bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence and Documentation of Overweight and Obesity in Hospitalized Children and Adolescents
Authors: Azhdam Devora Bita , Reyhan Iris , Grant-Guimaraes Jamilah , Feinstein Ronald
Published: October 2014

Objective:

Overweight and obesity (OAO) are major problems among children and adolescents. Hospitalization of pediatric patients provides an opportunity for physicians to initiate point-of-care services related to weight status. Our goal was to determine the prevalence of OAO among hospitalized pediatric patients and to assess the extent of documentation of OAO in their medical records.

Methods:

We conducted a retrospective chart review of 8- to 18-year-olds admitted to an inpatient pediatric unit during 6 months in 2012. Age, gender, height, weight, BMI, discharge diagnosis, and admitting specialty were extracted from electronic medical records. BMI percentile was calculated from Centers for Disease Control and Prevention growth charts. Prevalence of OAO was determined for medical and surgical subspecialties, and charts were queried for documentation of weight status.

Results:

The study included 603 patients. Approximately one-third (36.5%) of patients were either overweight or obese, and nearly one-fifth (19.7%) were obese. The prevalence of overweight was similar between medical and surgical specialties. Obesity prevalence differed slightly, at 20.8% and 17.3% (P > .05), respectively. Only 0.9% of overweight and obese patients had documented discharge diagnoses of overweight or obesity, and only 13.2% had documentation of weight status noted anywhere in their medical record.

Conclusions:

We identified a significant number of hospitalized OAO patients, an overwhelming percentage of whom never had weight status documented during their admission. Hospitalization offers health providers a window of opportunity to identify obesity, communicate risks, and initiate weight management interventions.
Parents as the Primary Caregivers for Their Infant in the NICU: Benefits and Challenges
Authors: Warre Ruth , O’Brien Karel , Lee Shoo K.
Published: October 2014

When an infant is admitted to the neonatal intensive care unit (NICU), the ability of parents to spend time with and provide meaningful care for their infant is often restricted. Added to this is the distress parents may be feeling as a result of the premature birth of their child, as well as the intimidating and technological environment of the NICU. These factors strain the development of an optimal parent-infant relationship, which can have effects that last beyond discharge. A solution to this problem is to offer parents the opportunity to be the primary caregivers for their infant in the NICU. This article reviews the development and theory of the care-by-parent model, including examples of successful programs, discusses the benefits and challenges of the model, and looks to the future of care in the NICU.
Dominikanie na kresach wschodnich Rzeczypospolitej Obojga Narodów (teren dzisiejszej Białorusi)
Authors: Miławicki Marek
Published: October 2014

Celem artykułu jest zarysowanie historii obecności zakonu dominikańskiego na tej części Kresów Wschodnich dawnej Rzeczypospolitej (Wielkie Księstwo Litewskie), które obecnie leżą w granicach państwa białoruskiego, począwszy od średniowiecza do drugiej połowy XIX wieku. Na terenie tym istniało 45 placówek dominikańskich, które zostały skasowane przez władze zaboru rosyjskiego w XIX wieku. Dominikanie prowadzili nie tylko działalność duszpasterską (głównie kaznodziejstwo i parafie), ale także oświatową i kulturalną. W okresie powstań zakonnicy również czynnie brali w nich udział, za co spotkały ich represje (emigracja, zsyłki na Syberię, kasaty klasztorów i konfiskata mienia i dóbr kultury).
Getting the most connectivity per conservation dollar
Authors: Torrubia Sara , McRae Brad H , Lawler Joshua J , Hall Sonia A , Halabisky Meghan , Langdon Jesse , Case Michael
Published: October 2014

The importance of connectivity for species conservation has resulted in myriad attempts to identify corridors linking habitat patches and conservation areas. However, making smart decisions for restoring connectivity requires information beyond simple maps of corridors. Here, we combine land‐parcel cost estimates with a new analytical approach that pinpoints where barrier removal can best improve connectivity to develop a return‐on‐investment framework for connectivity restoration. An iterative series of barrier analyses followed by simulated restorations allowed us to incorporate cumulative effects of previous restoration decisions, which can alter the potential value of future restorations. To demonstrate our approach, we identify specific sites that, if restored, would most increase habitat connectivity for the Washington ground squirrel (Urocitellus washingtoni). The analysis was performed in two ways: first without consideration of economic costs and then again, explicitly incorporating the costs of land purchase and restoration. We found that accounting for land costs could reduce overall restoration costs by 55% and increase the area of land restored by 30%. These methods can be tailored to meet different connectivity objectives and can complement reserve design selection methods that prioritize conservation of contiguous natural areas.
Distribution of barren‐ground caribou during winter in response to fire
Authors: Anderson T. A. , Johnson C. J.
Published: October 2014

We investigated the influence of past fires on the large‐scale distribution of barren‐ground caribou (Rangifer tarandus groenlandicus) in the Northwest Territories, Canada, during winter. We used an information‐theoretic approach and data describing fire history, vegetation, and predation risk to develop resource selection functions that explained caribou distribution on early‐ and late‐winter ranges. We evaluated multiple sets of models constructed across years for all caribou (pooled models) and for individual caribou by period (early and late winter). Winter range habitats important to caribou were characterized by a high percentage of ground cover of lichen and herbaceous forage and a close proximity to lakes and rivers. Although caribou avoided areas densely populated with burns, there was considerable use of early‐seral habitats as well as areas adjacent to the burn boundary. Disparate selection strategies among caribou highlight the importance of investigating both individual and global resource selection models. These results suggest that at some spatial and temporal scales, individual barren‐ground caribou may be less averse to fire than previously thought.
Western Palaearctic breeding geese can alter carbon cycling in their winter habitat
Authors: Fivez Lise , Vicca Sara , Janssens Ivan A. , Meire Patrick
Published: October 2014

