bluuebunny/crossref_metadata_2025 huggingface dataset:
Quantification of Erythema Associated With Continuous Versus Interrupted Nylon Sutures in Facial Surgery Repair: A Randomized Prospective Study
Authors: Majd Ali , Akbari Ardalan , Zloty David
Published: September 2019

BACKGROUND

Patients are often concerned about the cosmetic appearance of scars following Mohs micrographic surgery (MMS), including residual erythema. However, few studies have compared the cosmetic outcomes between different suturing techniques.

OBJECTIVE

To compare the erythema intensity (EI) associated with interrupted sutures (IS) and continuous sutures (CS), and the degree of its reduction over time.

MATERIALS AND METHODS

Mohs micrographic surgery patients were randomized to have half of their defect repaired with IS and the other half with CS. Postoperatively, subjects were assessed at 1 week, 2 months, and 6 months and close-up photographs of their scars were taken. Computer-assisted image analysis was utilized to quantify the EI in each half-scar.

RESULTS

The average EI of IS was greater than that of CS by 9.3% at 1 week (p < .001) and 7.2% at 2 months (p < .021) but comparable at 6 months. These differences were clinically detectable, but EI differences resolved by 6 months in most cases. At 6 months, EI regressed by 33.5% in IS and 26.3% in CS.

CONCLUSION

Continuous sutures are associated with less erythema during early scar maturation but are comparable to IS at 6 months. These results may guide the choice of suturing technique to improve early cosmetic outcomes and overall patient satisfaction.
Placental Membrane Provides Improved Healing Efficacy and Lower Cost Versus a Tissue-Engineered Human Skin in the Treatment of Diabetic Foot Ulcerations
Authors: Glat Paul , Orgill Dennis P. , Galiano Robert , Armstrong David , Serena Thomas , DiDomenico Lawrence A. , Kaufman Jarrod , Carter Marissa J. , Jacobs Alan M. , Zelen Charles M.
Published: September 2019

Background:

Aseptically processed dehydrated human amnion and chorion allograft (dHACA) (AmnioBand) has shown great promise in the treatment of recalcitrant diabetic foot ulcers (DFUs) when compared with standard wound care but has not yet been compared to any other tissue forms used in treating DFUs. The hypothesis was to conduct a randomized controlled trial in which dHACA was compared to one of the earliest and most commonly accepted tissue-engineered skin substitutes (TESS) (Apligraf) in the treatment of nonhealing DFUs over a period of 12 weeks to assess the superiority of healing.

Methods:

Following a 2-week screening period during which subjects with DFUs were treated with collagen alginate dressing, 60 subjects were randomized at 5 sites to receive either dHACA or TESS applied weekly, with weekly follow-up for up to 12 weeks.

Results:

The mean time to heal within 6-week time period for the dHACA group was 24 days (95% CI, 18.9–29.2) versus 39 days (95% CI, 36.4–41.9) for the TESS group; the mean time to heal at 12 weeks was 32 days (95% CI, 22.3–41.0) for dHACA-treated wounds versus 63 days (95% CI, 54.1–72.6) for TESS-treated wounds. The proportion of wounds healed at study completion (12 weeks) was 90% (27/30) for the dHACA group versus 40% (12/30) for the TESS group. The mean product cost for the dHACA group was significantly lower than that for the TESS group [dHACA: $2,200 (median: $1,300); TESS: $7,900 (median: $6,500)]. The mean wastage (%) at 12 weeks was also significantly lower for the dHACA group than that for the TESS group (36% vs 95%).

Conclusions:

It was concluded that aseptically processed dHACA heals diabetic foot wounds more reliably, statistically significantly faster than and at significantly lower cost than TESS.
Current Understanding of Religion, Spirituality, and Their Neurobiological Correlates
Authors: Rim James I. , Ojeda Jesse Caleb , Svob Connie , Kayser Jürgen , Drews Elisa , Kim Youkyung , Tenke Craig E. , Skipper Jamie , Weissman Myrna M.
Published: September 2019

Religion and spirituality (R/S) have been prominent aspects of most human cultures through the ages; however, scientific inquiry into this phenomenon has been limited. We conducted a systematic literature review of research on the neurobiological correlates of R/S, which resulted in 25 reports studying primarily R/S with electroencephalography, structural neuroimaging (MRI), and functional neuroimaging (fMRI, PET). These studies investigated a wide range of religions (e.g., Christianity, Buddhism, Islam) and R/S states and behaviors (e.g., resting state, prayer, judgments) and employed a wide range of methodologies, some of which (e.g., no control group, varying measures of religiosity, small sample sizes) raise concerns about the validity of the results. Despite these limitations, the findings of these studies collectively suggest that the experience of R/S has specific neurobiological correlates and that these correlates are distinct from non-R/S counterparts. The findings implicate several brain regions potentially associated with R/S development and behavior, including the medial frontal cortex, orbitofrontal cortex, precuneus, posterior cingulate cortex, default mode network, and caudate. This research may suggest future clinical applications and interventions related to R/S and various disorders, including mood, anxiety, psychotic, pain, and vertiginous disorders. Further studies with more rigorous study designs are warranted to elucidate the neurobiological mechanisms of R/S and their potential clinical applications.
Corneal Collagen Cross-Linking in Young Patients for Progressive Keratoconus
Authors: Barbisan Paulo Rodolfo Tagliari , Pinto Roberto Damian Pacheco , Gusmão Camillo Carneiro , de Castro Rosane Silvestre , Arieta Carlos Eduardo Leite
Published: September 2019

Purpose:

The goal of this study was to compare the effect of early corneal collagen cross-linking (CXL) intervention (before 17 years of age) with that of late intervention (after 17 years of age) on the characteristics and progression of keratoconus.

