bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dissociation between reduced diaphragm inspiratory motion and normal diaphragm thickening in acute chronic pulmonary obstructive disease exacerbation: a case report
Authors: Kracht Julien , Ogna Adam , Fayssoil Abdallah 
Published: March 2020

Abstract

Introduction:
Patients with chronic pulmonary obstructive disease (COPD) are at risk of acute exacerbation. Diaphragm muscle is classically highly solicited in COPD exacerbation.

Patient concerns:
A COPD patient was admitted because of acute dyspnea with wheezing.

Diagnosis:
acute COPD exacerbation.

Interventions:
A diaphragm ultrasound and a Doppler echocardiography were performed at bedside.

Outcomes:
We measured diaphragm thickening at the apposition zone and diaphragm inspiratory motion from the subcostal view, in addition with classical echocardiographic parameters.

Conclusion:
Despite a normal diaphragm thickening, diaphragm motion during inspiration is reduced in acute COPD exacerbation. These apparently discrepant findings may be explained by the alterations of the respiratory mechanics during COPD exacerbations, which should be considered when evaluating the diaphragmatic function by imaging.
Perioperative prevalence of deep vein thrombosis in patients with percutaneous kyphoplasty
Authors: Fan Wencan , Qiao Tianzhu , You Yongqing , Zhang Jun , Gao Jijian 
Published: March 2020

Abstract
In recent years, deep venous thrombosis (DVT) after spine surgery has received extensive attention, but perioperative prevalence of DVT in patients undergoing percutaneous kyphoplasty (PKP) is lacking.
To assess the perioperative prevalence of deep vein thrombosis (DVT) in patients undergoing PKP with routinely applied ultrasonography.
We reviewed 1113 consecutive patients undergoing PKP from January 2014 to August 2017. The surgical procedure was bilateral PKP. All patients were routinely examined with ultrasonography when admitted to the hospital and on the first post-operative day. Clinical signs of DVT were checked and recorded before examination.
Forty (3.6%) out of 1113 patients were diagnosed with DVT by ultrasonography. Of the 40 detected cases of DVT, only six (0.54%) patients presented with clinical signs of DVT, demonstrating that there were 34 (3.05%) asymptomatic cases. No patient presenting with clinically suspected pulmonary embolism (PE) was observed. Gender, body mass index (BMI), operative time, hypertension, diabetes, heart disease, and lower limb fracture were not significant risk factors for DVT (P > .05). In contrast, patient age, oncologic conditions, DVT history, and paraplegia appeared to be significant risk factors for DVT (P < .01). There was no significant difference in the incidence of DVT found between the three PKP surgical levels (P > .05).
The total incidence of perioperative DVT diagnosed with ultrasonography in patients undergoing PKP was 3.6%, of which only 0.54% was symptomatic cases. It is necessary to assess DVT using ultrasonography during the perioperative procedure of PKP, especially for high-risk patients.
Level of evidence: Level IV.
Clinical nomogram for predicting the survival of patients with cerebral anaplastic gliomas
Authors: Zhao Ye-Yu , Wan Qin-Si , Hao Zheng , Zhu Hua-Xin , Xing Ze-Long , Li Mei-Hua 
Published: March 2020

Abstract
The present study aimed to develop an effective nomogram for predicting the overall survival (OS) of patients with cerebral anaplastic glioma (AG).
This study included 1939 patients diagnosed with AG between 1973 and 2013 who were identified using the Surveillance, Epidemiology, and End Results database. A multivariate Cox regression analysis revealed that age, histology, tumor site, marital status, radiotherapy, and surgery were independent prognostic factors and, thus, these factors were selected to build a clinical nomogram. Harrell's concordance index (C-index) and a calibration curve were formulated to evaluate the discrimination and calibration of the nomogram using bootstrapping.
A nomogram was developed to predict 5- and 9-year OS rates based on 6 independent prognostic factors identified in the training set: age, tumor site, marital status, histology, radiotherapy, and surgery (P < .05). The Harrell's concordance index values of the training and validation sets were 0.776 (0.759–0.793) and 0.766 (0.739–0.792), respectively. The calibration curve exhibited good consistency with the actual observation curve in both sets.
Although the prognostic value of the World Health Organization (WHO) classification has been validated, we developed a novel nomogram based on readily available clinical variables in terms of demographic data, therapeutic modalities, and tumor characteristics to predict the survival of AG patients. When used in combination with the WHO classification system, this clinical nomogram can aid clinicians in making individualized predictions of AG patient survival and improving treatment strategies.
Beneficial effect of statin on preventing contrast-induced acute kidney injury in patients with renal insufficiency
Authors: Cho AJin , Lee Young-Ki , Sohn Seo Young 
Published: March 2020

Abstract

Background:
Renal insufficiency is an important predictor of contrast-induced acute kidney injury (CI-AKI). We performed a meta-analysis to examine the effects of short-term statin therapy on the incidence of CI-AKI, particularly in patients with renal insufficiency.

