bluuebunny/crossref_metadata_2025_split huggingface dataset:
L’alexithymie : historique, recherches et perspectives psychopathologiques
Authors: Maillard Benoît , Frick Eckhard 
Published: December 2019

La notion clinique d’alexithymie désigne littéralement l’absence de mot pour l’expression de l’humeur (a-lexis-thymie). Elle est composée de quatre traits : 1. l’incapacité à exprimer verbalement les émotions ou les sentiments, 2. la limitation de la vie imaginaire, 3. la tendance à recourir à l’action pour éviter ou résoudre les conflits, 4. la description détaillée des faits, des événements, des symptômes physiques. Il est évident que cette notion recoupe certains processus de la pensée opératoire développée par l’École de Paris dans ces travaux sur les phénomènes psycho-somatiques. Si certaines recherches proposent une étiologie neuropsychologique de l’alexithymie, cet article montre les limites d’une telle approche et propose de confronter les hypothèses psychanalytiques sur le fonctionnement alexithymique comme le résultat d’une carence ou la mise en œuvre d’un type défensif. L’idiosyncrasie affective en jeu dans ces processus ouvre la question de savoir si l’absence d’affects peut être impliquée dans des modalités défensives. Un repérage théorique sur l’inscription du corps dans les lignes du langage et les fondements de la subjectivité sera nécessaire pour éclairer la complexité des potentialités psycho-somatiques. Enfin, nous développerons certaines implications contemporaines de ces travaux, notamment dans la clinique de l’obésité.
Status epilepticus im Kindes- und Jugendalter – ein oft unterschätztes Notfallereignis
Authors: Bernhard Matthias K. , Kiep Henriette , Merkenschlager Andreas 
Published: December 2019

ZUSAMMENFASSUNGEin Status epilepticus stellt einen Notfall dar, der mit einer erheblichen Morbidität und Mortalität einhergeht. Aus operationaler Sicht wird daher mittlerweile ein Status epilepticus in der Erwachsenenneurologie ab einer Anfallsdauer von 5 Minuten definiert. Der Notfalltherapie sowohl im Laien- als auch im Klinikbereich kommt eine sehr wichtige Rolle zu. Therapie der ersten Wahl sind weiterhin Benzodiazepine. Zunehmend positive Erfahrungen und Studienergebnisse liegen für Valproat, Levetiracetam und Lacosamid auch für pädiatrische Patienten vor.
Infantile Spasmen
Authors: Hornemann Frauke , Weber Franziska , Beblo Skadi , Merkenschlager Andreas 
Published: December 2019

ZUSAMMENFASSUNGVorgestellt werden die aktuellen Behandlungsoptionen bei infantilen Spasmen (früher BNS-Epilepsie) in Form eines Stufenschemas. Berücksichtigung finden die deutsche AWMF-Leitlinie 14 sowie die Behandlungsdaten und aktuellen 18-Monats-Nachbeobachtungsergebnisse der internationalen Behandlungsstudie „ICISS“ mit Vergleich einer primären Kombinationstherapie aus Vigabatrin und Prednisolon versus Vigabatrin und ACTH 10, 11.Dargestellt werden typische und weniger bekannte Symptome bei infantilen Spasmen zur Früherkennung, die Nomenklatur im Bereich West-Syndrom/BNS-Epilepsie, außerdem die Möglichkeiten der akuten Diagnostik und Hinweise auf das Nebenwirkungsspektrum der Therapien.
Shortened Fingers and Toes: GNAS Abnormalities are Not the Only Cause
Authors: Reyes Monica , Silve Caroline , Jüppner Harald 
Published: December 2019