Patients and Methods:

One hundred five eyes of 94 patients with keratoconus undergoing treatment with CXL were included. The patients were divided into 2 groups by age: group 1 (mean age of 13.8 yrs; range 10–16) and group 2 (mean age of 21.5 yrs; range 17–36). Eyes were evaluated regarding best-corrected visual acuity (BCVA), refractive error, corneal endothelial cell density, and central corneal thickness, as well as using slit-lamp biomicroscopy, Goldmann tonometry, and the keratometry (Kmax, Ksteep, and Kflat parameters) test before CXL and at 1, 3, 6, and 12 months thereafter.

Results:

The mean (SD) BCVA of group 1 was 0.45 (±0.25) before CXL and 0.56 (±0.29) 1 year after CXL (P = 0.030); mean (SD) Kmax, Ksteep, and Kflat were 58.47 (±7.2), 52.93 (±5.4), 47.22 (±4.2) before CXL respectively, and 58.21 (±7.7), 52.25 (±5.5), and 46.56 (±4.6) 1 year after CXL, respectively (P = 0.897, 0.481, and 0.491). The mean (SD) BCVA of group 2 was 0.50 (±0.30) before CXL and 0.56 (±0.32) 1 year thereafter (P = 0.346); mean (SD) Kmax, Ksteep, and Kflat were, respectively, 57.64 (±7.1), 54.02 (±6.2), and 48.60 (±4.1) before CXL and 56.46 (±8.0), 52.46 (±5.8), and 47.85 (±4.9) 1 year after CXL, respectively (P = 0.553, 0.258, and 0.640).

Conclusions:

The study showed no statistical differences between younger and older patients. These findings support the indication of CXL treatment in pediatric patients for early stabilization of the disease and better progress regarding BCVA and keratometry parameters.
Comparative Analysis of KGF-2 and bFGF in Prevention of Excessive Wound Healing and Scar Formation in a Corneal Alkali Burn Model
Authors: Cai JianQiu , Zhou Qingde , Wang Zhitao , Guo Ruide , Yang Rongshuai , Yang Xuanxin , Li Wenqing , Ahmad Naveed , Chen Qi , Hui Qi , Wang Xiaojie
Published: September 2019

Purpose:

Basic fibroblast growth factor (bFGF) is an effective drug for corneal injury. However, the explicit role of bFGF in corneal scar formation still remains unclear. Keratinocyte growth factor-2 (KGF-2) is associated with the treatment of wound healing. We aimed to compare the efficacy of bFGF and KGF-2 in prevention of excessive wound healing and consequent scar formation in a rat alkali burn model, which provides important clues on the significance of KGF-2 to be developed as a new drug for such injuries.

Methods:

The epithelial defect area was evaluated using fluorescein sodium at a concentration of 0.5%. The therapeutic effect of KGF-2 and bFGF on proliferation of rabbit corneal fibroblasts (RCFs) was evaluated by methylthiazoletetrazolium. RCF migration assays were performed with a modified scratch method. Activation of mitogen-activated protein kinase (MAPK) was evaluated by Western blot with specific antibodies.

Results:

All corneal wounds treated with KGF-2 were found closed within 7 days; however, the wounds treated with bFGF or phosphate buffer saline (PBS) required 14 days to close. RCFs treated with KGF-2 or bFGF showed similar dose-dependent proliferation. The KGF-2 group significantly promoted cell migration compared with the bFGF group. The KGF-2 group showed less expression of α-smooth muscle actin (SMA) and numbers of myofibroblasts compared with the bFGF group. Our findings suggested identification of cascade reaction of extracellular regulated protein kinases (ERK)1/2 and p38 signals in KGF-2– and bFGF-induced proliferation and migration of RCFs. In addition, KGF-2 showed stronger effects during ERK1/2 and p38 phosphorylation in methylthiazoletetrazolium proliferation assay and scratch migration assay.

Conclusions:

KGF-2 exhibited better effects than bFGF in reepithelialization, acceleration of migration, and reduction of scar formation, which has potential to become a new drug to cure corneal injury.
The association between CKD-associated pruritus and quality of life in patients undergoing hemodialysis in Pakistan
Authors: Rehman Inayat Ur , Chan Kok Gan , Munib Syed , Lee Learn Han , Khan Tahir Mehmood
Published: September 2019

Chronic kidney disease (CKD)-associated pruritus is one of the most common symptoms found in patients who undergo dialysis for CKD, leading to a compromised quality of life. This study aimed to investigate the association between CKD-associated pruritus and the quality of life in patients undergoing hemodialysis in Pakistan.

A cross-sectional multicenter study was carried out from July 2016 to April 2017 in 2 tertiary care hospitals in Pakistan. Patients aged 18 years and above of both genders, undergoing hemodialysis, understood the Urdu language, and were willing to participate; were included.

Of 354 recruited patients with a response rate of 100%, majority (66.1%) of the patients were males. The median (intra-quartile range [IQR]) age of patients was 42.0 [34.0–50.0] years. The prevalence of pruritus was 74%. The median [IQR] score for pruritus was 10.0 (out of possible 25) [8.0–12.0]. Multivariate linear regression revealed a statistically significant association between CKD-associated pruritus with age of patients (β = 0.031; 95% confidence interval [CI] = 0.002–0.061; P = .038), duration of CKD (β = −0.013; 95% CI = −0.023 –−0.003; P = .014) and quality of life (β= −0.949; 95% CI = −1.450; −0.449). The median [IQR] score for health-related quality of life was 52.00 [43.00–58.00].

