bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surgical findings and outcomes after unilateral adrenalectomy for primary hyperaldosteronism in cats: a multi-institutional retrospective study
Authors: Del Magno Sara , Foglia Armando , Rossanese Matteo , Montinaro Vincenzo , Cola Veronica , Pisoni Luciano , Rossetti Diego , Cantatore Matteo , De La Puerta Benito , Nicoli Stefano , Pisani Guido , Collivignarelli Francesco , Romanelli Giorgio , Cinti Filippo , Olimpo Matteo , Fracassi Federico 
Published: January 2023

Case series summary Twenty-nine cats from different institutions with confirmed or highly suspected primary hyperaldosteronism treated by unilateral adrenalectomy were retrospectively included in this study. The most frequent clinical signs were lethargy (n = 20; 69%) and neck ventroflexion (n = 17; 59%). Hypokalaemia was present in all cats, creatinine kinase was elevated in 15 and hyperaldosteronism was documented in 24. Hypertension was frequently encountered (n = 24; 89%). Preoperative treatment included potassium supplementation (n = 19; 66%), spironolactone (n = 16; 55%) and amlodipine (n = 11; 38%). There were 13 adrenal masses on the right side, 15 on the left and, in one cat, no side was reported. The median adrenal mass size was 2 × 1.5 cm (range 1–4.6 × 0.4–3.8); vascular invasion was present in five cats, involving the caudal vena cava in four cats and the renal vein in one. Median duration of surgery was 57 mins. One major intraoperative complication (3%) was reported and consisted of haemorrhage during the removal of a neoplastic thrombus from the caudal vena cava. In 4/29 cats (14%), minor postoperative complications occurred and were treated medically. One fatal complication (3%) was observed, likely due to disseminated intravascular coagulation. The median duration of hospitalisation was 4 days; 97% of cats survived to discharge. The potassium level normalised in 24 cats within 3 months of surgery; hypertension resolved in 21/23 cats. Follow-up was available for 25 cats with a median survival of 1082 days. Death in the long-term follow-up was mainly related to worsening of comorbidities. Relevance and novel information Adrenalectomy appears to be a safe and effective treatment with a high rate of survival and a low rate of major complications. Long-term medical treatment was not required.
Ultrasonographic monitoring of feline epaxial muscle height as part of an annual wellness examination to assess for the development of sarcopenia
Authors: Lutchman Aaron , Shanker Natasha , Comerford Eithne , German Alexander J , Leung Y Becca , Maddox Thomas , Dowgray Nathalie 
Published: January 2023

Objectives The aim of this study was to determine if epaxial muscle height (EMH) could be reliably incorporated into annual routine wellness screenings, and also determine its relationship to age, body condition score (BCS), subjective muscle assessment (SMA), breed and sex in mature cats. Methods EMH was determined independently by three observers from ultrasonographic examinations – collected by an additional trained individual – of cats enrolled at the Feline Healthy Ageing Clinic, University of Liverpool, UK. Age, body weight, BCS and SMA data were also collected. Results A total of 92 cats were included, 35 of which had repeat ultrasonographic examinations 12 months apart. Enrolled cats were a median age of 8 years and 9 months at the time of the first measurement. Variation in the quality of ultrasonographic images collected did not affect muscle depth measurements ( P = 0.974). Further, there was good intra- and inter-observer repeatability for all observations (intraclass correlation range 0.97−0.99). There was a moderate positive association between EMH and body weight ( r = 0.49, P <0.001) but no association with age ( r = −0.05, P = 0.680). There were also positive associations in EMH among cats with different BCSs ( P = 0.001) and SMAs (thoracic spine, P = 0.021; lumbar spine, P = 0.014), but breed ( P = 0.429) and sex ( P = 0.187) had no effect. Finally, there was no change in EMH measurements in the paired samples ( P = 0.145) or correlation between percentage weight and EMH change over 12 months. Conclusions and relevance The accuracy of EMH measurement using ultrasonographic imaging is good, irrespective of observer experience and provided that the ultrasonographer has some training. This suggests that ultrasonographic measurement of EMH could have a major practical impact as a non-invasive determination of muscle mass in pet cat populations. Further research is required to assess longitudinal changes in muscle mass over time in senior pet cats.
Onion ring sign on spectral domain optical coherence tomography in diabetic macular edema: Its evolution and outcomes
Authors: Venkatesh Ramesh , Mangla Rubble , Sharief Shama , Arora Sahil , Reddy Nikitha Gurram , Yadav Naresh Kumar , Chhablani Jay 
Published: January 2023

