bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early Initiation of Renal Replacement Therapy Among Burned Patients With Acute Kidney Injury
Authors: Tan Bien-Keem , Liew Zhong Hong , Kaushik Manish , Cheah Andrew Kim Wee , Tan Han Khim 
Published: January 2020

Background
Burned patients with acute kidney injury (AKI) requiring renal replacement therapy (RRT) have exceedingly high mortality rates of 73% to 100%. Since January 2011, we have been adopting an early RRT approach in managing burned patients with AKI. Our hypothesis was that early initiation of RRT leads to improved outcome and survival among burned patients with AKI.

Methodology
We conducted a retrospective analysis of Burns Database in Singapore General Hospital from January 2011 to February 2016. Indications for dialysis included serum creatinine of greater than 1.5 times baseline or urine output of less than 0.5 mL/kg per hour for at least 6 consecutive hours. Patients with similar condition from January 2006 to December 2010 were recruited for comparison.

Result
A total of 27 patients with burns and AKI were recruited from January 2011 to February 2016. The mean age was 45.4 years and 88.9% were male. The mean total burn surface area (TBSA) was 54.8%. The total volume of fluid resuscitation was 2.7 mL/kg per TBSA. The time from onset of burn to RRT was 6.4 days. Most patients presented with stage 1 AKI (51.9%), whereas 22.2% and 25.9% had stage 2 and stage 3 AKI, respectively. Most patients (74.1%) received CRRT and 18.5% received SLED. The mortality rate was 37.0% with majority of death (70%) due to sepsis/multiorgan failure. Only 1 patient required long-term RRT after discharge, and there was no occurrence of abdominal compartment syndrome. The mean age of 15 patients from 2006 to 2010 was 47.8 years. The mean TBSA was 49.5%. Only 26.7% of patients were started on RRT. The mortality rate was 66.7%, which was higher than that of subjects from 2011 to 2016 (37.0%) (P = 0.039).

Conclusions
Optimal timing of RRT for burned patients with AKI has not been established and data on early RRT approach are scarce. The findings of our study suggested that early RRT was associated with lower mortality rates among burned victims with AKI.
Application of Self-Made Connection Device in Intractable Intramedullary Device
Authors: Lei Pengfei , Cui Juncheng , Wang Wu , Liu Hao , Luo Zhenhua , Yang Xucheng 
Published: January 2020

Background:
Intramedullary fixation a standard surgical technique for long bone meta/diaphyseal fractures. There were many difficulties in removal of the intractable intramedullary device. The authors reported a new technique to remove the intractable intramedullary nail by using a self-made connecting device.

Methods:
The subject underwent removal of the intramedullary nail using a self-made connecting device, the core components of which were a caudal connecting rod and a sliding hammer in the common intramedullary nail removal device, and the auxiliary device was mainly a clinically commonly used Kirschner wire (K-wire; diameter 1.5–2.5 mm). In technical procedure, the key point was the connection between the k-wire and the intramedullary device, according to the specific conditions of the intramedullary device.

Results:
From 2012 to 2017, a total of 10 cases of intractable intramedullary devices were taken out using this self-made connection device, including 7 cases of tibial intramedullary nails, 1 case of femoral nail, and 1 case of tibial elastic nail. The technique provided satisfactory results, no infection or re-fracture occurred after the.

Conclusion:
The self-made connecting device may provide new technique for more surgeons in the face of intractable intramedullary device.
SAPHO Syndrome Involving the Mandible Treated With 99Tc-MDP
Authors: Shao Shengjie , Wang Weihong , Qian Yemei 
Published: January 2020

AbstractSAPHO (synovitis-acne-pustulosis-hyperostosis-osteitis) syndrome is a chronic inflammatory disease involving multiple organs such as skin and bones. At present, its etiology and pathogenesis are still unclear. Due to the variety of clinical manifestations and the small number of SAPHO syndrome involving the mandible, accurate diagnosis is difficult for oral and maxillofacial surgeons. Here, the authors report that a male patient with SAPHO syndrome involving the maxillofacial skin and mandible, followed for 3 years. We used99Tc-MDP (technetium-99 conjugated with methylene disphosphonate) (commercially known as Yunke) to treat this disease and achieved significant clinical treatment. This suggests that99Tc-MDP can be used as a bisphosphonate to treat SAPHO syndrome.
Recurrent Orbital Trauma Following Repaired Orbital Floor Fracture
Authors: Homer Benjamin , Homer Alexander , Sullivan Stephen R. , Taylor Helena O. 
Published: January 2020

