bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidemiology and Clinical Features of Human Metapneumovirus and Respiratory Syncytial Viral Infections in Children
Authors: Nadiger Meghana , Sendi Prithvi , Martinez Paul A. , Totapally Balagangadhar R. 
Published: July 2023

Background:
Human metapneumovirus (HMPV) and respiratory syncytial virus (RSV) are 2 common causes of acute respiratory tract infections in infants and young children. The objective of this study is to compare the demographics and outcomes of children hospitalized with HMPV and RSV infections in the United States.

Methods:
We performed a retrospective cohort analysis of children 1 month to less than 3 years old discharged during 2016 with HMPV or RSV infection using the Kids’ Inpatient Database. Children with HMPV and RSV coinfection were excluded. Data were weighted for national estimates.

Results:
There were 6585 children with HMPV infection and 70,824 with RSV infection discharged during the study period. The mean age of children with HMPV infection was higher than that of children with RSV infection (0.73 ± 0.8 vs. 0.42 ± 0.7 years; P < 0.05). The mortality rate was significantly higher in children with the presence of any complex chronic conditions compared to those without, in both HMPV [odds ratio (OR): 32.42; CI: 9.931–105.857; P < 0.05] as well as RSV (OR: 35.81; CI: 21.12–57.97; P < 0.05) groups. The adjusted median length of stay was longer (4.64 days; CI: 4.52–4.76 days vs. 3.33 days; CI: 3.31–3.35 days; P < 0.001) and total charges were higher ($44,358; CI: $42,145–$46,570 vs. $22,839; CI: $22,512–$23,166; P < 0.001), with HMPV infection. The mortality rate was similar in HMPV infection compared to RSV infection on multivariable analysis (OR: 1.48; P > 0.05).

Conclusion:
In hospitalized children in the United States, HMPV infection is less common than RSV infection. Complex chronic conditions are more prevalent in children hospitalized with HMPV infection. Hospitalization with HMPV is associated with longer length of stay and higher hospital charges. The adjusted mortality is similar with both infections.
Antimicrobial Resistance Patterns Among Neonates Referred to Pediatric Emergency in North India: A Prospective Cohort Study
Authors: Kumar Jogender , Soni Prakash Kumar , Angrup Archana , Saini Shiv Sajan , Sundaram Venkataseshan , Mukhopadhyay Kanya , Dutta Sourabh , Kumar Praveen 
Published: July 2023

Background:
Sepsis is a leading cause of neonatal mortality worldwide, with a disproportionately high burden in low-income and middle-income countries. There is limited prospective data on microorganism profiles and antimicrobial resistance (AMR) in outborn newborns referred to pediatric emergency in developing countries. We aimed to assess the pathogen profile and AMR patterns in outborn neonates referred to the pediatric emergency at a tertiary care center.

Methods:
In this prospective cohort study, we enrolled neonates with suspected sepsis and sent blood or cerebrospinal fluid cultures. Neonates were followed up daily until discharge or death. The isolated organisms were identified and tested for antimicrobial susceptibility. Standard definitions were used to define multidrug resistance.

Results:
Between January 1, 2020, and December 31, 2020, 1072 outborn neonates with suspected sepsis were enrolled. The rate of proven sepsis was 223.6 (95% CI:198.7–248.4) per 1000 infants. Gram-negative sepsis was the most common (n = 107,10%), followed by gram-positive sepsis (n = 81,7.6%) and fungal sepsis (n = 67,6.3%). Coagulase-negative staphylococci (n = 69), Candida spp. (n = 68), Klebsiella spp. (n = 55), Acinetobacter spp. (n = 31) and Escherichia coli (n = 9) were the most common pathogens. Over two-thirds (68.6%) of pathogens were multidrug resistance, with an alarming prevalence in Klebsiella spp. (33/53, 62%), Acinetobacter spp. (25/30, 83%) and coagulase-negative staphylococci (54/66, 82%). In total, 124 (11.6%) neonates died in the hospital (13.3% of proven cases and 11.1% of culture-negative sepsis cases).

