bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sleep During Pelvic-Abdominal Radiotherapy for Cancer
Authors: Blom Kerstin , Efverman Anna 
Published: May 2020

BackgroundPoor sleep, nausea, psychological distress, and a lowered quality of life are common during radiotherapy for cancer. There is a lack of studies on the relationship between radiotherapy-induced nausea and sleep. This longitudinal study analyzes data from 196 patients who underwent pelvic-abdominal radiotherapy for cancer.ObjectiveThe aim of this study was to investigate sleep parameters weekly before, during, and after radiotherapy in relation to nausea and other patient characteristics, clinical characteristics, psychological distress, and quality of life.MethodsPatients (n = 196, 84% women; mean age, 63 years; 68% had gynecological tumor, 28% had colorectal tumor, and 4% had other tumors) longitudinally answered questionnaires before, during, and after their radiotherapy over the abdominal and pelvic fields.ResultsPoor sleep was experienced by 30% of the participants, and sleep (quality and difficulty falling asleep) improved during and after treatment compared with baseline. Experiencing nausea during treatment was associated with worse sleep quality during radiotherapy. Baseline anxiety was associated with worse sleep quality before, during, and after treatment. Poor sleep was associated with worse quality of life.ConclusionNausea, more than a number of other variables, is a possible predictor of poor sleep in patients during radiotherapy for cancer.Implications for PracticeThe results indicate that effectively managing nausea may be important for sleep quality, and possibly quality of life, in patients undergoing radiotherapy for cancer. More research is needed before recommendations for practice can be made.
18F-FDG PET/CT in Follicular Dendritic Cell Sarcoma With Paraneoplastic Pemphigus as the First Manifestation
Authors: Chen Xueqi , Fu Zhanli , Yang Xing , Li Qian 
Published: May 2020

Abstract
A 48-year-old woman presented with refractory oral ulcers and skin rashes on the palms and trunk, diagnosed as paraneoplastic pemphigus. The chest x-ray revealed a mass in the right lower chest, and the 18F-FDG PET/CT scan showed the lesion in the right anterior-inferior mediastinum with intense 18F-FDG uptake, accompanied by right parasternal adenopathy and pleural effusion. The surgical pathology proved a follicular dendritic cell sarcoma, with right parasternal lymph node metastasis.
Maxillofacial Trauma Surgery Patients With Titanium Osteosynthesis Miniplates: Remove or Not?
Authors: Sukegawa Shintaro , Masui Masanori , Sukegawa-Takahashi Yuka , Nakano Keisuke , Takabatake Kiyofumi , Kawai Hotaka , Nagatsuka Hitoshi , Furuki Yoshihiko 
Published: May 2020

Abstract
The authors examined the timing and causes of titanium miniplate removal after maxillofacial trauma surgery. The authors performed a retrospective study of maxillofacial fracture patients in whom maxillofacial osteosynthesis miniplates were inserted or removed at the Kagawa Prefectural Central Hospital, between 2008 and 2017. Predictive variables were age, sex, fracture site distribution, and time to miniplate removal with or without complications in relation to primary outcome variables. Among 185 patients, 440 miniplates were inserted and 272 miniplates were removed. In total, 116 patients (73.4%) had 282 miniplates (64.1%) removed, of which 4.8% fracture sites and 5.7% miniplates were removed because of complications. The mean time to miniplate removal was 630.9 and 258.0 days in patients with and without complications, respectively. There was a statistically significant difference in miniplate removal and miniplate retention relative to age and sex. This difference was not related to the presence or absence of sex- or age-related complications. The miniplates as osteosynthesis material were safe and useful for a long period of time with relatively few complications. Because complications requiring miniplate removal occurred within 1 or after 5 years postoperatively, osteosynthesis miniplate treatments should be decided while considering the patient's age and sex. Long-term follow-up is recommended for miniplates that remain implanted for >1 year.
Adipose Tissue Grafting Improves Contour Deformities Related Hyperpigmentation of Face
Authors: Bashir Afzaal , Bashir Muhammad Mustehsan , Sohail Muhammad , Choudhery Mahmood S. 
Published: May 2020

