bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bewegungserhaltende operative Korrektur der idiopathischen adoleszenten Skoliose – Pro Fusion
Authors: Halm Henry , Berlin Clara 
Published: March 2022

ZusammenfassungInstrumentierte spinale Korrekturen und Fusionen in der Wirbelsäulenchirurgie sind häufig durchgeführte operative Eingriffe bei der adoleszenten idiopathischen Skoliose ab einem Cobb-Winkel von >35–45°, abhängig von der Lokalisation. Neben der aktuell nachrangigen ventralen Derotationsspondylodese ist insbesondere die dorsale Korrekturspondylodese mit Pedikelschrauben-Doppelstabsystemen der Goldstandard. Sowohl ventrale als auch dorsale korrigierende und fusionierende Verfahren sind in der Literatur zahlreich beschrieben. Die Zuverlässigkeit, hervorragende Ergebnisse sowie geringe Komplikationsraten wurden in Langzeitstudien nachgewiesen. Ventrale Verfahren sind bei strukturell einbogigen thorakalen, thorakolumbalen beziehungsweise lumbalen Skoliosen vor allem dann indiziert, wenn dadurch im Vergleich zu dorsal Segmente eingespart werden können. Der Derotationseffekt ist größer als bei dorsalen Verfahren, was sich klinisch in einer besseren Korrektur von Rippenbuckel und Lendenwulst ausdrückt. Die dorsale Korrektur weist keine Einschränkung bezüglich Typen der Lenke-Klassifikation auf. Ein neues, bewegungserhaltendes, wachstumslenkendes Verfahren ist das ventrale Tethering (Zuggurten) der Wirbelkörper („Vertebral Body Tethering“). Es wird fälschlicherweise als „minimalinvasiv“, Flexibilität erhaltend („inneres Korsett“) und komplikationsarm beworben. Dabei ist jedoch die Indikation des Verfahrens in Bezug auf das Wachstumsstadium der Patienten, den Krümmungstyp und die Instrumentationslänge erheblich eingeschränkt. Das System ist mit einer deutlich erhöhten Rate an Überkorrekturen als auch Korrekturverlusten, perioperativen Komplikationen und chirurgischen Revisionen verbunden. Aufgrund der fehlenden Langzeitdaten (Follow-up <5 Jahre) sind die Sicherheit und das Behandlungsergebnis des Verfahrens als kritisch zu bewerten. Hinzu kommt, dass sich keine wesentliche Verkürzung der Operationszeit im Vergleich zur dorsal instrumentierten Korrekturspondylodese zeigt. Die Komplikationsraten sind zum Teil erheblich. In Bezug auf die mittelfristigen Ergebnisse für die jungen Patienten ist die verzögert einsetzende (meist nach 2–3 Jahren) und zeitlich zunehmende Rate an Rupturen des Tetherings mit Korrekturverlusten sehr kritisch zu betrachten.
Konservative Adipositastherapie
Authors: Engeli Stefan 
Published: March 2022

Liebe Leserinnen und Leser, liebe Kolleginnen und Kollegen,2022 startet wie 2021 mit den gleichen Sorgen und Hoffnungen mit Blick auf die
Corona Pandemie - das haben wir uns alle so nicht vorstellen können!
Dennoch – auch viele andere wichtige Themen bedürfen der
Aufmerksamkeit und wir alle wissen, dass das Thema Adipositas nie an Bedeutung
verliert. Und so richten wir den Blick auf die neue Bundesregierung und sind
gespannt, ob hier neue Impulse in den Bereichen Ernährung,
Lebensmittelwerbung und Umgang mit dem Thema Adipositas erlebt werden
können. Zu hoffen ist es!
Das Behandlungsprogramm bei Adipositas mit den Schwerpunkten
Essverhalten und Lebensstiländerung (BASEL) ist effektiv, aber nicht
kostendeckend
Authors: Goetschmann Mara , Nickolai Beate , Hegar Karin , Fäh David , Kiss Caroline 
Published: March 2022