Prevalence of CKD-associated pruritus was reported to be 74% and it negatively affected the patient's quality of life. Patients with moderate to severe CKD-associated pruritus have poor quality of life. With an increase in intensity of pruritus, the QOL score decreased among the patients undergoing hemodialysis.
Excess weight loss is a vital strategy for controlling hypertension among multi-ethnic population in northwest China
Authors: Wang Lin , Heizhati Mulalibieke , Zhang Delian , Chang Guijuan , Yao Xiaoguang , Hong Jing , Kamilijiang Mayila , Li Mei , Li Nanfang
Published: September 2019

Hypertension is a common global health problem including China. This study aimed to assess the prevalence and awareness of hypertension, and evaluate risk factors associated with hypertension among multi-ethnic population in northwest China using a random sampling cross-sectional data.

A cross-sectional survey was conducted between 2014 and 2015 as part of a nationwide survey using stratified four-stage random sampling in Xinjiang. Hypertension was defined as mean systolic blood pressure (SBP) and/or diastolic blood pressure (DBP) ≥140/90 mm Hg and/or taking anti-hypertensive medication. In addition, the prevalence of hypertension (SBP ≥ 130 or DBP ≥ 80 mm Hg) was also estimated according to the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) High Blood Pressure Guideline. Awareness of hypertension was based on self-report. An optimized risk score model was used to assess the risk and determine the predictive power of risk factors on hypertension.

Totally 6722 subjects aged ≥18 years were enrolled and prevalence of hypertension was 24.3%, while the prevalence of hypertension based on the 2017 ACC/AHA guideline was approximately twice as high as that based on 2010 Chinese guideline (37.6%). Among individuals with hypertension, 55.5% were aware of their condition. Six potential factors were estimated to be associated with increased risk of hypertension including age, ethnicity, marital status, body mass index (BMI), waistline circumference, and comorbidity. In the analyses of calculated risk score, BMI ≥ 28.0 corresponded to the highest risk score of 23 points. The area under the receiver operation curve for the multivariable prediction model was 0.803 (95%CI: 0.789–0.813).

There is a considerable prevalence of hypertension among Xinjiang adults, northwest China; awareness of hypertension is low. Excess weight loss may be a vital strategy for controlling hypertension, particularly if accompanied with other preventive measures in this region.
The valuation of concave-side thoracoplasty on the treatment of extremely severe scoliosis with severe pulmonary dysfunction on the base of halo-pelvic traction
Authors: Zhao Hehong , Hu Zhengjun , Zhao Deng , Wang Fei , Zhong Rui , Liang Yijian
Published: September 2019

Extremely severe scoliosis patients, especially main thoracic Cobb’ s angle >150°, often have severe thoracic deformity and pulmonary dysfunction, even the scoliosis is reduced by halo-pelvic traction, the improvement of pulmonary function is not satisfactory, the risk of spinal osteotomy in the next stage is still very high and left with obvious thoracic deformity. How to further improve the pulmonary function and appearance of these patients is a difficult problem to be solved.

Twenty extremely severe scoliosis patients with severe pulmonary dysfunction who underwent concave-side thoracoplasty in our hospital from September 2014 to September 2017 were included, data of thoracic volume and pulmonary function were collected before and after operation. The pulmonary function value reported was predicted forced vital capacity (FVC%), T-test was used to analyze the changes of the data by the statistical software SPSS21.0.

The 20 patient's averaged Cobb's angle of main thoracic was 163° ± 8° at admission and all of them with severe pulmonary dysfunction before concave-side thracoplasty. After operation, the thoracic volume of patients increased by 500.9 ± 222.9 mL, FVC% increased by 8.9% ± 7.5%. Both the difference has statistical significance (P < .01).

Concave-side thoracoplasty based on the halo-pelvic traction cannot only enlarge the volume of the concave thoracic cavity, lighten the compression of lung and further improve the pulmonary function of extremely severe scoliosis, but also can strengthen the correction of scoliosis and spinal rotation. Therefore, it is a safe and effective surgical approach.
Radiologic criteria to predict injury of the transverse atlantal ligament in unilateral sagittal split fractures of the C1 lateral mass
Authors: Park Heui-Jeon , Chang Dong-Gune , Park Jong-Beom , Kim Whoan Jeang , Song Kyung-Jin , Min Woo-Kie , Park Seung Chan
Published: September 2019

Unilateral sagittal split fracture (USSF) of the C1 lateral mass (LM) has been recently recognized as a rare variant of C1 atlas fracture. To date, there has been no study to investigate whether radiologic criteria can be applied to determine the presence or absence of transverse atlantal ligament (TAL) injury in USSF of the C1 LM.

Twenty six consecutive cases of USSF of the C1 LM were included in this study. According to Dickman classification, 16 cases were TAL injury, and 10 cases were TAL intact. Radiologic parameters were measured and compared between the 2 groups.

Total LM displacement (LMD) of the 2 sides (5.9 ± 2.0 mm vs 1.2 ± 2.0 mm), unilateral LMD of the fracture side (4.3 ± 1.2 mm vs 1.0 ± 1.1 mm), atlanto-dental interval (ADI) (2.0 ± 0.9 mm vs 1.5 ± 0.4 mm), and fracture gap (6.9 ± 2.7 mm vs 2.1 ± 1.1 mm) were statistically higher in the TAL injury group than the TAL intact group. However, basion-dental interval, clivus canal angle, and atlanto-occipital joint axis angle were not different between the 2 groups. Total LMD and unilateral LMD positively correlated with ADI and fracture gap. The incidence of fracture gap larger than 7 mm was statistically higher in the TAL injury group than the TAL intact group (81% vs 30%).