Methods:
A systematic search was conducted to retrieve randomized controlled trials (RCTs) that investigated the impact of statin pretreatment before administration of contrast media on the development of CI-AKI in patients with mild to moderate renal insufficiency. The primary outcome was development of CI-AKI. The secondary outcome was the incidence ofacute kidney injury requiring hemodialysis.

Results:
Data analysis from 8 RCTs, which included a total of 2313 subjects in the statin-treated group and 2322 in the control group, showed that statin pretreatment was associated with significant reduction of the risk of CI-AKI (relative risk [RR] = 0.59; 95% confidential interval [CI] 0.44–0.79; P = .0003, I
2 = 0%). A beneficial effect of statin on preventing CI-AKI was consistent, regardless of the dose of statin and use of N-acetylcysteine. In subgroup analysis based on baseline estimated glomerular filtration rate (eGFR), patients with baseline eGFR <60 mL/min/1.73 m2 (RR = 0.63; 95% CI 0.41–0.98; P = .04, I
2 = 0%) and 30 < eGFR < 90 mL/min/1.73 m2 (RR = 0.56; 95% CI 0.39–0.82; P = .003, I
2 = 0%) showed significant reduction of risk of CI-AKI.

Conclusion:
Statin pretreatment is effective at preventing CI-AKI and should be considered in patients with preexisting renal insufficiency.
A Secondary Mixed Methods Analysis of a Pay-it-Forward Gonorrhea/Chlamydia Testing Program Among Men Who Have Sex With Men in China
Authors: Li Katherine T. , Huang Wenting , Tang Weiming , Wu Feng , Zhao Yang , Wu Dan , Yang Fan , Zhang Tiange P. , Forastiere Laura , Alexander Marcus , Kumar Navin , Tucker Joseph D. 
Published: March 2020

Background
Gonorrhea and chlamydia are common among Chinese men who have sex with men (MSM), but testing rates are low. We developed a pay-it-forward program where men receive a free gonorrhea/chlamydia test and can then donate toward future participants' tests. This study aims to investigate drivers of testing uptake and donation using a mixed methods approach.

Methods
We used a sequential explanatory design to explore drivers of testing uptake and donation unique to pay-it-forward through a quantitative cross-sectional survey and a qualitative thematic analysis of semistructured interviews. We collected data on sociodemographics and perceived benefits of pay-it-forward among men offered the pay-it-forward interventionand analyzed testing uptake and donations using descriptive statistics and logistic regression. We then conducted 30 semistructured interviews with men and coded interview data to identify themes.

Results
Three hundred and one MSM were offered pay-it-forward and 55% (165/301) received gonorrhea/chlamydia testing. Ninety-one percent (150 of 165) donated any amount with a mean of 58.31 ± 53.39 RMB (US $8.61 ± 7.88), or 39% of the standard price of gonorrhea/chlamydia testing. Getting tested was not associated with income, but donations were higher in the highest income bracket (adjusted odds ratio, 7.12; 95% confidence interval, 1.61–31.52). Fifty-eight percent (94 of 162) selected “more MSM can get tested,” and 54% (88 of 162) selected “I can help someone else” as benefits of pay-it-forward. Qualitative themes for drivers of testing and donation included flexible pricing, generosity and reciprocity, and MSM community identity.

Conclusions
Quantitative and qualitative results suggest that this pay-it-forward program may increase gonorrhea/chlamydia testing by reducing cost barriers, leveraging generosity and reciprocity, and mobilizing community altruism.
Social Risk Screening in Pediatric Primary Care Anticipates Acute Care Utilization
Authors: Wurster Ovalle Victoria M. , Beck Andrew F. , Ollberding Nicholas J. , Klein Melissa D. 
Published: March 2020

Objective
The aim of the study was to assess whether responses to a standardized social risk screen administered during pediatric well-child visits (WCV) were associated with emergency department (ED) or urgent care (UC) utilization.