Zusammenfassung
Hintergründe Gruppenprogramme zur Adipositastherapie unter
Alltagsbedingungen sind wenig untersucht. Diese Studie analysiert das
interprofessionelle Behandlungsprogramm bei Adipositas mit den Schwerpunkten
Ernährungsverhalten und Lebensstiländerung (BASEL)
bezüglich Effektivität und betrieblicher Wirtschaftlichkeit.
Material und Methodik Retrospektive Untersuchung der Gewichtsentwicklung
von Programmstart bis Programmende sowie bis zum Nachtreffen. Analyse der
Zusammenhänge zwischen einer Gewichtsreduktion≥5% und
weiteren Faktoren durch eine multivariate logistische Regression.
Zusätzlich erfolgte eine Kostenanalyse.
Ergebnisse Die 454 Teilnehmenden hatten ein mittleres Ausgangsgewicht von
114 kg (68–195 kg), BMI
40 kg/m2 (25,2–63,7), waren 46 Jahre
(17–75) und mehrheitlich Frauen (72%). Bei Programmende lag die
mittlere Gewichtsreduktion bei 4,9% (SD±4,2%)
(44,3% erreichten Reduktion≥5%; 11,5% erreichten
Reduktion≥10%). Beim Nachtreffen (n=256) betrug die
Reduktion 7% (SD±6,4%) (33,5% erreichten
Reduktion≥5%; 16,7% erreichten
Reduktion≥10%). Personen, die≥75% der Lektionen
und das Nachtreffen besuchten, hatten bei Programmende eine 3,8-mal
höhere Chance zur erfolgreichen Gewichtsreduktion (≥5%),
als Personen, die<75% der Lektionen besuchten und nicht zum
Nachtreffen erschienen (p=<0,001). Der Kostendeckungsgrad des
Programms lag bei 66%.
Schlussfolgerung Das BASEL ist ein effektives
Adipositas-Behandlungsprogramm, wobei die regelmäßige Teilnahme
mit einem besseren Therapieerfolg assoziiert war. Über die
Hälfte der Personen mit hoher Teilnahmerate erzielten eine klinisch
relevante Gewichtsreduktion von≥5%. Das Programm ist aufgrund
tiefer Gruppentarife der Krankenversicherer in der Schweiz für Anbieter
nicht kostendeckend.
Skin Incision Selection in Superobese Women Undergoing Cesarean Birth
Authors: Grasch Jennifer L. , Thompson Jennifer L. , Alamri Lamia A. , Osmundson Sarah S. 
Published: March 2022

Objective The aim of this study was to examine whether vertical versus transverse skin incision is associated with increased wound complications in superobese women undergoing cesarean.
Study Design This is a secondary analysis of a retrospective cohort study that included women with a body mass index (BMI) ≥ 50 kg/m2 and a cesarean birth with documented skin incision type from 1/1/2008 to 12/31/2015 at a single academic medical center. The primary outcome was a composite of wound complications: infection requiring antibiotics including superficial cellulitis, deep and organ space infections requiring packing, vacuum placement or exploration and debridement in the operating room. Secondary outcomes included estimated blood loss (EBL), time from skin incision to delivery, need for classical or T-hysterotomy, prolonged hospital admission (>4 days), and a composite of adverse neonatal outcomes. The primary exposure was skin incision type, transverse or vertical. Modified Poisson regression variance was used to adjust for differences in baseline characteristics.
Results During the study period, 298 women underwent a cesarean with a known skin incision type. Vertical skin incision occurred in 25.8%. Women with a vertical skin incision were younger, had a higher BMI at delivery, had less weight gain in pregnancy, and were less likely to have labored prior to cesarean. Wound complications were not significantly more common in women with a vertical skin incision after adjusting for covariates (vertical 48.1 vs. transverse 29.4%, adjusted relative risk (aRR): 1.31, 95% confidence interval [CI]: 0.92–1.86). Compared with a transverse skin incision, vertical skin incision was associated with an increased risk for classical hysterotomy (67 vs. 17%, aRR: 2.96, 95% CI: 2.12–4.14), higher EBL, prolonged hospital stay, and composite neonatal morbidity. There were no statistically significant differences in the time from skin incision to delivery.
Conclusion In superobese women, vertical skin incision was not associated with increased wound complications, but was associated with increased risk for classical hysterotomy.
Key Points
Entorse no tornozelo em jovens atletas: Um estudo retrospectivo de 2 anos em um clube multiesportivo
Authors: Santos Thiago Ribeiro Teles , Silva Edilene Isidora , Leite Marcela Mendes de Almeida Gomide , Pinho Guilherme Bernardone , Marcati Mateus Martins , Bittencourt Natalia Franco Netto 
Published: March 2022