Changes in land use, implementation of protective measures and a warming climate have improved the survival rate of geese, resulting in considerable increases in the majority of Western Palaearctic goose populations during recent decades. To the best of our knowledge, this is the first study aiming to understand the impact of goose grazing on carbon cycling in their winter habitat. To this end, the impact of goose grazing pressure on biomass, litter decomposition and CO2fluxes (net CO2exchange partitioned into photosynthesis and ecosystem respiration) was studied in the coastal polders of Belgium, a wintering habitat for geese of international importance. Experimentally manipulated grazing byAnser anser(Greylag Geese) in grassland mimicked four different grazing pressures, including a control treatment from which geese were excluded. We found that grazing pressure by geese has a significant, but variable effect on carbon fluxes during the entire year. In winter, at the end of the grazing season, both plants' carbon assimilation and total ecosystem respiration were decreased with increasing grazing pressure, resulting in less carbon taken up during day time. Total ecosystem respiration was also reduced due to goose grazing in spring and autumn (i.e., outside the grazing season), while no significant difference in ecosystem CO2fluxes was detected in summer. These grazing effects on CO2fluxes can partly be explained by the effect of goose grazing on standing biomass. Decomposition rates were significantly reduced by higher grazing pressure during the winter season when geese were present, but on the long term grazing accelerated decomposition rates. Our data suggest that the rising numbers of Western Palaearctic breeding geese can alter the carbon balance of their winter habitat. The differences between short‐ and long‐term effects observed in our study demonstrate the complexity of goose grazing effects on carbon cycling and indicate directions for future studies.
Identifying polar bear resource selection patterns to inform offshore development in a dynamic and changing Arctic
Authors: Wilson Ryan R. , Horne Jon S. , Rode Karyn D. , Regehr Eric V. , Durner George M.
Published: October 2014

Although sea ice loss is the primary threat to polar bears (Ursus maritimus), little can be done to mitigate its effects without global efforts to reduce greenhouse gas emissions. Other factors, however, could exacerbate the impacts of sea ice loss on polar bears, such as exposure to increased industrial activity. The Arctic Ocean has enormous oil and gas potential, and its development is expected to increase in the coming decades. Estimates of polar bear resource selection will inform managers how bears use areas slated for oil development and to help guide conservation planning. We estimated temporally‐varying resource selection patterns for non‐denning adult female polar bears in the Chukchi Sea population (2008–2012) at two scales (i.e., home range and weekly steps) to identify factors predictive of polar bear use throughout the year, before any offshore development. From the best models at each scale, we estimated scale‐integrated resource selection functions to predict polar bear space use across the population's range and determined when bears were most likely to use the region where offshore oil and gas development in the United States is slated to occur. Polar bears exhibited significant intra‐annual variation in selection patterns at both scales but the strength and annual patterns of selection differed between scales for most variables. Bears were most likely to use the offshore oil and gas planning area during ice retreat and growth with the highest predicted use occurring in the southern portion of the planning area. The average proportion of predicted high‐value habitat in the planning area was >15% of the total high‐value habitat for the population during sea ice retreat and growth and reached a high of 50% during November 2010. Our results provide a baseline on which to judge future changes to non‐denning adult female polar bear resource selection in the Chukchi Sea and help guide offshore development in the region. Lastly, our study provides a framework for assessing potential impacts of offshore oil and gas development to other polar bear populations around the Arctic.
Placenta Medicine as a Galactogogue: Tradition or Trend?
Authors: Cole Melissa
Published: October 2014

For some mothers, insufficient milk supply impacts their ability to fully breastfeed their infants. Many of these mothers seek holistic options to increase their milk supply. Placenta medicine, or postpartum placenta consumption as a purported galactogogue, appears to be a practice
on the rise in the United States. There is some limited historical research, and more recently some phenomenological data, about the practice of placenta as a galactogogue. However, little is truly known about the benefits and risks of placentophagy, in general, or specifically as a galactogogue.
This article reviews existing literature and proposes a further call for research regarding the safety and efficacy of placenta consumption.
“Bfed” Texting Program and “Breastfeeding: A Smart Choice” Class: Using Cell Phones to Reach Gen Y Mothers
Authors: Beard Meg
Published: October 2014

Santa Barbara County Public Health Department Nutrition Services and Women, Infants, and Children program in California are meeting the needs of Generation Y mothers through the first of its kind two-way texting program for breastfeeding peer counselor participants called “Bfed.”
In addition, there is a prenatal breastfeeding class that has topics that use the phone with apps, video clips that include actual successful breastfeeding peers, and a YouTube site to view at a later time. Class participants actually use their cell phones during class instead of having to
turn them off.
Increasing Precision in Agronomic Field Trials Using Latin Square Designs
Authors: Jones Marcus , Woodward Richard , Stoller Jerry
Published: October 2014