Methods
This was a retrospective cohort study of 26,509 children younger than 13 years with a WCV between January 1, 2012, and December 31, 2013. Exposure was positive response(s) on a standardized social risk screening questionnaire at the index WCV. Primary outcome was number of ED or UC visits in the 12 months after the WCV.

Results
The cohort was 50.9% male and 65.7% black, with a median age of 3.6 years. More than 20% had a positive response to at least one question on the social risk screen. For those reporting any social risk, 46.7% had 1 or more EDs or UC visit within 12 months. Each additional reported risk was associated with a 4% increase in the rate of ED utilization (incidence rate ratio = 1.04, 95% confidence interval = 1.02–1.07) and a 16% increase in the rate of hospitalizations (incidence rate ratio = 1.16, 95% confidence interval = 1.08–1.24). Similar patterns were noted for those visiting the ED 4 times or more (adjusted odds ratio = 1.09, 1.03–1.15) and hospitalization 2 times or more (adjusted odds ratio = 1.19, 1.04–1.35) in the year after the WCV. Those who screened positive on food insecurity, safety, and desire to meet with a social worker questions also had higher odds of ED or UC utilization.

Conclusions
Families reporting a social concern on a standardized screen during a WCV had increased acute care utilization in the subsequent year. Identifying socially at-risk families may allow for the creation of more effective strategies to prevent future utilization.
Seymour Fractures
Authors: Rask Dawn M. G. , Wingfield Jessica , Elrick Bryant , Chen Christopher , Lalka Andy , Sibbel Sarah E. , Scott Frank A. 
Published: March 2020

Background
Seymour fractures are important to recognize and treat promptly because injuries may result in growth disturbance, nail deformity, or infection. We hypothesize that the administration of antibiotics within 24 hours of injury will be associated with a decreased rate of infection.

Methods
Patients younger than 18 years were included if clinical examination and radiographs demonstrated a Seymour fracture. The timing of antibiotic administration and treatment details were reviewed. The presence of superficial infections or radiographic evidence of osteomyelitis was recorded.

Results
A total of 52 patients with 54 fracture that had greater than 30 days of follow-up and were included in data analysis. The average age at the time of injury was 10.2 years. Thirty-four (63%) of 54 patients were most commonly injured secondary to a crush type mechanism. The overall infection rate was 27.3% (15/54 fractures). Among the 29 fractures that received antibiotics within 24 hours of injury, 2 infections (6.9%) were noted at final follow-up. Delayed administration of antibiotics beyond 24 hours postinjury was observed in 17 fractures and was associated with an increased infection rate of 76.5% (13/17, P = 0.000).

Conclusions
Early administration of antibiotics within 24 hours of injury is associated with a reduction in the development of infections. Patients with delayed antibiotic administration may be at high risk for early superficial infection or osteomyelitis. This study highlights the importance of early identification and appropriate treatment of Seymour fractures including the prompt administration of antibiotics following injury.
Decision-Making in Evidence-Based Practice in Rehabilitation Medicine
Authors: Gutenbrunner Christoph , Nugraha Boya 
Published: March 2020

Abstract
According to the Sackett’s model, evidence-based decision-making in medicine includes the clinical judgment, scientific evidence, and the patient’s values and preferences. In rehabilitation medicine, it is well established that according to the International Classification of Functioning, Disability and Health model, contextual factors (environmental and personal factors) influence a person’s individual level of functioning. This article argues that component of the health system (eg, health insurance coverage, availability of services, treatments, and assistive devices) and the service organization (eg, spectrum and training level of health professionals, availability of diagnostic, and treatment devices) have relevant influence on the decision-making in the individual case. For that reason, it is proposed to add the health system and service organization as a fourth factor to the model of evidence-based decision-making. Taking the influence of it into consideration and to describe it clearly will improve transparency of the decision-making process and the acceptance of health care users. This fourth factor is also relevant for other medical fields. However, the proposed factor and its components need to be discussed and further elucidated scientifically.
Evaluation of Dental Status and Temporomandibular Joint in Children With Generalized Joint Hypermobility
Authors: Demir Ferhat , Tüzüner Tamer , Baygın Özgül , Kalyoncu Mukaddes 
Published: March 2020

Objective
The aim of this study was to evaluate the dental status and temporomandibular diseases (TMDs)–related symptoms in children with generalized joint hypermobility (GJH) and compare them with healthy controls (HCs).