Conclusions:
High sepsis burden and alarming AMR among neonates referred to tertiary care centers warrant urgent attention toward coordinated implementation of rigorous sepsis prevention measures and antimicrobial stewardship across all healthcare levels.
Fulminant Myocarditis Associated With Parvovirus B19 and Epstein-Barr Virus Coinfection
Authors: Yan Crystal Lihong , Gupta Gaurav , Guido Luiz Paulo , Ruiz Philip , Grazette Luanda , Bauerlein E. Joseph , Rivera Nina Thakkar 
Published: July 2023

Abstract
Parvovirus B19 (PVB19) and Epstein-Barr virus (EBV) commonly cause infection worldwide, with most persons infected during childhood. Their disease courses are usually mild and brief; however, PVB19 and EBV have been implicated as etiologies of viral myocarditis. We report a case of PVB19 and EBV coinfection associated with fulminant lymphocytic myocarditis. We address the implications of the case, including the differential diagnosis, immunomodulatory treatment considerations, and evidence for the pathologic roles of PVB19, EBV, and coinfection in myocarditis. Although the pathogenic roles of PVB19 or EBV alone in myocarditis are not well established, coinfection of PVB19 and EBV may unlock their pathogenic roles causing fulminant myocarditis. Treatment with steroids and intravenous immunoglobulin G in a patient with rapid clinical deterioration despite the presence of active infection on endomyocardial biopsy by polymerase chain reaction can result in a safe and quick recovery of fulminant viral myocarditis. Early and aggressive intervention, including both mechanical circulatory support and immunomodulatory therapy, may be key to improved outcomes in cases of fulminant myocarditis.
Endotherapy in pediatric pancreatitis
Authors: Norris Nicholas , Troendle David M. 
Published: July 2023

Purpose of review
Some children with acute recurrent and chronic pancreatitis stand to benefit from therapeutic endoscopic interventions. The purpose of this review is to summarize specific endoscopic therapies used for these conditions and highlight areas of future research.

Recent findings
Multicenter collaboration and consortium efforts have provided more data now than ever on the technical outcomes and safety of therapeutic endoscopic procedures for pancreatitis in children. Indications are growing but more research is needed to help guide patient selection.

Summary
Advanced endoscopic procedures including endoscopic retrograde cholangiopancreatography, endoscopic-ultrasound guided therapies, and single-operator pancreatoscopy may be used in patients with acute recurrent or chronic pancreatitis to manage pancreatic duct obstruction or local complications including pseudocysts and walled-off necrosis. Patient and procedural factors differ between adults and children. Access to these procedures for younger children is growing, and technical outcomes and adverse event rates appear similar between adults and children.
Endoluminal bariatric and metabolic therapies: state-of-the-art
Authors: Bakheet Nader , Badurdeen Dilhana , Sartoretto Adrian , Kumbhari Vivek 
Published: July 2023

Purpose of review
The aim of this review is to present the current state of the field, highlight recent developments, and describe the clinical outcomes of these endoluminal bariatric and metabolic procedures.

Recent findings
The landscape of endoluminal devices and techniques for treating obesity has expanded significantly, with FDA-approved therapies currently available to patients with a body mass index values as high as 50 kg/m2. Although notable advancements have been made in this area, there is a need for further emphasis to be placed on the metabolic improvements resulting from these therapies, in addition to the conventional focus on weight loss outcomes. Some of these procedures are now FDA approved for the treatment of metabolic disease as opposed to weight loss. To achieve the most favorable results, it is imperative that all endoluminal interventions are combined with a moderately intensive diet and lifestyle program lasting at least 12 months.

Summary
Endoluminal metabolic and bariatric therapy represents a bridge between lifestyle counseling, pharmaceutical interventions, and the most efficacious treatment for obesity, bariatric surgery. By virtue of its minimally invasive approach, this therapy may be an appealing option for patients who are ineligible for, or averse to, bariatric surgery and who have experienced suboptimal outcomes or unable to afford medical treatments. Furthermore, these interventions may be particularly beneficial in the early stages of obesity.
Tissue factor positive microparticles as a biomarker for increased risk of breast cancer-associated thrombosis: a mini review
Authors: Bucciol Regan , Othman Maha 
Published: July 2023

Purpose of review
Cancer-associated thrombosis (CAT), such as venous thromboembolism (VTE), is a frequent complication in cancer patients, resulting in poor prognosis. Breast cancer is not highly thrombogenic but is highly prevalent, resulting in increased VTE cases. Many cancers express tissue factor (TF), a glycoprotein that triggers coagulation. The cancer cells were shown to express and release substantial amounts of TF-positive microparticles (MPTF), associated with a prothrombotic state. This narrative review evaluated the current use of the procoagulant MPTF as a biomarker for thrombosis risk in breast cancer.

Recent findings
Tumors of epithelial origin with elevated TF expression have been associated with increased VTE incidence. Thus, studies have affirmed the use of MPTF biomarkers for VTE risk in many cancers. Patients with metastatic breast cancer and CAT were found to exhibit elevated procoagulant microparticles in vitro, due to TF expression. The silencing of TF was associated with decreased microparticle release in breast carcinoma cell lines, associated with decreased coagulation.