Resumo
Objetivo O presente estudo teve como objetivo analisar entorses no tornozelo em jovens atletas de basquete, futsal, ginástica artística, trampolim, tênis, judô e vôlei ao longo de duas temporadas.
Métodos Foram investigados dados de 529 atletas no 1° ano e 495 atletas no 2° ano de análise a partir do banco de dados de registros de lesões de um clube esportivo. Foram considerados os seguintes dados: as características demográficas (idade, massa corporal, altura e sexo), o mecanismo (contato ou não contato), a severidade, o momento em que ocorreu a lesão e a recorrência. Além disso, foram calculadas a taxa de incidência, o risco de lesão da primeira entorse no tornozelo e a razão da taxa de incidência entre os esportes.
Resultados Os atletas sofreram 124 entorses no tornozelo nos 2 anos de análise. A maioria ocorreu durante o treinamento (76,6%) e levou à interrupção da prática esportiva (75,8%). A recorrência da lesão foi baixa: 2 atletas (1,6%) tiveram recorrência no mesmo ano e 5 (4,0%) no ano seguinte. A taxa de incidência (0,79 a 12,81 por 1.000 horas) e o risco de lesão (1,14 a 19,44%) variaram entre os esportes. Vôlei, basquete e futsal apresentaram a maior incidência de lesões. Tênis, ginástica e trampolim apresentaram a menor incidência de lesões. O judô apresentou uma taxa de incidência diferente das do basquete e do vôlei no 1° ano e semelhante às dos outros esportes no 2° ano.
Conclusão A entorse no tornozelo impactou muito a prática esportiva e apresentou características que diferem entre os esportes investigados. Esses achados podem contribuir para o desenvolvimento de programas de prevenção de lesões.
An Algorithmic Approach to the Surgical Management of Sternal Dehiscence: A Single-Center Experience
Authors: Cauley Ryan P. , Barron Sivana , Slatnick Brianna , Maselli Amy , Kang Christine , Delvalle Diana , Chu Louis , Morris Donald 
Published: March 2022

Abstract
Background Deep sternal wound complications following sternotomy represent a complex challenge. Management can involve debridement, flap reconstruction, and rigid sternal fixation (RSF). We present our 11-year experience in the surgical treatment of deep sternal wound dehiscence using a standardized treatment algorithm.
Methods A retrospective review was conducted of all 134 cardiac patients who required operative debridement after median sternotomy at a single institution between October 2007 and March 2019. Demographics, perioperative covariates, and outcomes were recorded. Univariate and subgroup analyses were performed.
Results One-hundred twelve patients (83.5%) with a deep sternal dehiscence underwent flap closure and 56 (50%) RSF. Of the patients who underwent flap closure, 87.5% received pectoralis advancement flaps. A 30-day mortality following reconstruction was 3.9%. Median length of stay after initial debridement was 8 days (interquartile range: 5–15). Of patients with flaps, 54 (48%) required multiple debridements prior to closure, and 30 (27%) underwent reoperation after flap closure. Patients who needed only a single debridement were significantly less likely to have a complication requiring reoperation (N = 10/58 vs. 20/54, 17 vs. 37%, p = 0.02), undergo a second flap (N = 6/58 vs. 17/54, 10 vs. 32%, p < 0.001), or, if plated, require removal of sternal plates (N = 6/34 vs. 11/22, 18 vs. 50%, p = 0.02).
Conclusion Although sternal dehiscence remains a complex challenge, an aggressive treatment algorithm, including debridement, flap closure, and consideration of RSF, can achieve good long-term outcomes. In low-risk patients, RSF does not appear to increase the likelihood of reoperation. We hypothesize that earlier surgical intervention, before the development of systemic symptoms, may be associated with improved outcomes.
Intramuscular Deep Inferior Epigastric Vessels Are Insulated by Perimysial Fibroadipose Tissue Network
Authors: Kim Young Chul , Jo Taehee , Hur Joon , Han Hyun Ho , Kim Eun Key , Eom Jin Sup 
Published: March 2022