Spatial variation from soil and related factors often affects the outcome of agronomic field experiments. The randomized complete block (RCB) is the most prevalent design despite inefficiencies that can result in inflated error terms. Experimental designs such as the Latin square (LS) allow for bidirectional blocking and offer the potential to account for spatial variability better. The objectives of this research were to investigate the occurrence of two‐way gradients in agronomic field trials and compare the estimated relative efficiency (ERE) of a LS to a RCB. Thirty LS trials were evaluated in 10 states during 2013 across the midwestern United States investigating crop yields of corn (Zea mays L.), soybean [Glycine max (L.) Merr.], and sorghum [Sorghum bicolor (L.) Moench]. The results show that 47% of the trials exhibited a two‐way gradient, indicating this characteristic is widespread across a large geographic region. Overall, the ERE was increased in 70% of the trials by using the LS design. A lower ERE occurred in 7% of the trials conducted using a LS. Multiple gradients appear common in agronomic field plot trials and enough variation existed between the two blocking directions to justify the use of a LS design. Our data indicate the LS offers a low risk, high reward option of experimental design for controlling spatial heterogeneity and increasing precision. When possible, the LS design should be used in field experiments where the trial area appears uniform and gradients to block against are not obvious.
Planting Date and Staggered Seeding of Rye–Vetch Mixtures: Biomass, Nitrogen, and Legume Winter Survival
Authors: Hayden Zachary D. , Ngouajio Mathieu , Brainard Daniel C.
Published: October 2014

Mixtures of cereal rye (Secale cereale L.) and the legume hairy vetch (Vicia villosa Roth) are used to provide fixed N in balance with other important cover crop services, but late planting and interference from rye can limit vetch productivity. This 2‐yr study in Michigan investigated how fall planting dates influence rye–vetch cover crop biomass quantity and quality in the spring, and evaluated whether staggering (delaying) rye seeding could improve vetch performance (biomass production, N fixation, and winter survival) in mixtures. Treatments consisted of a two‐way factorial of three vetch planting dates (late August, mid‐September, and late September) and three lengths of rye seeding stagger (co‐seeded, short stagger, and long stagger). Later planting of co‐seeded mixtures generally led to reduced total shoot biomass and lower proportions of vetch, resulting in cover crop residues with less vetch N and a higher total C/N. For earlier planting dates, delaying rye seeding until vetch emergence (short stagger) increased vetch shoot biomass by 760 to 1060 kg ha−1 (30–36 kg vetch N ha−1) relative to co‐seeding. Staggered seeding provided no benefit to vetch biomass at later planting dates, and delaying rye seeding until the vetch three to four leaf stage (long stagger) reduced vetch winter survival by 12 to 42% compared with co‐seeding. Additional research is needed to determine whether potential on‐farm benefits of rye–vetch staggered seeding justify the additional management complexity involved and possible tradeoffs with other cover crop services.
A New Map Location of Gene Stb3 for Resistance to Septoria Tritici Blotch in Wheat
Authors: Goodwin Stephen B. , Cavaletto Jessica R. , Hale Iago L. , Thompson Ian , Xu Steven S. , Adhikari Tika B. , Dubcovsky Jorge
Published: October 2014

Septoria tritici blotch (STB), caused by Mycosphaerella graminicola (synonym: Zymoseptoria tritici; asexual stage: Septoria tritici), is an important disease of wheat (Triticum aestivum L.) worldwide. Management of the disease usually is by host resistance or fungicides. However, M. graminicola has developed insensitivity to most commonly applied fungicides, so there is a continuing need for well‐characterized sources of host resistance to accelerate the development of improved wheat cultivars. Gene Stb3 has been a useful source of major resistance, but its mapping location has not been well characterized. On the basis of linkage to a single marker, a previous study assigned Stb3 to a location on the short arm of chromosome 6D. However, the results from the present study show that this reported location is incorrect. Instead, linkage analysis revealed that Stb3 is located on the short arm of wheat chromosome 7A, completely linked to microsatellite (simple‐sequence repeat) locus Xwmc83 and flanked by loci Xcfa2028 (12.4 cM distal) and Xbarc222 (2.1 cM proximal). Linkage between Stb3 and Xwmc83 was validated in BC1F3 progeny of other crosses, and analyses of the flanking markers with deletion stocks showed that the gene is located on 7AS between fraction lengths 0.73 and 0.83. This revised location of Stb3 is different from those for other STB resistance genes previously mapped in hexaploid wheat but is approximately 20 cM proximal to an STB resistance gene mapped on the short arm of chromosome 7Am in Triticum monococcum. The markers described in this study are useful for accelerating the deployment of Stb3 in wheat breeding programs.
Digital Mapping of Soil Particle‐Size Fractions for Nigeria
Authors: Akpa Stephen I. C. , Odeh Inakwu O. A. , Bishop Thomas F. A. , Hartemink Alfred E.
Published: October 2014

