bluuebunny/crossref_metadata_2025_split huggingface dataset:
Traumatic Blunt Injuries to the Celiac Artery: A 5-Year Review From a Level I Trauma Center
Authors: Fitzgerald Caitlin A. , Tootla Yasmin , Morse Bryan C. , Benarroch-Gampel Jaime , Ramos Christopher R. , Nguyen Jonathan 
Published: July 2020

Background Injury to the celiac artery secondary to a blunt mechanism of trauma is an extremely rare injury that accounts for only 1%-2% of all visceral vascular lesions. Although rare, this injury is associated with significant mortality. Despite this high mortality, there are currently only a few published case series of blunt celiac artery injuries in the literature. This study sought to review all cases of blunt celiac artery injuries that presented to our Level I trauma center over a 5-year period. Methods This was a retrospective chart review of all patients who presented with a traumatic blunt celiac artery injury between January 2012 and March 2017. Results A total of 10 patients met the inclusion criteria for this study. The majority of patients were male (7/10, 70%), the average age was 38.3 ± 16.1 years, and overall mortality was 20% (2/10). On average, patients spent 10.2 ± 6.5 days in the hospital, 4.4 ± 4.5 days in the ICU, and 1.6 ± 2.0 days on the ventilator. The majority of patients presented with either an intimal dissection (3/10, 30%) or an intraluminal thrombus (3/10, 30%). Other injuries included pseudoaneurysms (2/10, 20%), complete avulsion (1/10, 10%), and an intimal dissection with thrombus (1/10, 10%). Of these injuries, 2 (20%) were noted to have retrograde flow on imaging studies including computed tomography angiography and a visceral angiogram. The majority of patients (8/10, 80%) were managed nonoperatively, and 5 (50%) patients were discharged home on aspirin. One patient who was initially managed nonoperatively required an unplanned return to the operating room for ischemic bowel, liver, and stomach. There were no other complications noted. Discussion Traumatic blunt injury to the celiac artery is rare. Although there are multiple treatment options, there is currently no consensus in regard to management guidelines. In this case series, the majority of patients were successfully managed nonoperatively suggesting that a selective approach for intervention on patients with a blunt celiac artery injury should be considered.
Perceived discrimination and subjective well-being among Middle Eastern migrants in Australia: The moderating role of perceived social support
Authors: Hashemi Neda , Marzban Maryam , Sebar Bernadette , Harris Neil 
Published: July 2020

Background: Middle Eastern (ME) migrants are vulnerable to developing mental health problems due to pre-migration and post-migration traumas and stresses. The evidence on the subjective well-being of ME migrants and its contributing factors is limited and inconclusive. Objectives: The aim of this study is to examine the moderating role of perceived social support in the association between perceived discrimination and subjective well-being, after controlling for socio-demographic factors. Method(s): This cross-sectional survey study was conducted in Queensland, Australia. A total of 382 first-generation young adult ME migrants, aged between 20 to 39 years, completed a self-administered questionnaire. To analyse data, a series of three hierarchical multiple regression (HMR) analyses were conducted, one for each of the subjective well-being components (i.e., positive affect, negative affect, and satisfaction with life). The interaction between perceived social support and perceived discrimination for the prediction of subjective well-being components was further explored using simple slope analysis. Results: Gender was found to be a significant predictor of positive and negative affect. Education was found to predict satisfaction with life, but not positive and negative affect. Married migrants were found to have significantly higher life satisfaction, positive affect and lower negative affect. Perceived social support had a moderating role in the association between perceived discrimination and subjective well-being. Conclusion: Considering the buffering role of perceived social support against the adverse effects of perceived discrimination on subjective well-being, organizations and individuals working with ME migrants should acknowledge the significance of social support and improve their capacity to deliver effective and appropriate social support services to migrants experiencing discrimination.
Relationship Between Gender, Stress, and Quality of Social Support
Authors: Kneavel Meredith 
Published: July 2020