Abstract
Background The difficulty of elevating a deep inferior epigastric perforator (DIEP) flap largely depends on the intramuscular course of the vessel and the perforator. Previous studies, however, have lacked histologic descriptions of the vessels and surrounding structures. The present study analyzed the histologic aspects of the deep inferior epigastric vessels and perforators, focusing on their perivascular relationships with muscle fibers.
Methods The abdomen of a cadaver was histologically evaluated to identify intramuscular deep inferior epigastric vessels. Tissue samples were stained with hematoxylin and eosin and with Masson trichrome stain to visualize fibrous components. Twenty-one DIEPs from 12 patients were also evaluated to determine the histologic aspects of the perivascular structure. In the cross-section of each perforator and adjacent tissue, the perforator-to-muscle distance and trichrome-stained area were measured, and the correlation of the perforator size with the perforator-to-muscle distance and the percent collagenous portion of the distance were determined.
Results Histologic analysis showed that the deep inferior epigastric vessels and perforators were encased by perimysial connective tissue and were not in direct contact with the muscle fibers. The smaller perimysia branched out from the larger perimysia, forming an interconnecting network structure. Correlation analysis showed that larger vessels had more collagenous portions in the perimysial structures (Spearman's ρ = 0.537, p = 0.012).
Conclusion The deep inferior epigastric vessels and perforators reside in a perimysial fibroadipose tissue network. This may provide surgeons with a microscopic perspective during DIEP dissections. Having an idea of the perforator anatomy in microscopic level can help us to perform safer perforator dissections.
Timing of Maternal Discharge after Cesarean Delivery and Risk of Maternal Readmission
Authors: Oben Ayamo , Perez William , Jauk Victoria C. , Boggess Kim , Clark Erin , Saade George , Esplin M Sean , Longo Sherri , Cleary Kirsten L. , Wapner Ronald , Blackwell Sean C. , Owens Michelle Y. , Ambalavanan Namasivayam , Szychowski Jeff M. , Tita Alan 
Published: March 2022