Abstract
A study of a 22-year-old male who was assaulted and sustained a left orbital floor blowout fracture was presented in this study. The orbital floor was repaired with a titanium-reinforced porous polyethylene implant. Two years postoperatively, the patient sustained repeated left orbital trauma. The orbital floor implant remained stable while the medial wall blew out.
Maxillofacial Manifestation of a Giant Dimension Cranial Osteoma
Authors: Guerra Raphael Capelli , Carvalho Pedro Henrique de Azambuja , Pulino Bianca de Fátima Borim , Passetto Marcelo Teixeira , Junior José Carlos Rodrigues , Hochuli-Vieira Eduardo 
Published: January 2020

Abstract
Osteoma is the most frequent benign tumor in the craniomaxillofacial region. The most common initial manifestation is facial pressure or headache.
The clinical examination showed increased volume in the right supraorbital region, asymmetry of the orbital contour, exophthalmia, dystopia, proptosis and clinical restraint of ocular movement for supraversion. The lesion measured approximately 4 cm in diameter with irregular contour. Osteotomy was performed with saw surrounding the tumor, with aid of a surgical piezo on the orbital medial wall.
The result of histopathological examination was osteoma. The patient is 2.5 years postoperatively and so far without complications.
Macrocystic Lymphangioma in Children Treated by Sclerotherapy With Bleomycin
Authors: Sonmez Kaan , Karabulut Ramazan , Turkyilmaz Zafer 
Published: January 2020

Abstract
Although surgical operation is a commonly preferred method in lymphangiomas (LAs), there is a risk of vascular or nerve injury especially in macrocystic LA. Therefore, sclerotherapy would be more appropriate as the first treatment. The authors wanted to share the excellent results of intralesional bleomycin treatment in 3 patients with cervical macrocystic LA.
Application of Superficial Temporal Artery Flap in Wound Repairing After the Resection of Craniofacial Malignant Tumors
Authors: Ni Xiao-Dong , Xu Yuan , Wang Min , Cang Zheng-Qiang , Wang Qian , Yuan Si-Ming 
Published: January 2020

Background and Objective:
Craniofacial malignant tumors require not only extended resection but also appropriate reconstruction to restore appearance, which remains a major challenge. Here the authors introduced the application of superficial temporal artery (STA) flap in wound repairing after the resection of craniofacial malignant tumors.

Methods:
From January 2015 to December 2018, 16 patients with craniofacial malignant tumors were enrolled into the study, including squamous cell carcinoma (n = 6), basal cell carcinoma (n = 3), melanoma (n = 4), neuroendocrine carcinoma (n = 2), and dermatofibrosarcoma protuberance (n = 1). All of the tumors underwent extended resection. The defects formed were repaired by flaps pedicled with superior or frontal branch of STA. Donor sites were repaired with skin grafts. Patients were followed up for 6 months to 3 years to monitor the recurrence of tumor.

Results:
All the flaps survived well. Venous congestion occurred in two cases but resolved after blood-letting and application of drugs promoting venous draining. During the follow-up, no recurrence of tumors was observed and the appearance of flaps was satisfying. But flap donor sites suffered from relatively poor appearance or alopecia deformity.