Background Research suggests that gender differences exist in both stress and how social support is utilized and that the relationship between stress and social support may not be linear. Methods An internet survey of n = 1080 participants was conducted evaluating quality and quantity of social support, gender, age, and perceived stress and coping. Results Reported quality of social support, gender, and age significantly predicted perceived stress and that there was a curvilinear interaction between the quality of social support and gender which significantly predicted perceived stress. Conclusion The current findings supported Taylor’s Tend and Befriend theory that females have higher reported stress levels, a larger support network, and report more quality in their social support. Practitioner points:  • Males and females may manifest stress differently in their relationships. • When working with males and females in practice it may be important to understand the depth and breadth of their social networks and how they utilize those networks. • Females indicate higher levels of stress and greater social support quality. • It is important to understand that one’s social network can be an important source of support (a coping mechanism) but that it can also serve as a stressor in some cases.
Differential modulation of the contextual conditioned emotional response by CB1 and TRPV1 receptors in the ventromedial prefrontal cortex: Possible involvement of NMDA/nitric oxide-related mechanisms
Authors: Uliana Daniela L , Antero Leandro S , Borges-Assis Anna B , Rosa Jessica , Vila-Verde Carla , Lisboa Sabrina F , Resstel Leonardo BM 
Published: July 2020

Background: Blockade of cannabinoid CB1 or vanilloid TRPV1 receptors in the ventromedial prefrontal cortex of rats respectively increases or decreases the conditioned emotional response during re-exposure to a context previously paired with footshocks. Although these mechanisms are unknown, they may involve local modulation of glutamatergic and nitrergic signaling. Aim: We investigated whether these mechanisms are involved in the reported effects of CB1 and TRPV1 modulation in the ventromedial prefrontal cortex. Methods: Freezing behavior and autonomic parameters were recorded during the conditioned response expression. Results: The CB1 receptors antagonist NIDA, or the TRPV1 agonist capsaicin (CPS) in the ventromedial prefrontal cortex increased the conditioned emotional response expression, and these effects were prevented by TRPV1 and CB1 antagonism, respectively. The increased conditioned emotional response evoked by NIDA and CPS were prevented by an NMDA antagonist or a neuronal nitric oxide synthase inhibitor. A nitric oxide scavenger or a soluble guanylate cyclase inhibitor prevented only the NIDA effects and the CPS effect was prevented by a non-selective antioxidant drug, as nitric oxide can also induce reactive oxygen species production. Conclusion: Our results suggest that CB1 and TRPV1 receptors in the ventromedial prefrontal cortex differently modulate the expression of conditioned emotional response through glutamatergic and nitrergic mechanisms, although different pathways may be involved.
Rates of delirium associated with calcium channel blockers compared to diuretics, renin-angiotensin system agents and beta-blockers: An electronic health records network study
Authors: Harrison Paul J , Luciano Sierra , Colbourne Lucy 
Published: July 2020

Background: Antihypertensive drugs, especially calcium channel blockers, have been associated with differential rates of a number of neuropsychiatric outcomes. Delirium is commonly attributed to medication, including antihypertensive drugs, but delirium incidence has not been compared directly between antihypertensive drug classes. Methods: Using a federated electronic health records network of 25.5 million people aged 50 years or older, we measured rates of delirium over a two-year period in patients prescribed calcium channel blockers compared to the other main antihypertensive drug classes. Extensive propensity score matching was used to create cohorts matched for a range of demographic factors and delirium risk factors. Negative control outcomes were also measured. Results: Cohort sizes ranged from 54,000–577,000. Delirium was more common with calcium channel blockers than with renin-angiotensin system agents (~40% higher) but less common than with beta-blockers (~20% lower). These differences remained when patients with a range of other delirium risk factors were excluded, and they were not paralleled by the negative control outcomes. Comparisons between calcium channel blockers and diuretics produced inconclusive results. Conclusions: Calcium channel blockers are associated with higher rates of delirium than renin-angiotensin system agents, but lower rates compared to beta-blockers. The findings add to the list of factors which may be considered when choosing antihypertensive drug class.
Postoperative risk of pancreatic fistula after distal pancreatectomy with or without spleen preservation
Authors: Mazzola Michele , Crippa Jacopo , Bertoglio Camillo L. , Andreani Sara , Morini Lorenzo , Sfondrini Stefano , Ferrari Giovanni 
Published: July 2020

