfassen von der Zeit vor der Krankenhausaufnahme (Patientenaufklärung, Screening und Behandlung möglicher Risikofaktoren wie Anämie, Mangelernährung, Beendigung des Nikotin- oder Alkoholmissbrauchs, Prähabilitation, Kohlenhydratbelastung) über die unmittelbare präoperative Phase (verkürzte Nüchternheitsphase, nicht sedative Prämedikation, Prophylaxe von PONV und thromboembolischen Komplikationen), die intraoperativen Maßnahmen (Antibiotikaprophylaxe, standardisierte
Anästhesie, Normothermie, zielgerichtete Flüssigkeitstherapie, minimalinvasive Chirurgie, Vermeidung von Kathetern und Sonden) und die postoperativen Maßnahmen (frühzeitige Mobilisierung, frühzeitige Ernährung, Entfernung eines Blasenkatheters, Hyperglykämiekontrolle). Die meisten dieser Maßnahmen beruhen auf wissenschaftlichen Studien mit hohem Evidenzlevel und führen zu einer Reduktion postoperativer allgemeiner Komplikationen.Das ERAS-Programm ist ein optimiertes perioperatives Behandlungsverfahren und kann die postoperative Genesung von Patienten bei elektiven Lungenresektionen durch eine Verringerung der allgemeinen Komplikationsrate und der Gesamtmorbidität verbessern.
Phytotherapeutische Empfehlungen in medizinischen Leitlinien zur Behandlung gastroenterologischer Erkrankungen – ein systematischer Überblick
Authors: Utz Sandra , Bittel Miriam , Langhorst Jost 
Published: April 2024

ZusammenfassungPhytotherapeutika gewinnen zunehmend an Einfluss bei der Behandlung von gastroenterologischen Erkrankungen. Ihre Beliebtheit und wachsende Wirksamkeitsevidenz führen dazu, dass sie vermehrt in medizinische Leitlinien integriert werden. Ein systematisches Screening identifizierte empfohlene phytotherapeutische Ansätze. Entsprechend der aktuellen wissenschaftlichen Datenlage werden einige Empfehlungen für die Anwendung von Phytotherapeutika ausgesprochen. Bei Reizdarmsyndrom wird vor allem bei Schmerzen und Blähungen der Einsatz von Pfefferminzöl „stark empfohlen“. Weitere Phytotherapeutika wie beispielsweise STW-5, tibetanisches Padma Lax oder warme Kümmelölauflagen haben sich wirksam zur Symptomlinderung erwiesen. Es wird „empfohlen“, sie ins Behandlungskonzept zu integrieren. Bei Chronischer Obstipation werden 30g Ballaststoffe am Tag empfohlen. Die beste Datenlage existiert dabei zu Flohsamenschalen mit moderater Evidenz und für Chicorée-Inulin. Bei Colitis ulcerosa können Flohsamenschalen und die Kombination von Myrrhe, Kamillenblütenextrakt und Kaffeekohle komplementär in der remissionserhaltenden Behandlung eingesetzt werden. Ebenfalls eine „offene Empfehlung“ gibt es für Curcumin (Curcuma longa radix) sowohl für die Remissionsinduktion als auch -erhaltung. Einige Phytotherapeutika (z.B. Wermut [Artemisia absintium herba], Weihrauch [Boswellia serrata resina]) zeigen Wirksamkeitshinweise zur Behandlung von Morbus Crohn, jedoch ist die Datenlage noch nicht ausreichend für Empfehlungen. Cannabisbasierte Arzneimittel können nach nicht ausreichender Wirksamkeit oder Kontraindikation der empfohlenen Standardtherapie bei abdominellen Schmerzen und bei klinisch relevantem Appetitverlust erwogen werden, sollte jedoch nicht zur Therapie der akuten Entzündung bei aktivem Morbus Crohn eingesetzt werden. Weitere Empfehlungen für andere gastroenterologische Erkrankungen werden diskutiert. Die Sicherheit und Verträglichkeit der Phytotherapeutika wurden als überwiegend “sehr gut“ bis „tolerabel“ eingestuft. Einige klare Empfehlungen für den Einsatz von Phytotherapeutika zur Behandlung gastroenterologischer Erkrankungen zeigen das große Wirkpotenzial. Phytotherapeutika können aufgrund ihres großen Wirkspektrums bei komplexen Regulationsstörungen sehr gut komplementär zu herkömmlichen Medikamenten eingesetzt werden. Dennoch sind weitere methodisch gut durchgeführte Wirkungsstudien für weitere Empfehlungen erforderlich.
Association Between Liver Fibrosis Score and Diabetic Kidney Disease:
A Retrospective Cross-Sectional Study of Hospitalized Patients
Authors: Chen Shen , Zhang Jie , Tian Zhendong , Cao Jiarui , Jiao Yijie , Wang Bangqi , Feng Shenghui , Luo Zhanpeng , Zhang Qingfang , Deng Yuanyuan , Cai Wei , Xu Jixiong 
Published: April 2024