Methods
This is a cross-sectional, observational study carried out between September 2016 and April 2017. A total of 124 children with GJH (n = 62) and HC (n = 62) were enrolled. The GJH was assessed with the Beighton hypermobility score. The subjects were screened for dental status and TMD-related symptoms. The assessment included the index for “decayed,” “missing,” and “filled teeth” (DMFT, dmft); plaque; gingival bleeding; tooth mobility; and temporomandibular joint (TMJ) evaluation.

Results
The mean Beighton hypermobility score was 6.3 ± 1.2 in the GJH group. Visible plaque index and gingival bleeding index scores were found to be significantly higher in children with GJH then in the HC (p = 0.031, p = 0.023). No differences were found regarding the DMFT scores between the groups (p = 0.16). Temporomandibular disorder–related symptom frequencies were significantly higher in children with GJH (p < 0.001). The most common clinically determined sign of TMD was clicking with a maximum active mouth-opening. Combined TMJ symptoms and TMD were observed in approximately one third of the children with GJH.

Conclusions
The presence of GJH in a child may be indicative of future dental or TMJ problems, and it may cause dental problems due to increased gingival bleeding index and visible plaque index scores. Therefore, children with GJH require preventive dental and TMJ care.
Gastric Gastrointestinal Stromal Tumor Incidentally Detected With Meckel Scintigraphy
Authors: Hamman Susan M. , Biyyam Deepa R. , Mandell Gerald A. 
Published: March 2020

Abstract
A 17-year-old boy presented with fatigue, hypoxia, palpitations, and anemia (hemoglobin 3.5 g/dL). The search for the etiology of the bleeding began with a Meckel scan. A photopenic region in the gastric body and a region of abnormal tracer uptake in the right midabdomen were unexpected findings. Further investigation with ultrasound and computed tomography revealed a gastric mass, which proved to be a gastrointestinal stromal tumor at pathology. The right-sided tracer uptake resulted from stasis in the collecting system of a malpositioned right kidney, a cause of false uptake in a Meckel scan.
Revisiting 99mTc-MIBI Radioguided Surgery in Management of TENIS Syndrome
Authors: Prashar Sarika , Dahiya Divya , Sood Ashwani , Chatterjee Debajyoti , Kaur Ravneet , Mittal Bhagwant Rai 
Published: March 2020

Abstract
Management of patients with thyroglobulin elevated and negative iodine scan is still a challenge with limited options left as the disease stops concentrating iodine. The minimally invasive surgery is the best option for residual/recurrent locoregional disease in postsurgical setup requiring accurate presurgical localization. Intraoperative gamma probe using low-dose tracer has shown its utility in radioguided surgery. The authors present a 46-year-old man with thyroglobulin elevated and negative iodine scan showing FDG-avid left supraclavicular lymph node on whole-body 18F-FDG PET/CT with physiological uptake on whole-body radioactive iodine scan, where 99mTc-MIBI radioguided probe helped in carrying out minimally invasive surgery with excision of malignant node.
The Added Value of Tau-PET in the Assessment of Progressive Supranuclear Palsy
Authors: López-Mora Diego Alfonso , Fernández León Alejandro , Lleó Alberto , Blesa Rafael , Camacho Valle 
Published: March 2020

Abstract
Progressive supranuclear palsy (PSP) is rare neurodegenerative disorder characterized by deposition of fibrillar aggregates of 4R tau-protein in neurons and glial cells. This disorder is underdiagnosed due to the overlap of the clinical syndrome with other related conditions. The clinical manifestations include cognitive impairment associated with behavioral changes, akinetic rigid syndrome, and prominent oculomotor dysfunction. We present the 18F-FDG and 18F-THK5351 PET images of a 71-year-old man diagnosed of probable PSP. This image highlights the hopeful results of the new tau-PET ligands radiotracers, because it allows to assess the distribution of tau-protein over time, closely associated with neurodegeneration in PSP.
Diffuse Metastases in Bilateral Penile Corpus Cavernosum From Renal Cancer Diagnosed by 18F-FDG PET/CT
Authors: Zou Qiong , Jiao Ju , Zou Min-hong , Yang Ting , Zhang Yong 
Published: March 2020