Introduction: Outcomes after distal pancreatectomy with or without splenectomy are controversial. The present study aims to investigate differences in short-term and long-term outcomes between spleen-preserving distal pancreatectomy (SPDP) and distal pancreatectomy with splenectomy (DPS). Methods: In this retrospective review of consecutive patients undergoing distal pancreatectomy with or without splenectomy from January 2011 until December 2017 for benign disease, the primary endpoint was to compare postoperative pancreatic fistula (POPF). The secondary endpoint was to compare duration of surgery, intraoperative blood loss, postoperative complications, length of hospital stay, and long-term outcomes. Results: Patients undergoing SPDP had a lower rate of POPF (13.6% vs 46.1%; p = 0.02). Patients undergoing SPDP (n = 22) were discharged earlier than patients undergoing DPS (n = 26) (8 [4–29] vs 12 [6.48] days; p = 0.003). No differences in other intraoperative and postoperative outcomes were found between groups. Conclusion: Patients undergoing SPDP developed fewer POPF and were discharged earlier compared to patients undergoing DPS.
HPV nonrelated endocervical adenocarcinoma in hereditary cancer syndromes
Authors: Carnevali Ileana , Di Lauro Eleonora , Pensotti Valeria , Sahnane Nora , Leoni Eleonora , Formenti Giorgio , Ghezzi Fabio , Sessa Fausto , Tibiletti Maria Grazia 
Published: July 2020

Introduction: The relationship between endocervical cancer and cancer susceptibility syndromes is not yet fully understood. We present 2 cases of endocervical cancer: 1 arising in a patient carrier with a pathogenic BRCA1 variant and the second detected in a Lynch syndrome family carrying the MSH2 germline pathogenic variant. Case description: Somatic analyses including loss of heterozygosity and fluorescent in situ hybridization demonstrated that the second hit in patient 1 is BRCA1-related. Mismatch repair somatic analyses in the second family demonstrated that the endocervical cancers of patient 2 and of her sister are MSH2-related. These data confirm the relationship between the pathogenesis of endocervical cancer and the presence of germline BRCA1 and MSH2 mutations. Conclusions: Our study confirms that gynecologic cancers including rare entities such as non–human papillomavirus–related endocervical cancer (NHPVA) are sentinels for inherited cancer syndromes. Endocervical cancer NHPVAs might be considered for cancer genetic counseling in order to improve cancer prevention. For this reason, the role of pathologists is particularly important for the correct identification of the cervical tumor site.
The influence of friendship on migraine in young adolescents: A social network analysis
Authors: Pan Yi-Ju , Chen Yu-Chun , Lu Shiang-Ru , Juang Kai-Dih , Chen Shih-Pin , Wang Yen-Feng , Fuh Jong-Ling , Wang Shuu-Jiun 
Published: July 2020

Objective The current study explored whether the chances of having migraine are influenced by a youth’s friendship with a migraineur. Methods The study was centered on a community-based non-referral cohort of eighth graders from two middle schools in Taiwan. Among the 642 recruited adolescent students, 610 (95%) (mean age 14.1 years, male ratio 51.2%) nominated three good friends and completed a validated headache questionnaire for migraine diagnosis at the follow-up survey 1 year later. To explore social influences on incident migraine, we used longitudinal statistical models to examine whether the development of migraine in one adolescent during the 1-year observational period was associated with that in his/her friends. Results Overall, 1700 social ties were established in the social network based on the reported lists of good friends. Randomization test for the homophily effect demonstrated that the students with migraine tended to cluster together in the social network even when those with incident migraine were also considered ( p = 0.003). Besides, when friendship choices were mutual, the relative risk of an adolescent becoming a migraineur was 3.26 (95% CI: 1.25–8.47, p = 0.015) if his/her friend became a migraineur (induction) during the 1-year observational period. Conclusion To the best of our knowledge, this is the first study to demonstrate that migraine may spread through social networks in young adolescents. Both homophily and induction effects are possibly contributory.
Association of MBL-2 gene polymorphisms with systemic lupus erythematosus: an updated meta-analysis and trial sequential analysis
Authors: Mahto Harishankar , Pati Abhijit , Sahu Sushil K , Sharma Hanuman Prasad , Padhi Archana , Panda Aditya K 
Published: July 2020

