bluuebunny/crossref_metadata_2025_split huggingface dataset:
Living donation – any news on the donor?
Authors: Haugen Anders J. , Mjøen Geir 
Published: December 2020

Purpose of review
Living kidney donation has been an established practice for many years. Although studies from the past decade have uncovered risks to the donor, living kidney donation is still promoted. In this review, the most recent studies are summarized.

Recent findings
Retrospective studies with long follow-up have detected an increased risk of hypertension among donors. Donors with hypertension at the time of donation may be at increased risk of adverse outcomes, but results differ. Recent studies have not found increased long-term mortality, but follow-up is short and control groups are of different quality.

Summary
In all, the most recent findings more or less corroborate previous knowledge in the field of living donation. There is still a need for new studies on mortality with appropriate control groups and long enough follow-up.
An Exploratory Study on Physical Function in Stem Cell Transplant Patients Undergoing Corticosteroid Treatment for Acute Graft-Versus-Host-Disease
Authors: Ngo-Huang An , Yadav Rajesh , Bansal Swati , Williams Janet , Wu Jimin , Fu Jack B. , Alousi Amin M. , Bruera Eduardo 
Published: December 2020

Abstract
Acute graft-versus-host disease after allogeneic hematopoietic stem cell transplantation is treated with corticosteroids, placing patients at risk for steroid myopathy. In this single-arm cohort study, 23 patients who were started on high-dose corticosteroids for acute graft-versus-host disease underwent a series of functional tests (baseline and days 14, 28, and 56): 6-min walk test, hip flexor and knee extensor strength via dynamometry, five times sit-to-stand, Brooke scale for myopathy, modified Adult Myopathy Assessment Tool, and manual muscle testing. Participants were prescribed home exercises including walking and resistance exercises, with low adherence. Fifteen (63%) participants were male and median (range) age was 60 (36–70) yrs. Median (range) corticosteroid duration and cumulative equivalent methylprednisolone dose were 66 (22–165) days and 3625 (1020–11720) mg, respectively. At day 14, there was a significant decline in five times sit-to-stand (P = 0.0132), knee extensor (P = 0.0182), and manual muscle testing (P = 0.0466). Functional tests negatively associated with cumulative corticosteroid dose included 6-min walk test distance (P = 0.0103), hip flexor strength (P = 0.0262), knee extensor strength (P = 0.0369), and manual muscle testing strength (P = 0.0319). Five times sit-to-stand was positively associated with corticosteroid dose (P = 0.0003). In conclusion, stem cell transplant patients receiving high-dose corticosteroids for acute graft-versus-host disease are at risk for weakness detected as early as day 14. Increasing adherence to exercise may mitigate these changes.
Cotrimoxazole and clindamycin in skin and soft tissue infections
Authors: Montravers Philippe , Eckmann Christian 
Published: December 2020

Purpose of review
The aim of this study was to present recent microbiological, experimental, clinical and tolerance data for cotrimoxazole and clindamycin in the specific field of skin and soft tissue infections (SSTIs).

Recent findings

Staphylococcus aureus and streptococci remain the leading cause of SSTIs. Cotrimoxazole is a good anti-Gram-positive agent with preserved activity against methicillin-susceptible and methicillin-resistant S. aureus (MRSA) and streptococci. Although clindamycin has good methicillin-susceptible S. aureus activity, a growing number of resistant MRSA and streptococci have been reported. Strong experimental data support the antitoxin activity of clindamycin, but clinical observations remain scarce. Several recent randomized trials involving cotrimoxazole and/or clindamycin demonstrate the efficacy and tolerance of both drugs. The oral formulation of both drugs may facilitate the implementation of early switch and early discharge protocols in clinical practice.

Summary
Recent publications demonstrate that cotrimoxazole and clindamycin remain reliable and realistic therapeutic approaches for SSTIs.
Current management of necrotizing soft-tissue infections
Authors: Eckmann Christian , Montravers Philippe 
Published: December 2020

Purpose of review
The aim of the article is to present recent epidemiological, microbiological, and clinical data for the surgical, antimicrobial, and adjunctive management of necrotizing soft-tissue infections (NSTI).