Abstract
Contour deformities of face are commonly associated with overlying skin hyperpigmentation. Such hyperpigmentation causes aesthetic problems as well as makes contour deformities more prominent. Conventional surgical and cosmetic approaches to treat hyperpigmentation have limitations and therefore it is imperative to use other innovative techniques to simultaneously heal the contour deformity and also to remove hyperpigmentation. The current study aims to evaluate the effect of autologous adipose tissue in improving contour deformities related hyperpigmentation of face. One hundred patients with contour deformities related hyper-pigmentation of overlying skin were enrolled from February 2017 to January 2018. Adipose tissue was harvested from each patient and processed under sterilized conditions. Purified fat collected in a 10cc Luer-Lok syringe was transferred to 1cc syringes and injected into affected areas of face. The patients were followed for 12 months after adipose tissue injections. Both subjective and objective assessment was performed before treatment and 12 months after adipose tissue injections. Results indicated that after adipose tissue grafting, there was a statistically significant improvement in hyperpigmentation of skin. Most of the patients were highly satisfied after use of adipose tissue injections. Image J scanning also showed significant changes in hyperpigmentation of face after adipose tissue use. In all parameters, the patient exhibited statistically significant improvement. In conclusion, autologous fat grafting is a promising and effective therapeutic approach for hyperpigmentation associated with contour deformities of face.
Occlusal Analysis Using T-Scan in Patients With Condylar Fractures When Managed by Closed Method
Authors: Syed Irfon , Joshi Abhijit , Desai Anil Kumar , Anehosur Venkatesh 
Published: May 2020

Abstract
The aim of the study is to assess the occlusion in mandibular condyle fractures using T-Scan and analyze the data obtained. Twenty patients underwent non-surgical management for condylar fractures were treated with Erich arch bar and guiding elastics, and periodically subjected to T-Scan III evaluations. The data obtained was analyzed with the clinical evaluation conducted. There were 18 males and 2 females. Mean age of the patients was 25.4 ± 7.4 years. There were statistically no significant changes in Centre of Force values, in Bite Force at First Contact (P < 0.05) during the study period. There were significant differences in Maximum Bite Force between preoperative and postoperative values, preoperative and sixth-month values, postoperative and first-month values, first-month and sixth-month values. There were significant (P < 0.05) differences in Bite Force at Maximum Intercuspation between preoperative and third month, preoperative and sixth-month values, postoperative and sixth-month values, first-month and consequent follow-ups. Subjective evaluation of occlusion revealed significant differences (P < 0.05) between preoperative and 1-month, preoperative and postoperative, postoperative and 1-month values. All patients improved by the end of 6 months with regards to their mouth opening. The center of force does not alter significantly in post trauma period. Mouth opening improves significantly at the end of 6-month period post-operative. Improvement in maximum bite force and maximum intercuspation take place simultaneously. Mouth opening improved significantly. Subjective evaluation of occlusion does not change significantly after the third month evaluation. Longer follow-ups would help us in understanding when or if the bite forces equilibrate after a condylar trauma.
Modified Tragus Edge and Transmasseteric Anteroparotid Approach for Intracapsular and Condylar Neck Fractures
Authors: Tang Mengying , Wang Lang , Zhang Maorui , Sun Libo , Fu Guangxin , Xiao Jingang 
Published: May 2020

Abstract
The aim of this study was to evaluate the effects of protecting the facial nerve and reducing the scar visibility using a modified tragus edge and transmasseteric anteroparotid approach compared to classic preauricular approach for intracapsular and condylar neck fractures. This retrospective study included 64 patients (78 sides) who underwent surgical treatment for intracapsular or condylar neck fractures from January 2014 to June 2018. Patients were divided into the experimental group (treated via a modified tragus edge and transmasseteric anteroparotid approach), and the control group (treated via the classical preauricular approach). Therapeutic outcome assessment parameters included facial nerve injury, salivary fistulae, wound infection, restricted mouth opening, postoperative occlusion disorders, and scar visibility. In the control group, there were 3 cases of facial nerve injuries and 2 cases of salivary fistulae. One case of temporary facial nerve injury occurred in the experimental group, with complete recovery within 1 month. The scars were less visible in the experimental group than in the control group. These results suggest that a modified tragus edge and transmasseteric anteroparotid approach reduced the incidences of facial nerve injuries, minimized the scar visibility, improved exposure of the operative site and fixation of titanium screws or plates, and did not increase the frequency of other complications.
Nonoperative Molding of Congenital Ear Deformities: The Impact of Birth-Initiation Delay on Correction Outcome
Authors: Nigam Manas , Kotha Vikas S. , Barra Christina , Baker Stephen B. 
Published: May 2020