AbstractThe PTH/PTHrP receptor (PTHR1) mediates the actions of parathyroid hormone (PTH) and PTH-related peptide (PTHrP) by coupling this G protein-coupled receptor (GPCR) to the alpha-subunit of the heterotrimeric stimulatory G protein (Gsα) and thereby to the formation of cAMP. In growth plates, PTHrP-dependent activation of the cAMP/PKA second messenger pathway prevents the premature differentiation of chondrocytes into hypertrophic cells resulting in delayed growth plate closure. Heterozygous mutations in GNAS, the gene encoding Gsα, lead to a reduction in cAMP levels in growth plate chondrocytes that is sufficient to cause shortening of metacarpals and/or -tarsals, i. e. typical skeletal aspects of Albright’s Hereditary Osteodystrophy (AHO). However, heterozygous mutations in other genes, including those encoding PTHrP, PRKAR1A, PDE4D, and PDE3A, can lead to similar or even more pronounced acceleration of skeletal maturation that is particularly obvious in hands and feet, and reduces final adult height. Genetic mutations other than those resulting in Gsα haploinsufficiency thus reduce intracellular cAMP levels in growth plate chondrocytes to a similar extent and thereby accelerate skeletal maturation.
Bristow artroscópico: Avaliação da segurança e da eficácia, 12 anos de experiência
Authors: Garcia Jose Carlos 
Published: December 2019

Resumo
Objetivo O procedimento de Bristow aberto é um método há muito estabelecido e eficaz no tratamento da instabilidade anterior do ombro. Seguindo as tendências das cirurgias minimamente invasivas, essa cirurgia foi realizada por artroscopia, e seus resultados foram avaliados.
Métodos Foram avaliados 43 ombros de pacientes submetidos ao procedimento de Bristow por artroscopia, com o enxerto em posição horizontal e uso de um parafuso, com pelo menos dois anos de seguimento pós-cirúrgico, por meio de escores qualidade de vida, índice de reluxação e perda de rotação lateral.
Resultados A média de seguimento foi de 76 meses (variando de 129 a 24 meses), e o escore da University of California at Los Angeles (UCLA) variou de 25,56 ± 0,50 (desvio padrão [DP] = 3,25) para 33,23 ± 0,44 (DP = 2,91) (p < 0,0001). A média para o escore de Rowe com 2 anos ou mais de cirurgia foi de 94,25 ± 1,52(DP = 1,34), sendo que o padrão de bons resultados é de 75 pontos (p < 0,0001). A média do teste simples de ombro foi de 11,35 ± 0,21 (DP = 1,34), e, para perda de rotação lateral, foi de 10,37° ± 1,36° (DP = 8,58°). Não houve reluxações.Entre os 43 pacientes operados, ocorreram um total de 12 complicações, das quais 8 não apresentaram qualquer repercussão clínica. As complicações com repercussão clínica foram uma infecção de possível origem hematogênica seis meses após a cirurgia, uma fratura do coracoide que fez com que o paciente precisasse mudar o procedimento no intraoperatório, e dois pacientes com impacto anterior, que necessitaram de retirada de material de síntese mais de seis meses após a cirurgia.
Conclusão O procedimento de Bristow artroscópico mostrou eficácia no tratamento da instabilidade anterior do ombro, embora não seja livre de complicações.
Recurrence of Cholesteatoma - A Retrospective Study Including 1,006 Patients for More than 33 Years
Authors: Møller Patrick Rønde , Pedersen Christina Nygaard , Grosfjeld Line R. , Faber Christian E. , Djurhuus Bjarki D. 
Published: December 2019