In conclusion, total LMD > 5.9 mm or unilateral LMD > 4.3 mm suggests the presence of TAL injury in USSF of the C1 LM. The possibility of diagnostic error for TAL injury can be further reduced in USSF of the C1 LM by considering the fracture gap larger than 7 mm.
Second primary malignancy in patients with esophageal adenocarcinoma and squamous cell carcinoma
Authors: Zhang Guoqing , Wu Bin , Wang Xiaofei , Li Jindong
Published: September 2019

There have been no studies on implementing effective screening models for esophageal adenocarcinoma and squamous cell carcinoma survivors. We used a proportional subdistribution hazards model to estimate second primary malignancy risks among patients with esophageal adenocarcinoma and squamous cell carcinoma. We validated models using a bootstrap cross-validation method and performed decision curve analysis to evaluate their clinical utility. Age group and SEER historic stage were significantly associated with second primary malignancy risk after diagnosis of esophageal adenocarcinoma and squamous cell carcinoma. Saving positive lymph nodes and distant metastasis were significant factors in the adenocarcinoma group, and marital status, tumor location, and chemotherapy were significant factors in the squamous cell carcinoma group. Calibration plots show good concordance between predicted and actual outcomes except in high-probability areas for the risk of a second primary malignancy in patients with esophageal squamous cell carcinoma. Discrimination performances of the Fine–Gray models were evaluated using c-indices, which were 0.691 and 0.662 for second primary malignancies in patients with esophageal adenocarcinoma and squamous cell carcinoma, respectively. Decision curve analysis yielded a range of threshold probabilities (0.020–0.177 and 0.021–0.133 for patients with esophageal adenocarcinoma and squamous cell carcinoma, respectively) at which the clinical net benefit of the risk model was larger than those of hypothetical all-screening and no-screening scenarios. Our nomograms enable selection of patient populations at high risk for a second primary malignancy and thus will facilitate the design of prevention trials for affected populations.
Accuracy of liver stiffness-based model by different imaging modalities in compensated advanced chronic liver disease
Authors: Liu Changchun , Ji Dong , Huang Fangze , Huang Yifei , Du Xiaoxue , Liu Chuan , Mao Xiaorong , Zhang Qingge , Fang Chihua , Ju Shenghong , An Weimin , Chen Guofeng , Qi Xiaolong
Published: September 2019

Objectives

A liver stiffness × spleen size/platelet count score (LSPS) model which can rule out high-risk varices and identify high likelihood of clinically significant portal hypertension in patients with compensated cirrhosis has been endorsed by American Association for the Study of Liver Diseases in the 2016 practice guidance on portal hypertension bleeding. This study aims to evaluate the accuracy of LSPS model assessed by ultrasound in well characterized patients with compensated advanced chronic liver disease.

Methods

Eligible patients with compensated advanced chronic liver disease were retrospectively enrolled between January 2017 and March 2018, who had undergone routine clinical and laboratory tests, liver stiffness measurement, ultrasound examination, and computed tomography scanning. Spleen sizes were evaluated by ultrasound and computed tomography reconstructed model, respectively. The correlation and agreement of spleen size and LSPS derived from ultrasound and computed tomography imaging modality were compared.

Results

A total of 158 patients were included and analyzed. Spleen size showed a moderate correlation (R = 0.649, P < 0.001) according to ultrasound and computed tomography imaging. Also, the correlation between the two LSPS models based on ultrasound and computed tomography was excellent (R = 0.985, P < 0.001). The Bland–Altman plots demonstrated a superior agreement of LSPS model values evaluated by ultrasound and computed tomography, respectively.

Conclusion

This study demonstrated the accuracy of LSPS model based on ultrasound in a well characterized cohort of fully compensated patients with advanced chronic liver disease.
Patients with suboptimal hepatitis B virus diagnostic characterization are at risk of liver fibrosis progression
Authors: Morales-Arraez Dalia , Diaz-Flores Felicitas , Alonso Ana , de Vera Antonia , Jimenez Alejandro , Garcia Dopico Jose A. , Quintero Enrique , Hernández-Guerra Manuel
Published: September 2019

Background

Many patients with chronic hepatitis B virus infection remain infradiagnosed and untreated. In a national health system with unrestricted access to treatment, our aims were to assess the level of compliance with clinical guidelines and the characteristics and risk of fibrosis progression in patients with suboptimal diagnosis.

Methods

In a cohort of patients with positive hepatitis B surface antigen from January 2011 to December 2013, data were registered to assess characteristics and compliance with guidelines. For assessing the risk of liver fibrosis, positive hepatitis B surface antigen patients from January 2008 to December 2013 were grouped depending on DNA request. Liver fibrosis was estimated by serological scores.

Results

Of 41 158 subjects with hepatitis B surface antigen request, 351 (0.9%) tested positive, and DNA was not available from 110 patients (66.4% male, mean 42.4 ± 14.5 years) after a median of 25.6 months (range 12.0–43.5). Most of these patients (76%) were assessed by primary care. Half of the patients (47.2%) showed hypertransaminasemia, at least significant fibrosis, or both conditions. After long follow-up (mean 90.1 ± 45.2 months), these patients had a higher risk of achieving at least significant fibrosis during follow-up (log-rank 8.73; P = 0.003).

