bluuebunny/crossref_metadata_2025_split huggingface dataset:
Subcutaneous Nitroglycerin for Radial Arterial Catheterization in Pediatric Patients
Authors: Jang Young-Eun , Ji Sang-Hwan , Kim Eun-Hee , Lee Ji-Hyun , Kim Hee-Soo , Mossad Emad B. , Kim Jin-Tae 
Published: April 2020

Background
Pediatric radial artery cannulation is challenging because of the small vessel size. Nitroglycerin is a potent vasodilator and facilitates radial artery cannulation by increasing the internal diameter and preventing the vasospasm in adult patients. The authors hypothesize that subcutaneous nitroglycerin injection will improve the success rate of pediatric radial artery cannulation.

Methods
This double-blind, randomized, controlled, single-center study enrolled pediatric patients (n = 113, age less than 2 yr) requiring radial artery cannulation during general anesthesia. The participants were randomized into the nitroglycerin group (n = 57) or control group (n = 56). After inducing general anesthesia, nitroglycerin solution (5 μg/kg in 0.5 ml), or normal saline (0.5 ml) was subcutaneously injected above the chosen radial artery over 10 s with ultrasound guidance. Three minutes later, the ultrasound-guided radial artery cannulation was performed. Radial artery diameter was measured before and after the subcutaneous injection and after cannulation. The primary outcome was the first-attempt successful cannulation rate. The secondary outcomes included the diameter of the radial artery and the overall complication rate including hematoma and vasospasm.

Results
A total of 113 children were included in the analysis. The nitroglycerin group had a higher first-attempt success rate than the control group (91.2% [52 of 57] vs. 66.1% [37 of 56]; P = 0.002; odds ratio, 5.3; 95% CI, 1.83 to 15.6; absolute risk reduction, –25.2%; 95% CI, –39.6 to –10.7%). Subcutaneous nitroglycerin injection increased the diameter of the radial artery greater than normal saline (25.0 ± 19.5% vs. 1.9 ± 13.1%; 95% CI of mean difference, 16.9 to 29.3%; P < 0.001). Overall complication rate was lower in the nitroglycerin group than in the control group (3.5% [2 of 57] vs. 31.2% [18 of 56]; P = 0.001; odds ratio, 0.077; 95% CI, 0.017 to 0.350; absolute risk reduction, 28.6%; 95% CI, 15.5 to 41.8%).

Conclusions
Subcutaneous nitroglycerin injection before radial artery cannulation improved the first-attempt success rate and reduced the overall complication rates in pediatric patients.

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Weight-lowering Effects of Glucagon-like Peptide-1 Receptor Agonists and Detection of Breast Cancer Among Obese Women with Diabetes
Authors: Santella Christina , Yin Hui , Hicks Blánaid M. , Yu Oriana H. Y. , Bouganim Nathaniel , Azoulay Laurent 
Published: April 2020

Background:
It has been proposed that the weight loss associated with glucagon-like peptide-1 receptor agonists (GLP-1 RAs) may improve detection of breast cancer in patients undergoing this treatment. We aimed to determine whether the weight-lowering effects of GLP-1 RAs are associated with an increased detection of breast cancer among obese women with type 2 diabetes.

Methods:
Using the UK Clinical Practice Research Datalink, we conducted a propensity score-matched cohort study among female obese patients with type 2 diabetes newly treated with antidiabetic drugs between 1 January 2007 and 31 January 2018. New users of GLP-1 RAs (n = 5,510) were matched to new users of second- to third-line noninsulin antidiabetic drugs (n = 5,510). We used time-dependent Cox proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of breast cancer associated with different GLP-1 RA maximal weight loss categories (<5%, 5%–10%, >10%).

Results:
Breast cancer incidence gradually increased with GLP-1 RA maximal weight loss categories, with the highest HR observed for patients achieving at least 10% weight loss (HR = 1.8, 95% CI = 1.1, 2.8). In secondary analyses, the HR for >10% weight loss was highest in the 2–3 years since treatment initiation (HR = 2.9, 95% CI = 1.2, 6.9).