Abstract
Introduction Cholesteatomas are benign tumors consisting of skin, and growing inside a retraction pocket in the tympanic membrane. Cholesteatomas can occupy the entirety of the middle ear, and are known for their osteolytic capabilities. Surgery is the only curative treatment for cholesteatomas.
Objective To describe the risk of recurrence after first-time surgically-treated middle-ear cholesteatoma (STMEC1) on the island of Funen from 1983 to 2015.
Methods Cases of STMEC1 were identified in the Danish National Hospital Register. The medical records were reviewed. Time-to-event analyses were applied. The ears were followed from STMEC1 to a secondary cholesteatoma, emigration, death, or end of follow-up.
Results Records from 1,006 patients with STMEC1 were reviewed. A total of 54 patients were submitted to surgery on both ears. The total sample consisted of 1,060 ears with STMEC1; 300 were children's (< 16 years) ears, and 760 were adult's ears. The total observation time was of 12,049 years.The overall estimated proportion with recurrence 5 years after surgery was of 37% in children and of 15% in adults. The older the child was at the first surgery, the risk decreased by 7% per year. In children, canal wall up (CWU) mastoidectomy without obliteration was associated with a hazard ratio for recurrence of 1.9 (95% confidence interval [95%CI]: 1.2–3.0) compared with CWU with obliteration.
Conclusion Compared with adults, children were had 2.6 times more risk of recurrence. Procedures performed without mastoidectomy had the lowest risk of recurrence. In children, obliteration was associated with a significantly lower risk of recurrence. However, patients were not randomized regarding the surgical approach; thus, the association between approach and risk of recurrence was likely influenced by confounding factors.
The Watershed Line of the Distal Radius: Cadaveric and Imaging Study of Anatomical Landmarks
Authors: Bergsma Minke , Doornberg Job N. , Borghorst Annelise , Kernkamp W.A. , Jaarsma R. L. , Bain Gregory I. 
Published: December 2019

Abstract
Background Placement of volar plates remains a challenge as the watershed line may not be an easy-identifiable distinct line intraoperatively.
Objectives The main objective of this article is to define how anatomical landmarks identifiable upon the volar surgical approach to the distal radius relate to the watershed line.
Methods We identified anatomical landmarks macroscopically upon standard volar approach to the distal radius in 10 cadaveric forearms and marked these with radiostereometric analysis (RSA) beads in cadaveric wrists. The RSA beads were then referenced against the volar osseous structures using quantification of three-dimensional computed tomography and advanced imaging software.
Results The mean measurements were the radial and ulnar prominences 11.1 mm and 2.1 mm proximal to the joint line of the distal radius, respectively. The interfossa sulcus was 0.3 mm proximal and 3 mm dorsal to the ulnar prominence. The watershed line was between 3.5 (minimal) and 7.6 (maximal) mm distal to the distal line of insertion of the pronator quadratus.
Conclusion The watershed line is situated distal to the pronator quadratus, but with a wide variability making it an impractical landmark for plate position. The osseous ulnar prominence is a good anatomical reference for safe plate positioning, as it is located on the watershed line and easily palpated at surgery. One should keep in mind the sulcus—the point on the watershed line where the flexor pollicis longus runs—can be situated just proximal to the ulnar prominence.
Clinical Relevance To provide anatomical landmarks that are easy to identify upon surgical approach without the direct need for intraoperative imaging.
Shortening Postoperative Stay after Parathyroidectomy - A District General Hospital Experience
Authors: Sinha Sidhartha , Fok Matthew , Ahmad Ijaz , Al-Sheikh Mustafa , Backhouse Christopher 
Published: December 2019

Introduction Historically, concerns about complications following parathyroid surgery, such as airway compromise, bleeding and hypocalcemia, have precluded its consideration as a short-stay surgical procedure. Recent advancements in perioperative care have resulted in several publications demonstrating that parathyroidectomy can be safely performed as a short-stay procedure.Objectives The aim of the present study was to describe the process of implementing a short-stay protocol focusing on preoperative patient education and postoperative calcium management for those undergoing surgery for primary hyperparathyroidism (PHP).Method A retrospective audit of consecutive parathyroidectomies performed for PHP over the period between 2010 and 2013 was performed. A short-stay protocol (SSP) was introduced focusing on postoperative calcium management. Results were reaudited over the period between 2013 and 2015.Results Consecutive parathyroidectomies in 76 patients were included in the study. A total of 42 patients underwent parathyroidectomy prior to the introduction of the protocol. A total of 26.2% of these patients were symptomatic from hypercalcemia. A total of 40 out of 42 (95.2%) patients had a biochemical cure. A total of 36 out of 42 (85.7%) cases were due to parathyroid adenomas. A total of 34 patients underwent surgery following the introduction of the protocol. A total of 13 out of 34 (38.2%) of the patients had symptomatic hypercalcemia. A total of 33 out of 34 (97.1%) had a biochemical cure. A total of 32 out of 34 (94.1%) cases were due to parathyroid adenomas.The length of stay decreased from a median of 3 days (range 2–9 days; mean 3.32) preprotocol to a median of 2 days (range 2–3 days; mean 2.16) postprotocol (p < 0.0001) with no difference in the 30-day unplanned readmission rate (4.8 versus 2.9%; p = 0.999).Conclusions The postoperative length of stay after parathyroidectomy for PHP can be safely reduced through patient education and by rationalizing postoperative calcium management without adversely affecting outcomes.
Protocolo de prevenção do tromboembolismo venoso: Experiência de 2.000 casos em artroplastia total de joelho*
Authors: Carvalho Júnior Lúcio Honório de , Correa Matheus de Almeida , Lima Matheus Rezende , Silvestre Camila Barreto , Almeida Victor Ferreira , Temponi Eduardo Frois 
Published: December 2019