Recent findings
NSTI can be caused by a broad variety of organisms. Reports about NSTI caused by multidrug-resistant bacteria are increasing. Owing to the rareness of NSTI, general clinical awareness is low and prompt diagnosis is often delayed. New diagnostic instruments (scoring systems, MRI) have either a low accuracy or are time consuming and cannot guide clinicians reliable currently. The value of adjunctive measures (intravenous immunoglobulin, hyperbaric oxygen therapy) is uncertain as well. Morbidity and mortality in NSTI remain high, ranging from 20 up to over 30%.

Summary
Early radical surgical debridement and empirical broad-spectrum antimicrobial treatment remain the cornerstones of therapy in NSTI. Further clinical research is necessary to shorten diagnostic pathways and to optimize surgical, antimicrobial, and adjunctive treatment.
Transgender Scrotoplasty and Perineal Reconstruction With Labia Majora Flaps
Authors: Miller Travis J. , Lin Walter C. , Safa Bauback , Watt Andrew J. , Chen Mang L. 
Published: December 2020

Purpose
Labia majora, the embryologic homologs of the scrotum, are ideal donor tissue for transgender scrotoplasty. The technique is detailed, and surgical outcomes are assessed for scrotoplasty using labia majora rotational advancement flaps.

Methods
We retrospectively reviewed the outcomes of phalloplasty patients who underwent either primary or secondary labia majora flap scrotoplasty and perineal reconstruction from October 1, 2017, to December 1, 2019. Bilateral elevation and rotational flap advancement from the posterior to anterior position formed a pouch-like scrotum. Perineal reconstruction involved multilayered closure with apposition of the inner thigh skin.

Results
The mean follow-up was 12.5 months (0.5–26 months). One hundred forty-seven scrotoplasties were performed. Of the 147 total scrotoplasty patients, 133 had labia majora flap scrotoplasty and perineal reconstruction with single-stage phalloplasty. Distal flap necrosis occurred in 6 patients (4.1%); 5 were ipsilateral to the groin dissection required for phalloplasty. Large (>1 cm diameter) perineoscrotal junction dehiscence occurred in 7 patients (4.7%). All wounds were managed conservatively except for 3 patients who developed urethrocutaneous fistulas at the perineoscrotal junction. All 3 patients required fistula repair. Two (1.4%) scrotal hematomas and 3 (2.0%) perineal hematomas were seen; all required operative intervention.

Conclusions
Labia majora flap scrotoplasty via the bilateral rotational advancement technique and perineal reconstruction can be safely performed during phalloplasty. Minor wound complications are common and frequently heal with conservative management. Wounds that do not heal may be associated with urethral complications. Hematomas are rare but usually require operative intervention.
Advances in ophthalmic structural and functional measures in multiple sclerosis: do the potential ocular biomarkers meet the unmet needs?
Authors: Jiang Hong , Delgado Silvia , Wang Jianhua 
Published: December 2020

Purpose of review
Multiple sclerosis is a heterogeneous disorder. Biomarkers to monitor disease activities are highly desirable especially because of the recent shift toward personalized medicine that coincides with the expansion of disease-modifying therapy. The visual system is highly involved in multiple sclerosis, and the rapid advancement of ophthalmic techniques has boosted the development of potential ocular biomarkers for multiple sclerosis management.

Recent findings
Recent studies have found that the rapid thinning of the peripapillary retinal nerve fiber layer and ganglion cell-inner plexiform layer (GCIPL) occurs in the progressive stage. Furthermore, the inter-eye thickness difference of the GCIPL could be used in identifying unilateral optic neuritis to facilitate the early diagnosis of multiple sclerosis. Moreover, the retinal microvascular alterations measured as vessel density were found to be related to the disability and visual function, although a standardized protocol to measure retinal microvascular alterations has not been well established. Additionally, aberrant ocular motility, such as fixation microsaccades, can be used to measure disability objectively.