Conclusion

In more than one-third of patients with positive hepatitis B surface antigen, DNA was not requested despite showing hypertransaminasemia and significant fibrosis. Patients without DNA request are at high risk of liver fibrosis progression. Thus, educational measures and other strategies are necessary, especially targeting primary care, to improve access to treatment.
Meningioma-like Tumor of the Skin Revisited
Authors: Monteagudo Carlos , Jiménez Ana I. , Arnandis Angeles , Barr Ronald J.
Published: September 2019

The term meningioma-like tumor of the skin (MLTS) was coined in 1993 to designate a particular whorled spindle cell superficial cutaneous tumor. No additional confirmed cases of this entity have been reported to date. Some authors have speculated that these cases might be cellular neurothekeomas. In order to delineate the histologic spectrum and the immunophenotype of this unusual tumor, we studied 5 cases, 2 previously unreported and the 3 original cases. The immunohistochemical findings of case 5, however, were limited to those from the original study. Clinically, the tumor presented as a reddish papule, plaque, or nodule, located in the extremities or trunk. The patient often referred to a recent growth of a longstanding lesion. Histologically, the characteristic whorled spindle and stellate dendritic cell population, commonly in a perivascular arrangement, and variable myxoid component, were consistently found in all cases. A prominent microvasculature was also a constant finding. The presence of large deciduoid cells was conspicuous in one case. A reticular pattern of multivacuolated cells giving a chordoma-like appearance was evident in another case. Tumor cells were diffusely positive for CD34 in all 4 cases studied, and negative for S-100, EMA, NKI-C3, CD68, and smooth muscle markers. No complete loss of retinoblastoma protein was found. No brachyury immunostaining was found in the case with chordoid features. No EWSR1 or NAB2-STAT6 gene fusions were found. From these findings, we demonstrate that MLTS is a distinct CD34+ spindle cell benign dermal tumor, unrelated to cellular neurothekeoma, and exhibiting myxoid, deciduoid, or chordoma-like features.
Uptake of 18F-FDG in Adrenal Adenomas Is Associated With Unenhanced CT Value and Constituent Cells
Authors: Murayama Ryo , Nishie Akihiro , Hida Tomoyuki , Baba Shingo , Inokuchi Junichi , Oda Yoshinao , Honda Hiroshi
Published: September 2019

Purpose

The purposes of this study were to investigate the correlation between unenhanced CT attenuation values and 18F-FDG uptake in adrenal adenomas, and to clarify the mechanism of FDG uptake in adrenal adenomas based on immunohistochemical findings.

Materials and Methods

In 57 adrenal adenomas, the correlation between SUVmax on 18F-FDG PET and unenhanced CT attenuation was retrospectively investigated. In the 11 surgically resected nodules, the clear cell ratio (CCR) and expression levels of glucose transporters (GLUTs) 1 to 4 were pathologically evaluated. The GLUT expression levels were scored at 0 to 3 points for each transporter, and the sum of these expression levels was defined as the GLUT score. The relationships between CCR and either the CT attenuation number or SUVmax, and between the GLUT score and each of the CT attenutation value, SUVmax, or CCR were evaluated.

Results

There was a significant positive correlation between SUVmax and the CT attenuation value for the group of 57 adenomas (R = 0.44, P = 0.0007). For the 11 surgically resected cases, there was a nonsignificant trend of negative correlation between SUVmax and CCR (R = 0.57, P = 0.06). There was a significant positive correlation between GLUT score and CT attenuation value (R = 0.68, P = 0.02), and a significant negative correlation between GLUT score and CCR (R = 0.60, P = 0.003).

Conclusions

Adrenal adenomas composed of many compact cells or having high attenuation on unenhanced CT showed high FDG uptake. FDG uptake of adrenal adenomas may depend on the constituent cells.
Quality of Life Assessment for Elderly Patients Treated With Orthognathic Surgery
Authors: Avelar Rafael Linard , Silva Paulo Goberlanio de Barros , Magalhaes Maria Thereza Carvalho de , Parente Antônia Edivanda Aguiar , Alencar Natália Maria Carvalho de , Barros Livia de Oliveira
Published: September 2019

Aim:

The purpose of the present study was to evaluate the impact of orthognathic surgery on quality of life (QoL) in elderly patients.

Methods:

Twenty patients who underwent orthognathic surgery to correct Angle Class I, II e, III relations were evaluated. Condition-specific QoL through a 22-item Orthognathic Quality of Life Questionnaire (OQLQ) and generic oral health-related QoL through a 14-item short-form Oral Health Impact Profile (OHIP-14) were assessed.

Results:

A statistically significant reduction (P < 0.001) in the average overall score was detected between the presurgical and postsurgical assessments. Male group showed significant improvement in physical pain (P = 0.047) and psychological discomfort (P = 0.039). No difference was found between the OHIP-14 (P = 0.582) and OQLQ (P = 0.525) total scores for the type of surgery (mono-maxillary or bimaxillary).