Conclusions:
In this population-based study, the detection of breast cancer gradually increased with GLP-1 RA weight loss categories, particularly among those achieving >10% weight loss. These results are consistent with the hypothesis that substantial weight loss with GLP-1 RAs may improve detection of breast cancer among obese patients with type 2 diabetes.
The Role of Ambient Particle Radioactivity in Inflammation and Endothelial Function in an Elderly Cohort
Authors: Blomberg Annelise J. , Nyhan Marguerite M. , Bind Marie-Abèle , Vokonas Pantel , Coull Brent A. , Schwartz Joel , Koutrakis Petros 
Published: April 2020

Background:
The mechanisms by which exposure to particulate matter might increase risk of cardiovascular morbidity and mortality are not fully known. However, few existing studies have investigated the potential role of particle radioactivity. Naturally occurring radionuclides attach to particulate matter and continue to release ionizing radiation after inhalation and deposition in the lungs. We hypothesize that exposure to particle radioactivity increases biomarkers of inflammation.

Methods:
Our repeated-measures study included 752 men in the greater Boston area. We estimated regional particle radioactivity as a daily spatial average of gross beta concentrations from five monitors in the study area. We used linear mixed-effects regression models to estimate short- and medium-term associations between particle radioactivity and biomarkers of inflammation and endothelial dysfunction, with and without adjustment for additional particulate air pollutants.

Results:
We observed associations between particle radioactivity on C-reactive protein (CRP), intercellular adhesion molecule-1 (ICAM-1), and vascular cell adhesion molecule-1 (VCAM-1), but no associations with fibrinogen. An interquartile range width increase in mean 7-day particle radioactivity (1.2 × 10−4 Bq/m3) was associated with a 4.9% increase in CRP (95% CI = 0.077, 9.9), a 2.8% increase in ICAM-1 (95% CI = 1.4, 4.2), and a 4.3% increase in VCAM-1 (95% CI = 2.5, 6.1). The main effects of particle radioactivity remained similar after adjustment in most cases. We also obtained similar effect estimates in a sensitivity analysis applying a robust causal model.

Conclusion:
Regional particle radioactivity is positively associated with inflammatory biomarkers, indicating a potential pathway for radiation-induced cardiovascular effects.
Long Noncoding RNA XIST/miR-17/PTEN Axis Modulates the Proliferation and Apoptosis of Vascular Smooth Muscle Cells to Affect Stanford Type A Aortic Dissection
Authors: Zhang Xiaoyun , Wu Hongyu , Mai Changjiang , Qi Yanqing 
Published: April 2020

Abstract:
Stanford type A aortic dissection (TAAD) is one of the most lethal cardiovascular diseases with an extremely high morbidity and mortality rate. LncRNA X-inactive specific transcript (XIST) is abundantly expressed in human thoracic aortic dissection, indicating it may play important roles in TAAD progression. However, the molecular mechanism of lncRNA XIST in TAAD is still in its infancy. Quantitative real-time PCR (qRT-PCR) was performed to detect the expression of XIST and miR-17 in the aortic wall tissues of TAAD patients and age-matched healthy volunteers. The relationships between XIST, miR-17, and PTEN were evaluated using dual-luciferase reporter, western blot, and qRT-PCR assays. The biological functions of XIST in rat aortic vascular smooth muscle cells (VSMCs) were explored with Cell Counting Kit 8 (CCK-8), qRT-PCR, and western blot assays. Results found that XIST was upregulated in aortic wall tissues of patients with TAAD and associated with the prognosis of patients with TAAD. Silence XIST facilitated VSMC proliferation and inhibited VSMC apoptosis, whereas restoration XIST displayed opposite effects. Moreover, mechanistic studies revealed that XIST contained binding sites for miR-17 and miR-17 downregulation reversed the elevation of cell proliferation and attenuation of cell apoptosis, which was induced by silence XIST. Further study revealed that XIST positively regulated PTEN expression through its competitive target miR-17. In conclusion, knockdown of lncRNA XIST might attenuate the progression of TAAD by sponging miR-17 and regulating the following downstream PTEN, which suggested a novel therapeutic target for TAAD treatment.
Neurologic Complications in Children Hospitalized With Influenza Infections
Authors: Solís-García Gonzalo , Chacón-Pascual Almudena , González Martínez Felipe , Miranda Herrero Mª Concepción , Hernández-Sampelayo Teresa , Catalán Alonso Pilar , Rodríguez-Fernández Rosa 
Published: April 2020

Background:
Influenza infection is a common cause of respiratory disease and hospitalization in children. Neurologic manifestations of the infection have been increasingly reported and may have an impact on the severity of the disease. The aim of this study is to describe neurologic events in pediatric patients hospitalized with influenza and identify associated risk factors.

Methods:
Retrospective cohort study which included all hospitalized patients with microbiologic confirmation of influenza disease over 4 epidemic seasons, focusing on neurologic complications. Demographic, laboratory and clinical data, as well as past history, were recorded. Descriptive and analytic statistical study was performed using SPSS and R statistical software.