Abstract
Objectives To investigate the association between liver fibrosis score and
diabetic kidney disease (DKD) in type 2 diabetes mellitus (T2DM).
Methods A total of 897 hospitalized patients with T2DM were included in
this study. Each patient completed DKD screening. Logistic regression analysis
was used to assess the predictive value of non-alcoholic fatty liver disease
fibrosis score (NAFLD-FS) and fibrosis-4 (FIB-4) for the occurrence of DKD and
risk for DKD progression, respectively.
Results The prevalence of DKD and risk for its progression significantly
increased with increasing NAFLD-FS risk category. DKD prevalence also increased
with increasing FIB-4 risk category. Multivariate logistic regression analysis
showed that the “high-risk” NAFLD-FS had a significantly higher risk of DKD
(odds ratio [OR]: 1.89, 95% confidence interval [CI]: 1.16–3.08) and risk for
DKD progression (OR: 2.88, 95% CI: 1.23–6.78), and the “intermediate-risk” FIB-4
had a significantly higher risk of DKD (OR: 1.41, 95% CI: 1.00–1.98). Subgroup
analysis showed that the association between NAFLD-FS and FIB-4 and DKD was
significant in the female subgroup, whereas the association between the
“high-risk” NAFLD-FS and risk for DKD progression was significant in the male
subgroup.
Conclusions NAFLD-FS and FIB-4 are strongly associated with DKD and risk
for DKD progression in patients with T2DM. Additionally, sexual dimorphism
exists in this association.
Entwicklung der endoskopischen Enukleation der Prostata
Authors: Gross Andreas J. , Rosenbaum Clemens , Becker Benedikt , Netsch Christopher 
Published: April 2024

ZusammenfassungDer Artikel befasst sich mit Lasern von deren Erstbeschreibung bis hin zu den modernsten Anwendungen im Bereich der Behandlung der gutartigen Prostatavergrößerung.
Apaydin Classification of Spreader Flaps Updated
Authors: Capelleras Marta , Saghir Meshari , Apaydin Fazil 
Published: April 2024

AbstractThe use of spreader flaps (SFs) is very helpful in middle vault reconstruction. The aim of the study was to evaluate the versatility of Apaydin classification of SFs on a patient population. This was a retrospective analysis which included 120 rhinoplasty cases. Thorough preoperative planning adhering to precision profileplasty principles was conducted for all patients. The study employed six primary variants of SFs. SFs' types were utilized as follows: type 1 in 41 patients (34.2%), type 2 in 2 patients (1.7%), type 3A in 38 patients (31.7%), types 3B and 3D in 10 cases each (8.3%), type 3C in 2 cases (1.7%), type 4 in 5 cases (4.2%), type 5 in 7 cases (5.8%), and type 6 in 5 cases (4.2%). This study highlights that different SF techniques should be tailored according to the need of the patient when dealing with middle vault reconstruction during reduction rhinoplasty.
Volumizing Threads (Jamber) in the Midface and Managing Side Effects: Clinical Cases
Authors: Yi Kyu-Ho , Park Soo-Yeon 
Published: April 2024