Conclusions:
The STA flap is reliable for wound repairing after resection of craniofacial malignant tumors. The STA parietal branch flap is preferred for repairing scalp defects, while the STA frontal branch flap is preferred for repairing facial defects. However, the STA flap should be used prudently due to its disadvantage of the deformity in scalp donor sites.
Parry-Romberg Syndrome With Hemimasticatory Spasm: A Rare Combination
Authors: Chen Guang-can , Chen Min-jie , Wei Wen-bin , Hao Yun-bo 
Published: January 2020

Abstract
Parry-Romberg syndrome is a rare craniofacial disorder characterized by progressive hemifacial atrophy with systematic manifestations. The combination with hemimasticatory spasm is rare, with only 9 patients reported before. In this study, a study of a young male patient with Parry-Romberg syndrome and hemimasticatory spasm on his left side was presented. Radiologic examinations showed severe atrophy limited to subcutaneous tissue and electromyography demonstrated as hemimasticatory spasm. Injection of botulinum toxin type A was applied for the treatment of hemimasticatory spasm and after 2 separated injections, the patient was significantly relieved from symptom. The theory of focal demyelination of the trigeminal nerve peripheral brunches is the possible link between hemifacial atrophy and hemimasticatory spasm, although the pathogenesis of both diseases requires further study and current therapeutic methods are still limited to symptomatic treatments. Injection of botulinum toxin type A is an effective way to treat hemimasticatory spasm and autologous fat transplant is a promising solution to correct facial asymmetry.
Therapeutic Effects of Hyaluronic Acid in Peritonitis-Induced Sepsis in Mice
Authors: Lee Jae Hoon , Liu Airan , Park Jeong-Hyun , Kato Hideya , Hao Qi , Zhang Xiwen , Zhou Li , Lee Jae-Woo 
Published: January 2020

ABSTRACT
Intra-abdominal infection is the second most common cause of sepsis, and the mortality rate from abdominal sepsis remains high. High molecular weight (HMW) hyaluronic acid (HA) has been studied in sterile injury models as an anti-inflammatory and anti-permeability agent. This study evaluated the therapeutic effects of intraperitoneal HMW HA administration in mice with peritonitis-induced sepsis. Sepsis was induced in C57BL/6 mice by cecal ligation and puncture (CLP), followed 4 h later by an intraperitoneal injection of HMW HA (20 mg/kg) solution or phosphate buffered saline (PBS). Survival, physiological data, organ injury, bacterial burden, and inflammatory cytokine levels were assessed in the CLP mice. To assess the effect of HA on macrophage phagocytosis activity, RAW264.7 cells, primed with lipopolysaccharide, were exposed with either PBS or HMW HA (500 μg/mL) prior to exposure to 107 CFU of E coli bacteria. HMW HA instillation significantly improved blood oxygenation, lung histology, and survival in CLP mice. Inflammatory cytokine levels in the plasma and bacterial burdens in the lung and spleen were significantly decreased by HA administration at 24 h after CLP. At 6 h after CLP, HA significantly decreased bacterial burden in the peritoneal lavage fluid. HMW HA administration significantly increased E coli bacterial phagocytosis by RAW264.7 cells in part through increased phosphorylation of ezrin/radixin/moesin, a known downstream target of CD44 (a HA receptor); ezrin inhibition abolished the enhanced phagocytosis by RAW264.7 cells induced by HA. Intraperitoneal administration of HMW HA had therapeutic effects against CLP-induced sepsis in terms of suppressing inflammation and increasing antimicrobial activity.
Abdominal Drainage at Appendectomy for Complicated Appendicitis in Children
Authors: Fujishiro Jun , Fujiogi Michimasa , Hirahara Norimichi , Terui Keita , Okamoto Tatsuya , Watanabe Eiichiro , Ishimaru Tetsuya , Miyata Hiroaki 
Published: January 2020

Objective:
The aim of the study was to investigate the effect of abdominal drainage at appendectomy for complicated appendicitis in children.

Summary of Background Data:
Although an abdominal drain placement at appendectomy is an option for reducing or preventing postoperative infectious complication, there is controversy regarding its effect for complicated appendicitis.

Method:
The study used the data on appendectomies for complicated appendicitis in children (≤15 years old) that were operated in 2015 and registered in the National Clinical Database, a nationwide surgical database in Japan. One-to-two propensity score matching was performed to compare postoperative outcomes between patients with and without drainage at appendectomy.