Purpose To report evolution and outcomes of hyperreflective crystalline deposit (HCD) on optical coherence tomography (OCT) in diabetic maculopathy (DM). Methods Patients with DM showing HCD on OCT for the first time between June 2017 and May 2021 were included in the study. Demographic, ophthalmic and OCT features were documented and analysed. Factors leading to the development of HCD and its effect on the functional outcome were analysed and described in this study. Results Sixty cases of HCD were identified in 45 (males −33; females – 12) patients for the first-time during the defined study period. Mean age of the eligible patients was 61.53 ± 8.19 years. Average duration of diabetes was 13.82 ± 7.38 years. Mean visual acuity of these patients was 0.902 ± 0.438 logMAR units (Snellen equivalent = 20/160). Patients with HCD showed subretinal hard exudates, were on anti-cholesterol medications (n = 36, 80%) and showed reduced visual acuity (20/160) if the HCD involved the fovea. The median time taken for the development of HCD was 28 months. Mean follow-up duration of the study was 26.19 ± 27.98 months. Persistence of HCD in all cases (n = 42, 100%) was noted at the last follow-up visit. Conclusion Horizontal, single or multi-layered HCDs on OCT in DM represent intraretinal or subretinal cholesterol crystal precipitates evolving from the hard exudates identical to the “onion ring sign” seen in neovascular AMD. HCDs or CCs depict deranged lipid metabolism, chronic vascular leakage and can lead to substantial visual impairment if the fovea gets involved.
Efficacy of Cryotherapy Combined With Intralesional Purified Protein Derivative (PPD) Versus Intralesional PPD Monotherapy in the Treatment of Multiple Common Warts
Authors: Awad Sara M. , Gomaa Ahmed S. , Hassan Hiba A. , Tawfik Yasmin M. 
Published: January 2023

IntroductionIntralesional antigen immunotherapy represents a promising therapeutic approach for the treatment of different types of warts, particularly if multiple and/or recalcitrant.Aimto investigate the efficacy and safety of combined cryotherapy with intralesional purified protein derivative (PPD) immunotherapy in the treatment of multiple common warts.MethodsFifty patients were randomly divided into two groups (25 patients each): Group A: receiving intralesional PPD immunotherapy for the largest wart, while group B: receiving cryotherapy for all warts plus intralesional PPD for the largest wart. Treatments were performed every 2 weeks for a maximum of four sessions. Photographs were taken at baseline and at each visit and clinical response was evaluated by the reduction in number and size of warts. Adverse effects were recorded.ResultsThere was a significant reduction in size and number of warts in both groups ( P < .001), with no significant difference between the two groups. Complete clearance of the lesions was observed in 48% of patients in group A and 44% in group B ( P = .39). Higher rates of near complete/complete response were achieved after fewer sessions (2, 3 sessions) in group B ( P = .002). Blistering was common after cryotherapy. Higher rate of hypopigmentation was noticed after combined treatment than after PPD monotherapy (56%, 8% respectively; P < .001), which resolved gradually.ConclusionBoth intralesional PPD alone and combined cryotherapy with PPD are safe and effective in clearing of common warts. Cryotherapy may be a successful adjunct to intralesional PPD immunotherapy that helps in reducing the number of treatment sessions. The study protocol was registered at ClinicalTrials.gov with ID: NCT04288817
Pulmonary hypertension, pulmonary embolism and COVID-19: A district general hospital experience from the UK
Authors: Mahdi Noor , Nadeem Iftikhar , Ur Rasool Masood , Ul Munamm Syed Ata , Khatana Usman Feroze , Rashad Faisal , Babu Anoop 
Published: January 2023