Abstract
We report a rare case of a 60-year-old man with diffuse metastases in bilateral penile corpus cavernosum after radical nephrectomy for left renal carcinoma. 18F-FDG PET/CT demonstrated diffuse hypermetabolic lesions in bilateral penile corpus cavernosum, hypermetabolic tumor recurrences in left renal operation region, and left pulmonary metastasis. Biopsy confirmed penile metastasis from renal clear cell carcinoma. Diffuse penile metastatic carcinoma from renal cancer is extremely rare and associated with poor prognosis. 18F-FDG PET/CT is helpful for diagnosis of penis metastasis and accurate staging of primary cancer.
68Ga–Prostate-Specific Membrane Antigen Uptake in a Pancreatic Neuroendocrine Tumor
Authors: Luong Thien Vinh , Iversen Peter , Bouchelouche Kirsten , Arveschoug Anne Kirstine 
Published: March 2020

Abstract
We present a 60-year-old man with known prostate cancer treated with robot-assisted radical prostatectomy. Prostate-specific antigen levels did not decline accordingly, and a second 68Ga-PSMA PET/CT demonstrated a new focus with high 68Ga-PSMA uptake in the pancreatic tail. A subsequent CT scan did not display the lesion as a typical pancreatic tumor, and a spleen scintigraphy was also negative excluding an ectopic intrapancreatic accessory spleen. 68Ga-DOTATOC PET/CT showed uptake in the same area of the pancreatic tail consistent with a neuroendocrine tumor. This case illustrates that neuroendocrine tumors can be important pitfalls in 68Ga-PSMA PET/CT performed in prostate cancer patients.
Granulocytic Sarcoma
Authors: Schaeffer Christine V. , Moran Thomas E. , Keng Michael K. , Bateman Henry R. , DeGeorge Brent R. 
Published: March 2020

Abstract
Septic, inflammatory, or crystal-induced arthritis are common etiologies of wrist pain without antecedent trauma associated with pain, loss of motion, swelling, redness, and warmth. In this report, we detail the case of granulocytic sarcoma of the wrist that presented as acute wrist pain, swelling, and limitation in motion. Granulocytic sarcoma is an exceedingly rare extramedullary tumor associated with acute myeloblastic leukemia. It may be found in any part of the body; however, upper extremity involvement is uncommon. To our knowledge, this is the first description of granulocytic sarcoma occurring in the wrist joint.
Does Postoperative Cognitive Decline Result in New Disability After Surgery?
Authors: Deiner Stacie , Liu Xiaoyu , Lin Hung-Mo , Jacoby Rachelle , Kim Jong , Baxter Mark G. , Sieber Frederick , Boockvar Kenneth , Sano Mary 
Published: March 2020

Objective:
Establish whether POCD is associated with new disability after surgery, which would inform whether POCD impacts patient-centered outcomes.

Background:
POCD is a decline in neuropsychiatric tests scores from presurgical baseline which occurs in approximately 15% of older patients 3 months after surgery. POCD is a research construct meant to investigate patient and family reports of older adults who were “never the same after surgery.” However, many patients with POCD do not perceive difficulty with thinking and memory, and the question remains whether POCD impacts patient function.

Methods:
We performed a prospective cohort study of 167 older adults undergoing major noncardiac surgery (requiring at least a 2-day hospital stay). Exclusion criteria were: history of dementia, cardiac or intracranial procedure, inability to consent for themselves, or emergency surgery. We administered formal neuropsychiatric testing (Alzheimer Disease Research Center UDS battery), basic and instrumental activities of daily living (Alzheimer Disease Research Center IADLs), pain (geriatric pain measure), and depression screening (hospital depression and anxiety scale) before and 3 months after surgery. We recorded all patient refined diagnostic related groups codes, blood pressure, anesthetics and narcotics administered, surgical and anesthesia duration, and measured complications and severity, length of stay, and readmissions.

Results:
Patients with POCD (21/167, 14.1%) had twice the proportion of new impairment in IADL as compared to those without POCD (57% vs 27%, P = .01). The most common areas of decline were social activities, ability to find items around the house, remember appointments, shop and pay for items, do laundry, drive a car/use public transport, and do housework. Predictors of IADL change after surgery included POCD, presurgical cognition, presurgical function, postoperative depression, and the development of postoperative complications.

Conclusions:
Patients with POCD experience a much higher incidence of new disability after surgery. Baseline cognitive or functional limitations are also risk factors for new disability. Many patients are not aware of their limitations before surgery. Future study is needed to identify practical ways to routinely screen patients and reduce risk. Patients need to be informed of their risk for new disability after surgery to inform their medical decision making.