Conclusions:

Orthognathic surgical treatment had a positive impact on oral health-related QoL in the patients evaluated. The results of this study emphasize the concept that dental esthetics influence patients’ oral health–related QoL.
Traumatic Telecanthus and Posterior Lacrimal Crest Avulsion in a Six-Year-Old Child
Authors: Díaz Oswaldo J. Gómez , Carreño Andrés Parra , Serna Daniel Restrepo
Published: September 2019

Pediatric facial fractures are uncommon, especially orbital fractures, which can be unnoticed in 30% of the cases. Any delay regarding either diagnosis or treatment implies the risk of long-term sequels. Limited data exists concerning craniofacial fractures in children, especially the ones compromising the orbital substructures. Distribution varies upon several series; however, there is inexistence of literature regarding specific and isolated fractures of the lacrimal skeletal system. Injuries to the medial orbital wall canthal tendon can lead to disinsertion/ruptures of the medial canthal tendon. A canthopexy is the most indicated treatment to restore the original canthal position and the re-establishment of palpebral normal function. This paper's purpose is to present an isolated posterior lacrimal crest fracture/avulsion case secondary to a high-energy trauma involving a 6-year-old girl and present an exhaust literature revision.
Recurrent Maxillary Sinusitis and Periorbital Cellulitis Revealing an Unnoticed Medial Wall Orbital Fracture
Authors: Bachelet Jean-Thomas , Landis Basile N. , Scolozzi Paolo
Published: September 2019

Unilateral recurrent maxillary sinusitis is a common sinunasal pathology, mostly related to the ostiomeatal complex dysfunction. Although sinusitis can potentially spread to the adjacent structures, orbital cellulitis remains an exceptionally rare sequela.

The authors report the unusual case of a patient who presented with recurrent maxillary sinusitis complicated by cyclic episodes of periorbital cellulitis related to ostiomeatal complex obstruction from herniated periorbital fat through an unnoticed medial orbital wall fracture. To the best of our knowledge, no other similar case has previously been reported. The possible explanation for such an unusual association is discussed.
The Postoperative Morphometrics of Orbital and Maxillary Area for Craniosynostosis
Authors: Shi Lijun , Shen Weimin , Gao Qingwen , Kong Liangliang
Published: September 2019

Purpose:

One of the most characteristic features in premature craniosynostosis is fronto-orbital retrusion. The standardized surgical technique of fronto-orbital advancement (FOA) can treat this (some) deformity, such as bilateral coronal synostosis. The purpose of the study is to investigate an available method to assess the postoperative outcome of the craniofacial surgery.

Methods:

From 2010 to 2015, 6 pediatric patients were taken the FOA in the Department of Burn and Plastic Surgery in the Children‘s Hospital of Nanjing Medical University. All the patients were performed the computed tomography (CT) scan preoperatively and postoperatively. The CT databases were processed by DICOM files into MIMICS 16.0 software, which were automatically calculated into orbital volume and orbital roof and base surface area. T-test was used to compare measured values before and after surgery. P < 0.05 was considered statistically significant.

Results:

The average preoperative orbital volume was 13930.70 mm3, and the postoperative was 18578.67917 mm3. After operation, the volume of orbital was significantly increased (P < 0.05). The mean area of the orbital roof surface was 753.989025 mm preoperatively, and the postoperative was 1122.074583 mm. The difference was statistically significant (P < 0.05). The average area of the orbital base (S2) was 334.94 ± 91.76 mm2. After the FOA, the orbital base was 356.99 ± 114.21 mm2. P(S2) = 0.6072 > 0.05, there was no significant statistical difference.

Conclusions:

Fronto-orbital advancement can successfully improve morphological orbital deformities in children with premature craniosynostosis, but much less for maxillary. The computer-assisted technique can present a measurement of FOA preoperatively and postoperatively, which make the evaluation intuitive.
Evaluating the effects of the pharmacological and nonpharmacological interventions to manage delirium symptoms in palliative care patients: systematic review
Authors: Skelton Luke , Guo Ping
Published: September 2019

Purpose of review

There is a high prevalence of delirium in palliative care patients. This review aims to evaluate the effects of the pharmacological and nonpharmacological interventions used to manage delirium symptoms in this patient group.

Recent findings

A recent study has suggested there is no role for antipsychotic medication in the management of delirium in palliative care patients, which is a move away from previous expert opinion. In addition, recent findings suggest there may be a role for the use of antipsychotics in combination with benzodiazepines in the management of agitated delirium.

It is too early to abandon the use of antipsychotic medication entirely in the management of delirium, however there remains inadequate evidence to support the routine use of either pharmacological or nonpharmacological interventions for delirium treatment. Clinicians should determine the delirium subtype and severity, using this to inform the most appropriate pharmacological treatment if required. Further rigorously designed research is needed to seek clarity over whether the alleviation of symptoms is dose dependent, and to determine whether there is a severity threshold over which pharmacological interventions are most effective. Future research is required to evaluate nonpharmacological interventions in this population.
The Challenges With the Cardiac Evaluation of Liver and Kidney Transplant Candidates
Authors: Sandal Shaifali , Chen Tianyan , Cantarovich Marcelo
Published: September 2019

Cardiovascular events are among the leading cause of mortality in kidney and liver transplant recipients. Thus, screening for cardiovascular disease and risk stratification for cardiovascular events constitute an important part of the pretransplant evaluation. In this review, we first summarize current guidelines in the cardiac risk assessment of kidney and liver transplant candidates. We then elaborate on the limitations of these guidelines, summarize the current knowledge gaps, and narrow down a spectrum of 6 themes that serve as challenges to research and practice development. This spectrum pertains to understanding the disease itself, which is challenging due to the altered cardiac physiology in these patients and current guidelines that do not adequately account for nonischemic diseases and events. We then describe the challenges in assessing these patients, their symptoms, and individualizing their risk of cardiovascular events with a special consideration for nontraditional risk factors. We also explore the limitations of the current and novel diagnostic tests and the lack of evidence of therapeutic efficacy in intervening in patients with asymptomatic disease. The transplant procedure itself can be a potential modifiable risk factor for cardiovascular events, that is, surgical technique, type of donor, and induction immunosuppression. Lastly, we describe the potential issues with the current literature when defining cardiac diseases and events across different studies and shortcomings of extrapolating data from the nontransplant literature. We conclude by proposing research and practice implications of our discussion and that there is a need for evidence to guide the revision of current guidelines.
A case of intellectual disability reveals a novel mutation in IQSEC2 gene by whole exome sequencing
Authors: Zou Qianqian , Zheng Jie , Zhang Ruiping , Fang Yulian , Cai Chunquan
Published: September 2019

