bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chronic troponin elevation assessed by myocardial T1 mapping in patients with stable coronary artery disease
Authors: Segre Carlos Alexandre W. , de Lemos James A. , Assunção Junior Antonildes Nascimento , Nomura Cesar Higa , Favarato Desiderio , Strunz Celia Maria Cassaro , Villa Alexandre Volney , Parga Filho Jose Rodrigues , Rezende Paulo Cury , Hueb Whady , Ramires Jose Antonio Franchini , Kalil Filho Roberto , Serrano Junior Carlos Vicente 
Published: April 2023

Background:
Cardiac troponin detected with sensitive assays can be chronically elevated, in the absence of unstable coronary syndromes. In patients with chronic coronary artery disease, clinically silent ischemic episodes may cause chronic troponin release. T1 mapping is a cardiovascular magnetic resonance technique useful in quantitative cardiac tissue characterization. We selected patients with anatomically and functionally normal hearts to investigate associations between chronic troponin release and myocardial tissue characteristics assessed by T1 mapping.

Methods:
We investigated the relationship between cardiac troponin I concentrations and cardiovascular magnetic resonance T1 mapping parameters in patients with stable coronary artery disease enrolled in MASS V study before elective revascularization. Participants had no previous myocardial infarction, negative late gadolinium enhancement, normal left ventricular function, chamber dimensions and wall thickness.

Results:
A total of 56 patients were analyzed in troponin tertiles: nativeT1 and extracellular volume (ECV) values (expressed as means ± standard deviations) increased across tertiles: nativeT1 (1006 ± 27 ms vs 1016 ± 27 ms vs 1034 ± 37 ms, ptrend = 0.006) and ECV (22 ± 3% vs 23 ± 1.9% vs 25 ± 3%, ptrend = 0.007). Cardiac troponin I concentrations correlated with native T1(R = 0.33, P = .012) and ECV (R = 0.3, P = .025), and were independently associated with nativeT1 (P = .049) and ventricular mass index (P = .041) in multivariable analysis.

Conclusion:
In patients with chronic coronary artery disease and structurally normal hearts, troponin I concentrations correlated with T1 mapping parameters, suggesting that diffuse edema or fibrosis scattered in normal myocardium might be associated with chronic troponin release.
An Open Label, Randomized, Multicenter Study of Elafibranor in Children With Nonalcoholic Steatohepatitis
Authors: Goyal Nidhi P. , Mencin Ali , Newton Kimberly P. , Durelle Janis , Carrier Carissa , Ugalde-Nicalo Patricia , Noel Benoit , Mouton Julie , Vargas Dawn , Magrez David , Tadde Bachirou , Birman Pascal , Best Brookie M. , Addy Carol , Schwimmer Jeffrey B. 
Published: April 2023

Objectives:
Nonalcoholic fatty liver disease is the most common chronic liver disease in children. Elafibranor, a dual peroxisome proliferator-activated receptor α/δ agonist, has been proposed as a treatment for nonalcoholic steatohepatitis (NASH). The aims were to (1) describe pharmacokinetics (PK), safety, and tolerability of oral elafibranor at 2 doses (80 and 120 mg) in children 8–17 years and (2) assess changes in aminotransferases.

Methods:
Children with NASH were randomized to open-label elafibranor 80 mg or 120 mg daily for 12 weeks. The intent-to-treat analysis included all participants who received at least 1 dose. Standard descriptive statistics and PK analyses were performed.

Results:
Ten males [mean 15.1 years, standard deviation (SD) 2.2] with NASH were randomized to 80 mg (n = 5) or 120 mg (n = 5). Baseline mean alanine aminotransferase (ALT) was 82 U/L (SD 13) and 87 U/L (SD 20) for 80 mg and 120 mg groups, respectively. Elafibranor was rapidly absorbed and well tolerated. Elafibranor plasma exposure increased between the 80 mg and 120 mg dose with a 1.9- and 1.3-fold increase in median C
max and AUC0–24, respectively. End of treatment mean ALT was 52 U/L (SD 20) for the 120 mg group, with a relative mean ALT change from baseline of −37.4% (SD 23.8%) at 12 weeks.