ResumoObjetivo O objetivo do presente estudo é avaliar o impacto de um protocolo institucional em um hospital terciário na prevenção do tromboembolismo venoso em 2.005 pacientes submetidos a artroplastia total primária de joelho.Métodos Os dados dos prontuários de pacientes submetidos a artroplastia total do joelho antes (n = 1.115) e após (n = 890) a implantação do protocolo institucional, totalizando 2.005 pacientes, foram relatados retrospectivamente. Dados demográficos, comorbidades e desfechos foram analisados.Resultados Não houve alteração significativa nos casos de trombose venosa profunda (TVP) (1,6% versus 2,4%; p = 0,211). Houve um aumento nos casos de embolia pulmonar (EP) (0,2% versus 0,8%; p = 0,049).Conclusão Apesar da implementação do protocolo de prevenção, não houve redução nos eventos estudados. A pequena incidência global faz com que novos estudos, com séries maiores, sejam necessários para confirmar ou descartar esses achados.
A síndrome da dor patelofemoral altera o movimento do retropé, mas não modifica a distribuição da pressão plantar
Authors: Luza Lisiane Piazza , Luza Marcelo , Santos Gilmar Moraes 
Published: December 2019

Resumo
Objetivo Comparar a distribuição da pressão plantar e a cinemática do retropé durante a fase de apoio da marcha de sujeitos com e sem síndrome da dor patelofemoral (SDPF).
Métodos Participaram 26 sujeitos com SDPF e 31 clinicamente saudáveis, pareados em idade, estatura e massa corporal. Foi avaliada a distribuição da pressão plantar (pico de pressão) em seis regiões plantares, e a cinemática do retropé (ângulo máximo de eversão do retropé, porcentagem da fase de apoio da marcha em que o ângulo é atingido, e porcentagem da fase de apoio em que o retropé permaneceu em eversão). Os dados foram analisados por meio da estatística descritiva e inferencial, com nível de significância de p ≤ 0,05.
Resultados A pressão nas seis regiões plantares analisadas e a magnitude do ângulo máximo de eversão do retropé durante a marcha em superfície plana não se mostrou diferente nos sujeitos com SDPF. No entanto, sujeitos com SDPF apresentaram, dentro do ciclo da marcha, ângulo máximo de eversão do retropé mais cedo do que sujeitos do grupo controle, e permaneceram menos tempo com o retropé em eversão.
Conclusão A SDPF parece estar relacionada à alteração no padrão temporal na cinemática do retropé.
Hypovitaminosis D, Low Bone Mineral Density, and Diabetes Mellitus as Probable Risk Factors for Benign Paroxysmal Positional Vertigo in the Elderly
Authors: Bazoni Jessica Aparecida , Ciquinato Daiane Soares Almeida , Marquez Audrey de Souza , Costa Viviane de Souza Pinho , Marchiori Glória de Moraes , Marchiori Luciana Lozza de Moraes 
Published: December 2019