Intellectual disability refers to significantly subaverage intellectual function (intelligence quotient < 70) with impairment of adaptive function. The IQSEC2 gene is one of the pathogenic genes located on chromosome Xp11.22. IQSEC2 is an X-linked gene correlated with intellectual disability and epilepsy. In this study, we reported a 2-year-old male patient presented with reacting sluggishly with people and surroungdings. Active electroencephalogram showed the background of epileptic activity. Brain MRI revealed patchy hyperintensity of bilateral parietal lobe white matter on fluid-attenuated inversion recovery image and widened ventricle, cistern and sulci on T2-weighted image. Delayed myelination was considered. The diagnosis of intellectual disability and epilepsy was made. Whole exome-sequencing was conducted and identified a novel frameshift mutation in exon 15 of IQSEC2 (NM_001111125.2: c.4164dupC: p.Ile1389 Hisfs*218). The variant resulted in the deletion of termination codon, and the protein was extended to termination after stretch of 218 amino acids.This study expands the mutation spectrum of IQSEC2. It supports the published data suggesting that IQSEC2 plays a significant part in patients with intellectual disability and epilepsy. IQSEC2 should be detected in patients with intellectual disability and epilepsy.
AETIONOMY, a Cross-Sectional Study Aimed at validating a new taxonomy of Neurodegenerative Diseases: Study design and subject characteristics
Authors: Corvol Jean Christophe , Bujac Sarah , Carvalho Stephanie , Clarke Bethan , Marovac Jacqueline , Mangone Graziella , Rascol Olivier , Meissner Wassilios G , Magnin Eloi , Foubert-Samier Alexandra , Catala Hélène , Markaki Ioanna , Tsitsi Panagiota , Sanchez-Valle Raquel , Heneka Michael T. , Molinuevo Jose-Luis , Wuellner Ullrich , Svenningsson Per , Scordis Phil , Hofmann-Apitius Martin
Published: September 2019

Background

Although advances in the understanding of neurodegenerative diseases (NDDs) have led to improvements in classification and diagnosis and most importantly to new therapies, the unmet medical needs remain significant due to high treatment failure rates. The AETIONOMY project funded by the Innovative Medicine Initiative (IMI) aims at using multi-OMICs and bioinformatics to identify new classifications for NDDs based on common molecular pathophysiological mechanisms in view of improving the availability of personalised treatments.

Objectives

The purpose of the AETIONOMY cross-sectional study is to validate novel patient classification criteria provided by these tools.

Methods

This was a European multi centre, cross-sectional, clinical study conducted at 6 sites in 3 countries. Standardised clinical data, biosamples from peripheral blood, cerebrospinal fluid, skin biopsies, and data from a multi-OMICs approach were collected in patients suffering from Alzheimer’s and Parkinson’s disease, as well as healthy controls.

Results

From September 2015 to December 2017 a total of 421 participants were recruited including 95 Healthy Controls. Nearly 1,500 biological samples were collected. The study achieved its objective with respect to Parkinson’s disease (PD) recruitment, however it was unable to recruit many new Alzheimer Disease (AD) patients. Overall, data from 413 evaluable subjects (405 PD and 8 AD) are available for analysis. PD patients and controls were well matched with respect to age (mean 63.4 years), however, close gender matching was not achieved. Approximately half of all PD patients and one At-Risk subject were taking dopamine agonists; rates of Levodopa usage were slightly higher (∼60%). Median MDS-UPDRS Part III Scores (OFF state) ranged from 45 (SD 18) in those with Genetic PD to 2 (SD 3) in Healthy Controls. The standardised methodologies applied resulted in a high-quality database with very few missing data.

Conclusion

This is one of the collaborative multi-OMICs studies in individuals suffering from PD and AD involving a control group. It is expected that the integration of data will provide new biomarker-led descriptions of clusters of patient subgroups.
Exome sequences of toque macaques (Macaca sinica) of Sri Lanka reveal many amino acid changes
Authors: Hettiarachchi Nilmini , Osada Naoki , Nakaoka Hirofumi , Hayakawa Takashi , Inoue Ituro , Saitou Naruya
Published: September 2019