Conclusions:
Once daily dosing of elafibranor was well tolerated in children with NASH. There was a 37.4% relative reduction from mean baseline ALT in the 120 mg group. Decreasing ALT may be associated with improvement in liver histology, thus could be considered a surrogate for histology in early phase trials. These results may support further exploration of elafibranor in children with NASH.
A Multidisciplinary Approach to Infants With GERD-Like Symptoms: A New Paradigm
Authors: Fishbein Mark H. , Kronberg Jessica , Alvarado Stephanie , Bohm Diana , Ideran Patricia , Scarborough Donna R. 
Published: April 2023

Objectives:
Infants with gastroesophageal reflux disease (GERD)-like symptoms have been classically defined as having a wide array of symptoms. In these instances, anti-reflux medications are ineffective and overprescribed. Rather these symptoms are more attributable to dysphagia and unsettledness/colic. To address these conditions at our center, both speech language pathologist (SLP) and/or occupational therapist (OT) have contributed to evaluation. We hypothesized that dysphagia and unsettledness/colic are highly prevalent, yet under recognized in this population.

Methods:
Full-term infants with typical development and under 6 months of age (N = 174) were included. Infants with suspected dysphagia and/or evident colic/unsettledness were evaluated by SLP and OT, respectively.

Results:
GERD-like symptoms were present in 109 infants with attributes of dysphagia in n = 46, unsettledness/colic in n = 37, and combined in n = 26.

Conclusion:
A multidisciplinary approach, including SLP and OT, is recommended for the evaluation of infants with GERD-like symptoms.
Is mirror therapy associated with progressive muscle relaxation more effective than mirror therapy alone in reducing phantom limb pain in patients with lower limb amputation?
Authors: Brunelli Stefano , D’Auria Lucia , Stefani Andrea , Giglioni Filippo , Mariani Giorgio , Ciccarello Marcello , Benedetti Maria Grazia 
Published: April 2023

Mirror therapy is a widely used treatment for phantom limb pain (PLP) relief in patients with limb loss. Less common is progressive muscle relaxation (PMR), used mostly in other medical conditions (psychological, terminal cancer pain, etc). The purpose of this study is to evaluate the efficacy of a mirror therapy preceded by PMR intervention compared to mirror therapy preceded by unguided generic relaxation-mirror therapy in patients with lower limb amputation suffering from PLP. This pilot study was a single-blind, controlled, randomized trial. Thirty lower limb amputees suffering from PLP were recruited and randomly assigned to three groups respectively undergoing a PMR-mirror therapy rehabilitative intervention, generic relaxation-mirror therapy, and conventional physiotherapy (ConvPT). Selected items from Prosthesis Evaluation Questionnaire (PEQ) and the Brief Pain Inventory (BPI) were used to test the pain features at the beginning and 1 week after 3 weeks of intervention.
A decrease of about 65% was found in the rate and duration of PLP at the PEQ in PMR-mirror therapy with respect to generic relaxation-mirror therapy (about 30%) and ConvPT (about 6%). A decrease of about 90% in intensity (worst and average) of PLP in PMR-mirror therapy when compared to generic relaxation-mirror therapy (about 45%) and ConvPT (about 20%) was found at the BPI.
We preliminary concluded, albeit with limitations due to the small sample of patients, that mirror therapy can improve PLP when associated with PMR. Further studies are required to confirm that PMR could be an effective technique for more successful PLP management.
Isolated pericardial hydatid cyst: a case report
Authors: Tlohi Imane , Karim Fatiha , Rhaichi Hind , Elamraoui Asmaa , Habbal Rachida 
Published: April 2023

Introduction and importance:
Hydatid cysts are most commonly found in the liver and lungs but rarely in the heart. Most heart hydatid cysts are located in the left ventricle and the interventricular septum. Few cases of isolated pericardial hydatid cysts have been reported in the literature. Cardiac involvement can have serious consequences and can be fatal if the cyst perforates. Methods for diagnosing cardiac hydatid cysts include serological tests and noninvasive imaging tests such as transthoracic echocardiography, computed tomography, and magnetic resonance imagery.