Results:
Two hundred forty-five patients were included. Median age was 21 months (interquartile range, 6–57) and 47.8% had a previous underlying condition. Oseltamivir was administered to 86% of patients, median hospitalization was 4 days (interquartile range, 3–6), and pediatric intensive care unit admission rate 8.9%. Twenty-nine patients (11.8%) developed neurologic events, febrile seizures being the most frequent, followed by nonfebrile seizures and encephalopathy. Status epilepticus occurred in 4 children, and 69.6% of seizures recurred. Patients with a previous underlying condition were at greater risk of developing a neurologic complication [odds ratio (OR), 4.55; confidence interval (CI), 95% 1.23–16.81). Male sex (OR, 3.21; CI 95%, 1.22–8.33), influenza B virus (OR, 2.82; CI 95%, 1.14–7.14) and neurologic events (OR, 3.34; CI 95%, 1.10–10.19) were found to be risk factors for pediatric intensive care unit admission.

Conclusions:
A significant proportion of influenza-related hospitalized patients develop neurologic complications, especially seizures which may be prolonged or recurrent. Previous underlying conditions pose the greatest risk to neurologic events, which increase disease severity.
Primary Nasocutaneous Fistulae in Granulomatosis With Polyangiitis: A Case Series and Literature Review
Authors: Bahrami Bobak , Curragh David , McNab Alan A. , Davis Garry , Dolman Peter J. , Selva Dinesh 
Published: April 2020

Purpose:
To report the presentation, investigation, management, and outcomes of primary nasocutaneous fistulae in granulomatosis with polyangiitis and review the literature of this complication.

Methods:
Retrospective series of 5 patients with granulomatosis with polyangiitis and nasocutaneous fistulae and the medical and surgical management strategies employed.

Results:
Two cases presented with fistulae as the primary symptom of their systemic disease. Systemic management of granulomatosis with polyangiitis is a primary concern and two cases had inadequate control at presentation such that surgical intervention was deferred. Of the other 3 cases, 2 were closed using a median forehead flap and the other with an orbicularis advancement flap. An endonasal approach was attempted in 1 case but was unsuccessful due to the friable nature of the nasal mucosal tissue.

Conclusions:
Nasocutaneous fistulae should alert the clinician to underlying granulomatosis with polyangiitis, which may be a presentation of this condition. Systemic management of disease is often a barrier to surgical management. Myocutaneous flaps may be the most reliable management option to achieve closure.
The effect of periodontal bacteria infection on incidence and prognosis of cancer
Authors: Xiao Li , Zhang Qianyu , Peng Yanshuang , Wang Daqing , Liu Ying 
Published: April 2020

Abstract

Background:
Periodontal bacteria is the major pathogens in the oral cavity and the main cause of adult chronic periodontitis, but their association with incidence and prognosis in cancer is controversial. The aim of this study was to evaluate the effect of periodontal bacteria infection on incidence and prognosis of cancer.

Methods:
A systematic literature search of PubMed, Embase, Web of Science, and Cochrane Library databases was performed to obtain 39 studies comprising 7184 participants. The incidence of cancer was evaluated as odd ratios (OR) with a 95% confidence interval (95% CI) using Review Manager 5.2 software. Overall survival, cancer-specific survival and disease-free survival, which were measured as hazard ratios (HR) with a 95% CI using Review Manager 5.2 software.

Results:
Our results indicated that periodontal bacteria infection increased the incidence of cancer (OR = 1.25; 95%CI: 1.03–1.52) and was associated with poor overall survival (HR = 1.75; 95% CI: 1.40–2.20), disease-free survival (HR = 2.18; 95%CI: 1.24–3.84) and cancer-specific survival (HR = 1.85, 95%CI: 1.44–2.39). Subgroup analysis indicted that the risk of cancer was associated with Porphyromonas gingivalis (Pg) infection (OR = 2.16; 95%CI: 1.34–3.47) and Prevotella intermedia (Pi) infection (OR = 1.28; 95%CI: 1.01–1.63) but not Tannerella forsythia (Tf) (OR = 1.06; 95%CI: 0.8–1.41), Treponema denticola (Td) (OR = 1.30; 95%CI: 0.99–1.72), Aggregatibacter actinomycetemcomitans (Aa) (OR = 1.00; 95%CI: 0.48–2.08) and Fusobacterium nucleatum (Fn) (OR = 0.61; 95%CI: 0.32–1.16).