There is a growing need for spatially continuous and quantitative soil information for environmental modeling and management, especially at the national scale. This study was aimed at predicting soil particle‐size fractions (PSF) for Nigeria using random forest model (RFM). Equal‐area quadratic splines were fitted to Nigerian legacy soil profile data to estimate PSFs at six standard soil depths (0–5, 5–15, 15–30, 30–60, 60–100, and 100–200 cm) using the GlobalSoilMap project specification. We applied an additive log‐ratio (ALR) transformation of the PSFs. There was a better prediction performance (based on 33% model validation) in the upper depth intervals than the lower depth intervals (e.g., R2 of 0.53; RMSE of 13.59 g kg−1 for clay at 0–5 cm and R2 of 0.16; RMSE of 15.60 g kg−1 at 100–200 cm). Overall, the PSFs show marked variations across the entire Nigeria region with a higher sand content compared with silt and clay contents and increasing clay content with soil depth. The variation in soil texture (ST) shows a progressive transition from a coarse texture (sand) along the fringes of northern Nigeria (e.g., upper part of Maiduguri and Sokoto), to finer texture (loam to clay loam) toward the western part of the Niger Delta region in the south. The inclusion of depth as a predictor variable significantly improved the prediction accuracy of RFM especially at lower depth intervals. These results could be used for producing soil function maps for national agricultural planning and in assessments of environmental sustainability.
Approximate generalized additive mappings in proper multi-CQ*-algebras
Authors: Saadati R. , Sadeghi Gh. , Rassias Th.M.
Published: October 2014

In this paper, we approximate the following additive functional inequality ?(
?d+1,i=1 f(x1i),..., ?d+1,i=1, f(xki))? ? ?mf (?d+1,i=1 x1i/m),..., mf (?d+1,i=1 xki/m))
?k for all x11,..., xkd+1?X. We investigate homomorphisms in proper
multi-CQ*-algebras and derivations on proper multi-CQ*-algebras associated
with the above additive functional inequality.
Geometric properties of a certain general family of integral operators
Authors: Srivastava H.M. , Prajapat J.K. , Oros Georgia , Şendruţiu Roxana
Published: October 2014

In this paper, we give a set of sufficient conditions for the univalence,
starlikeness and convexity of a certain newly-defined general family of
integral operators in the open unit disk. Relevant connections of the results
presented here with those that were obtained in earlier works as well as
several interesting corollaries and consequences of the main results are also
presented.
Ideal convergence in locally solid Riesz spaces
Authors: Hazarika Bipan
Published: October 2014

An ideal I is a family of subsets of positive integers N which is closed
under taking finite unions and subsets of its elements. In this paper, we
introduce the concepts of ideal ?-convergence, ideal ?-Cauchy and ideal
?-bounded sequence in locally solid Riesz space endowed with the topology ?.
Some basic properties of these concepts has been investigated. We also
examine the ideal ?-continuity of a mapping defined on locally solid Riesz
space.
Some properties of functions related to certain classes of completely monotonic functions and logarithmically completely monotonic functions
Authors: Guo Senlin , Srivastava H.M. , Cheung Wing-Sum
Published: October 2014

In this article, we establish several properties of the composition of functions
which are related to certain classes of completely monotonic functions and
logarithmically completely monotonic functions.
Squashing maximum packings of Kn with 8-cycles into maximum packings of Kn with 4-cycles
Authors: Lindner Charles , Faro Giovanni , Meszka Mariusz , Tripodi Antoinette
Published: October 2014

An 8-cycle is said to be squashed if we identify a pair of opposite vertices
and name one of them with the other (and thereby turning the 8-cycle into a
pair of 4-cycles with exactly one vertex in common). The resulting pair of
4-cycles is called a bowtie. We say that we have squashed the 8-cycle into a
bowtie. Evidently an 8-cycle can be squashed into a bowtie in eight different
ways. The object of this paper is the construction, for every n > 8, of a
maximum packing of Kn with 8-cycles which can be squashed in a maximum
packing of Kn with 4-cycles.
Liquid-liquid extraction of ion-association complexes of cobalt(II)-4-(2-pyridylazo)resorcinol with ditetrazolium salts
Authors: Divarova Vidka , Stojnova Kirila , Racheva Petya , Lekova Vanya , Dimitrov Atanas
Published: October 2014

The formation and liquid-liquid extraction of ion-association complexes
between Co(II)-4-(2-Pyridylazo)resorcinol (PAR) anionic chelates and cations
of three ditetrazolium chlorides were studied: Blue Tetrazolium chloride
(BTC), Neotetrazolium chloride (NTC) and Nitro Blue Tetrazolium chloride
(NBT). The optimum conditions for the formation and solvent extraction of the
ion-association comlpex chelates were determined. It has been found that in
the systems of Co(II)-PAR-DTS, the reactants are reacted in molar ratios
1:2:1 and the general formula of complexes was suggested. The extraction
equilibria were investigated and quantitatively characterized by the
equilibrium constants and the recovery factors. The analytical
characteristics of the complexes were calculated.
Surgical treatment and dilemmas in the treatment of basal cell carcinomas with intracranial propagation
Authors: Rasulic Lukas , Jovanovic Milan
Published: October 2014