AbstractThe clinical application of polydioxanone (PDO) threads, traditionally utilized for tissue lifting, is now being explored for its volumizing effects in midface rejuvenation. The novel approach involves employing PDO volumizing threads to achieve physical augmentation akin to a “solid filler.” The study introduces a more convenient insertion method for these threads, prioritizing ease and efficacy. Clinical cases demonstrate the efficacy of volumizing threads in addressing midface concerns, such as nasolabial folds and midcheek grooves. Additionally, the integration of volumizing threads to provide support in sagging areas is examined for achieving natural-looking enhancements. While highlighting positive outcomes, potential side effects like thread protrusion are addressed, along with strategies for their mitigation. Volumizing threads are presented as a suitable procedure for patients wary of traditional fillers or seeking subtle enhancements, with the recommendation of combining them with cog threads for those desiring more pronounced changes in facial contour. In summary, volumizing thread offers a minimally invasive alternative with fewer side effects for midface rejuvenation.
Prenatal Diagnosis of Renal Rhabdoid Tumor: A Rare Malignant Neoplasm
Authors: Berwal Vidhika , Krishnan Vivek , Eapen Malini , Chandraprabha Vidya , Elayedatt Rinshi Abid 
Published: April 2024

AbstractRhabdoid tumors of the kidney are highly lethal malignancies of infancy. We report the prenatal detection of this renal tumor in a fetus in the third trimester of pregnancy. Ultrasonologically, the tumor appeared as a large mass in the left renal area associated with severe polyhydramnios. Though the sonographic features alone did not allow distinction from a benign lesion, tumor extension into the subcutaneous plane favored the possibility of a malignant renal tumor and this was confirmed postnatally on histopathology.
A Provider-Facing Decision Support Tool for Prostate Cancer Screening in Primary Care: A Pilot Study
Authors: Carlsson Sigrid V. , Preston Mark A. , Vickers Andrew , Malhotra Deepak , Ehdaie Behfar , Healey Michael J. , Kibel Adam S. 
Published: April 2024

Abstract
Objectives Our objective was to pilot test an electronic health record-embedded decision support tool to facilitate prostate-specific antigen (PSA) screening discussions in the primary care setting.
Methods We pilot-tested a novel decision support tool that was used by 10 primary care physicians (PCPs) for 6 months, followed by a survey. The tool comprised (1) a risk-stratified algorithm, (2) a tool for facilitating shared decision-making (Simple Schema), (3) three best practice advisories (BPAs: <45, 45–75, and >75 years), and (4) a health maintenance module for scheduling automated reminders about PSA rescreening.
Results All PCPs found the tool feasible, acceptable, and clear to use. Eight out of ten PCPs reported that the tool made PSA screening conversations somewhat or much easier. Before using the tool, 70% of PCPs felt confident in their ability to discuss PSA screening with their patient, and this improved to 100% after the tool was used by PCPs for 6 months. PCPs found the BPAs for eligible (45–75 years) and older men (>75 years) more useful than the BPA for younger men (<45 years). Among the 10 PCPs, 60% found the Simple Schema to be very useful, and 50% found the health maintenance module to be extremely or very useful. Most PCPs reported the components of the tool to be at least somewhat useful, with 10% finding them to be very burdensome.
Conclusion We demonstrated the feasibility and acceptability of the tool, which is notable given the marked low acceptance of existing tools. All PCPs reported that they would consider continuing to use the tool in their clinic and were likely or very likely to recommend the tool to a colleague.
Provider Perceptions of an Electronic Health Record Prostate Cancer Screening Tool
Authors: Carlsson Sigrid V. , Preston Mark , Vickers Andrew , Malhotra Deepak , Ehdaie Behfar , Healey Michael , Kibel Adam S. 
Published: April 2024

