bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Evaluation of Oxidative Stress With Thiol/Disulfide Homeostasis in Patients With Persistent Allergic Rhinitis
Authors: Göker Ayse E. , Alagöz Maide H. , Kumral Tolgar L. , Karaketir Semih , Yilmazer Ayça B. , Tutar Belgin , Ahmed Esmail A. , Biçer Cemile , Uyar Yavuz 
Published: July 2020

Background: We evaluated the efficacy of medical treatment on thiol–disulfide balance despite ongoing allergic stimulation. Methods: The research design was a prospective observational study that included 35 persistent allergic rhinitis (AR) patients. All patients who were diagnosed with persistent AR were included. A skin prick test was applied to all patients, and the Sino-nasal Outcome Test-22 was used to evaluate sinonasal symptoms. Thiol/disulfide homeostasis balance parameters were measured using a novel automatic and spectrophotometric method and compared statistically. Serum total thiol (TT), native thiol (SH), disulphide (SS), disulphide/native thiol (SS/SH), disulphide/total thiol (SS/TT), and native thiol/total thiol (SH/TT) ratios were measured after the second month of the treatment. Results: The 35 patients included 20 (58%) females and 15 (42%) males. The mean age of the patients was 33.17 ± 9.9 years. Disulphide, SS/SH, and SS/TT ratios decreased significantly after the treatment ( P < .05), while SH and SH/TT increased significantly ( P < .05). The mean SH measurement increased significantly in the second month ( P = .001), but TT mean measurements showed no difference after the treatment ( P = .058). The mean SS measurements, on the other hand, decreased significantly in the second month ( P = .003). Conclusion: Thiol/disulfide homeostasis may be used as a marker to evaluate the efficacy of persistent AR treatments. After the treatment, the increase in SH levels suggested the decrease in oxidative stress, even though allergen exposure continued.
The Association Between Vitamin D Deficiency and Recurrent Tonsillitis: A Systematic Review and Meta‐analysis
Authors: Mirza Ahmad A. , Alharbi Abdulrahman A. , Marzouki Hani , Al‐Khatib Talal , Zawawi Faisal 
Published: July 2020

ObjectivesThe role of vitamin D deficiency has been linked with recurrent upper respiratory tract infections, but its impact on the frequency of tonsillitis is not yet fully understood. The objective of this study is to determine the association between vitamin D deficiency and recurrent tonsillitis based on current literature.Data SourceA systematic review was performed following the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guideline. Data were collected from online medical databases (PubMed, MEDLINE, EMBASE, and Cochrane Collaboration Registry of Controlled Trials).Review MethodsAll studies addressing the association of vitamin D deficiency and recurrent tonsillitis prior to March 2019. The data were collected in different phases: screening review using search words and controlled vocabularies followed by detailed review of screened articles based on inclusion and exclusion criteria, then a full review that included screening the references of selected articles.ResultsFifty‐three studies were potentially eligible; of these, 4 publications met the inclusion criteria and were included in the quantitative synthesis. There was a statistically significant reduction of vitamin D levels in patients with recurrent tonsillitis as compared to healthy controls (mean difference, −10.71; 95% CI, −19.12 to −2.31; P =. 01). The odds of vitamin D insufficiency were significantly higher in patients with recurrent tonsillitis as compared to the control group (odds ratio, 4.37; 95% CI, 2.78‐6.88; P <. 001).ConclusionVitamin D deficiency was present in patients with recurrent tonsillitis and might be associated with an increase in the risk of recurrent tonsillitis. There is a need to explore these findings via clinical trials based on large populations.
Discriminating Malignancy in Thyroid Nodules: The Nomogram Versus the Kwak and ACR TI‐RADS
Authors: Xiao Juan , Xiao Qiang , Cong Wei , Li Ting , Ding Shouluan , Shao Chunchun , Zhang Yuan , Liu Jianing , Wu Mei , Jia Hongying 
Published: July 2020