Background/Aim. Basal cell carcinoma (BCC) is one of the most common
malignant skin tumors on the head in 90% of cases and is characterized by a
high local infiltrating potential and destructive growth. The aim of this
study was to show the characteristics of a correlation between
pathohistological types of basal cell carcinoma and the size of this lesion,
aggressiveness and infiltration of basal cell carcinoma, and its effect on
the course of the therapy. Methods. We analyzed 27 patients operated on for
BCC that affected the scalp and the bone. We described and considered the
clinical characteristics (size, depth of invasion), duration and speed of
intracranial propagation and then made comparison with the type of BCC. We
described the extent of surgical treatment and the width of excision to
determine the best course of the treatment. The patients went through
examinations during the next three years. Results. According to the
histopathological type the most common tumors were: infiltrative (60.2%),
noduloinfiltrative (37.2%), and morpheaform (2.6%). Tumors were clinically
manifested as ulcerative lesions, ulcus rodens and ulcus terebrans. Tumor
diameters ranged from 2 to 25 cm. The depth of intracranial propagation
depended on the histological type and tumor size. Most relapses (35%)
occurred with morpheaform type of BCC. In 17 of the cases, BCC affected the
bone without intracranial propagation. In 10 of the cases, basalioma
infiltrated intracranial space - in 8 of the cases it infiltrated the dura
and in 6 of the cases the brain parenchyma, of which in two of them, the
superior sagittal sinus was affected and had to be surgically tied off.
Conclusion. The aggressiveness and infiltration of basal cell carcinoma into
the brain parenchyma is directly linked to the histological type and the size
of the tumor. The larger the basalioma or if histopathological findings
confirm morpheaform type of basalioma the larger surrounding healthy tissue,
sometimes more than 3 cm in diameter, needs to be removed. In cases of these
tumors postoperative radiotherapy is recommended.
The Effect of Tax Preparation Software on Tax Compliance: A Research Note
Authors: Brink William D. , Lee Lorraine S.
Published: October 2014

Tax software is commonly used in the preparation of U.S. federal and state income tax returns. A common feature of tax return preparation software is the prepayment-position status bar, which automatically calculates an updated refund/tax-due position. This paper examines whether the prepayment-position status bar, influences taxpayer decision making. This study utilizes a 2 × 2 experimental design, manipulating the taxpayers' prepayment position (refund/tax-due) and manipulating whether the prepayment-position status bar is present or absent. Using experienced taxpayers as study participants, the results of the experiment show that taxpayers are more aggressive when they are in a tax-due position compared to a refund position and that this effect is exaggerated when the tax software contains a prepayment-position status bar.
Breastfeeding Practices in Kathmandu
Authors: Mathema Smriti
Published: October 2014

Introduction: In spite of significant evidence on a number of important health benefits of breastfeeding, it has been seen that a vast number of infants in Nepal are not being breastfed appropriately based on standard recommendations. This study was conducted to evaluate the breastfeeding practices prevalent in Kathmandu.Materials and Methods: This was across-sectional survey carried out over a period of 24 months from January 2011 to December 2012 on a convenient sample of children aged 6 months to 23 months when they were brought for treatment to Kathmandu Medical College and Teaching Hospital. Breastfeeding was defined according to the recent WHO guidelines and mothers were interviewed as per a structured questionnaire.Results: There were 1250 children enrolled in the study, out of which almost all infants (99.7%, n=1246) received colostrum. Only 62.64% (n=783) babies received breast milk as their first food. Initiation of breastfeeding within one hour of delivery was done by 719 (57.5%) mothers. The median duration of exclusive breastfeeding was 3.8 months.Conclusion: This study reflects that majority of infants in Kathmandu are still not fed in accordance with breastfeeding recommendations and guidelines. More attention should be given to a proper community-based program including subsequent monitoring of its implementation as exclusive breastfeeding has been proved to be one of the most effective ways to improve infant survival.DOI: http://dx.doi.org/10.3126/jnps.v34i2.10032J Nepal Paediatr Soc 2014;34(2):96-99
Methylmalonic Acidemia – Cause of Recurrent Neonatal Death and Its Social Implications
Authors: Madhavi Vasikarla , Sharma Deepak Kumar , Murki Srinivas , Pratap Tejo
Published: October 2014

Mr and Mrs R, non-consanguineous couple had history of all their children during neonatal period. First two neonates were normal at birth, then presented with lethargy, vomiting and decreased acceptance of feeds. Both the babies expired after birth without being investigated for cause of death. The third neonate was investigated for inborn error of metabolism and found to be affected with methylmalonic acidemia. The couple departed away inspite of extensive counselling. In the fourth pregnancy antenatally fetus was diagnosed as carrier case of methylmalonic acidemia and short chain fatty acid oxidase deficiency. The fourth baby was normal and was in follow up till one year age. DOI: http://dx.doi.org/10.3126/jnps.v34i2.10577 J Nepal Paediatr Soc 2014;34(2):150-153
Cervical Lymphadenitis Due to Nodular Fasciitis in a Child
Authors: Kanik Ali , Eliacik Kayi , Ince Tolga , Bayol Umit , Helvacı Mehmet
Published: October 2014

Nodular fasciitis is a benign, reactive proliferation of fibroblasts in the subcutaneous tissues. It usually affects the trunk and upper extremities, and rarely the head and neck region of young adults. It is rare among children and the histologic findings may incorrectly suggest malignant lesions. We describe a two-year-old girl that referred to our clinic with complaints of fever and swelling on the right side of neck and diagnosed as lymphadenitis clinically. Cervical lymphadenitis due to nodular fasciitis is a rarity. We emphasize that nodular fasciitis needs to be included in the differential diagnoses of neck lymphadenitis during childhood. DOI: http://dx.doi.org/10.3126/jnps.v34i2.9548J Nepal Paediatr Soc 2014;34(2):141-143
Neonatal Near Miss Cases of Different Health Facilities
Authors: Manandhar Sunil Raja , Manandhar Dharma S , Adhikari Dhruba , Shrestha Jyoti Raj , Rai Chandra , Rana Hari , Paudel Mohan
Published: October 2014