Summary
CAT is a multifactorial condition, with several various underlying diseases. It is proposed that MPTF may be an effective biomarker for thrombosis risk in breast cancer patients but requires a more systemic evaluation utilizing standardized quantification methods.
Switching and increasing prophylaxis regimen with a genetically recombinant fusion of coagulation factor IX and albumin in haemophilia B: a case report
Authors: Álvarez-Román María Teresa , Merchán Raquel Díaz , Mellado Roberto Carlos Raynero , Jiménez-Yuste Victor 
Published: July 2023

Purpose of review
We present a case of a boy diagnosed in 2007 with severe haemophilia B [factor IX (FIX) concentration < 1%] at age of 9 months. He was initially treated with recombinant FIX concentrates, but changes in regimens were frequent due to spontaneous hemarthros. In 2013, he entered a phase III trial (NCT01662531) and received rIX-FP, IDELVION at 50 IU/kg once a week. Although the boy was safely maintained with this regimen (2015–2017), the number of hemarthros increased after he started to play football. Thus, rIX-FP regimen was modified (40 IU/kg twice/week) to optimize therapy. This modification was efficient on maintaining patient's thought levels (33%), helped during his fully incorporation at school and social life, and significantly improved synovial hypertrophy. In the last year, the boy has not suffered any bleeding episode and his joint situation improved significantly, which allowed reducing doses to weekly recommended doses.

Recent findings
FIX replacement therapies with intravenous plasma-derived FIX (pdFIX) or standard half-life recombinant FIX (rFIX) concentrates are hampered by the relatively short terminal elimination half-life (t
1/2) of these substances (around 17–34 h), resulting in the need for frequent infusions (e.g. once every 3 or 4 days) to maintain protective FIX levels. In the past years, the first genetically recombinant fusion of rFIX with another protein - a recombinant human albumin – was developed (albutrepenonacog-alfa or rIX-FP; IDELVION) as a strategy to extend the t
1/2 of rFIX-FP (around 95 h).

Summary
We provide information about the difficult management of a patient with a major bleeding haemorrhagic phenotype, which caused serious limitations in the patient's daily life, impacting his quality of life at his young age, and how the switch to IDELVION allowed the situation to improve considerably.
A Ruptured Mucinous Cystadenocarcinoma of the Pancreas Extensively Evaluated Before and After the Rupture
Authors: Oyama Keisuke , Iwagami Yoshifumi , Kobayashi Shogo , Sasaki Kazuki , Yamada Daisaku , Tomimaru Yoshito , Akita Hirofumi , Noda Takehiro , Asaoka Tadafumi , Nakahira Shin , Gotoh Kunihito , Takahashi Hidenori , Tanemura Masahiro , Doki Yuichiro , Eguchi Hidetoshi 
Published: July 2023

Abstract
Pancreatic mucinous cystic neoplasm (MCN) rarely ruptures because of their surrounding fibrotic capsules and has never been reported with detailed information regarding prerupture and postrupture states. We report a case of MCN rupture where performed emergency surgery was performed while waiting for elective surgery. A 54-year-old woman was referred to our department for a pancreatic cystic tumor with slight abdominal pain. A cystic tumor with a nodular lesion was found, with a contrast effect measuring 78 mm in diameter. On day 21, the patient visited our hospital complaining of increased abdominal pain, but few signs of peritonitis were observed. Tests conducted revealed moderate ascites, marginal shrinkage of the cyst diameter, and a slight elevation of inflammatory markers. We suspected an MCN rupture and immediately performed distal pancreatectomy. Brown turbid ascites and rupture of the anterior wall of the cyst were observed. In the ascites, amylase levels were not elevated, and bacterial cultures were negative. The histopathological diagnosis was noninvasive mucinous cystadenocarcinoma. At 9 months after surgery, she started chemotherapy because of a recurrence of the peritoneal dissemination. This case provided valuable insight into the rupture of MCNs using thorough imaging techniques, laboratory, and physical findings before and after rupturing.
Endoscopic Ultrasound Guided Shear Wave Elastography Is Safe With High Feasibility and Reproducibility When Used in the Pancreas
Authors: Abboud Yazan , Kim Katherine , Samaan Jamil S. , Chen Clara , Lew Daniel , Ghaith Jenan , Caldera Wendy , El Helou Mohamad Othman , Park Kenneth H. , Liu Quin , Gupta Kapil , Watson Rabindra , Lo Simon K. , Pandol Stephen J. , Gaddam Srinivas 
Published: July 2023

Objectives
The aim of this study was to assess the safety, feasibility, and reproducibility of endoscopic ultrasound shear wave elastography (EUS-SWE) in the pancreas.