Result:
The study included 1762 pediatric appendectomies for complicated appendicitis, 458 of which underwent abdominal drainage at appendectomy. In the propensity-matched analysis, the drainage group showed a significant increase in wound dehiscence [drain (−) vs drain (+); 0.3% vs 2.4%, P = 0.001], and postoperative hospital stay (median: 7 days vs 9 days, P < 0.001). There were no significant differences in the incidence of any complications, organ space surgical site infection, re-admission, and reoperation.
Subgroup analyses in perforated appendicitis and perforated appendicitis with abscess, and open and laparoscopic appendectomy all demonstrated that drain placement was not associated with a reduction in any complication or organ space surgical site infection. However, it was significantly associated with longer hospital stays.

Conclusion:
This study suggested that an abdominal drain placement at appendectomy for complicated appendicitis among children has no advantage and can be harmful for preventing postoperative complications.
Effectiveness of the combat application tourniquet for arterial occlusion in young children
Authors: Kelly Joseph R. , Levy Matthew J. , Reyes Jose , Anders Jennifer 
Published: January 2020

BACKGROUND
Tourniquet use for extremity hemorrhage has become a mainstay in adult trauma care in last 15 years. The efforts of the Stop the Bleed campaign have increased the distribution and use of tourniquets in civilian settings in response to mass shootings and as part of disaster preparedness. Little research or published experience exists regarding the use of tourniquets in the pediatric population. This study sought to determine the minimum patient age on which the combat application tourniquet (CAT) is able to control extremity hemorrhage.

METHODS
A convenience sample of pediatric patients, ages 1 year to 8 years, scheduled for elective orthopedic surgery at an academic hospital, were eligible for enrollment. Subject age, weight, height, blood pressure, and arm and leg circumferences were obtained. Once under general anesthesia, the pulse of an upper and a lower limb were obtained by Doppler, a CAT was then placed at the most proximal practical location of the limb until the corresponding pulse was either no longer obtainable by Doppler or until the tourniquet was as tight as its design allows. The tourniquet was removed after 30 seconds of arterial occlusion.

RESULTS
Thirteen children, ages 2 years to 7 years were enrolled. Weights ranged from 12.8 kg to 23.9 kg, with a mean of 16.7 kg. Leg circumferences were 24.5 cm to 34.5 cm, with a mean of 27.9 cm and arm circumferences were 13 cm to 24 cm, with a mean of 16.3 cm. Subject heights were 87 cm to 122 cm, with a mean of 103.4 cm. Twenty-four total extremities were tested, 11 arms and 13 legs. Arterial occlusion was obtained on 100% of limbs tested (95% confidence interval, 85.8–100%).

CONCLUSION
This study is similar to previous adult tourniquet efficacy studies in design, size and outcomes. It is the first to show successful arterial occlusion on preschool-aged children with a commercial tourniquet in a controlled setting. The results suggest that the CAT can be used in school-aged children with severe extremity hemorrhage with a high likelihood of success.

LEVEL OF EVIDENCE
Therapeutic, level II.
Muscle Quality Index as a Predictor of Hip Osteoarthritis
Authors: Machado-Payer Ramón , Latorre-Román Pedro Ángel , Jerez-Mayorga Daniel , Chirosa Luis Javier , Ábalos-Medina Gracia 
Published: January 2020

Objective:
To determine the utility of the muscle quality index (MQI) as a predictor of osteoarthritis (OA) and to assess the influence of strength and body composition manifestations in subjects with hip OA.

Methods:
Fifty subjects (21 men and 29 women, 66.4 ± 5.3 years) participated in this study. Of them, 25 subjects had unilateral hip OA, and 25 healthy subjects. The 2 groups were matched by age and sex. We evaluated muscle perimeter, length of the upper limb, body mass, and administered the sit-to-stand test, which measures the time it takes to rise and sit 10 times, and the MQI, in addition to the maximum voluntary isometric contraction in hip flexion and extension movements.

Results:
The OA group presented significantly (P < .05) higher body mass index, but lower fat mass and greater leg length. In turn, significant differences were observed between the groups for the sit-to-stand test (P = .002) and, as a consequence, in the MQI (P = .003). The binary logistic regression analysis shows that a higher MQI is a protective factor against OA, with the cut-off point being 144.20.

