bluuebunny/crossref_metadata_2025_split huggingface dataset:
Analysis of 5-year hospitalization data of patients with systemic lupus erythematosus: Damage is a risk factor for frequent and longer stays
Authors: Çetin Çiğdem , Can Melodi Gizem , Öztaşkın Sinem , Yalçınkaya Yasemin , Gül Ahmet , İnanç Murat , Artım Esen Bahar 
Published: January 2024

Objective The annual hospitalization rate of patients with systemic lupus erythematosus (SLE) is approximately 10%, and hospitalizations are responsible for most of the healthcare expenses. Herein, we analyzed 5-year hospitalization data of SLE patients and determined factors leading to hospitalization. Methods Clinical, laboratory, and hospitalization data of SLE patients admitted to our rheumatology clinic in 2015–2020 were retrieved from our SLE database and analyzed. SLICC SLE damage index (SDI) and disease activity at admission (SLEDAI-2K) were determined. Results Among 161 hospitalized patients, 86% were females. Total rheumatologic hospitalization number was 298, and 38% of the patients were hospitalized more than once (1.85 ± 1.56). The mean hospitalization duration covering all stays for each patient was 25 ± 26.5 days. Active disease, infection, and damage-related complications were first three causes of hospitalization. Compared to patients hospitalized for active disease or damage, patients hospitalized for infection had a significantly higher number of readmissions ( p < .05) and their total hospital stay was longer ( p < .01). The frequency of patients with damage and the mean SDI score was significantly lower in the active disease group (68%, 1.93 ± 2.05) than hospitalizations for infection (90%, 2.68 ± 1.63) and damage-related causes (96%, 3.04 ± 1.65) ( p < .05). The mean SDI score and duration (r = 0.551, p < .001) and the number of hospitalizations (r = 0.393, p < .001) were positively correlated. The mean disease activity scores of patients hospitalized for active disease, infection, and damage-related reasons were 11.03 ± 6.08, 3.21 ± 2.80, and 2.96 ± 3.32, respectively ( p < .001). Renal active disease was the most common (44%), followed by hematological (34.8%), articular (21.7%), and mucocutaneous (21%) activity. Ten percent of the patients all of whom had damage were admitted to intensive care unit (ICU). Total hospitalization duration, mean SDI, antiphospholipid syndrome, lupus anticoagulant, thrombocytopenia, serositis, pulmonary hypertension, history of alveolar hemorrhage, and cardiac valve involvement were associated with ICU admission ( p < .05 for all). Conclusion Disease activity, infections, and damage are the leading causes of hospitalization in SLE patients. Damage prolongs hospital stay and increases hospitalization rate and ICU need. Tight control of disease activity with rational use of immunosuppressive treatment is important to reduce damage and hospitalizations.
Peritoneal Dialysis in Micro-preemie With NEC Using Pigtail Catheter: Case Report and Literature Review
Authors: Ramya Gurujala Mahadeva , Balakrishnan Umamaheswari , Shaik Shafi Jan Mohammad , Amboiram Prakash , Tangirala Susmitha 
Published: January 2024

Background Acute kidney injury (AKI) is a commonly encountered condition in the neonatal intensive care unit (NICU), especially among micro-preemies. Management of AKI is challenging in these micro-preemies and peritoneal dialysis (PD) is the preferred modality when medical treatment fails. Case A 27-week-old female baby with a birth weight of 940 grams was delivered via emergency cesarean section for grade 2 abruption. She developed AKI secondary to necrotizing enterocolitis. PD was initiated on day 19 with a neonatal pigtail catheter and discontinued 24 hours after normalization of kidney function tests with adequate urine output on day 20. However, the patient died due to complications of short bowel syndrome. Conclusion This is the first case report of a micro-premie on whom PD was performed sucessfully using a pigtail catheter. PD is a safe, effective, feasible, and life-saving therapy in micro-preemies with AKI and necrotizing enterocolitis.
Improving Early Initiation of Skin-to-Skin Contact Among Newborns Delivered Vaginally at a Tertiary Care Hospital: A Quality Improvement Study
Authors: Sinha Anish , Pujara Reshma , Patel Shradha , Patel Dipen , Nimbalkar Somashekhar 
Published: January 2024