Introduction: The near miss concept and the criterion-based clinical audit are proposed as useful approaches for obtaining such information in newborn health care. There is currently no Standard definition and criteria for neonatal near miss especially for the community level intervention. Thus, lifesaving interventions could be an entry point to initiate the development of the neonatal near-miss definition. Mother and Infants Research Activities and Health Right International (HRI) developed a new tool for assessing neonatal near miss cases based on the Community based newborn care package programme. This is a part of operational research programme on strengthening the health facilities of Electoral constituency No; 2 of Arghakhanchi district of Nepal. The objective of this study was to identify and analyze neonatal near miss cases at different health facilities of Electoral constituency No; 2 of Arghakhanchi district, Nepal.Materials and Methods: One day of training on identifying neonatal near miss cases was given by an expert at Arghakhanchi district hospital to the health facilities staff in two groups. Health facility staffs were trained on identifying neonatal near miss cases and completing the modified neonatal near miss case forms. Neonatal near miss cases were documented for nine months period.Results: There were a total of 28 cases of neonatal near miss reported from different health facilities. Among them, 90% babies were delivered at health facility and 72% babies were of normal birth weight. Low birth weight incidence is 21% among near miss cases. Neonatal near miss contributed possible severe bacterial infection/ severe infection 47%, birth asphyxia in 43% cases and very low birth weight 7%.Conclusions: Birth asphyxia and PSBI were the two most common causes of neonatal near miss in the health facilities of Arghakhanchi district. There is a need to improve the quality of neonatal care in health facilities to properly manage these neonatal near miss cases which were referred to higher centre.DOI: http://dx.doi.org/10.3126/jnps.v34i2.9880J Nepal Paediatr Soc 2014;34(2):115-118
Long-term outcomes of resective epilepsy surgery after invasive presurgical evaluation in children with tuberous sclerosis complex and bilateral multiple lesions
Authors: Arya Ravindra , Tenney Jeffrey R. , Horn Paul S. , Greiner Hansel M. , Holland Katherine D. , Leach James L. , Gelfand Michael J. , Rozhkov Leonid , Fujiwara Hisako , Rose Douglas F. , Franz David N. , Mangano Francesco T.
Published: October 2014

OBJECT

Tuberous sclerosis complex (TSC) with medically refractory epilepsy is characterized by multifocal brain abnormalities, traditionally indicating poor surgical candidacy. This single-center, retrospective study appraised seizurerelated, neuropsychological, and other outcomes of resective surgery in TSC patients with medically refractory epilepsy, and analyzed predictors for these outcomes.

METHODS

Patients with multilesional TSC who underwent epilepsy surgery between 2007 and 2012 were identified from an electronic database. All patients underwent multimodality noninvasive and subsequent invasive evaluation. Seizure outcomes were classified using the International League Against Epilepsy (ILAE) scale. The primary outcome measure was complete seizure remission (ILAE Class 1). Secondary outcome measures included 50% responder rate, change in full-scale IQ, electroencephalography improvement, and reduction in antiepileptic drug (AED) burden.

RESULTS

A total of 37 patients with TSC underwent resective surgery during the study period. After a mean follow-up of 5.68 ± 3.67 years, 56.8% achieved complete seizure freedom (ILAE Class 1) and 86.5% had ILAE Class 4 outcomes or better. The full-scale IQ on follow-up was significantly higher in patients with ILAE Class 1 outcome (66.70 ± 12.36) compared with those with ILAE Class 2 or worse outcomes (56.00 ± 1.41, p = 0.025). In 62.5% of the patients with ILAE Class 2 or worse outcomes, the number of AEDs were found to be significantly reduced (p = 0.004).

CONCLUSIONS

This study substantiates the evidence for efficacy of resective epilepsy surgery in patients with bilateral multilesional TSC. More than half of the patients were completely seizure free. Additionally, a high proportion achieved clinically meaningful reduction in seizure burden and the number of AEDs.
The natural clinical course of hemodynamically stable adult moyamoya disease
Authors: Cho Won-Sang , Chung Young Seob , Kim Jeong Eun , Jeon Jin Pyeong , Son Young Je , Bang Jae Seung , Kang Hyun-Seung , Sohn Chul-Ho , Oh Chang Wan
Published: October 2014

OBJECT

Moyamoya disease (MMD) is a rare cerebrovascular disease and its natural history is still unclear. The authors aimed to investigate the natural course of hemodynamically stable cases of adult MMD, with the analysis of stroke risk factors.

METHODS

Two hundred forty-one patients were included in this retrospective study. One hundred sixty-six (68.9%) were female, and mean age (± SD) at first visit was 41.3 ± 12.0 years (range 18–69 years). Unilateral involvement was identified in 33 patients, and 19 patients (7.9%) had a family history of MMD. According to the clinical presentations, patients were classified into hemorrhagic (n = 62, 25.7%), ischemic (n = 144, 59.8%), and asymptomatic (n = 35, 14.5%) groups. The mean duration of follow-up was 82.5 ± 62.9 months (range 7.3–347.0 months).