Objectives Mannose-binding lectin (MBL), an essential innate immune molecule, enhances the opsonization process and activates the complement system. Genetic variations at the promoter and coding region of the MBL-2 gene have been associated with susceptibility to systemic lupus erythematosus (SLE); however, reports remained inconsistent. The present study performs a meta-analysis of published peer-reviewed articles to draw a definitive conclusion. Materials and Methods Published peer-reviewed articles on the association of MBL-2 gene polymorphisms and SLE were screened on various databases such as PubMed (Medline), ScienceDirect, and Google Scholar. A total of 23 eligible articles were included in the present study, comprising 3074 SLE patients and 3985 controls. Genotype and/or allele data for MBL-2 polymorphisms (A > B, A > C, A > D, A > O, Y > X and H > L) were extracted and analyzed by Comprehensive Meta-Analysis software (CMA V3.1). Results The overall analysis revealed a significant association of MBL-2 (A > O) polymorphism with a predisposition to SLE in allele contrast ( p = 0.000; OR = 1.261), homozygous ( p = 0.005; OR = 1.482), heterozygous ( p = 0.004; OR = 1.247), dominant ( p = 0.000; OR = 1.303) and recessive ( p = 0.025; OR = 1.356) genetic comparison model. Similar results were also observed in the comparison of allele and the dominant genetic model of MBL-2 (A > B) polymorphism in overall (allele: p = 0.000, OR = 1.46, dominant: p = 0.001, OR = 1.31) and in the Asian cohorts (allele: p = 0.007, OR = 1.43, dominant: p = 0.008, OR = 1.32). Interestingly, MBL-2 (Y-221X) polymorphism exhibited protection against the development of SLE in heterozygous ( p = 0.005, OR = 0.619) and dominant genetic comparison ( p = 0.01, OR = 0.672) models. Conclusions MBL-2 variants (A > O and A > B) are associated with predisposition to SLE. Conversely, promoter polymorphism (Y-221X) offers protection against SLE development.
Infections in hospitalized children with newly diagnosed systemic lupus erythematosus in underresourced areas
Authors: Rianthavorn Pornpimol , Prurapark Pattareeya 
Published: July 2020

Background The administration of induction immunosuppressive therapy to children with newly diagnosed systemic lupus erythematosus (SLE) and concurrent infections can lead to unfavourable outcomes. This study was conducted to describe characteristics of infections occurring before the initiation of immunosuppressants in hospitalized children with newly diagnosed SLE in underresourced areas. Methods Medical records of paediatric patients with the diagnosis of SLE, who were admitted to a university-based hospital from 2002 to 2018, were reviewed. Only patients younger than 18 years of age with newly diagnosed SLE were included in the study. The primary outcome was infection before the administration of immunosuppressants. Logistic regression analysis was used to determine factors associated with infection and adjusted odds ratio (OR). The diagnostic accuracy of CRP was assessed. Results Infections were confirmed in 52/124 (41.9%) children. Pathogens were identified in 24 (46.2%) patients with bacterial predominance. The most common site was respiratory infections (36.5%). Fever and serosal involvement were more prevalent in patients with infection. Serum CRP levels were significantly higher in patients with infection than in those without infection (median 5.5 mg/L (interquartile range (IQR) 3.6–76.3 mg/L) vs. 3.5 mg/L (IQR 3.0–3.6 mg/L), p = 0.004). When a positive CRP level of >5 mg/L was used, positive CRP was found with a higher prevalence in patients with infection and was independently associated with infection (adjusted odds ratio (OR) = 28.6, 95% confidence interval (CI) 2.3–350.6; p = 0.009). Patients with infection had a longer hospital stay than patients without infection (median 20 days (IQR 13–25 days) vs. 15 days (IQR 9–24 days), p = 0.04). Sensitivity, specificity, positive predictive value and negative predictive value with 95% CI of CRP >5 mg/L were 62.5% (35.4–84.8%), 88.9% (65.3–98.6%), 80.3% (51.0–94.1%) and 76.6% (63.1–86.3%), respectively. Conclusions Infections were common among hospitalized children with newly diagnosed SLE. Children with infections had a prolonged course of hospitalization. Positive CRP was associated with a predisposition towards infection. However, the diagnostic accuracy of CRP requires further validation in a larger study.
Matrix-Induced Autologous Chondrocyte Implantation (MACI) Grafting for Osteochondral Lesions of the Talus
Authors: Lenz Christopher G. , Tan Shu , Carey Andrew L. , Ang Kaenson , Schneider Timothy 
Published: July 2020