Case presentation:
Here we report a rare case of an isolated pericardial hydatid cyst in a young woman who complained of sternal chest pain, palpitations, and shortness of breath. The diagnosis of pericardial hydatic cyst in our case was confirmed by serologic tests for hydatidosis and the results of echocardiography and tomography. No other localizations were found after realizing a body scan. The patient was started on oral albendazole and then was referred to surgery for the resection of the cardiac mass.

Conclusion:
Cardiac hydatid cyst represents a rare disease, frequently associated with fatal complications, which makes its early diagnosis and treatment an urgent priority.
Management of floating arm: a case report
Authors: Biglari Farsad , Zameni Nadia , Sabaghzadeh Amir , Tadayon Niki , Kafiabadi Meisam J. 
Published: April 2023

Introduction and importance:
The floating arm is a rare fracture, and so far there have been few cases reported. The treatment of this type of fracture is challenging and depends on several factors including age, underlying conditions, daily level of activity, fracture pattern, surgeon’s experience, and availability of devices.

Case presentation:
This study report a 59-year-old man with a rare humeral fracture and a severe crush injury of the forearm. There is a paucity of evidence regarding the management of concomitant floating arm and soft tissue injuries in the literature.
The patient was managed by minimally invasive plate osteosynthesis (MIPO) and vacuum-assisted closure (VAC) followed by a split-thickness skin graft.

Clinical discussion:
The concurrent presence of the two pathologies exacerbated the patient’s condition and made the management challenging. In this case, the authors have used the MIPO approach to fix both fractures with minimal soft tissue injury. To manage the prominent soft tissue injury, we applied the VAC device. VAC has the advantages of reducing edema, controlling bacterial growth, and promoting granulation tissue formation, leading to faster cellular turnover and healing.

Conclusions:
In patients with floating arm, especially with concomitant soft tissue damage, the MIPO approach is a safe, minimally invasive, and quick method with minimal bleeding.
Effects of floods on the mental health of Pakistanis: a commentary
Authors: Yousuf Juvairia , Mehmood Hassan , Aquil Sakina , Rija Aiman , Syyeda Rahmat Zainab , Malikzai Abdullah 
Published: April 2023

Over the years, worsening climate change has led to multiple spells of heavy rain and floods in Pakistan, with the 2022 floods ranked as the deadliest in world history. To top it off, decades of political instability, mental health stigma, and lack of psychological support have tipped the after-effects over the edge. These floods have taken a toll on more than 13 000 people, with inaccessibility to vital necessities leading to further deaths every week. Local and international support is imminent for better handling of the crisis and reducing the incidence of post-traumatic stress disorders and other mental health-related issues.
Quality of life of breast cancer survivors: a comparison of breast conserving surgery versus total mastectomy with and without immediate reconstruction: a prospective cohort study
Authors: Vohra Lubna M. , Javed Saad Malik , Jabeen Dua , Abidi Syeda Sakina , Tahseen Muhammad Umair 
Published: April 2023

Background:
Quality of life after breast cancer surgery is frequently ignored during and after treatment in many cancer survivors. To enhance this aspect of patient’s life should be the primary goal of every cancer treatment. Therefore, the present study aimed to highlight the quality of life and patients’ satisfaction with their breast cosmesis following breast conserving surgery (BCS), total mastectomy with and without reconstruction.

Material and methods:
Data were collected prospectively from cancer patients who had undergone breast surgery at our institution from 1 January 2015 to 31 December 2021. The validated Breast-Q questionnaires were utilized for conducting patient interviews and mean scores between three cohorts were compared using one-way ANOVA test / Kruskal–Wallis test.

Results:
Overall, 210 patients were recruited in which 70 patients (33.3%) had undergone BCS, 71 patients (33.8%) had total mastectomy only and 69 (32.9%) patients had total mastectomy with reconstruction. Physical well-being scores were consistent between the three groups while patients operated with total mastectomy with reconstructive surgery scored higher in sexual and psychosocial health measures as compared to patients of total mastectomy. However, BCS patients were the most satisfied with their cosmetic outcome following patients of total mastectomy with reconstruction and without reconstruction.