Macaques are one of the most widely used model organisms in biomedical research. Macaca mulatta and M. fascicularis are currently being used for toxicology, HIV, diabetes, neuroscience and psychiatric and psychological disorder researches. Many studies have been conducted on M. mulatta and M. fascicularis genomes for this purpose in order to understand the genomic properties of these species. Several M. fascicularis individuals from different geographical locations and also M. mulatta genomes have been sequenced and studied in depth for the purpose of understanding the phylogenetic and evolutionary relationships between various macaque populations. But still a gap in knowledge remains for other macaque populations such as the Sinica group. In this study for the very first time, we sequenced the exome of toque macaques (M. sinica), an endemic island population of Sri Lanka. Here we confirmed that M. sinica and M. thibetana cluster together and are closely related, also the three distinct phylogenetic groupings of fascicularis and sinica. We also found that M. sinica has less number of polymorphisms with respect to the reference genome M. mulatta signifying the smaller and restricted population size of this species.
Essential omega-3 fatty acids tune microglial phagocytosis of synaptic elements in the developing brain
Authors: Madore C. , Leyrolle Q. , Morel L. , Delpech J.C. , Greenhalgh A.D. , Lacabanne C. , Bosch-Bouju C. , Bourel J. , Thomazeau A. , Hopperton K.E. , Beccari S. , Sere A. , Aubert A. , De Smedt-Peyrusse V. , Lecours C. , Bisht K. , Fourgeaud L. , Gregoire S. , Bretillon L. , Grant N. J. , Badaut J. , Gressens P. , Sierra A. , Butovsky O. , Tremblay M.E. , Bazinet R.P. , Joffre C. , Nadjar A. , Layé S.
Published: September 2019

Omega-3 fatty acids (n-3 polyunsaturated fatty acids; n-3 PUFAs) are essential for the functional maturation of the brain. Westernization of dietary habits in both developed and developing countries is accompanied by a progressive reduction in dietary intake of n-3 PUFAs. Low maternal intake of n-3 PUFAs has been linked to neurodevelopmental diseases in epidemiological studies, but the mechanisms by which a n-3 PUFA dietary imbalance affects CNS development are poorly understood. Active microglial engulfment of synaptic elements is an important process for normal brain development and altered synapse refinement is a hallmark of several neurodevelopmental disorders. Here, we identify a molecular mechanism for detrimental effects of low maternal n-3 PUFA intake on hippocampal development. Our results show that maternal dietary n-3 PUFA deficiency increases microglial phagocytosis of synaptic elements in the developing hippocampus, through the activation of 12/15- lipoxygenase (LOX)/12-HETE signaling, which alters neuronal morphology and affects cognition in the postnatal offspring. While women of child bearing age are at higher risk of dietary n-3 PUFA deficiency, these findings provide new insights into the mechanisms linking maternal nutrition to neurodevelopmental disorders.

One Sentence Summary

Low maternal omega-3 fatty acids intake impairs microglia-mediated synaptic refinementvia12-HETE pathway in the developing brain.
Omic-Sig: Utilizing Omics Data to Explore and Visualize Kinase-Substrate Interactions
Authors: Lih T. Mamie , Clark David J. , Zhang Hui
Published: September 2019

Protein phosphorylation is one of the most prevalent post-translational modifications, resulting from the activity of protein kinases phosphorylating specific substrates. Multiple cellular processes are regulated via protein phosphorylation, with aberrant signaling driven by dysregulation of phosphorylation events and associating with disease progression (e.g., cancer). Mass spectrometry-based phosphoprotomics approaches can be leveraged for studying alterations of kinase-substrate activity in clinical cohorts. However, the information gained via interrogation of global proteomes and transcriptomes can offer additional insight into the interaction of kinases and their respective substrates. Therefore, we have developed the bioinformatics, data visualization software tool, Omic-Sig, which can stratify prominent phospho-substrates and their associated kinases based on differential abundances between case and control samples (e.g., tumors and their normal adjacent tissues from a cancer cohort) in a multi-omics fashion. Omic-Sig is available at https://github.com/hzhangjhu/Omic-Sig.
The microbiome as a biosensor: functional profiles elucidate hidden stress in hosts
Authors: Zolti Avihai , Green Stefan J. , Sela Noa , Hadar Yitzhak , Minz Dror
Published: September 2019

Microbial communities are highly responsive to environmental cues, and both their structure and activity can be altered in response to changing conditions. We hypothesized that host-associated microbial communities, particularly those colonizing host surfaces, can serve asin situsensors to reveal environmental conditions experienced by both microorganisms and the host. For a proof-of-concept, we studied a model plant-soil system and employed a non-deterministic gene-centric approach. A holistic analysis was performed using plants of two species and irrigation with water of low quality to induce host stress. Our analyses examined the genetic potential (DNA) and gene expression patterns (RNA) of plant-associated microbial communities, as well as transcriptional profiling of host plants. Transcriptional analysis of plants irrigated with treated wastewater revealed significant enrichment of general stress-associated root transcripts relative to plants irrigated with fresh water. Metagenomic analysis of root-associated microbial communities in treated wastewater-irrigated plants, however, revealed enrichment of more specific stress-associated genes relating to high levels of salt, high pH and lower levels of oxygen. Meta-analysis of these differentially abundant genes obtained from other metagenome studies provided evidence of the link between environmental factors such as pH and oxygen and these genes. Analysis of microbial transcriptional response demonstrated that enriched gene content was actively expressed, which implies contemporary response to elevated levels of pH and salt. We demonstrate here that microbial profiling can elucidate stress signals that cannot be observed even through interrogation of host transcriptome, leading to an alternate mechanism for evaluatingin situconditions experienced by host organisms.

Significance Statement

This study examines the potential for microbial communities to provide insight into stresses experienced by their eukaryotic host organisms, through profiling of metagenomes and metatranscriptomes. Our study uses plant host-associated microorganisms as anin vivoandin situmicrosensor to identify environmental stresses experienced by the microbial community and by the plant. Transcriptionally active host-associated microbial communities are responsive in a highly specific manner to environmental conditions. Conversely, host transcriptome sequencing provides only a very general stress response. This study is a proof-of-concept for the use of microbial communities as microsensors, with a great potential for interrogation of a wide range of host systems.