Background: Matrix-induced autologous chondrocyte implantation (MACI) is an established treatment method for larger joints and has shown promising results in the ankle as well. We present a series of patients after ankle MACI with long-term follow-up of clinical and radiological outcomes. Methods: We present the follow-up of 15 patients who underwent MACI grafting from August 2003 to February 2006. The mean follow-up was 12.9 years. Clinical evaluations were conducted using the American Orthopaedic Foot & Ankle Society (AOFAS), Foot and Ankle Activity Measurement (FAAM), and visual analog scale (VAS) scoring systems and the magnetic resonance observation of cartilage repair tissue (MOCART) scoring system for radiological evaluation. Results: The mean size of the talar osteochondral defects was 204 mm2. We found a significant improvement in mean AOFAS score from 60 preoperatively to a mean of 84 at 12 years postoperatively. The 12-year FAAM score for Activities of Daily Living was 89% (range, 62%-99%). The mean 12-year MOCART score was 65 points (range, 30-100 points) with significant agreement between assessors ( P < .001). However, the MOCART scores did not correlate with the FAAM scores ( P = .86). Conclusion: Considering our long-term follow-up, we believe MACI is a reliable treatment method for talar osteochondral defects providing lasting pain relief and satisfying clinical results. However, with an equivalent outcome, but at higher costs, and the requirement for 2 operative procedures, the results do not seem to be superior to other established methods. The clinical utility of the MOCART score requires further scrutiny since we were not able to show any correlation between the score and clinical outcome. Level of Evidence: Level IV, case series.
The Virtual Foot and Ankle Physical Examination
Authors: Eble Stephanie K. , Hansen Oliver B. , Ellis Scott J. , Drakos Mark C. 
Published: July 2020

The COVID-19 pandemic has necessitated a rapid and drastic shift for clinicians and patients away from traditional in-person visits and toward internet-based virtual visits. The adoption of telehealth services is likely to persist in some capacity even as in-person visits resume, given the convenience and efficiency of telehealth consultations for patients and perhaps surgeons. A primary challenge of virtual visits, particularly in the field of orthopedic surgery, is the physical examination. However, for the foot and ankle, routine physical examination maneuvers can be completed virtually with little modification given proper patient instruction. We present a comprehensive virtual foot and ankle examination for telehealth visits, including instructions that can be provided to patients verbatim and a corresponding checklist for provider documentation. Level of Evidence: Level V, expert opinion.
Successful oxaliplatin desensitization protocol in a patient with colorectal metastatic cancer
Authors: de Lira-Quezada Cindy E. , Villarreal-Gonzalez Rosalaura V. , Gonzalez-Diaz Sandra N. , Carrasco-Diaz Ligia L. 
Published: July 2020

Introduction Platinum compounds are frequently used for the treatment of colorectal cancer as initial chemotherapy. Oxaliplatin is a third-generation platinum used for the treatment of stage III colorectal cancer and is associated with hypersensitivity reactions. The incidence of hypersensitivity reaction is approximately 12%, with 1–2% of patients developing moderate to severe reactions. Case report A 54-year-old male patient with stage III B colon cancer was diagnosed and chemotherapy with oxaliplatin was indicated by the oncology service. Within 20 min of the first cycle of oxaliplatin, he developed dyspnea, laryngeal spam, foreign body sensation in the throat, nausea, and diarrhea; therefore, the infusion of oxaliplatin was suspended, and intramuscular epinephrine was administered and intravenous hydrocortisone along with chlorpheniramine with adequate resolution of symptoms. Management and outcome: Intradermal skin test performed at the concentration of 5 mg/ml (dilution 1:100) was positive. Due to the symptoms presented we decided to perform desensitization to oxaliplatin (total dose: 250 mg) with three bags–12 steps protocol with an initial concentration dose of 1/100 of the total dose in a course of 5.56 h with no hypersensitivity reactions. Discussion Approximately 50% of patients who are exposed to oxaliplatin may have hypersensitivity despite premedication. Desensitization protocol induces tolerance to a drug temporarily and is dependent on continuous exposure.