ObjectiveTo develop an easy‐to‐use nomogram for discrimination of malignant thyroid nodules and to compare diagnostic efficiency with the Kwak and American College of Radiology (ACR) Thyroid Imaging, Reporting and Data System (TI‐RADS).Study DesignRetrospective diagnostic study.SettingThe Second Hospital of Shandong University.Subjects and MethodsFrom March 2017 to April 2019, 792 patients with 1940 thyroid nodules were included into the training set; from May 2019 to December 2019, 174 patients with 389 nodules were included into the validation set. Multivariable logistic regression model was used to develop a nomogram for discriminating malignant nodules. To compare the diagnostic performance of the nomogram with the Kwak and ACR TI‐RADS, the area under the receiver operating characteristic curve, sensitivity, specificity, and positive and negative predictive values were calculated.ResultsThe nomogram consisted of 7 factors: composition, orientation, echogenicity, border, margin, extrathyroidal extension, and calcification. In the training set, for all nodules, the area under the curve (AUC) for the nomogram was 0.844, which was higher than the Kwak TI‐RADS (0.826, P =. 008) and the ACR TI‐RADS (0.810, P <. 001). For the 822 nodules >1 cm, the AUC of the nomogram was 0.891, which was higher than the Kwak TI‐RADS (0.852, P <. 001) and the ACR TI‐RADS (0.853, P <. 001). In the validation set, the AUC of the nomogram was also higher than the Kwak and ACR TI‐RADS (P <. 05), each in the whole series and separately for nodules >1 or ≤1 cm.ConclusionsWhen compared with the Kwak and ACR TI‐RADS, the nomogram had a better performance in discriminating malignant thyroid nodules.
Clinical Implications of the Submental and Sublingual Arteries in Relation to the Mylohyoid Boutonnière
Authors: Zdilla Matthew J. , Bender‐Heine Adam N. , Lambert H. Wayne , Hunter Dawn D. 
Published: July 2020

ObjectiveMylohyoid musculature may be included in the submental artery flap to protect perforators. However, blood vessels may pass through the mylohyoid muscle and therefore cause bleeding and risk to pedicle or perforator injury when a mylohyoid‐containing flap is lifted. The objectives of this study were to identify the prevalence of the submental and sublingual arteries that traverse the mylohyoid and to assess relationships between vasculature transmitted through mylohyoid muscles and mylohyoid boutonnières.Study DesignCross‐sectional human cadaveric study.SettingThe West Virginia University School of Medicine human gross anatomic laboratories.Subjects and MethodsA total of 43 intact mylohyoid muscles from 22 cadavers were dissected. The prevalence of submental vasculature perforating the mylohyoid was recorded in addition to the prevalence and contents of mylohyoid boutonnières.ResultsOf 43 mylohyoid muscles, 21 (48.8%) transmitted the submental or sublingual arteries, and 30 (69.1%) possessed boutonnières. One muscle had 2 boutonnières. Of 31 mylohyoid boutonnières, 21 transmitted blood vessels (67.7%). Specifically, 9 transmitted an artery and a vein (29.0%), and 12 transmitted an artery (38.7%). Ten boutonnières (32.3%) were exclusively occupied by fascia.ConclusionThis report identifies the importance of identifying and carefully ligating branches of the submental artery that pierce the mylohyoid during elevation of the submental island flap. This report also identifies that a boutonnière is often present where a submental or sublingual artery is traversing the mylohyoid to supply sublingual glands, tongue, and anterior mandible.
Development and Validation of the Short Version of the Reflux Symptom Score: Reflux Symptom Score–12
Authors: Lechien Jerome R. , Bobin Francois , Rodriguez Alexandra , Dequanter Didier , Muls Vinciane , Huet Kathy , Harmegnies Bernard , Crevier‐Buchman Lise , Hans Stéphane , Saussez Sven , Carroll Thomas L. 
Published: July 2020