Objective Despite legislation and hospital policies (present in some institutions) mandating a minimum length of stay in an effort to decrease the frequency of hospital readmissions, the effectiveness of this approach remains uncertain.We hypothesized that following cesarean delivery (CD), the rates of maternal readmission or unscheduled health care visits are lower in patients discharged on postoperative day (POD) 3 or ≥4 as compared with those discharged earlier on POD 2.
Methods This is a secondary analysis of a multicenter randomized trial comparing adjunctive azithromycin for unscheduled CD to prevent infection. Groups were compared based on the duration of hospitalization measured in days from delivery (POD 0) to day of discharge and categorized as POD 2, 3, and ≥4. The primary outcome was the composite of any maternal postpartum readmission, unscheduled clinic, or emergency room (ER) visit, within 6 weeks of delivery. Secondary outcomes included components of the primary outcome and neonatal readmissions. We excluded women with hypertensive disorders of pregnancy and infections diagnosed prior to POD 2.
Results A total of 1,391 patients were included. The rate of the primary outcome of any readmission increased with POD at discharge: 5.9% for POD 2, 9.4% for POD 3, and 10.9% for POD ≥4 group (trend for p = 0.03). The primary outcome increased with later discharge (POD ≥4 when compared with POD 2). Among components of the composite, ER and unscheduled clinic visits, but not maternal readmissions, increased with the timing of discharge for patients discharged on POD ≥4 when compared with POD 2. Using logistic regression, discharge on POD 3 and on POD ≥4 was significantly associated with the composite (adjusted odds ratios [aOR] 2.6, 95% confidence interval [CI] [1.3–5.3]; aOR 2.9, 95% CI [1.3–6.4], respectively) compared with POD 2.
Conclusion The risk of maternal readmission composite following uncomplicated but unscheduled CD was not lower in patients discharged home on POD 3 or ≥4 compared with patients discharged earlier (POD 2).
Key Points
Aspirin for Primary Cardiovascular Prevention in Patients with Diabetes: Uncertainties and Opportunities
Authors: Del Bianco-Rondeau Mélina , Robert-Halabi Maxime , Bloom Samara , Rabasa-Lhoret Remi , Tardif Jean-Claude , Lordkipanidzé Marie , Marquis-Gravel Guillaume 
Published: March 2022

AbstractThe use of the antiplatelet agent aspirin (acetylsalicylic acid) was previously routinely recommended for the primary prevention of cardiovascular (CV) events in patients with diabetes, but recent large-scale randomized trials have failed to demonstrate a sizeable net clinical benefit with a once-daily, low-dose (81–100 mg) regimen in this population. Previous pharmacokinetic and pharmacodynamic studies have suggested that the aspirin formulation (enteric-coated) and dosing schedule (once daily) studied in randomized trials for primary prevention of CV events defining contemporary clinical practice may not leverage the full potential of the drug, particularly in patients with diabetes. Indeed, the diabetic platelets bear characteristics that increase their thrombotic potential and alter their pharmacologic response to the drug. Consequently, the appropriateness of studying a uniform aspirin regimen in landmark primary prevention trials needs to be revisited. In this review, we present the evidence showing that diabetes not only increases baseline platelet reactivity, but also alters platelet response to aspirin through different mechanisms including a faster platelet turnover rate. Obesity, which is frequently associated with diabetes, also impacts its pharmacokinetics via an increase in distribution volume. Small-scale pharmacokinetic and pharmacodynamic studies have suggested that the relative aspirin resistance phenotype observed in patients with diabetes may be reversed with a twice-daily dosing schedule, and with nonenteric-coated aspirin formulations. Properly powered randomized controlled trials investigating the efficacy and safety of aspirin dosing schedules and formulations tailored to the population of patients with diabetes are urgently required to optimize patient care.
Intraoperative Alcoholization of the Pituitary Gland Does Not Reduce the Recurrence Rate of Growth Hormone Secreting Pituitary Adenomas
Authors: Gill Amarbir S. , Sumsion Jorgen , Alt Jeremiah A. , Karsy Michael , Couldwell William T. , Menacho Sarah T. 
Published: March 2022

Abstract
Objective Although the role of intraoperative alcoholization of the pituitary gland has been examined for the management of malignant tumor metastases and Rathke's cleft cysts, no such studies have been conducted relating to growth hormone (GH) secreting pituitary tumors, despite the high rate of recurrence in this cohort of patients. Here, we sought to understand the impact of adjunctive intraoperative alcoholization of the pituitary gland on recurrence rates and perioperative complications associated with resection of GH-secreting tumors.
Methods This is a single-institution retrospective cohort study analyzing recurrence rates and complications among patients with GH-secreting tumors who received intraoperative alcoholization of the pituitary gland postresection versus those that did not. Welch's t-tests and analysis of variance (ANOVA) analyses were employed to compare continuous variables between groups, whereas chi-squared tests for independence or Fisher's exact tests were used for comparing categorical variables.
Results A total of 42 patients (n = 22 no alcohol and n = 20 alcohol) were included in the final analysis. The overall recurrence rates did not significantly differ between the alcohol and no alcohol groups (35 and 22.7%, respectively; p = 0.59). The average time to recurrence in the alcohol and no alcohol groups was 22.9 and 39 months, respectively (p = 0.63), with a mean follow-up of 41.2 and 53.5 months (p = 0.34). Complications, including diabetes insipidus, were not significantly different between the alcohol and no alcohol groups (30.0 vs. 27.2%, p = 0.99).
Conclusion Intraoperative alcoholization of the pituitary gland after resection of GH-secreting pituitary adenomas does not reduce recurrence rates or increase perioperative complications.
Measuring Hearing Aid Benefit Using a Willingness-To-Pay Approach
Authors: Chisolm Theresa Hnath , Abrams Harvey B. 
Published: March 2022