Conclusion:
This meta-analysis revealed periodontal bacteria infection increased the incidence of cancer and predicted poor prognosis of cancer.
Prosthetic joint infection due to Candida species
Authors: Saconi Eduardo Schincariol , de Carvalho Vladimir Cordeiro , de Oliveira Priscila Rosalba Domingos , Lima Ana Lúcia Lei Munhoz 
Published: April 2020

Abstract

Introduction:
The increase in the number of patients with prosthetic joints will entail a rise in the absolute number of infections associated with these procedures. Although less frequent, infections by Candida species are also expected to increase, and the clinical and surgical management of these cases is based on case reports and opinion of specialists. The objective of the present study was to review the available literature and describe the cases of prosthetic joint infection caused by Candida species in patients of the Institute of Orthopedics and Trauma of the University of São Paulo Faculty of Medicine Clinics Hospital (IOT-HCFMUSP) between 2007 and 2014.

Patient concerns:
Eleven patients were diagnosed with prosthetic joint infection due to Candida with mean age of 65 years. The most frequent comorbidities were heart disease and diabetes mellitus, and the main personal antecedent was previous bacterial infection in the prosthetic joint. At least one risk factor for fungal infection was present in 73% of the patients. There was no difference between the prevalence of infections caused by Candida albicans and non-albicans Candida species, and there was bacterial co-infection in 55% of the cases.

Diagnosis:
For building up the case series, patients with cultures of bone and joint specimens that were positive for Candida species and had a clinical diagnosis of prosthetic joint infection were included in the case series.

Interventions:
Surgical debridement with removal of the prosthesis was the most frequently used surgical approach (45%). All patients were treated with monotherapy, and the most frequently used antifungal agent was fluconazole. The total duration of antifungal therapy was 6 months in 73% of the cases.

Outcomes:
After the initial management, 73% of the patients achieved clinical remission.

Conclusion:
The most indicated initial management was debridement with removal of the prosthesis, and the most used treatment regimen was fluconazole monotherapy. The most prevalent treatment duration was 6 months. The initial management led to a favorable outcome in 73% of the cases.

Descriptors:
Prosthetic joint infection, Candida, treatment, and diagnosis.
Inhaled methoxyflurane for the management of trauma related pain in patients admitted to hospital emergency departments: a randomised, double-blind placebo-controlled trial (PenASAP study)
Authors: Ricard-Hibon Agnès , Lecoules Nathalie , Savary Dominique , Jacquin Laurent , Wiel Eric , Deschamps Patrick , Douplat Marion , Montestruc François , Chomier Bérangère , Tazarourte Karim , Adnet Frédéric 
Published: April 2020

BackgroundOligo-analgesia is common in the emergency department (ED). This study aimed at reporting, when initiated by triage nurse, the superior efficacy of inhaled methoxyflurane plus standard of care (m-SoC) analgesia versus placebo plus SoC (p-SoC) for moderate-to-severe trauma-related pain in the hospital ED.MethodsA randomised, double-blind, placebo-controlled trial was conducted at eight EDs. Adults with pain score ≥4 (11-point numerical rate scale, NRS) at admission were randomised to receive one or two inhalers containing m-SoC or p-SoC. Primary outcome measure was time until pain relief ≤30 mm, assessed on the 100-mm Visual Analogic Scale (VAS).ResultsA total of 351 patients were analysed (178 m-SoC; 173 p-SoC). Median pain prior to first inhalation was 66 mm, 75% had severe pain (NRS 6–10). Median time to pain relief was 35 min [95% confidence interval (CI), 28–62] for m-SoC versus not reached in p-SoC (92 – not reached) [hazard ratio), 1.93 (1.43–2.60),P < 0.001]. Pain relief was most pronounced in the severe pain subgroup: hazard ratio, 2.5 (1.7–3.7). As SoC, 24 (7%) patients received weak opioids (6 versus 8%), 4 (1%) strong opioid and 44 (13%) escalated to weak or strong opioids (8 versus 17%, respectively,P = 0.02). Most adverse events were of mild (111/147) intensity.ConclusionsIn this study, we report that methoxyflurane, initiated at triage nurse as part of a multimodal analgesic approach, is effective in achieving pain relief for trauma patients. This effect was particularly pronounced in the severe pain subgroup.
Simultaneous Orthognathic Surgery and Mandibular Contour Osteoplasty for Treating Mandibular Protrusion With High Gonial Angle
Authors: Zhang Yaoyao , Sun Xiumei , Wang Lin , Chen Kai , Wang Xiangshen , Wu Guomin 
Published: April 2020

Objective:
The purpose of this study was to confirm the effectiveness and feasibility of simultaneous orthognathic surgery and mandibular contour osteoplasty with the help of the accurate surgical templates to treat mandibular protrusion with high gonial angle.