Conclusion:
Reconstruction postmastectomy has a positive impact on sexual and psychosocial well-being of survivors; however, those who had breast conservation were more satisfied with cosmetic outcome post-surgery as compared with mastectomy with or without reconstruction.
Investigating the correlation between hip abductor muscle strength and width in anteroposterior pelvic radiographs in hip revision candidates following previous total hip arthroplasty: a cross-sectional study
Authors: Shafiei Seyyed Hossein , Nourbakhsh Amir Salar , Siavashi Babak , Soleimani Mohammad , Talebian Parham 
Published: April 2023

Background:
The changes in strength of hip abductor muscles after total hip arthroplasty may depend on its anatomical parameters. In the present study the correlation between the strength of the hip abductor muscles before hip revision surgery and the diameter of the abductor muscles in the pelvic anterior posterior X-ray was investigated.

Methods:
This cross-sectional study included the patients underwent hip arthroplasty and were candidates for revision surgery. The diameter of the hip abductor muscles on the affected and unaffected sides were calculated based on plain radiography. Patients were also clinically examined and their abductor muscle strength on both sides were determined based on Medical Research Council Manual Muscle Testing scale.

Results:
A total of 51 patients were included in the study and after exiting 20 patients; finally 31 patients’ data were analyzed. Based on results there was a significant correlation between the ratios of muscle strength and muscle diameter in affected side to unaffected side (r=0.517, P=0.003). As indicated in Table 3, such significant association was revealed in men (r=0.719, P=0.001), but not in women (r=-0.092, P=0.754). Also, this relationship was found to be significant in patients older than 60 years (r=0.529, P=0.011), not in the younger.

Conclusion:
In patients undergoing total hip arthroplasty revision surgery, there is a strong association between the ratio of strength and diameter of the abductor muscles in the affected side to the unaffected side especially in men and older ages.
Twenty-year experience in liver surgery in metastatic colorectal patients: a case series study in Ukraine
Authors: Burlaka Anton , Ryzhov Anton , Ostapenko Yurii , Bankovska Natalia , Kopchak Kostiantyn , Zvirych Vitalii , Golovko Tetiana , Shypko Andriy , Lukashenko Andrii 
Published: April 2023

Background:
For the last three decades, the world surgical community successfully adopted different surgical strategies for colorectal cancer (CRC) patients with liver metastases (LM), however, we are still seeing the evolution of treatment guidelines. The purpose of the study was to analyze a 20-year evolution of CRC patients with LM being treated in a specialized state Ukrainian oncological center.

Materials and methods:
The retrospective analysis of 1118 CRC patient cases using prospectively collected patient data from the National Cancer Institute registry. The time ranges between 2000–2010 and 2011–2022 and the LM manifestation – metachronous (M0)/synchronous (M1) were the two main grouping criteria.

Results:
The overall survival 5-year survival of patients who had surgery between 2000–2011 and 2012–2022 was 51.3 and 58.2% (P=0.61) for the M0 cohort and 22.6 and 34.7% at M1 (P=0.002), respectively. The results of the multivariate analysis in 1118 cases revealed that liver re-resection and regional lymph node dissection ≥D2 were associated with better overall survival [hazard ratio (95% CI)=0.76 (0.58–0.99) P=0.04] in the M0 cohort and receiving at least 15 courses of chemotherapy had better recurrence-free survival rates [hazard ratio (95% CI)=0.97 (0.95–0.99), P=0.03] for both M0 and M1.

Conclusions:
It was shown the improvement of the oncological prognosis for CRC patients with synchronous LM who were treated after 2012. The adaptation of world experience algorithms and the surgical strategy evolution have become the root cause of the above.
Effect of intravenous tramadol versus pethidine on postspinal shivering control among mothers during cesarean section at Wolaita Sodo University Comprehensive Specialized Hospital, Southern Ethiopia: a prospective observational cohort study
Authors: Mamo Mebratu , Zema Zewde , Abera Wogayehu , Tila Mebratu , Darma Bahiru , Suileman Mohammed , Gurmu Mesfin , Ayele Mitiku , Demeke Tsegaye , Sintayhu Ashagire , Dendir Getahun 
Published: April 2023

Background:
Postspinal anesthesia shivering is a common complication during spinal anesthesia. It is very unpleasant and physiologically stressful for patients and challenging for healthcare providers. Shivering could be treated with tramadol or pethidine. However, the comparative effectiveness of one drug over the other drug has not been proven with a low-drug setup.