Introduction WHO and UNICEF recommend initiating early skin-to-skin contact (SSC) of newborns as an important intervention to reduce neonatal mortality. In India, it has been reported that only 15% of babies receive early SSC, and at our institution, only 22% of stable babies delivered vaginally were receiving SSC at birth. Aim To increase the early initiation of SSC practice in neonates born through vaginal delivery ≥36 weeks from the observed baseline of 22% to ≥85% over 3 months. Methods The study was conducted in the labor room of a tertiary care hospital over 3 months (December 2022 to February 2023) and a sustenance phase from April 2023 to June 2023. A root cause analysis was done using the fishbone framework, focusing on barriers related to mothers, hospital staff, policy, place, and practices. Based on this, a comprehensive early initiation of SSC intervention was planned utilizing Plan-Do-Study-Act cycles. Results At the end of the three months, we achieved 100% compliance in the early initiation of SSC from a baseline of 22%, and the same compliance was maintained during the sustenance phase. The line chart used for interpretation showed an increase in compliance and increased duration of SSC till early initiation of breastfeeding was established.
‘Human Milk Bank (HMB): The Journey till Now and the Road Ahead’: A Retrospective Observational Study in a Tertiary Care Centre of Western India
Authors: Sayan Kumar Das , Prajapati Nisha , Khaitan Geet Gunjana 
Published: January 2024

Background In the era of the 21st Century, Human Milk Bank (HMB) is making its tortoise steps towards revolution. The goals and objectives of this study is to compare five years of data between the Pre Human Milk Bank phase (2018–2021) and Post Human Milk Bank phase (2021–2023) in order to evaluate the morbidity and mortality profile of neonates fed with PDHM (pasteurized donor human milk) or MOM (Mother’s Own Milk). Methods A retrospective observational study was done in HMB, Neonatal Intensive Care Unit, Department of Paediatrics, Gmers Medical College, Gandhinagar, Gujarat. Data obtained retrospectively comparing pre-HMB Phase (4th August, 2018–3rd August, 2021) and post-HMB Phase (4th August, 2021–3rd August, 2023). Results Around 1822 newborns benefited from the establishment of the HMB and 2.89 lakh ml of milk from 188 donor mothers were gathered during the study. Bacterial contamination of PDHM was reduced. There was a reduction in mortality and morbidity profiles like sepsis rate, NEC/Feed intolerance and ROP. Duration of NICU stay was improved in all preterm babies. Conclusions In this study, mortality and morbidity outcomes improved and sepsis decreased after the establishment of the HMB with reduced time to reach full feeds and shorter hospital stay. It helps significantly in NEC cases. We concluded that the creation of an HMB will be more advantageous and useful for all preterm babies in order to achieve better results.
Developmental Risk for Infants with Cleft Lip with or Without Cleft Palate Based on Caregiver-Proxy Reports
Authors: Kapp-Simon Kathleen A. , Albert Meredith , Edwards Todd C. , Jones Salene M. , Crilly Bellucci Claudia , Rosenberg Janine , Patrick Donald L. , Heike Carrie L. 
Published: January 2024

Objectives (1) Assess caregiver-reported development in infants born with cleft lip ± alveolus (CL ± A) and cleft lip and palate (CLP); (2) determine factors associated with increased developmental risk; and (3) determine consistency of developmental risk before and after surgery for cleft lip. Design Prospective, longitudinal assessment of development. Time (T) 1, prior to lip closure; T2, 2 months post lip closure. Setting Three US craniofacial teams and online parent support groups. Participants 123 total caregivers (96% mothers); 100 at T1, 92 at T2, and 69 at both T1 and T2. Measure Ages and Stages Questionnaire-3 (ASQ-3): Communication, Gross Motor, Fine Motor, Problem Solving, Personal Social Domains. Results At T1 47%; at T2 42% passed all 5 Domains; 36% of infants pass all 5 Domains at both T1 and T2. Infants with CLP were at greatest risk on Communication [ B = 1.449 (CI = .149-20.079), p = .038; Odds Ratio (OR) = 4.3 (CI = .923-19.650)] and Gross Motor Domains [ B = 1.753 (CI = .316-20.605), p = .034; OR = 5.8 (CI = 1.162-28.671)]. Male infants were at greatest risk on Fine Motor [ B = 1.542 (CI = .495-20.005), p = .009; OR = 4.7 (CI = 1.278-17.101)] and Problem Solving Domains [ B = 1.200 (CI = .118-19.708), p = .044; OR = 3.3 (CI = .896-12.285)]. Conclusions Based on caregiver report, infants with CL ± A and CLP meet referral criteria at a high rate. Infants with CLP and male infants were at greatest risk. Regular developmental screening is recommended.
Clinical significance of coadministration of moderate to strong CYP enzyme inhibitors with doxorubicin in breast cancer patients receiving AC chemotherapy
Authors: Dawson Amy Priest , Frick Chrissy D , Burd Megan , Conliffe Brette 
Published: January 2024