ObjectiveTo develop and validate a short version of the Reflux Symptom Score—the 12‐question Reflux Symptom Score–12 (RSS‐12)—for patients with laryngopharyngeal reflux disease (LPR).Study DesignProspective study.SettingMulticenter academic hospitals.MethodsPatients with LPR diagnosed via multichannel intraluminal impedance pH monitoring were enrolled from 3 European hospitals. Healthy individuals completed the study. Individuals completed the Reflux Symptom Score, Reflux Symptom Index (RSI), and Voice Handicap Index (VHI) at baseline and 3 months posttreatment. The Reflux Symptom Score was completed twice within a 7‐day period to assess test‐retest reliability. Cronbach’s α was used for assessing internal consistency. The RSS‐12 was developed and validity assessed through a comparison of the RSS‐12, RSI, and VHI. Responsiveness to change was evaluated through the pre‐ to posttreatment evolution of the RSS‐12 total score. Receiver operating characteristic analysis was used to determine the RSS‐12 threshold that is suggestive of LPR.ResultsThe RSS‐12 was characterized by high test‐retest reliability (rs = 0.956) and adequate internal consistency reliability (α = 0.739). The RSS‐12 was significantly correlated with the RSI (rs = 0.845), suggesting high external validity. The RSS‐12 total and item scores were significantly higher in patients with LPR as compared with healthy individuals (P =. 001), supporting high internal validity. RSS‐12, VHI, and RSI significantly improved throughout treatment. Regarding the receiver operating characteristic curve, an RSS‐12 score >11 is suggestive of LPR, exhibiting a sensitivity of 94.5% and a specificity of 86.2%.ConclusionThe RSS‐12 is a shorter, reliable, and valid self‐administered patient‐reported outcome measure questionnaire that can be used in the outpatient setting to suggest and monitor LPR.
With the Incidence of Otosclerosis Declining, Should Stapedectomy Remain a Key‐Indicator Case for Otolaryngology Residents?
Authors: Totten Douglas J. , Marinelli John P. , Spear Samuel A. , Bowe Sarah N. , Carlson Matthew L. 
Published: July 2020

Stapedectomy remains a joint key‐indicator case with ossiculoplasty for otolaryngology residents in the United States. Yet, residents consistently report feeling inadequately prepared to perform stapes surgery following graduation. Applying recently described age‐ and sex‐standardized incidence rates of surgically confirmed cases of otosclerosis to the US populace, upper and lower estimates of residents’ case exposure to stapedectomy can be approximated. With this, uppermost projections estimate 6484 new cases of stapes surgery are performed annually nationwide. With approximately 1424 otolaryngology residents nationally, the average case exposure is 7.8 stapedectomies throughout their training, with upper and lower estimates of 17.1 and 4.2 cases, respectively. As such, proficiency in stapedectomy is no longer a realistic expectation for US graduating residents. This reality supports the removal of “stapedectomy” from the list of 14 key‐indicator case requirements, leaving ossiculoplasty as its own key‐indicator case, thereby reinforcing true competence in this fundamental procedure for the graduating otolaryngologist.
An Analysis of Otolaryngology Medical Malpractice Payments From the National Practitioner Data Bank
Authors: Breen Christopher T. , Mehra Saral 
Published: July 2020

ObjectiveTo describe malpractice payments made on behalf of otolaryngologists, analyze trends over time, and test the association of payment amount with severity of alleged malpractice and patient age.Study DesignRetrospective cross‐sectional analysis.SettingNational Practitioner Data Bank.Subjects and MethodsThis study comprised all payments made on behalf of otolaryngologists from 1991 to 2018 that were reported to the National Practitioner Data Bank. Descriptive statistics were calculated within and across years. Trends in payments were analyzed with the Mann‐Kendall test. Generalized linear regression was utilized to test for association of payment amount with severity of the alleged injury and patient age.ResultsFrom 1991 to 2018, there was a significant decrease in the number of payments (272 to 81) and number of otolaryngologists on whose behalf payments were made (250 to 77). Mean and median payments increased significantly from $248,848 to $420,386 and from $96,813 to $275,000, respectively. By severity of alleged injury, mean payments ranged from $39,755 (95% CI, $20,957‐$75,412) for insignificant injury to $754,349 (95% CI, $624,847‐$910,692) for patients who were left quadriplegic, sustained brain damage, or required lifelong care. By patient age, mean payments for patients ≥60 years old were $191,465 (95% CI, $159,880‐$229,292) versus $247,878 (95% CI, $209,416‐$293,402) for patients aged 20 to 39 years and $232,225 (95% CI, $197,691‐$272,793) for patients aged 40 to 59 years.ConclusionThe annual number and total value of malpractice payments decreased, while the annual mean and median payments increased. Payment amount was associated with severity of alleged malpractice and patient age.
Systematic Review and Meta‐analysis of the Change in Pharyngeal Bacterial Cultures After Pediatric Tonsillectomy
Authors: Brietzke Scott E. , Andreoli Steven M. 
Published: July 2020