Summary
The fast expansion of potential ocular biomarkers measured as retinal microstructural, microvascular, and ocular motility changes may facilitate the diagnosis and management of multiple sclerosis.
Behaviour across the lifespan in Cornelia de Lange syndrome
Authors: Groves Laura , Oliver Chris , Moss Joanna 
Published: December 2020

Purpose of review
While previous reviews have extended descriptions of the behavioural phenotype of Cornelia de Lange syndrome (CdLS) significantly, potential changes with age across the lifespan have been neglected. Age-related difference in the behavioural phenotype constitutes preliminary evidence of change with age. Documenting and understanding the developmental trajectories of behaviours is informative as it enables identification of risk periods for behavioural challenges and compromised mental health.

Recent findings
Recent cross sectional, longitudinal and mixed design studies report differing presentations of the behavioural phenotype across the lifespan. Of particular interest are autistic characteristics and behaviours consistent with compromised mental health, particularly anxiety and negative affect, which are reported to be more common and severe in older individuals. Preliminary evidence for identified causal pathways with consideration of biological, cognitive and environmental factors are discussed.

Summary
Older individuals with CdLS appear to be at greater risk of poorer psychological wellbeing than younger peers with significant implications for risk informed preventive and early interventions. Further work is required to document the behavioural phenotype across the lifespan with consideration of multiple factors that may influence the trajectory and extent of negative outcomes
Recent developments in Phelan–McDermid syndrome research: an update on cognitive development, communication and psychiatric disorders
Authors: Vogels Annick , Droogmans Gilles , Vergaelen Elfi , Van Buggenhout Griet , Swillen Ann 
Published: December 2020

Purpose of review
The purpose of this review is to summarize the literature on cognitive development, communication, behavioral or psychiatric aspects in Phelan–McDermid syndrome (PMS) and to discuss the clinical implications and recommendations of these summarized findings.

Recent findings
PMS is often associated with severe communication impairments, behavioral or psychiatric problems and regression. These challenges may adversely affect and impair the quality of life of the individual with PMS and his family.

Summary
Individuals with PMS experience intellectual disability, communication and behavioral/psychiatric challenges, such as catatonia, bipolar disorder and regression across the lifespan. Providing appropriate guidance and support to them and their families demands a better understanding of these challenges.
A cohort study of 223 patients explores the clinical risk factors for the severity diagnosis of COVID-19
Authors: Huang Yongsheng , Lyu Xiaoyu , Li Dan , Wang Yujun , Wang Lin , Zou Wenbin , Wei Yingxin , Wu Xiaowei 
Published: December 2020

AbstractBACKGROUNDCoronavirus Disease 2019 (COVID-19) has recently become a public emergency and a worldwide pandemic. The clinical symptoms of severe and non-severe patients vary, and the case-fatality rate (CFR) in severe COVID-19 patients is very high. However, the information on the risk factors associated with the severity of COVID-19 and of their prognostic potential is limited.METHODSIn this retrospective study, the clinical characteristics, laboratory findings, treatment and outcome data were collected and analyzed from 223 COVID-19 patients stratified into 125 non-severe patients and 98 severe patients. In addition, a pooled large-scale meta-analysis of 1646 cases was performed.RESULTSWe found that the age, gender and comorbidities are the common risk factors associated with the severity of COVID-19. For the diagnosis markers, we found that the levels of D-dimer, C-reactive protein (CRP), lactate dehydrogenase (LDH), procalcitonin (PCT) were significantly higher in severe group compared with the non-severe group on admission (D-Dimer: 87.3% vs. 35.3%, P<0.001; CRP, 65.1% vs. 13.5%, P<0.001; LDH: 83.9% vs. 22.2%, P<0.001; PCT: 35.1% vs. 2.2%, P<0.001), while the levels of aspartate aminotransferase (ASP) and creatinine kinase (CK) were only mildly increased. We also made a large scale meta-analysis of 1646 cases combined with 4 related literatures, and further confirmed the relationship between the COVID-19 severity and these risk factors. Moreover, we tracked dynamic changes during the process of COVID-19, and found CRP, D-dimer, LDH, PCT kept in high levels in severe patient. Among all these markers, D-dimer increased remarkably in severe patients and mostly related with the case-fatality rate (CFR). We found adjuvant antithrombotic treatment in some severe patients achieved good therapeutic effect in the cohort.CONCLUSIONSThe diagnosis markers CRP, D-dimer, LDH and PCT are associated with severity of COVID-19. Among these markers, D-dimer is sensitive for both severity and CFR of COVID-19. Treatment with heparin or other anticoagulants may be beneficial for COVID-19 patients.FundingThis study was supported by funding from the National Key Research and Development Program of China (2016YFC1302203); Beijing Nova Program (grant number: xx2018040).Role of the funding sourceThe funding listed above supports this study, but had no role in the design and conduct of the study.
Peripheral and lung resident T cell responses against SARS-CoV-2
Authors: Grau-Expósito Judith , Sánchez-Gaona Nerea , Massana Núria , Suppi Marina , Astorga-Gamaza Antonio , Perea David , Rosado Joel , Falcó Anna , Kirkegaard Cristina , Torrella Ariadna , Planas Bibiana , Navarro Jordi , Suanzes Paula , la Sierra Daniel Alvarez-de , Ayora Alfonso , Sansano Irene , Esperalba Juliana , Andrés Cristina , Antón Andrés , Ramón y Cajal Santiago , Almirante Benito , Pujol-Borrell Ricardo , Falcó Vicenç , Burgos Joaquín , Buzón María J. , Genescà Meritxell 
Published: December 2020