Background: Preliminary data suggest that the prevalence of pulmonary hypertension (PH) in patients with COVID-19 is around 13%, but its prognostic role remains unclear. Approximately 3% of patients develop chronic thrombo-embolic pulmonary hypertension (CTEPH) following diagnosis of acute pulmonary embolism (PE). It is recommended that patients are screened for CTEPH if they remain symptomatic 3 months following diagnosis of PE. The primary aim of the study was to assess the chances of persistent PH following PE secondary to COVID-19. Methods: We conducted a retrospective cohort study at a District General Hospital (DGH) in the United Kingdom. All patients diagnosed with COVID-19 and PE between April 2020 and October 2021 were examined. Patients were divided into two groups:·COVID-19 and PE with comorbidities (excluding pre-existing PH) and·COVID-19 and PE without comorbidities. We compared the ECHO features suggestive of PH between the two groups at the time of diagnosis of PE and at 3 months following treatment. Results: 80 patients were included in the study (49 with comorbidities and 31 with no comorbidities). Average age of comorbidities and no comorbidities groups were 73 years and 70 years, respectively. Average PaO2/FiO2 ratio for comorbidities and no comorbidities groups were 170 and 195, respectively. Fourteen patients (13 with comorbidities and 1 with no comorbidities) died in total. Results showed that risk of persistent PH and subsequent mortality following PE in COVID-19 is 4.17 times and 1.32 times more in comorbidity group as compared to no comorbidity group, respectively ( p < 0.001). Conclusion: Patients with comorbidities are at high risk of persistent PH and mortality due to PE secondary to COVID-19.
Availability and characteristics of pulmonary rehabilitation programs in family health centers and hospitals from Chile: Descriptive, retrospective and multicentric study
Authors: Méndez Andrea , Nieto Carlos , Hidalgo Gonzalo , Rodríguez-Núñez Iván 
Published: January 2023

Objective To determine availability and characteristics of pulmonary rehabilitation programs performed in 2019 in family health centers and hospitals from Chile. Methodology: A descriptive and retrospective study was designed, considering PR programs operated in 2019. A non-probability and convenience sample was obtained. Availability and characteristics of centers and PR were measured using a questionnaire translated, modified, validated, and sent by email. Results Out of 80 responses (22.8%), 60% of centers offered PR program, where the lack of time was the greatest barrier. The programs were mainly outpatient, non-personalized, with 10(IQR 4–11) participants, 12 (IQR 12–16) weeks of length, with 2.4 ± 0.6 session/week, and 1 (IQR 1–2) hours/session. Chronic Obstructive Pulmonary Disease (COPD) was the most frequent diagnostic. The programs were mainly comprised of strength training exercises of lower extremity, upper extremity, walking and education. Team was constituted of physiotherapist and physician, with completed training, and directed by a physiotherapist. Modified Borg, MRC dyspnea scale, six-minute walking test and oximetry were used in the assessments. Between 40-80% of patients completed PR, and the major barrier was patient relocated. Conclusion Increasing PR availability, homogenization of exercises and education, prioritization of assessments supported by scientific evidence, and inclusion of follow-up could be useful to improve the access, quality and results of the treatment, considering new models of PR that allow greater access and acceptability.
Using a Community-Informed Translational Model to Prioritize Translational Benefits in Youth Concussion Return-to-Learn Programs
Authors: Takagi-Stewart Julian , Avery Aspen , Deshpande Shyam J. , Andersen Stephanie , Combs Todd , Vavilala Monica S. , Prater Laura 
Published: January 2023