Introduction Cytochrome P450 (CYP) enzyme inhibitors may increase the toxicity of many chemotherapies. Medication databases classify doxorubicin coadministration with CYP2D6 or CYP3A4 inhibitors as either a major interaction or contraindication. This study assessed the incidence of toxicity secondary to doxorubicin given with or without CYP enzyme inhibitors in breast cancer patients receiving doxorubicin and cyclophosphamide. Methods This retrospective study included female breast cancer patients treated with doxorubicin and cyclophosphamide (AC). Patients were divided into three arms: no moderate or strong CYP inhibitor interactions, moderate or strong CYP2D6 inhibitor interactions, or moderate or strong CYP3A4 inhibitor interactions. Primary outcomes included incidence of doxorubicin-associated toxicity, unplanned medical visits, chemotherapy treatment delays, and doxorubicin dose reductions. The secondary endpoint was time to toxicity. Results There were 171 patients included ( n = 20 patients in the CYP2D6 inhibitor group and n = 15 in the CYP3A4 inhibitor group). Neither CYP inhibitor group showed a difference in incidence of hepatotoxicity, cardiotoxicity, myelotoxicity, moderate/severe nausea, or treatment delays. Compared to the no CYP inhibitor group, the CYP2D6 inhibitor group experienced a higher incidence of unplanned medical visits (45% vs. 19.4%; p = 0.023) and more frequent doxorubicin dose reductions (30% vs. 7.2%; p = 0.006). The CYP3A4 inhibitor group did not differ from the no CYP inhibitor group for these outcomes. Conclusions CYP inhibitors, particularly CYP2D6 inhibitors, may affect doxorubicin tolerability, as seen in this study by an increased incidence of unplanned medical visits and doxorubicin dose reductions.
Effect of Acute Vasodilator Testing Using Oxygen in Pulmonary Hypertension Due to Left Heart Disease
Authors: Rajkumar Sundararaj , Jha Ajay Kumar , Parida Satyen , Thangaswamy Chitra Rajeshwari , Panneerselvam Sakthirajan , Prasad Sreevathsa K. S. 
Published: January 2024

Background Pulmonary vasodilators, including oxygen, have not shown consistent beneficial effects on pulmonary hypertension due to valvular heart disease (PH-VHD). Therefore, the study aimed to assess the effect of 100% fractional inspiration of oxygen (FiO2) on pulmonary and systemic hemodynamics in patients with combined pre- and post-capillary pulmonary hypertension (CpcPH) and isolated post-capillary pulmonary hypertension (IpcPH) due to PH-VHD. Methods This prospective study was conducted among patients with PH-VHD undergoing mitral or aortic valve replacement or repair. The study was conducted after induction of anesthesia and pulmonary artery catheterization. Cardiac output was obtained using thermodilution and all direct, and derived hemodynamic variables were obtained at 30% and 100% FiO2. The patients were stratified a priori into responders {(≥10 mmHg fall in mean pulmonary artery pressure (MPAP)} and non-responders. Results Fifty-seven patients completed the acute vasodilator test. The mean age and body mass index of the study population was 41.8 ± 14.1 years and 21.4 ± 4.6 kg/m2, respectively. There was a significant decrease in MPAP (40.77 ± 12.07 mmHg vs 36.74 ± 13.3 mmHg; P < .001) and pulmonary vascular resistance (PVR) {(median; Interquartile range (IQR); 388; 371 vs 323; 362 dynes sec.cm−5; P < .001) at 100% FiO2. Transpulmonary gradient (TPG) and diastolic pulmonary gradient (DPG) also decreased significantly ( P < .001 and P < .001). Cardiac output did not change significantly. The magnitude of decrease in MPAP, PVR, TPG, DPG, and pulmonary artery compliance (PAC) between CpcPH and IpcPH was comparable. Responders did not show a significantly greater fall in MPAP, PVR, TPG, DPG, and PAC after surgery. Conclusion Hyperoxia may lead to reduction in MPAP and PVR in both hemodynamic phenotypes of PH-VHD. A larger sample size is required to support or refute the findings of this study.
Risk Factors Analysis and Pathogen Distribution of Urinary Tract Infection in Patients Undergoing Cutaneous Ureterostomy After Radical Cystectomy for Bladder Cancer
Authors: Zhu Mu-Rong , Hong Han-Xia , Cheng Jing-Ru , Tang Jing , Lu Tong , Xie Rui 
Published: January 2024