SUMMARYConsidering that SARS-CoV-2 interacts with the host at the respiratory tract mucosal interface, T cells strategically placed within these surfaces, namely resident memory T cells, will be essential to limit viral spread and disease. Importantly, these cells are mostly non-recirculating, which reduces the window of opportunity to examine circulating lymphocytes in blood as they home to the lung parenchyma. Here, we demonstrate that viral specific T cells can migrate and establish in the lung as resident memory T cells remaining detectable up to 10 months after initial infection. Moreover, focusing on the acute phase of the infection, we identified virus-specific T cell responses in blood with functional, migratory and apoptotic patterns modulated by viral proteins and associated with clinical outcome. Our study highlights IL-10 secretion by virus-specific T cells associated to a better outcome and the persistence of resident memory T cells as key players for future protection against SARS-CoV-2 infection.
Sensorimotor cortex forms prism adaptation memories in older adults and stroke patients
Authors: Spitz Gershon , Petitet Pierre , Bultitude Janet , Farnè Alessandro , Luaute Jacques , O’Shea Jacinta 
Published: December 2020

AbstractStroke is the largest cause of complex disability in adults. Approximately half of right-hemisphere stroke survivors suffer spatial neglect–an inability to voluntarily orient to people or objects in contralesional space. Neglect is a significant impediment to successful community reintegration. Prism adaptation (PA) is a promising behavioural intervention that can alleviate symptoms of spatial neglect. PA induces a leftward pointing bias–the prism after-effect (AE). In neglect, the prism AE generalises to improve other sensory, motor, and cognitive domains. Although the formation of an AE is a key index in neglect, we do not yet know where it is formed in the brain. Here, we used a novel computational fMRI-based approach to study, for the first time, the brain circuits that mediate the formation of PA in stroke survivors and age matched controls. Healthy individuals (n = 17) and stroke patients (n = 11) performed prism adaptation during fMRI. Temporal signatures of memory formation were extracted from the behavioural data using a state-space model and regressed against the fMRI data. This revealed that, in both groups, fMRI signal in left sensorimotor cortex correlated with the gradual formation of the prism after-effect during adaptation. This indicates that the sensorimotor cortex may be a useful target for neuromodulation that aims to improve the persistence of therapeutic prism after effects.
Tuberculous meningitis in adult patients of a Mexican neurological referral center: A-six-year retrospective cohort study
Authors: Daniela Maldonado-Diaz Ellis , Luis Soto-Hernández José , Citlaltepetl Salinas-Lara , Ashuin Kammar-Garcia , Graciela Cárdenas 
Published: December 2020