ObjectiveTo review all available biomedical literature to assess published data regarding the effect of pediatric tonsillectomy on the culture results of potentially pathogenic respiratory pharyngeal bacteria before and after surgery.Data SourcesBiomedical literature databases (PubMed, Embase, Web of Science) from January 1970 to December 2019.Review MethodsA systematic review of the literature was performed with the assistance of a medical librarian. Inclusion criteria consisted of pediatric patients and extractable data regarding respiratory bacteria culture data before and after tonsillectomy. Meta‐analysis with random effects modeling was used on a limited basis.ResultsOnly 5 studies met the inclusion criteria. The grand mean age was 5.9 years; the sample size range was 31 to 134; and the range of follow‐up was 1 to 12 months. Group A beta hemolytic Streptococcus was generally the least commonly cultured pathogenic bacteria on preoperative cultures. Qualitative culture data generally showed an overall decrease in potentially pathogenic bacteria and some increase in nonpathologic respiratory flora after tonsillectomy. Meta‐analysis showed significant reductions in postoperative culture rates for group A beta hemolytic Streptococcus (positive post‐ vs preoperative culture: risk ratio [RR], 0.144; 95% CI, 0‐0.342), Haemophilus influenzae (RR, 0.437; 95% CI, 0.266‐0.608), and Streptococcus pneumoniae (RR, 0.268; 95% CI, 0‐0.567) and mixed results for Moraxella catarrhalis (0.736; 95% CI, 0.446‐1.03) but no significant reduction for Staphylococcus aureus (RR, 0.774; 95% CI, 0.157‐1.39).ConclusionThe majority of published evidence shows that pediatric tonsillectomy appears to reduce the quantity of most cultured potentially pathogenic respiratory bacteria in the pharynx after surgery. The implications and possible benefits of this favorable change in the microbiologic environment after surgery require further study.
Establishment and assessment of a nomogram for predicting adverse outcomes of preterm preeclampsia
Authors: Chen Rongxin , Han Qing , Zheng Lianghui , Jiang Lingling , Yan Jianying 
Published: July 2020

Objective This prospective study was designed to develop and internally validate an accurate prognostic nomogram model with which to predict the adverse outcomes of preterm preeclampsia. Methods Pregnant women with preeclampsia were divided into the adverse outcome group and the no adverse outcome group. The Kaplan–Meier method, univariate Cox regression analysis, and calculation of the concordance index (C-index) were applied to predictive evaluation of the nomogram. Calibration curves were drawn to test the nomogram prediction and actual observation of the adverse outcome rate. Results After 1000 internal validations of bootstrap resampling, the C-index of the nomogram for predicting adverse outcomes within 48 hours was 0.74 and the cut-off value was 0.53, with a sensitivity of 61.57% and a specificity of 76.93%. The C-index of the nomogram for predicting adverse outcomes within 7 days was 0.76 and the cut-off value was 0.37, with a sensitivity of 58.17% and a specificity of 84.82%. The calibration curves showed good concordance of incidence of adverse outcomes between nomogram prediction and actual observation. Conclusion Cox regression has certain guiding significance in preventing and treating adverse outcomes, choosing the time of termination of pregnancy, and improving the prognosis of the mother and child.
Improved cardiovascular autonomic function and decreased protein-bound uremic toxins in patients with end-stage renal disease after peritoneal dialysis
Authors: Cheng Ben-Chung , Lai Yun-Ru , Huang Chih-Cheng , Lu Cheng-Hsien 
Published: July 2020

Objective Cardiovascular autonomic neuropathy is highly prevalent in patients with end-stage renal disease (ESRD), and it has a high fatality rate. This study aimed to determine whether peritoneal dialysis (PD) improves cardiovascular autonomic function (CAF) and decreases protein-bound uremic toxin (indoxyl sulfate [IS], p-cresyl sulfate [PCS]) levels. Methods IS and PCS levels, and parameters of CAF (heart rate response to deep breathing [HR_DB], the Valsalva ratio, baroreflex sensitivity, and the frequency domain) were prospectively evaluated in 26 patients with ESRD undergoing PD at two time points (pre-PD and 6 months post-PD). For comparison, 19 consecutive patients with pre-dialysis chronic kidney disease and 30 age- and sex-matched healthy volunteers were included as the disease and control groups, respectively. Results Baroreflex sensitivity, HR_DB, and the Valsalva ratio were significantly lower in the ESRD and disease groups than in the control group. IS and PCS levels were significantly higher in the ESRD group than in the control group. Sympathetic/parasympathetic activity was improved after PD. IS levels were significantly decreased after PD and IS level changes were correlated with the frequency domain. Conclusions IS may play a role in cardiovascular autonomic neuropathy, and decreased IS levels after dialysis are associated with sympathetic/parasympathetic activity imbalance.
Plasma levels of IL-1β and IL-37 in patients with severe haemophilia
Authors: Lin Pei-Chin , Chiou Shyh-Shin , Hsu Wan-Yi , Liao Yu-Mei , Tsai Shih-Pien , Su Hsiu-Lan , Lu Ping-Tao , Tseng Yu-Hsin 
Published: July 2020

