TASK DEFINITION: Given a passage, construct a question on the basis of the information present in the passage. Construct the question in such a way that (i) it is unambiguous, (ii) it is answerable from the passage, (iii) its answer is unique (iv) it answer uses text phrases from the passage. Avoid creating questions that (i) can't be answered correctly without actually understanding the passage and (ii) uses the same words or phrases given in the passage.
PROBLEM: Various techniques and devices have been proposed for tricuspid valve (TV) repair in patients with tricuspid regurgitation (TR). However, residual or recurrent TR is not uncommon occurring in 20% to 30% of patients. This study reports first experiences with a new three-dimensional annuloplasty ring.', 'We retrospectively reviewed 200 consecutive patients who underwent TV repair for functional TR with the Contour 3D annuloplasty ring (Medtronic, Minneapolis, MN) from December 2010 to February 2013 at our institution. The follow-up is 98% complete (mean 1.0 0.7 years; cumulative total 189 patient-years).', 'Mean age was 70.4 9.1 years and the median logistic European system for cardiac operative risk was 7%. Sixty-nine percent of the patients were in New York Heart Association class III/IV. Echocardiography documented moderate or severe TR in 97.5% of the patients, with a mean annulus diameter of 45.1 4.9 mm; 93.5% of the patients underwent a combined procedure, and 20.5% an urgent or emergent operation. The 30-day mortality was 6%. The preoperative TR grade was reduced from 2.45 0.53 to 0.77 0.54 (p < 0.001). At hospital discharge residual II TR or greater was present in 4.3% of the patients. Freedom from recurrent II TR or greater at 2years was 90.9% 4.2% and freedom from TV-related reoperations at 2 years was 98.5% 1.0%. No case ofring dehiscence occurred. Fourteen patients (7%) required a permanent pacemaker implantation for atrioventricular block.

SOLUTION: Does early experience with a new three-dimensional annuloplasty ring for the treatment of functional tricuspid regurgitation?

PROBLEM: Because of greater recognition and improved imaging capabilities, intraductal papillary mucinous neoplasms (IPMNs) are being diagnosed with increasing frequency. IPMNs of the main pancreatic duct cause symptoms and lead to pancreatitis. Side-branch (SB) IPMNs are thought to cause symptoms less frequently, and their association with pancreatitis is not well defined.', 'Our purpose was to ascertain whether an association exists between SB-IPMN and pancreatitis.', 'Single-center, retrospective study.', 'Academic medical center.', 'A total of 305 patients underwent EUS examinations between October 2002 and October 2006 for pancreatic cystic lesions.', 'The main outcome measure was the frequency of acute or chronic pancreatitis that was not procedurally related.', 'Thirty-two patients had SB-IPMNs, and 11 (34%) had pancreatitis. Three patients reported a single episode, and 8 patients reported having recurrent episodes of pancreatitis. Overall, 17 (53%) patients had symptoms possibly attributable to SB-IPMN. Female sex (73% vs 38%) and multiple pancreatic lesions (54% vs 24%) were more commonly seen in those with pancreatitis, but were not statistically significant factors. Larger cyst size or cyst fluid marker levels did not appear associated with pancreatitis occurrence. EUS-FNA demonstrated communication with the pancreatic duct in 94% and thick, mucinous fluid in 84%.

SOLUTION: Is pancreatitis frequent among patients with side-branch intraductal papillary mucinous neoplasia diagnosed by EUS?

PROBLEM: The clinical effects of a pre-fixed flow of air-oxygen versus a flow titrated according to visible bubbling are not well understood.', 'To compare the effects of a fixed flow (5L/min) and titrated flow (flow just enough to ensure bubbling) at different set pressures on delivered intra-prong pressure, gas exchange and clinical parameters in preterm infants on bubble CPAP for respiratory distress.', 'Preterm infants <35 weeks gestational age on bubble CPAP and <96 h of age were enrolled in this crossover study. They were subjected to 30-min periods of titrated flow and fixed flow. At the end of both epochs, gas flow rate, set pressure, FiO2, SpO2, Silverman retraction score, respiratory rate, abdominal girth, and blood gases were recorded. The delivered intra-prong pressure was measured by an electronic manometer.', '69 recordings were made in 54 infants. For each of the set CPAP pressures (4, 5, and 6cm H2O), the mean delivered pressure with a fixed flow of 5L/min was higher than that delivered by the titrated flow. During the fixed flow epoch, the delivered pressure was closer to and higher than the set pressure resulting in higher PaO2 and lower PaCO2 as compared to titrated flow epoch. In the titrated flow period, the delivered pressure was consistently lower than the set pressure.

SOLUTION:
Is a Fixed Flow More Effective than Titrated Flow during Bubble Nasal CPAP for Respiratory Distress in Preterm Neonates?