Background Postoperative urinary tract infection is a common complication that not only significantly prolongs the hospital stay and amplifies the economic burden on patients, but also affects their quality of life and prognosis. This study aimed to investigate risk factors and distribution of pathogenic bacteria in urinary tract infections among bladder cancer patients who underwent cutaneous ureterostomy following radical cystectomy. Methods A total of 137 bladder cancer patients, who underwent cutaneous ureterostomy after radical cystectomy at our hospital from November 2018 to October 2022, were enrolled in this retrospective study. Univariate and multivariate logistic regression analyses were employed to investigate the risk factors associated with postoperative urinary tract infection and the distribution of pathogenic bacteria among the infected patients. Results The results of both univariate and multivariate analyses confirmed that age, proficiency in ostomy knowledge, frequency of ureteral stent tube replacement, ureteral stent tube dislodgement, urine immersion at the outer end of the ureteral stent tube, and the interval of ostomy bag replacement were independent risk factors for urinary tract infection after radical cystectomy and cutaneous ureterostomy in bladder cancer patients. A total of 55 pathogenic bacteria were isolated from 52 patients with infections. Predominantly, these were gram-negative bacteria (34 strains, 61.8%), with Proteus mirabilis having the highest proportion. Conclusion Urinary tract infections after radical cystectomy and cutaneous ureterostomy predominantly involve gram-negative bacteria. This is correlated with factors such as the age of bladder cancer patients, the level of nursing education, the duration of ureteral stent tubes and ostomy bag usage, as well as issues related to impaired urine drainage.
Inferior Vena Cava Filter Long Term Complications and Retrieval Techniques: A Case Series and Literature Review
Authors: Montoya Christopher , Rey Jorge , Polania-Sandoval Camilo A. , Bornak Arash , Shao Tony , Kenel-Pierre Stefan 
Published: January 2024

Introduction and Importance Long-term mechanical complications after inferior vena cava (IVC) filter placement include embedded or tilted filters, erosion of the vena cava, filter thrombosis. In the setting of caval thrombosis, patients may subsequently develop venous hypertension and post-thrombotic syndrome (PTS). Here we present three unique cases of IVC filter complications and surgical management. Case Presentation A 30-year-old female presented with acute abdominal pain, revealing a duodenal perforation caused by an IVC filter eroding into her duodenum. A 42-year-old female with an IVC filter in place for 20 years due to a prior pulmonary embolism underwent laser-assisted retrieval of the filter due to concerns of caval adherence. A 48-year-old male with a history of DVT, venous stasis ulcer, and an IVC filter presented for filter retrieval. Clinical Findings and Investigations The surgical techniques described in this report include complicated IVC filter retrieval, performed in cases of filter complications including migration, fracture, duodenal perforation and IVC thrombosis resulting in PTS. One case, requiring open retrieval, is explained and the surgical technique is provided. There are images and videos of these procedures to enrich the learning experience. Intervention and Outcomes The surgical techniques described in this report include complicated inferior vena cava filter retrieval, performed in cases of filter complications including migration, fracture, duodenal perforation and IVC thrombosis. One case, requiring open retrieval, is explained and the surgical technique is provided. There are images and videos of these procedures to enrich the learning experience. Relevance and Impact Endovascular retrieval of long-term complicated IVC filters is challenging, but it can be a safely performed in many patients. However, open surgery may be necessary in selected patients.
The Leaf Oils of Beilschmiedia tonkinensis (Lecomte) Ridl. and Lindera gracilipes H. W. Li: Chemical Composition, Cytotoxicity, Antimicrobial Activity, and Docking Study
Authors: Huan Duong Quang , Luyen Nguyen Dinh , Ha Nguyen Xuan , Dai Do Ngoc , Hop Nguyen Quang , Lan Huong Do Thi , Son Ninh The 
Published: January 2024