Conclusion:
The MQI is a complementary tool for the diagnosis and monitoring of OA in elderly people.
Integrating Working Memory Exercises With Nursing Home Rehabilitation to Achieve “Better, Faster” Functional Outcomes
Authors: Mansbach William E. , Mace Ryan A. , Tanner Melissa A. , Knoepfel Erin M. , Maxwell Robert , Chew Felicia 
Published: January 2020

Targets:
We examined the efficacy of working memory exercises (WME), applied concurrently with rehabilitation services provided in skilled nursing facilities, for improving activities of daily living (ADLs) among older skilled nursing facilities residents with cognitive impairment.

Intervention Description:
Participants (N = 63) were randomized to the WME or treatment-as-usual control group. The WME was a 3-week, 9-session course (30 minutes each) of a rehabilitation program for therapists in post–acute settings.

Mechanisms of Action:
Working memory exercises aim to improve ADLs by targeting attention and working memory, based on the link between executive function and everyday functional skills. By developing cognitive communication skills and strengthening strategies for learning and memory, WME may give patients an added boost to traditional ADLs remediation therapies.

Outcomes:
Working memory exercises participants' ADL performance increased by 1.59 points on average (95% confidence interval = 0.69-2.49, P < .001) on the Katz Index of ADL scale compared with a 0.05 decrease for the control group (95% confidence interval = −1.09 to 0.99, P = .92). A greater proportion of WME participants than controls progressed from ADL dependent to independent for continence, dressing, feeding, functional transfers, and toileting. Simultaneously targeting cognitive and functional skills was associated with greater improvements in ADLs than targeting functional deficits alone.
Injury Pathways That Lead to AKI in a Mouse Kidney Transplant Model
Authors: Jain Swati , Plenter Robert , Nydam Trevor , Jani Alkesh 
Published: January 2020

Background.
Prolonged cold ischemia (CI) is a risk factor for acute kidney injury after kidney transplantation. We endeavored to determine the pathways involved in the development of tubular cell injury and death before and after transplantation. We hypothesized that ex vivo cold storage before transplant would produce a different injury phenotype to that seen after engraftment in kidney transplants with or without CI.

Methods.
Four groups of mouse donor kidneys were studied: (1) nontransplanted control kidneys; (2) donor kidneys subjected to ex vivo cold ischemia (CI); (3) donor kidneys subjected to kidney transplant without CI (Txp); and (4) donor kidneys subjected to CI followed by transplantation (CI+Txp).

Results.
Acute kidney injury only occurred in the CI+Txp group, which had significantly increased sCr versus the Txp group and the control mice. Histologically, the CI group demonstrated significantly increased tubular cell apoptosis and caspase-9 expression, whereas the Txp group demonstrated only mild brush border injury without apoptosis or necrosis. In contrast, the CI+Txp group had tubular cell apoptosis associated with expression of caspase-8, TNFR1, and increased serum TNF-α. CI+Txp also led to significantly higher ATN scores in association with increased RIP1, RIP3, pMLKL, and TLR4 expression.

Conclusions.
Our results suggest distinct therapies are needed at different times during organ preservation and transplantation. Prevention of apoptosis during cold storage is best achieved by inhibiting intrinsic pathways. In contrast, prevention of cell death and innate immunity after CI+Txp requires inhibition of both the extrinsic death receptor pathway via TNFR1 and caspase-8 and inhibition of programmed necrosis via TLR4 and TNFR1.
Correlation of Visual Quality of Life With Clinical and Visual Status in Friedreich Ataxia
Authors: Afsharian Parisa , Nolan-Kenney Rachel , Lynch Abigail E. , Balcer Laura J. , Lynch David R. 
Published: January 2020

Background:
The primary objective was to determine the association of patient-reported vision-specific quality of life to disease status and visual function in patients with Friedreich's ataxia (FRDA).

Methods:
Patients with FRDA were assessed with the 25-Item National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25) along with measures of disease status (ataxia stage) and visual function (low- and high-contrast letter acuity scores). The relations of NEI-VFQ-25 scores to those for disease status and visual function were examined.

Results:
Scores for the NEI-VFQ-25 were lower in patients with FRDA (n = 99) compared with published disease-free controls, particularly reduced in a subgroup of FRDA patients with features of early onset, older age, and abnormal visual function.

Conclusions:
The NEI-VFQ-25 captures the subjective component of visual function in patients with FRDA.