Objective Haemophilia A and B are disorders caused by the lack of clotting factors VIII and IX, respectively. Repeated bleeding into the same joint leads to haemophilic arthropathy (HA). Interleukin (IL)-1β is responsible for the pro-inflammatory response and IL-37 is induced by IL-1β stimuli to have an anti-inflammatory response and prevent uncontrolled inflammation and tissue damage. Our objective was to investigate plasma levels of IL-1β and IL-37 in patients with severe haemophilia with different severities of HA. Methods Peripheral blood samples were collected from 14 patients with severe haemophilia A and 6 with severe haemophilia B, and 18 healthy individuals. Plasma levels of IL-1β and IL-37 were detected by immunoassay, and severity of HA was evaluated using the Pettersson scoring system. Plasma levels of IL-1β and IL-37 were analysed in patients with severe haemophilia grouped by Pettersson score and in healthy individuals. Results Plasma levels of IL-1β and IL-37 were significantly higher in patients with severe haemophilia compared with healthy individuals and significantly lower in those with moderate to severe HA than in those with no or mild HA. Conclusions Plasma levels of IL-1β and IL-37 may be useful to track HA progression in patients with severe haemophilia.
Association Between Concussion History and Factors Relating to Cognitive, Behavioral, and Emotional Health Among American High School Athletes: A Cross-sectional Analysis
Authors: Knell Gregory , Burkhart Scott O. , Caze Todd J. , Polousky John D. , Kohl Harold W. , Messiah Sarah E. 
Published: July 2020

Background: The cognitive, behavioral, and emotional deficits that may be associated with sports-related concussions among adolescents are unclear. Purpose: To examine the association between reported concussion history and factors relating to cognitive, behavioral, and emotional health among a population-based sample of US high school–aged adolescents. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Participants included a representative sample of US high school student-athletes who reported a concussion history (in the past 12 months) and relevant behaviors/outcomes within 3 domains: cognitive (academics, difficulty concentrating), behavioral (drinking and driving, carrying a weapon, physically fighting, tobacco use, marijuana use, binge drinking), and emotional (symptoms of depression, suicidal thoughts/actions). The adjusted relative odds of experiencing 0 and at least 1, 2, 3, or ≥4 concussions were modeled while mutually adjusting for the behaviors of interest in addition to age, race/ethnicity, and sleep problems. Data were reported in sex stratum. Results: A total of 13,268 participants were included in the unweighted data set. Overall, 14.5% (95% CI, 12.9%-16.2%) of female and 18.1% (95% CI, 16.4%-19.8%) of male student-athletes had at least 1 concussion in the past 12 months. As compared with those who reported not engaging in any of the behaviors deleterious to health or having had any of the negative health outcomes (composite score of 0), female athletes with composite scores of 1 to 4, 5 to 7, and 8 to 11 were 1.94 (95% CI, 1.55-2.43), 3.13 (95% CI, 2.30-4.33), and 6.05 (95% CI, 3.75-9.75) times more likely to have a recent history of concussions after accounting for relevant factors. As compared with those having a composite score of 0, male athletes with composite scores of 1 to 4, 5 to 7, and 8 to 11 were 2.03 (95% CI, 1.58-2.59), 3.80 (95% CI, 2.71-5.34), and 8.23 (95% CI, 4.91-13.77) times more likely to have a recent history of concussions after accounting for relevant factors. Conclusion: Self-reported concussions among US high school athletes is related to several deleterious health behaviors and outcomes. These associations should be confirmed in longitudinal analyses.