Objective The Lauraceae plants comprised high amounts of essential oils, some of which established pharmacological potentials such as anticancer and antimicrobial activities. The Lauraceae essential oils are also used in cuisines and perfumes. The present study provides the chemical analysis of the leaf oils of Beilschmiedia tonkinensis and Lindera gracilipes, collected from Vietnam. Method Chemical components in the obtained oils were identified by the GC-FID/MS. The MTT and broth microdilution assays were used to evaluate cytotoxic and antimicrobial effects, respectively. The protein interactions were viewed by a docking study. Result Beilschmiedia tonkinensis leaf oil was characterized by sesquiterpene hydrocarbons (66.0%), in which bicyclogermacrene (23.3%), ( E)-caryophyllene (21.9%), caryophyllene oxide (9.9%), and spathulenol (6.0%) were the main components. The major chemical class in L gracilipes leaf oil was still sesquiterpene hydrocarbons (64.2%) with bicyclogermacrene (32.2%) being the principal component. Both 2 oil samples (IC50 41.2-44.12 µg/mL) were actively cytotoxic against the proliferation of A-549 cancer cells. In particular, B tonkinensis leaf oil strongly controlled Hep-G2 and MCF-7 cancerous cells with the IC50 values of 20.6 and 9.36 µg/mL, respectively. Beilschmiedia tonkinensis leaf oil also strongly inhibited the Gram (–) bacterium Pseudomonas aeruginosa and the fungus Aspergillus niger with the MIC values of 16 and 32 µg/mL, respectively. By molecular docking approach, bicyclogermacrene interacted with the p38α MAPK cancer protein (PDB ID: 4FA2) with a potential binding affinity of −8.019 kcal/mol, whereas ( E)-caryophyllene tends to bind 2 bacterial proteins P aeruginosa QS regulator (PDB ID: 6B8A) and glucosamine-6-phosphate synthase (GlmS) (PDB ID: 2VF5) with the better binding affinities of −6.740 and −6.521 kcal/mol, respectively. The most preferable binding mode was due to hydrophobic π-alkyl and alkyl interactions. Conclusion The current result can be seen as a basic foundation in the applications of essential oils of B tonkinensis and L gracilipes for anticancer and antimicrobial treatments. Further phytochemical studies and mechanisms of action are needed.
Radiographic Robustness of Lumbar Interbody Fusion Techniques
Authors: Bouchard Alice , Mun Jeffrey , Vazquez Frank , Tang Alex , Delsole Edward , Strom Russell , Chen Tan 
Published: January 2024

Study Design Retrospective chart review. Objectives Lumbar interbody fusion (LIF) can be achieved with various techniques. Evidence supporting the long-term clinical advantages of one technique over another are inconclusive. The purpose of this study was to (1) determine the changes in sagittal parameters in the preoperative, intraoperative, and post-operative phase, (2) evaluate the radiographic maintenance of these parameters over time, and (3) compare the demographics and patient reported outcomes of patients undergoing various LIF techniques. Methods We performed a retrospective chart review of patients with degenerative spine disease undergoing single level anterior (ALIF), lateral (LLIF), posterior (PLIF), or transforaminal (TLIF) lumbar interbody fusion. Data collected included patient demographics and diagnosis at time of surgery. Upright lumbar radiographs taken pre-operatively, intra-operatively, and post-operatively were measured for lumbar lordosis (LL), segmental lordosis (SL), posterior disc height (PDH), and foraminal height (FH). Results 194 patients in a single center were included. PDH and FH increased intra-operatively following ALIF ( P < .0001), PLIF ( P < .0001), LLIF ( P < .0001), and TLIF ( P < .0001). SL also increased intra-operatively for ALIF ( P = .002) and LLIF ( P = .0007). Compared to intra-operative radiographs, PDH and FH decreased at latest post-operative phase for ALIF ( P < .03), LLIF ( P < .003), TLIF ( P < .001), and PLIF ( P < .005). SL decreased for ALIF ( P = .0008), and TLIF ( P = .02). LL did not change postoperatively across techniques. Patient reported outcomes improved post-surgically and disability index decreased, but neither differed between techniques. Conclusion LIF, regardless of technique, was shown to provide significant radiographic changes in PDH and FH. Techniques utilizing larger intervertebral cage sizes (ALIF/LLIF) improved SL. Single level LIF did not affect overall LL. No single technique displayed superior radiographic robustness over time.