Background The Translational Science Benefit Model (TSBM) was developed to broadly capture systematic measures of health and societal benefits from scientific research, beyond traditional outcome measures. We aimed to develop a systematic process for the application of the TSBM and to then provide an example of a novel application of the TSBM to an ongoing Return-to-Learn (RTL) after youth concussion project involving partnerships with community stakeholders. Methods We invited investigators, project advisory board, and participants of the RTL project to participate in a modified Delphi process. We first generated a list of potential translational benefits using the indicators of the TSBM as guideposts. We then prioritized the benefits on an adapted Eisenhower matrix. Results We invited 35 concussion care or research experts to participate, yielding 20 ranked translational benefits. Six of these recommendations were ranked high priority, six were regarded as investments, and eight were ranked as either low yield or low priority. Discussion This study found that activities such as education and training of stakeholders, development of policy and consensus statements, and innovation in dissemination, were perceived as higher priority than other activities. Our approach using a modified Delphi process and incorporating the TSBM can be replicated to generate and prioritize potential benefits to society from research studies.
Geometry of intracranial aneurysms and of intrasaccular devices may influence aneurysmal occlusion rates after endovascular treatment
Authors: Mantilla Daniel , Berod Alain , Ortiz Andrés F , D Vera Daniela , Nicoud Franck , Costalat Vincent 
Published: January 2023

Introduction The Woven EndoBridge device (WEB) is used to treat wide-neck bifurcation aneurysms. These devices are deployed inside the sac. Therefore, the mesh structure provides apposition with the aneurysm wall and induces aneurysmal thrombosis. The objective of our study was to evaluate the anatomic and device-related parameters and indexes with Computational Fluid Dynamics (CFD) of the intracranial aneurysms before and after WEB simulation and find their relationship to complete occlusion. Materials and methods Using the heterogeneous model based on the marching cubes algorithm, we created 3D representations of 27 bifurcated intracranial aneurysms treated with the single-layer WEB device to evaluate anatomic and device-related parameters with CFD. Results In our CFD analysis, we observed higher large volumes (Va) (0.25 ± 0.18 versus 0.39 ± 0.09, p-value= 0.025) and higher volume to neck surface ratio (Ra) (1.32 ± 0.17 versus 1.54 ± 0.14, p-value= 0.021) in cases with occlusion failure. Conclusions Large aneurysm volumes (Va) and higher volume to neck surface ratio (Ra) could be associated with occlusion failure in aneurysms treated with the WEB device.
Fractal analysis of healthy and diseased vasculature in pediatric Moyamoya disease
Authors: Weber Daniel S. , Huang Kevin T. , See Alfred P. 
Published: January 2023

Background and Purpose Fractal dimension is an objective metric for the notion of structural complexity. We sought to investigate differences in structural complexity between healthy and affected territories of cerebral vasculature in moyamoya, as well as associated scalp vasculature and native transdural collaterals in patients with moyamoya by comparing their respective fractal dimensions. Methods Our cohort consisted of 15 transdural collaterals from 12 patients with unilateral anterior circulation moyamoya. Frames of distal arterial vasculature from internal and external carotid angiograms were selected then automatically segmented and also manually annotated by a cerebrovascular surgeon. In the affected hemisphere, the region with transdural collateral supply was compared to the contralateral region. The resulting skeletonized angiograms were analyzed for their fractal dimensions. Results We found the average fractal dimension (Df) of the moyamoya-side ICA was 1.82 with slightly different means for the anteroposterial (AP) and lateral views (mean  =  1.82; mean  =  1.81). The overall mean for healthy cerebral vasculature was also found to be 1.82 (AP: mean  =  1.83; lateral: mean  =  1.81). Mean Df of native transdural collaterals was found to be 1.82 (AP: mean  =  1.83; lateral: mean  =  1.81). The mean Df difference between autosegmented and manually segmented images was 0.013. Conclusion In accordance with the clinical understanding of moyamoya disease, the distal arterial structural complexity is not affected in moyamoya, and is maintained by transdural collaterals formed by vasculogenesis. Autosegmentation of cerebral vasculature is also shown to be accurate when compared to manual segmentation.
Endovascular treatment of a critical common iliac artery stenosis using intravascular ultrasound guidance in a patient with a known severe iodine contrast allergy
Authors: Fee Charles , Lewis Katharine 
Published: January 2023