Abstract
Ear molding can improve the majority congenital ear deformities when employed early after birth. However, the best time to initiate treatment remains debated. In describing one surgeon's experience over the past near decade, this study aims to highlight differences conferred by treatment timing. The authors hypothesize that auricular outcomes are superior when deformities are molded beginning in the first 3 weeks of life. A retrospective review (2010–2018) of 272 cases was performed to compare early initiation of molding (<3 weeks of birth) and delayed initiation (>3 weeks). The mean patient age was 20.4 days and the mean follow-up was 0.5 months. The overall treatment was approximately 31 days. The number of devices required was similar (2.3 versus 2.5) between early and delayed molding cases, but fall-outs (1.0 versus 0.7, P = 0.02) and replacements (0.9 versus 0.6, P = 0.004) were more common after delayed molding. Skin complications developed in 13.6% (37) of ears overall and did not differ by treatment timing. Follow-up surgery was reported in 2 (0.7%) ears. The 85% of families reported subjective satisfaction with the final outcome; satisfaction was significantly higher for early cases (97% versus 79%, P = 0.03). Ear molding of congenital ear deformities should begin within 3 weeks of birth. From our experience, setting realistic expectations helps limit discrepancies between expectation and outcome.
Bilateral Tuberculous Otitis: A Furtive Middle Ear Infection
Authors: Apostol Anda , Grigoreanu Emanuela , Fetica Bogdan , Albu Silviu 
Published: May 2020

Abstract
Tuberculosis is a highly challenging infectious disease that remains an important health issue, not only in developing countries, but also globally, since new cases of atypical tuberculosis resurface. Even though the global incidence of tuberculosis is on the rise, otologic manifestations of this pathology are a rare encounter for the ear nose and throat specialist, and bilateral localization is exceptional. Due to the numerous non-specific signs and symptoms of the condition and continuous genetic evolution of Mycobacterium, the diagnosis requires deep knowledge and fortuitous suspicion. The authors report a rare case of bilateral tuberculous otitis. What makes this case stand out is the fulminant, bilateral debut of the disease in an immunocompetent patient, with unknown primary infection and the knowledgeable course of clinical diagnosis.
Alloplastic Auricular Reconstruction: Review of Implant Types, Adverse Events, and Aesthetic Outcomes
Authors: Oliver Jeremie D. , Rodriguez Daniel , Scott Derek , Santosa Katherine B. , Hu Michael S. 
Published: May 2020

Importance:
Alloplastic implants have been applied successfully in reconstruction of the external ear, either for congenital microtia or traumatic injury.

Objective:
The objective of this study was to conduct a comprehensive systematic review of alloplastic implant materials utilized in the reconstruction of the external ear stratified by indication, specific implant type, postoperative complications, and aesthetic outcomes.

Evidence Review:
A comprehensive systematic review of published literature on alloplastic external ear reconstruction data was conducted utilizing Medline/PubMed database without timeframe limitations in June 2019. Articles were stratified by (1) indication (microtia versus trauma reconstruction) and (2) implant material type. All postoperative complications were recorded and comparatively analyzed between implant types. Aesthetic outcomes were also identified and compared between implant types.

Findings:
A total of 755 patients (14 case series; follow-up range = 3 months--10 years) met the criteria for this study. Overall complication rate was 12.05% across all indications and materials used. The most frequent complications reported were graft exposure (7.8%), graft explantation (1.72%), and wound dehiscence (0.8%). Of the patients requiring graft explantation (n = 13), 7 (53.85%) received Medpor implants, and the other 6 (46.15%) were identified in silicone implants. Infection was only reported in Medpor implants. The overall rate of an acceptable aesthetic outcome was 99.34%.

Conclusions and Relevance:
Alloplastic implants are a reliable means of achieving an acceptable complication profile in external ear reconstruction. While there was an overall high rate of acceptable aesthetic outcomes, the studies evaluated in this systematic review differed in their criteria for final evaluation of aesthetic outcomes.
Anesthetic and Analgesic Efficient of Regional Nerve Blockade in Otoplasty
Authors: Kepekçi Ali Bestemi , Kepekçi Ahmet Hamdi 
Published: May 2020

Aim:
The prominent ear is the most common congenital deformity of the external ear. Otoplasty is performed to correct the appearance of the prominent ear. This study was planned to compare the analgesic and anesthetic effects of local nerve blockade and local infiltration anesthesia in the otoplasties.

Method:
Thirty-two patients who underwent otoplasty in both ears between February 2018 and March 2019 were included in the study. Three patients were excluded because they refused regional anesthesia. In the patients included in the study, only local infiltration anesthesia was applied to 1 ear and regional nerve blockade was applied to the other ear. Regional nerve blockade was applied to the study group; local infiltration anesthesia was applied to the control group. Surgical and anesthetic complications were recorded. The onset time, duration and severity of pain were followed. Numerical evaluation scale scores were used to evaluate pain levels.