RESULTS

The annual stroke risk was 4.5%, and the annual risks of rebleeding in the hemorrhagic group and recurrent ischemic events in the ischemic group were 4.3% and 3.0%, respectively. There was no significant difference in cumulative stroke risk between the 3 groups (p = 0.461). Risk factors included thyroid disease for overall strokes (HR 2.56, 95% CI 1.16–5.67), initial hemorrhagic presentation for hemorrhagic strokes (HR 2.53, 95% CI 1.24–5.17), and initial ischemic presentation for ischemic strokes (HR 2.69, 95% CI 1.15–6.27). Familial MMD was a common risk factor for all types of stroke. Among the 3 clinical groups, the hemorrhagic group showed the worst clinical status at discharge and at most recent follow-up. Twenty-three patients (9.5%) eventually underwent revascularization surgery.

CONCLUSIONS

There was no statistically significant difference in the incidence of stroke in the different clinical groups; clinical status, however, was most severe in patients with hemorrhagic presentation. In patients who experienced stroke during the follow-up period, the stroke type tended to correspond to their initial presentation. Close follow-up is needed in patients with thyroid disease and a family history of MMD.
Neuroendoscopic biopsy of brain lesions: accuracy and complications
Authors: Giannetti Alexandre Varella , Alvarenga Alexandre Yugo Holayama , de Lima Thiago Oliveira Lemos , Pedrosa Hugo Abi-Sáber Rodrigues , Souweidane Mark M.
Published: October 2014

OBJECT

The authors conducted a study to analyze the accuracy of neuroendoscopic biopsies of ventricular and periventricular lesions and record any difficulties or complications of the neuroendoscopic biopsy procedure.

METHODS

A total of 50 patients with different diseases consecutively underwent endoscopic biopsy procedures. The biopsy result was considered diagnostic if the pathologist reported any specific finding on which clinicians could base decisions about treatment or observation. The biopsy result was referred to as accurate if the results matched results of a sample obtained later or if the treatment response and disease evolution were compatible with the diagnosis. The biopsy result was considered inaccurate if results showed any relevant differences from those of the later sample or if the patient's disease did not evolve as expected. Complications were recorded and compared with those found in a literature review.

RESULTS

For 2 patients, the procedure had to be terminated. The biopsy diagnostic rate was 89.6%, and the accuracy rate was 86%. Complications associated with the procedure were 3 hemorrhages (6%), 2 infections (4%), and 1 death (2%); no reoperations were needed.

CONCLUSIONS

Endoscopic biopsy seems to be an accurate procedure with acceptable morbidity and mortality rates.
The results of a third Gamma Knife procedure for recurrent trigeminal neuralgia
Authors: Tempel Zachary J. , Chivukula Srinivas , Monaco Edward A. , Bowden Greg , Kano Hideyuki , Niranjan Ajay , Chang Edward F. , Sneed Penny K. , Kaufmann Anthony M. , Sheehan Jason , Mathieu David , Lunsford L. Dade
Published: October 2014

OBJECT

Gamma Knife radiosurgery (GKRS) is the least invasive treatment option for medically refractory, intractable trigeminal neuralgia (TN) and is especially valuable for treating elderly, infirm patients or those on anticoagulation therapy. The authors reviewed pain outcomes and complications in TN patients who required 3 radiosurgical procedures for recurrent or persistent pain.

METHODS

A retrospective review of all patients who underwent 3 GKRS procedures for TN at 4 participating centers of the North American Gamma Knife Consortium from 1995 to 2012 was performed. The Barrow Neurological Institute (BNI) pain score was used to evaluate pain outcomes.

RESULTS

Seventeen patients were identified; 7 were male and 10 were female. The mean age at the time of last GKRS was 79.6 years (range 51.2–95.6 years). The TN was Type I in 16 patients and Type II in 1 patient. No patient suffered from multiple sclerosis. Eight patients (47.1%) reported initial complete pain relief (BNI Score I) following their third GKRS and 8 others (47.1%) experienced at least partial relief (BNI Scores II–IIIb). The average time to initial response was 2.9 months following the third GKRS. Although 3 patients (17.6%) developed new facial sensory dysfunction following primary GKRS and 2 patients (11.8%) experienced new or worsening sensory disturbance following the second GKRS, no patient sustained additional sensory disturbances after the third procedure. At a mean follow-up of 22.9 months following the third GKRS, 6 patients (35.3%) reported continued Score I complete pain relief, while 7 others (41.2%) reported pain improvement (BNI Scores II–IIIb). Four patients (23.5%) suffered recurrent TN following the third procedure at a mean interval of 19.1 months.

CONCLUSIONS

A third GKRS resulted in pain reduction with a low risk of additional complications in most patients with medically refractory and recurrent, intractable TN. In patients unsuitable for other microsurgical or percutaneous strategies, especially those receiving long-term oral anticoagulation or antiplatelet agents, GKRS repeated for a third time was a satisfactory, low risk option.
Clinical, radiological, and pathological features in 43 cases of intracranial subependymoma
Authors: Bi Zhiyong , Ren Xiaohui , Zhang Junting , Jia Wang
Published: October 2014

OBJECT

Intracranial subependymomas are rarely reported due to their extremely low incidence. Knowledge about subependymomas is therefore poor. This study aimed to analyze the incidence and clinical, radiological, and pathological features of intracranial subependymomas.