Methods
This is a prospective registry of consecutive patients undergoing clinically indicated EUS. Ten readings of SWE velocities (Vs [distance/time, m/s]) were obtained in the head (HOP), body, and tail of pancreas to quantify tissue stiffness. Each Vs score was accompanied by a reliability measurement VsN (%) with VsN >50% considered reliable. Safety was evaluated by perioperative complications rate. Feasibility was determined by technical success of obtaining measurements. Reproducibility was evaluated using intraclass correlation coefficient analysis.

Results
Total of 3320 EUS-SWE measurements were performed on 117 patients without perioperative complications. Measurement success rate was 100% across all locations. Reliable measurements were more common in the HOP (953/1120 [85.1%]) followed by body (853/1130 [75.5%]) and tail of pancreas (687/1070 [64.2%]) (P < 0.001). The analysis showed good reproducibility in all locations (intraclass correlation coefficient range, 0.80–0.89).

Conclusions
Endoscopic ultrasound-SWE is safe, has 100% technical success rate, and is highly reproducible when used in the pancreas. Our study suggests that SWE measurements in the HOP offer the highest reliability, likely because of large study area and less respiratory artifact.
Pediatric Autoimmune Pancreatitis
Authors: Becker Erica C. , Kumar Rakesh , Altaf Adnan , Yu Zhongxin , Lawrence Tony , Palle Sirish 
Published: July 2023

ObjectivesAutoimmune pancreatitis (AIP) is a rare form of a chronic, immune-mediated, inflammatory pancreatic condition. There is limited data regarding presentation and outcome in the pediatric population. We described a single-center case series of 4 pediatric patients with AIP to better understand the presentation, symptoms, and outcomes of this rare condition.MethodsData collected included demographics, serology markers, symptoms at presentation, imaging, additional organ involvement, histology, treatment methods, and outcomes. The diagnosis of AIP was made by a combination of serology, pancreatic imaging, histology, extrapancreatic manifestations, and steroid response.ResultsAll patients were diagnosed with type 2 AIP. Abdominal pain, emesis, and obstructive jaundice were the most common symptoms at presentation. Autoimmune markers were negative. Cross-sectional abdominal imaging showed diffuse/focal pancreatic gland enlargement and common bile duct stricture universally and main pancreatic duct irregularity in half of the patients. Biopsies showed lymphoplasmacytic infiltration with associated pancreatic fibrosis and atrophy. Treatment with an 8-week tapering course of prednisone showed prompt response with resolution of symptoms and normalization of laboratory test results.ConclusionsOur case series shows that AIP in children is a rare entity with a distinct clinical presentation, classical radiographic and histological features with good long-term prognosis.
Effect of Aggressive Intravenous Fluid Resuscitation Versus Nonaggressive Fluid Resuscitation in the Treatment of Acute Pancreatitis
Authors: Ding Xiaowen , Chen Bo 
Published: July 2023

Objectives
Despite the need for active fluid therapy, fluid management of most acute pancreatitis (AP) cases is still supportive. The aim of this review is to compare the effect of aggressive versus nonaggressive intravenous (IV) fluid resuscitation in the treatment of acute pancreatitis.

Methods
A systematic search of medical databases, such as Medline, Google Scholar, Science Direct, Cochrane Central, was conducted for publication until April 2022. We included randomized controlled trials or cohort (prospective and retrospective) studies reporting the outcomes of AP in patients that were managed with aggressive and nonaggressive IV fluid resuscitation. The primary outcome of interest was in-hospital mortality.

Results
Fourteen trials involving 3423 acute pancreatitis patients were included in the review. We did not observe any differences in the risk of mortality, persistent organ failure, and systemic inflammatory response syndrome in both study groups. However, there was an increased risk of development of pancreatic necrosis, renal failure, and respiratory failure in the aggressive fluid therapy group compared with nonaggressive therapy. The funnel plot showed no publication bias

Conclusions
Aggressive fluid therapy did not improve mortality rates in acute AP patients and was associated with an increased risk of acute renal failure, and respiratory failure.
Is Delaying a Coloanal Anastomosis the Ideal Solution for Rectal Surgery
Authors: Collard Maxime K. , Rullier Eric , Tuech Jean-Jacques , Sabbagh Charles , Souadka Amine , Loriau Jérome , Faucheron Jean-Luc , Benoist Stéphane , Dubois Anne , Dumont Frédéric , Germain Adeline , Manceau Gilles , Marchal Frédéric , Sourrouille Isabelle , Lakkis Zaher , Lelong Bernard , Derieux Simon , Piessen Guillaume , Laforest Anaïs , Venara Aurélien , Prudhomme Michel , Brigand Cécile , Duchalais Emilie , Ouaissi Mehdi , Lebreton Gil , Rouanet Philippe , Mège Diane , Pautrat Karine , Reynolds Ian S. , Pocard Marc , Parc Yann , Denost Quentin , Lefevre Jérémie H. ,   for the GRECCAR Group
Published: July 2023

Objectives:
To assess the specific results of delayed coloanal anastomosis (DCAA) in light of its two main indications.