Abstract
Introduction Studies have found that elderly patients with benign paroxysmal positional vertigo (BPPV) may present low levels of vitamin D (25 (OH) D), changes in bone mineral density, and diabetes mellitus (DM).
Objective: To investigate the possible association between BPPV, bone mineral density, hypovitaminosis D, 25 (OH) D and DM.
Methods The sample consisted of 109 elderly subjects. The BPPV was verified by a standardized questionnaire and the Dix-Hallpike maneuver. Blood samples were collected for the investigation of 25 (OH) D serum levels. The bone mineral density was evaluated by means of a densitometer. Diabetes mellitus verification was performed using a self-reported questionnaire.
Results Of the 109 participants, 17 had BPPV. There was a statistically significant difference between BPPV and gender (p = 0.027, phi = 0.222), with female representing 88.2% of those with BPPV. In the group with BPPV, there was a statistically significant difference for the amount of vitamin D found (p = 0.001) and for age (p = 0.001). In the elderly group with DM and BPPV, a difference was found for the standard deviation of the femur (p = 0.022) with posthoc Dunn, identifying the difference between diabetics with and without BPPV (p = 0.047).
Conclusion Although no association was found (25 (OH) D levels) with BPPV in the general population of this study, it was observed that there was an association with bone mineral density in the elderly group with DM and BPPV, and, in the group with BPPV, there was an association between the amount of vitamin D and age.
Vocal Tract Discomfort Scale (VTDS) and Voice Symptom Scale (VoiSS) in the Early Identification of Italian Teachers with Voice Disorders
Authors: Galletti Bruno , Sireci Federico , Mollica Roberta , Iacona Elisabetta , Freni Francesco , Martines Francesco , Scherdel Enrique Perellò , Bruno Rocco , Longo Patrizia , Galletti Francesco 
Published: December 2019

Abstract
Introduction The current Italian law does not include any guidance regarding voice education, prevention of voice disorders and screening in subjects with high vocal loading such as teachers.
Objectives We aimed to check the correlation between the Vocal Tract Discomfort Scale (VTDS) with the Voice Symptom Scale (VoiSS) for the evaluation of Italian teachers. In addition, we aimed to investigate whether there are differences in the frequency and intensity of discomfort symptoms in teachers with disabilities comparing vocal tract discomfort symptoms in teachers with high risk (HRVD) and low risk (LRVD) of vocal disorders according to the VoiSS cutoff (> 15.5).
Methods We analyzed 160 Italian teachers (111 women and 49 men) that completed the VTDS and VoiSS at vocal evaluation. The Spearman correlation test was applied to all variables. The Mann-Whitney U test was used to compare the average number of discomfort symptoms among HRVD and LRVD teachers.
Results A moderate positive correlation was observed between the average number, frequency, and intensity of discomfort symptom and the total score, physical domain score, and limitation domain score of the VoiSS. Only the emotional domain score of the VoiSS showed a weak positive correlation (p < 0.001). Teachers considered in the HRVD group according to the VoiSS score had a higher number, frequency, and intensity of vocal tract discomfort symptoms.
Conclusion There is correlation between the VTDS and VoiSS scales. Like the VoiSS, the VTDS is a questionnaire that detects HRVD teachers. Therefore, the results suggest that both questionnaires could be useful for a preventive voice program for Italian teachers
25-Hydroxyl Vitamin D Deficiency in Nasal Polyposis
Authors: Chandrakar Ankur Kumar , Alexander Arun , R. Medha , Rajendiran Kalaiselvi , Ramasamy Karthikeyan 
Published: December 2019