AbstractThe value associated with self-perceived hearing aid benefit was assessed using a “willingness-to-pay” (WTP) approach. Abbreviated Profile of Hearing Aid Benefit (APHAB) data were obtained from 79 veterans who also indicated how much they were willing to pay for each hearing aid. The results of a multiple regression analysis revealed that veterans were willing to pay $22.06 more for a hearing aid for each 1 -point increase in APHAB global benefit. A second multiple regression analysis revealed that the APHAB subscale scores for Ease of Communication (EC) benefit and understanding speech in Background Noise (BN) benefit, as well as income level, were all significant predictors of WTP. In addition, each 1-point increase in EC, BN, and Reverberation benefit increased the value associated with amplification by $16.32, $16.88, and $13.78, respectively. Each 1 -point increase in the Aversiveness of Sounds subscale decreased the value associated with amplification by $7.63.The mean WTP across all income groups was $981.71 per hearing aid. These data are interpreted to support the use of WTP as a valid measure of hearing aid benefit.
Abbreviations: APHAB = Abbreviated Profile of Hearing Aid Benefit, AV = Aversiveness of Sounds, BN = Background Noise, COSI = Client Oriented Scale of Improvement, EC = Ease of Communication, RV = Reverberant Environments, VA = Department of Veterans Affairs, WTP = willingness to pay
Auditory-Verbal Graduates: Outcome Survey of Clinical Efficacy
Authors: Goldberg Donald M. , Flexer Carol 
Published: March 2022

AbstractThis project is an update of an earlier study on American and Canadian graduates of auditory-verbal programs. Survey research was conducted to obtain information on a variety of topics. Overall, the current results again indicated that the majority of respondents were integrated into “regular” or “typical” learning and living environments. In view of the earlier identification of hearing loss and the early fitting of sensory aids and availability of cochlear implant technology, coupled with intervention that emphasizes auditory learning, it is suggested that today’s infants have the potential to become independent, participating, and contributing citizens in mainstream society.
Political congruence between adolescence and their parents: evidence from a quasi-experimental local elections in the city of Ghent (Belgium)
Authors: Okolikj Martin , Hooghe Marc 
Published: March 2022

AbstractLowering the voting age is often criticized due to the alleged political immaturity of young voters, which is considered as negative for the quality of democracy. We adopt a unique approach to this issue by measuring political congruence between adolescents and their parents to ascertain whether ideological views and salient positional issues, such as attitudes on immigration, differ between different age groups in adolescence. Using a household survey in the city of Ghent (Belgium), first we compare political ideologies and attitudes toward immigration for those of age between 15 and 19, and their parents. We find that adolescent children tend to resemble the political ideologies of their parents, and they also tend to have similar attitudes about immigration. Second, we find that ideological resemblance is even higher among adolescents that regularly talk about politics with their parents. Finally, we do not find evidence that political congruence with parents differs by the age of adolescent children or their right to vote. Therefore, we conclude that political ideology and positional views are formed in an early stage of adolescence, i.e., before the age of 15. Our findings have relevance for the debate about lowering the voting age, as it points to already clearly formed ideological views and political attitudes at early stages of adolescent life.