Objective:
To compare the effect of intravenous tramadol versus pethidine on postspinal shivering control among obstetric mothers who underwent cesarean section.

Methods and materials:
A prospective cohort study design was conducted on 180 ASA (American Society of Anesthesiology) I and II obstetric mothers. A systematic random sampling method was employed. Data were entered into EpiData version 4.6 and exported into SPSS version 25 for analysis. The independent sample t test was used to compare the difference of means between groups for normally distributed data, and the Mann–Whitney U test was used for non-normally distributed data. Categorical data were analyzed using the chi-squared test. Data were presented by mean±standard deviation for normally distributed data and median and interquartile range for non-normally distributed data. Categorical data were presented as numbers and frequencies. P values less than 0.05 were considered statistically significant.

Results:
One hundred eighty participants were used for analysis. The mean time of shivering disappearance was 5.5±1.75 min and 6.6±2.08 min in tramadol and pethidine groups, respectively (P<0.001). The hemodynamic changes were all comparable between the two groups. The difference in the recurrence of shivering after treatment was significant between the groups (P<0.001). Sedation was higher in the pethidine group, 9 (10%), than in the tramadol group, 2 (2.2%). Nausea and vomiting were found to be higher in the tramadol group, 10 (11.1%), than in the pethidine group, 5 (5.6%).

Conclusions:
Tramadol controlled shivering early, and recurrence of shivering and incidence of sedation were also low in the tramadol group. Therefore, tramadol is as effective as pethidine for the treatment of postspinal shivering in obstetric mothers who underwent cesarean delivery. So tramadol can be used as an alternative for postspinal shivering in obstetric mothers.
A 5-year retrospective study of intraocular pressure control after trabeculectomy: a retrospective cohort study
Authors: Orezime Atima Mayor , Idakwo Ugbede , Komolafe Oyeronke , Emmanuel Otomi Ogho , Eisuke Shimizu , Shintaro Nakayama , Balogun Emmanuel Oluwadare , Dingwoke Emeka John , Jacob Orugun Ayodele , Melchizedek Munaje Ignatius , Douglas Pam Jah 
Published: April 2023

Background:
Glaucoma is a group of diseases that damage the optic nerve in the eye, resulting in vision loss and, in severe cases, blindness. The prevalence of glaucoma and glaucoma blindness is highest in West Africans.

Objective:
The study presents a 5-year retrospective analysis of intraocular pressure (IOP) and complications after trabeculectomy.

Materials and methods:
Trabeculectomy was performed using 5 mg/ml of 5-fluorouracil. A gentle diathermy was performed to secure hemostasis. Using a blade fragment of the scleral thickness, a 4×3 mm rectangular scleral flap was dissected. The central part of the flap was dissected 1 mm into the clear cornea. Before being tailed down, the patient was given topical 0.05% dexamethasone qid, 1% atropine tid, and 0.3% ciprofloxacin qid for 4–6 weeks. Patients with pain were given pain relievers, and all patients with photophobia were given sun protection. A successful surgical outcome was defined as a postoperative IOP of 20 mmHg or less.

Results:
There were 161 patients over the 5-year period under review, with men constituting 70.2% of the total. Out of 275 eyes operated on, 82.9% were bilateral cases, while 17.1% were unilateral. Glaucoma was found in both children and adults aged 11–82 years. However, it was observed to predominate between the ages of 51 and 60, with males having the highest incidence. The average preoperative IOP was 24.37 mmHg, while it was 15.24 mmHg postoperatively. The complication with the highest ranking was shallow anterior chamber (24; 8.73%) due to overfiltration, followed by leaking bleb (8; 2.91%). The most common late complications were cataract (32; 11.64%) and fibrotic bleb (8; 2.91%). Bilateral cataracts developed at an average of 25 months after trabeculectomy. It was seen in patients aged 2–3 with a frequency of 9, whereas 5 years after, 77 patients had improved vision, with a postoperative visual acuity of 6/18-6/6.

Conclusion:
Postoperatively, the patients had satisfying surgical outcomes as a result of the decrease in preoperative IOP. Although postoperative complications occurred, they had no effect on the surgical outcomes because they were temporary and not optically threatening. In our experience, trabeculectomy is an effective and safe procedure for achieving IOP control.