Abstract
Introduction Vitamin D is known to have immunomodulatory functions and has action on chronic inflammatory processes, such as nasal polyposis.
Objective The present study assessed the levels of 25-hydroxy vitamin D and high-sensitivity C-reactive protein (hs-CRP) in patients with nasal polyposis, as compared with healthy control subjects, and identified their association with disease severity in nasal polyposis. It further assessed the levels of 25-hydroxyl vitamin D and hs-CRP in patients with nasal polyposis and atopy and compared it with patients with nasal polyposis without atopy.
Methods This was a cross-sectional study involving 2 groups: 80 patients with nasal polyposis and 80 healthy subjects. In patients with nasal polyposis, the disease severity is assessed by the sino-nasal outcome test (SNOT20) and by the Lund & Mackay staging system. Levels of 25-hydroxy vitamin D and hs-CRP were measured by enzyme-linked immunosorbent assay (ELISA).
Result The mean 25-hydroxyl vitamin D levels (ng/ml) was 12.01 ± 7.29 for cases and 22.87 ± 14.95 for controls, with p < 0.0001. The mean hs-CRP levels (mg/L) was 5.99 ± 2.74 in cases and 2.41 ± 1.95 in controls, with p < 0.0001. The severity of polyposis correlated negatively with serum levels of 25-hydroxy vitamin D and positively with hs-CRP.
Conclusion The study has thus shown significant correlation between vitamin D deficiency and inflammation in patients with nasal polyps.
Juvenile Granulosa Cell Tumor of the Testis: Prenatal Diagnosis and Management
Authors: Vatta Fabrizio , Raffaele Alessandro , Pasqua Noemi , Cesari Stefania , Romano Piero , Parigi Gian Battista , Avolio Luigi 
Published: December 2019

AbstractPrepubertal primary testicular tumors account for ∼1% of all pediatric solid tumors. We report a new case of prenatal diagnosis of juvenile-type granulosa cell tumor (JGCT). A fetal ultrasound performed at the 38th week of gestation for suspected nonvertex presentation identified a left multilocular septated cystic testicular mass, suggestive for JGCT. At birth, a painless left scrotal mass was detected. Ultrasound re-evaluation excluded torsion of the testis. Tumor markers and abdominal ultrasound were normal for age. Inguinal exploration revealed a cystic mass beneath the tunica albuginea that had replaced all the normal parenchyma. Since organ-sparing surgery was thus not feasible, an orchiectomy was performed and diagnosis of JGCT was confirmed. At 7-year follow-up, the child presented an uneventful outcome. Our case shows that neonatal JGCT, which has an intrauterine genesis, can be diagnosed prenatally by ultrasound in the last weeks of pregnancy.
Intramural Injection of Botulinum Toxin A in Surgical Treatment of a Long Gap Esophageal Atresia—Rat Model
Authors: Pike Ashton Hideki , Zvara Peter , Antulov Marijana Rincic , Schrøder Henrik Daa , Hejboel Eva Kildall , Rasmussen Lars , Qvist Niels , Ellebæk Mark Bremholm 
Published: December 2019

Abstract
Introduction Anastomosis with minimal tension is desirable in long-gap esophageal atresia. Prior studies in piglets showed that intraesophageal injection of botulinum toxin type A (BTX-A) results in significant esophageal elongation. Our aim was to determine the BTX-A dose, number of injections, and time necessary to elicit maximal response.
Materials and Methods Adult male Wistar rats (n = 48) were randomly assorted into five groups. Four treatment groups received 2 or 4 U/kg of BTX-A, delivered using two or four injections, and a control group received 0.9% NaCl. Esophagus was removed 6 or 24-hours postinjection and tested ex vivo using a stretch tension device. Subsequently, an optimal dose and time following injection was used to study the effects of BTX-A on anastomotic healing in vivo. Rats (n = 12) received an intraesophageal injection of BTX-A or 0.9% NaCl, followed by resection of 0.5 cm of esophagus and end-to-end anastomosis. Rats were observed for 9 days, and esophagus was removed for gross and histological evaluation.
Results The largest effect on elongation was recorded in the BTX-A (2 U/kg) 24 hour, four injection group. In the anastomosis study, stricture formation was observed in all animals in the control group. Absence of esophageal stricture was found in three out of four animals in the treatment group macroscopically and histologically.
Conclusion We found that BTX-A exerts a positive effect on stretch characteristics of esophageal tissue in rats at 2 U/kg via four-injection delivery and 24-hour waiting period. This study suggests that BTX-A might improve anastomotic healing.