Summary Background Data:
DCAA can be proposed either immediately after a low anterior resection (primary-DCAA) or after failure of a primary pelvic surgery as a salvage procedure (salvage-DCAA).

Methods:
All patients who underwent DCAA intervention at 30 GRECCAR-affiliated hospitals between 2010 and 2021 were retrospectively included.

Results:
564 patients (male: 63%; median age: 62 years IQR[53-69]) underwent a DCAA: 66% for primary-DCAA and 34% for salvage-DCAA. Overall morbidity, major morbidity and mortality were 57%, 30% and 1.1%, without any significant differences between primary-DCAA and salvage-DCAA (P=0.933;P=0.238 andP=0.410 respectively). Anastomotic leakage was more frequent after salvage-DCAA (23%) than after primary-DCAA (15%), (P=0.016).
Fifty-five patients (10%) developed necrosis of intra-abdominal colon. In multivariate analysis, intra-abdominal colon necrosis was significantly associated with male sex (OR=2.67 95%CI[1.22-6.49];P=0.020), BMI>25 (OR=2.78 95%CI[1.37-6.00];P=0.006) and peripheral artery disease (OR=4.68 95%CI[1.12-19.1];P=0.030). The occurrence of this complication was similar between primary-DCAA (11%) and salvage-DCAA (8%), (P=0.289).
Preservation of bowel continuity was reached 3 years after DCAA in 74% of the cohort (primary-DCAA:77% vs. salvage-DCAA: 68%,P=0.031). Among patients with a DCAA fashioned without diverting stoma, 75% (301/403) have never required a stoma at the last follow-up.

Conclusions:
DCAA makes it possible to definitively avoid a stoma in 75% of patients when fashioned initially without stoma and to save bowel continuity in 68% of the patients in the setting of failure of primary pelvic surgery.
Keyhole Versus Sugarbaker Mesh Configuration in Parastomal Hernia Repair: A Systematic Review and Meta-analysis
Authors: Mazzola Poli de Figueiredo Sergio , Rodrigues Amanda Cyntia Lima Fonseca , de Araújo Sérgio Walmir , Mao Rui-Min Diana , Villasante-Tezanos Alejandro , Tastaldi Luciano , Lu Richard 
Published: July 2023

Background:
Parastomal hernia repairs (PHRs) are often complex and challenging, even for experienced abdominal wall surgeons. Although the ideal therapeutic option in the setting of a parastomal hernia is to restore intestinal continuity, this is often not feasible, and numerous techniques have been described for PHR. Current guidelines recommend using mesh for elective PHR, but there is a scarcity of evidence comparing different PHR techniques. We aimed to report a meta-analysis comparing the outcomes of the “Sugarbaker” and “Keyhole” mesh configuration in PHR.

Methods:
A literature search of PubMed, Embase, Scopus, and Cochrane Library databases was performed to identify studies comparing Sugarbaker and Keyhole mesh configuration in PHR. Postoperative outcomes were assessed by means of pooled analysis and meta-analysis. Statistical analysis was performed using RevMan 5.4. Heterogeneity was assessed with I
2 statistics.

Results:
A total of 3247 studies were screened, and 27 were fully reviewed. Ten studies and 632 patients were included in the meta-analysis. Three hundred five patients (48.3%) with Keyhole and 327 patients (51.7%) with Sugarbaker mesh configuration. Four hundred thirty-three patients (68.5%) underwent laparoscopic PHR with intraperitoneal onlay mesh. Sugarbaker mesh configuration was associated with lower hernia recurrence compared with Keyhole (odds ratio: 0.39; 95% CI: 0.19-0.83; P = 0.01; I
2 = 46%). No differences were seen in overall complications, reoperations, stoma outlet obstruction, mesh infection, and postoperative bleeding.

Conclusion:
PHR with Sugarbaker mesh configuration is associated with decreased hernia recurrence compared with Keyhole and had similar rates of overall complications, reoperations, stoma outlet obstruction, mesh infection, and postoperative bleeding.