Abstract
Objectives We conducted a focus group to assess the attitudes of primary care physicians (PCPs) toward prostate-specific antigen (PSA)-screening algorithms, perceptions of using decision support tools, and features that would make such tools feasible to implement.
Methods A multidisciplinary team (primary care, urology, behavioral sciences, bioinformatics) developed the decision support tool that was presented to a focus group of 10 PCPs who also filled out a survey. Notes and audio-recorded transcripts were analyzed using Thematic Content Analysis.
Results The survey showed that PCPs followed different guidelines. In total, 7/10 PCPs agreed that engaging in shared decision-making about PSA screening was burdensome. The majority (9/10) had never used a decision aid for PSA screening. Although 70% of PCPs felt confident about their ability to discuss PSA screening, 90% still felt a need for a provider-facing platform to assist in these discussions. Three major themes emerged: (1) confirmatory reactions regarding the importance, innovation, and unmet need for a decision support tool embedded in the electronic health record; (2) issues around implementation and application of the tool in clinic workflow and PCPs' own clinical bias; and (3) attitudes/reflections regarding discrepant recommendations from various guideline groups that cause confusion.
Conclusion There was overwhelmingly positive support for the need for a provider-facing decision support tool to assist with PSA-screening decisions in the primary care setting. PCPs appreciated that the tool would allow flexibility for clinical judgment and documentation of shared decision-making. Incorporation of suggestions from this focus group into a second version of the tool will be used in subsequent pilot testing.
12th Al Ain Symposium on Challenges in Diabetes and Endocrinology during Ramadan (Virtual Meeting), February 16 to 17, 2024
Authors: Kaabi Juma Al , Afandi Bachar 
Published: April 2024

AbstractThe 12th Al Ain Annual Meeting on Diabetes and Endocrine Challenges during Ramadan Fasting brings together health care professionals, researchers, and experts to address the complex interaction between diabetes management and religious fasting. The program aims to enhance understanding, share best practices, and explore innovative strategies for optimizing patient care during Ramadan fasting through engaging presentations, symposia, and discussions.
Association between Serum Lactate Dehydrogenase Level and 30-day Mortality in Patients with Intracranial Hemorrhage with Acute Leukemia in the Induction Phase: A Cohort Study
Authors: Zhang Jia-Yuan , Yan Zhang-Song , Sun Xiu-Juan , Liu Yong-Ze , Yin Yan-Ke , Su Ming-Huan , Li Qiu-Ling , Mi Ying-Chang , Li Da-Peng 
Published: April 2024

Abstract
Objectives This study aimed to identify the association between lactate dehydrogenase (LDH) levels and 30-day mortality in patients with intracranial hemorrhage (ICH) with acute leukemia during the induction phase.
Methods This cohort study included patients with acute leukemia with ICH during induction. We evaluated serum LDH levels upon admission. Multivariable Cox regression analyzed the LDH 30-day mortality association. Interaction and stratified analyses based on factors like age, sex, albumin, white blood cell count, hemoglobin level, and platelet count were conducted.
Results We selected 91 patients diagnosed with acute leukemia and ICH. The overall 30-day mortality rate was 61.5%, with 56 of the 91 patients succumbing. Among those with LDH levels ≥ 570 U/L, the mortality rate was 74.4% (32 out of 43), which was higher than the 50% mortality rate of the LDH < 570 U/L group (24 out of 48) (p = 0.017). In our multivariate regression models, the hazard ratios and their corresponding 95% confidence intervals for Log2 and twice the upper limit of normal LDH were 1.27 (1.01, 1.58) and 2.2 (1.05, 4.58), respectively. Interaction analysis revealed no significant interactive effect on the relationship between LDH levels and 30-day mortality.
Conclusions Serum LDH level was associated with 30-day mortality, especially in patients with LDH ≥ 570 U/L.