AbstractIntroductionTuberculosis (TB) remains as an important concern of public health worldwide because the high prevalence and severe sequelae. Tuberculous meningitis (TBM) is the most lethal and disabling form.AimTo describe the clinical, laboratory, and neuroimaging characteristics of TBM on admission at neurological center in Mexico City.MethodsRetrospective cohort study at the third level neurological center from 2010 to 2016. Clinical follow-up was evaluated at hospital discharge, three months, and one-year either due to lack of follow-up or mortality, during the follow-up the adverse events were registered.ResultsOne-hundred and six patients were included, 74 (69.8%) males and 32 (30.2%) females. From these 31 (29.2%) were HIV-positive. The median age was 35.5 (IQR:28-51). Pulmonary TB was found in 25% of the population. Alcoholism was observed in a half of the patients while diabetes in 15%, the latter being significant (p=0.04). Abnormalities in neuroimaging were significant among our population (p=0.003). Only one-third of the population had a positive Lowenstein-Jensen culture. There were no differences in clinical outcomes between HIV positive and non-HIV patients.ConclusionOur study shows data to those described in the literature. The initiation of empirical treatment in all patients with a high clinical suspicion of tuberculosis mandatory to try to avoid severe neurological sequels.
An evaluation of the accuracy of prehospital eFAST in the assessment of polytrauma by a physician-staffed helicopter emergency medical service
Authors: Partyka Christopher , Miller Matthew , Bliss Jimmy , Burns Brian , Coggins Andrew , Fiorentino Michele , Goorkiz Pierre 
Published: December 2020

ABSTRACTBACKGROUNDWhile the accuracy of point of care ultrasound in trauma is well understood, there is limited reporting on the efficacy of prehospital ultrasound by helicopter emergency medical service (HEMS). In severe trauma, early diagnosis and communication of life-threatening injuries has the potential to facilitate timely care. This HEMS ultrasound registry evaluation set out to report the accuracy of the extended focused assessment with sonography in trauma (eFAST) exam.METHODSRetrospective review of trauma patients who received a prehospital eFAST by GSA-HEMS clinicians between 1 January 2013 and 31 December 2017. Clinician interpretations of these scans were compared to immediate in-hospital CT imaging or operating room reports as the gold-standard reference. The primary outcome measure was the accuracy of eFAST for intraperitoneal free fluid compared to hospital CT scan. Secondary outcomes included accuracy of eFAST for pneumothorax, haemothorax and pericardial fluid, comparison of clinician seniority and whether prehospital interventions were supported by eFAST results.RESULTSWe included 896 patients who underwent eFAST by prehospital clinicians. 411 patients had adequate in-hospital data available for comparison. For the primary outcome of IPFF, eFAST had a sensitivity of 25% [95% CI 16-36%] and specificity of 96% [95% CI 93-98%]. Sensitivities and specificities were calculated for pneumothorax (38% and 96% respectively), haemothorax (17% and 97% respectively) and pericardial effusion (17% and 100% respectively). Fifty percent of patients had thoracostomies supported by lung US whilst 24% of patients who received a prehospital blood transfusion had an eFAST negative for haemorrhage.CONCLUSIONThis study shows that prehospital eFAST is a reliable tool for ruling in the diagnoses of intraperitoneal free fluid, pneumothorax, haemothorax and pericardial effusion and as expected less reliable than CT imaging for these injuries.What is already known about this subject?Extended Focused Abdominal Sonography in Trauma (eFAST) is widely used in an in hospital setting for the assessment of blunt and penetrating injury.Point of care sonography in the prehospital setting has become feasible due to advances in technology, widespread physician training and availability of scanning devices.What does this study add?Our study demonstrates that prehospital eFAST is highly specific for the diagnosis of significant abdominal haemorrhage.Prehospital eFAST is less accurate for other injuries including haemothorax and pneumothorax. The explanation for this finding is unclear, but may be associated with scanning earlier in the clinical course, diminishing sensitivity, environmental factors or human factors.Further studies are required to understand the optimal role of point of care ultrasound in the prehospital setting.