METHODS

Approximately 60,000 intracranial tumors were surgically treated at Beijing Tiantan Hospital between 2003 and 2013. The authors identified all cases in which patients underwent resection of an intracranial tumor that was found to be pathological examination demonstrated to be subependymoma and analyzed the data from these cases.

RESULTS

Forty-three cases of pathologically confirmed, surgically treated intracranial subependymoma were identified. Thus in this patient population, subependymomas accounted for approximately 0.07% of intracranial tumors (43 of an estimated 60,000). Radiologically, 79.1% (34/43) of intracranial subependymomas were misdiagnosed as other diseases. Pathologically, 34 were confirmed as pure subependymomas, 8 were mixed with ependymoma, and 1 was mixed with astrocytoma. Thirty-five patients were followed up for 3.0 to 120 months after surgery. Three of these patients experienced tumor recurrence, and one died of tumor recurrence. Univariate analysis revealed that shorter progression-free survival (PFS) was significantly associated with poorly defined borders. The association between shorter PFS and age < 14 years was almost significant (p = 0.51), and this variable was also included in the multivariate analysis. However, multivariate analysis showed showed only poorly defined borders to be an independent prognostic factor for shorter PFS (RR 18.655, 95% CI 1.141–304.884, p = 0.040). In patients 14 years of age or older, the lesions tended to be pure subependymomas located in the unilateral supratentorial area, total removal tended to be easier, and PFS tended to be longer. In comparison, in younger patients subependymomas tended to be mixed tumors involving the bilateral infratentorial area, with a lower total removal rate and shorter PFS.

CONCLUSIONS

Intracranial subependymoma is a rare benign intracranial tumor with definite radiological features. Long-term survival can be expected, although poorly defined borders are an independent predictor of shorter PFS. All the features that differ between tumors in younger and older patients suggest that they might have different origins, biological behaviors, and prognoses.
In vivo measurement of the frame-based application accuracy of the Neuromate neurosurgical robot
Authors: von Langsdorff Daniel , Paquis Philippe , Fontaine Denys
Published: October 2014

OBJECT

The application accuracy of the Neuromate neurosurgical robot has been validated in vitro but has not been evaluated in vivo for deep brain stimulation (DBS) electrode implantations. The authors conducted a study to evaluate this application accuracy in routine frame-based DBS procedures, with an independent system of measurement.

METHODS

The Euclidian distance was measured between the point theoretically targeted by the robot and the point actually reached, based on their respective stereotactic coordinates. The coordinates of the theoretical target were given by the robot's dedicated targeting software. The coordinates of the point actually reached were recalculated using the Stereoplan localizer system. This experiment was performed in vitro, with the frame fixed in the robot space without a patient, for 21 points spatially distributed. The in vivo accuracy was then measured in 30 basal ganglia targets in 17 consecutive patients undergoing DBS for movement disorders.

RESULTS

The mean in vitro application accuracy was 0.44 ± 0.23 mm. The maximal localization error was 1.0 mm. The mean (± SD) in vivo application accuracy was 0.86 ± 0.32 mm (Δx = 0.37 ± 0.34 mm, Δy = 0.32 ± 0.24 mm, Δz = 0.58 ± 0.31 mm). The maximal error was 1.55 mm.

CONCLUSIONS

The in vivo application accuracy of the Neuromate neurosurgical robot, measured with a system independent from the robot, in frame-based DBS procedures was better than 1 mm. This accuracy is at least similar to the accuracy of stereotactic frame arms and is compatible with the accuracy required in DBS procedures.
Neurological outcomes following intraprocedural rerupture during coil embolization of ruptured intracranial aneurysms
Authors: Stapleton Christopher J. , Walcott Brian P. , Butler William E. , Ogilvy Christopher S.
Published: October 2014

OBJECT

Intraprocedural rerupture (IPR) of intracranial aneurysms during coil embolization is associated with significant periprocedural disability and death. However, whether this morbidity and mortality are secondary to an increased risk of vasospasm and hydrocephalus is unknown. The authors undertook this study to determine the in-hospital and long-term neurological outcomes for patients with aneurysmal subarachnoid hemorrhage (SAH) treated with coil embolization who suffer aneurysm rerupture during treatment.

METHODS

The records of 156 patients admitted with SAH from previously untreated, ruptured, intracranial aneurysms and treated with endovascular coiling between January 2007 and January 2014 were retrospectively reviewed. Twelve patients (7.7%) experienced IPR during coil embolization.

RESULTS

Compared with the cohort of patients with uncomplicated coil embolization procedures, patients with aneurysm rerupture were more likely to require external ventricular drain (EVD) placement (91.7% vs 58.3%, p = 0.02) and postprocedural EVD placement (36.4% vs 7.1%, p = 0.01), to undergo permanent ventriculoperitoneal shunt placement (50.0% vs 18.8%, p = 0.02), to develop symptomatic vasospasm (50.0% vs 18.1%, p = 0.02), and to have longer lengths of hospital stay (median 21.5 days vs 15.0 days, p = 0.04). Admission Hunt and Hess, modified Fisher, and Barrow Neurological Institute grades did not differ between the 2 cohorts, nor did long-term functional neurological outcomes as assessed by the modified Rankin Scale.

CONCLUSIONS

Intraprocedural rerupture during coil embolization for ruptured intracranial aneurysms is associated with an increased risk of symptomatic vasospasm and need for temporary and permanent cerebrospinal fluid diversion for hydrocephalus.