Methods:
Ten patients diagnosed as mandibular protrusion with high gonial angle were included in this study. Besides the traditional orthognathic surgery, mandibular contour osteoplasty was performed simultaneously. Models of the mandible were fabricated via 3D printing technology. Accurate surgical templates were produced on the 3D printing model according to preoperative design. Radiographs and medical photographs preoperatively and postoperatively were taken to compare the effectiveness of the operation. Measurement items include gonial angle (Ar-Go-Me), midlines of maxilla and mandible. The clinical manifestation of the temporomandibular joint and condylar process were observed.

Results:
Radiographs and photographs of the face were taken after surgery showed satisfactory esthetic outcomes. The right gonial angle improved from 128.20° ± 5.67° to 120.35° ± 0.46°, and the left gonial angle improved from 129.91° ± 2.78° to 120.74° ± 0.59°. The midlines of the maxilla and mandibular basically consisted of the facial midline. After surgery, patients’ clinical manifestation of the temporomandibular joint was no significant difference compared with the preoperative and the condylar process had no absorption.

Conclusion:
The results of this study showed it was possible to perform orthognathic surgery and mandibular contour osteoplasty simultaneously with the help of surgical templates in the treatment of mandibular protrusion with high gonial angle.
Correlation of Intracranial Volume With Head Surface Volume in Patients With Multisutural Craniosynostosis
Authors: Ramdat Misier Karan R.R. , Breakey Richard W.F. , Caron Cornelia J.J.M. , Schievano Silvia , Dunaway David J. , Koudstaal Maarten J. , Jeelani Owase N.U. , Borghi Alessandro 
Published: April 2020

Abstract
Intracranial volume (ICV) is an important parameter for monitoring patients with multisutural craniosynostosis. Intracranial volume measurements are routinely derived from computed tomography (CT) head scans, which involves ionizing radiation. Estimation of ICV from head surface volumes could prove useful as 3D surface scanners could be used to indirectly acquire ICV information, using a non-invasive, non-ionizing method.
Pre- and postoperative 3D CT scans from spring-assisted posterior vault expansion (sPVE) patients operated between 2008 and 2018 in a single center were collected. Patients were treated for multisutural craniosynostosis, both syndromic and non-syndromic. For each patient, ICV was calculated from the CT scans as carried out in clinical practice. Additionally, the 3D soft tissue surface volume (STV) was extracted by 3D reconstruction of the CT image soft tissue of each case, further elaborated by computer-aided design (CAD) software. Correlations were analyzed before surgery, after surgery, combined for all patients and in syndrome subgroups.
Soft tissue surface volume was highly correlated to ICV for all analyses: r = 0.946 preoperatively, r = 0.959 postoperatively, and r = 0.960 all cases combined. Subgroup analyses for Apert, Crouzon-Pfeiffer and complex craniosynostosis were highly significant as well (P < 0.001).
In conclusion, 3D surface model volumes correlated strongly to ICV, measured from the same scan, and linear equations for this correlation are provided. Estimation of ICV with just a 3D surface model could thus be realized using a simple method, which does not require radiations and therefore would allow closer monitoring in patients through multiple acquisitions over time.
Prefabricated Composite Tissues for the Reconstruction of Complex Maxillary Defects: Functional and Aesthetic Principles
Authors: Vinzenz Kurt , Cohen Mimis 
Published: April 2020

Abstract
The anatomical structures of the maxilla include the mucosa lining attached to the bone in a pneumatized “light weight construction” to support facial tissues and to provide physiological oral and nasal function. Therefore, the anatomically correct restoration of the maxilla in the case of “full thickness defects“ still represents a barely resolved surgical challenge from a functional and aesthetic point of view. Since exactly similar tissues are hardly available for reconstructive purposes, reconstruction with various flaps remains highly accepted.
As there is no clear evidence, that any reconstructive option is superior to another, the surgeon's preference remains the main factor determining the treatment of choice for maxillary defects.
In order to provide for an anatomically correct reconstruction the concept of prefabrication of bone grafts accompanying soft tissues flaps could have a valuable option. This concept has been presented in the past but still has not gained wide acceptance. In this review paper, the authors will discuss the philosophy of our rational and approach, present details of the reconstruction to achieve improved functional and aesthetic results for full thickness maxillary defects based in almost 30 years of experience.