Introduction: The mainstay of endovascular treatment in peripheral arterial disease is digital subtraction angiography with an iodinated contrast. In patients with a known contrast allergy, the current most commonly used alternative is to perform carbon dioxide angiography. Operator experience and availability of carbon dioxide (CO2) angiography delivery systems are, however, limited. Intravascular ultrasound is now commonly used in combination with fluoroscopy in peripheral venous interventions and in coronary arterial disease and we propose that this also provides a safe and effective alternative option to guide endovascular intervention in patients with a known contrast allergy. Case report: We present a case describing the use of intravascular ultrasound and fluoroscopy to guide endovascular treatment of a critical left common iliac artery stenosis in a patient with known anaphylaxis to iodinated contrast. Discussion: Intravascular ultrasound is fast becoming the gold standard treatment option in peripheral venous interventions; however, the use in peripheral arterial disease is limited. We believe this is the first case that reports the use of predominantly intravascular ultrasound in endovascular peripheral arterial intervention with a contrast adjunct. Conclusion: We have demonstrated that intravascular ultrasound is a safe and effective alternative or adjunct to iodinated contrast for arterial angiography and stenting in the setting of patient contra-indications.
Effectiveness of iodine-impregnated incise drapes for preventing surgical site infection in patients with clean or clean contaminated wounds: A systematic literature review and cost-consequence analysis
Authors: Sworn Katie , Poku Edith , Thokala Praveen , Sutton Anthea , Foster Steve , Siddall Ian , Reuter Henning 
Published: January 2023

Background: Surgical site infection is a serious complication associated with significant morbidity, mortality and health care expenditure. Aims: To determine the clinical effectiveness and economic impact of using iodine-impregnated incise drapes for preventing surgical site infection. Methods: MEDLINE, Embase, Cochrane Library and CINAHL databases were systematically searched. Critical appraisal and synthesis of clinical evidence informed a decision analytical cost-consequence model. Findings: Nine studies were included in the systematic literature review. Evidence from cardiac surgery patients was considered appropriate to inform the cost analysis. The economic model evaluation estimated cost savings of £549 per patient with the iodophor-impregnated drape in the deterministic analysis and a mean cost saving per patient of £554,172 per 1000 in the probabilistic analysis. Conclusion: Using iodine-impregnated drapes in cardiac surgery patients may effectively reduce infections and provide cost-savings, but further research is required.
Histological and Radiological Assessment of Endogenously Generated Repair Tissue In Vivo Following a Chondral Harvest
Authors: McCarthy Helen S. , Tins Bernhard , Gallacher Peter D. , Jermin Paul , Richardson James B. , Kuiper Jan Herman , Roberts Sally 
Published: January 2023

Objective To examine repair tissue formed approximately 15 months after a chondral harvest in the human knee. Design Sixteen individuals (12 males, 4 females, mean age 36 ± 9 years) underwent a chondral harvest in the trochlea as a pre-requisite for autologous chondrocyte implantation (ACI) treatment. The harvest site was assessed via MRI at 14.3 ± 3.2 months and arthroscopy at 15 ± 3.5 months (using the Oswestry Arthroscopy Score [O-AS] and the International Cartilage Repair Society Arthroscopy Score [ICRS-AS]). Core biopsies (1.8 mm diameter, n = 16) of repair tissue obtained at arthroscopy were assessed histologically (using the ICRS II and OsScore histology scores) and examined via immunohistochemistry for the presence of collagen types I and II. Results The mean O-AS and ICRS-AS of the repaired harvest sites were 7.2 ± 3.2 and 10.1 ± 3.5, respectively, with 80.3% ± 26% repair fill depth on MRI. The histological quality of the repair tissue formed was variable, with some hyaline cartilage present in 50% of the biopsies; where this occurred, it was associated with a significantly higher ICRS-AS than those with no hyaline cartilage present (median 11 vs. 7.5, P = 0.049). Collagen types I and II were detected in 12/14 and 10/13 biopsies, respectively. Conclusions We demonstrate good-quality structural repair tissue formed following cartilage harvest in ACI, suggesting this site can be useful to study endogenous cartilage repair in humans. The trochlea is less commonly affected by osteoarthritis; therefore, location may be critical for spontaneous repair. Understanding the mechanisms and factors influencing this could improve future treatments for cartilage defects.