Results:
It was observed that the first pain of the patients On the side where regional nerve block (RNB) anesthesia was applied after an average of 10.5 hours. On the other hand on the side where local infiltration anesthesia was applied; the pain was observed to start after an average of 3.5 hours. At the 6th and 12th hours postoperatively, the scores of the numerical evaluation scale were significantly lower in the study group than the control group (P < 0.05). At the 24th-hour pain score, the values were lower in the study group, but the difference was not significant between the groups (P > 0.05). In the regional anesthesia group, can develop such as difficulty in swallowing, weakness in the neck, weakness in the upper extremity, nausea, Horner syndrome; but all side effects resolve spontaneously within 6 to 12 hours.

Conclusion:
The application of regional anesthesia in prominent ear surgical procedures can be considered as an alternative method to provide better quality preoperative anesthesia and better quality postoperative analgesia in patients.
Anti-gamma-aminobutyric acid receptor type A encephalitis: a review
Authors: Guo Chu-Yueh , Gelfand Jeffrey M. , Geschwind Michael D. 
Published: May 2020

Purpose of review
To systematically review the clinical features, diagnosis, and management of anti-gamma-aminobutyric acid receptor Type A (GABAA) autoimmune encephalitis with a focus on recent data.

Recent findings
In a review of published reports, we identified 50 cases of anti-GABAA receptor encephalitis with clinical features reported. The median age at presentation was 47 years old (range, 2.5 months–88 years old), 64% were adults, 36% were children and it occurred in both males and females. Eight-two percent (41/50) presented with seizures, 72% (36/50) with encephalopathy, and 58% (29/50) with both. Of those presenting with seizures, 42% developed status epilepticus during their disease course. Ninety-six percent (48/50) had MRI results reported, with 83% of these cases having abnormal findings, most commonly multifocal/diffuse cortical and subcortical T2/FLAIR hyperintense lesions without associated gadolinium enhancement. Almost one-third, 28% (14/50), had an associated malignancy detected by the time of diagnosis, 64% (9/14) of which was thymoma. Of 44 patients with outcomes reported, 80% had partial or complete recovery, whereas 20% had poor outcomes including 11% (5/44) who died. Of the 42 patients with type of treatment(s) and outcomes reported, 54% (23/42) received only first-line immunotherapy and 31% (13/42) received first-line and second-line immunotherapy. Receiving a combination of first-line and second-line immunotherapy may be associated with higher likelihood of complete recovery. When follow-up MRIs were reported, all showed improvement, and sometimes complete resolution, of T2/FLAIR hyperintensities.

Summary
Anti-GABAA receptor encephalitis can present across the age spectrum and should be considered in patients who present with rapidly progressive encephalopathy and/or seizures. Brain MRI often shows a distinctive pattern of multifocal cortical and subcortical T2/FLAIR hyperintense lesions, generally not typical of other known central nervous system autoantibody associated encephalitis syndromes. High clinical suspicion and early diagnosis are important given the potential for clinical improvement with immunotherapy.
Prevention and management of adverse effects of disease modifying treatments in multiple sclerosis
Authors: Moiola Lucia , Rommer Paulus S. , Zettl Uwe K. 
Published: May 2020

Purpose of review
To summarize the currently known side effects of the approved therapies of multiple sclerosis and to suggest monitoring procedures.

Recent findings
The progress in the treatment of multiple sclerosis with new very effective therapies is accompanied by a number of side effects. Some of these have already been described in the approval studies, but some only after approval in a real world situation. The reason for this is the short duration of the clinical studies, the very heterogeneous patient profile in the real world setting with a number of comorbidities, pretherapies, and wider age range. The side effects may occur during application of therapies or afterwards during the course of the treatment. The side effects may range from mild infections, mild laboratory abnormalities, secondary autoimmune diseases to life-threatening side effects such as progressive multifocal leukoencephalopathy.

Summary
It has to be pointed out that these side effects are not to be considered as final and neurologists should be vigilant against new unknown side effects. The doctor should be aware of these undesirable effects, should weigh the benefits of the therapies against the risks, but at the same time she/he should keep in mind that multiple sclerosis can be a very disabling disease if not treated properly.
National and state wise estimate of time varying reproduction number for COVID-19 in India during the nationwide lockdown
Authors: Venkatesan Padmanaban 
Published: May 2020

AbstractTo understand the effect of nationwide lockdown on transmissibilty of SARS-CoV-2 in India, time varying reproduction number during the first weeks of April, 2020 was estimated. The time varying reproduction number was estimated using EpiEstim package in R programming language. The reproduction number has come down significantly during the lockdown period both at national level and in most states but it wasn’t reduced to less than 1. This calls for urgent need for more effective control measures in addition to lockdown to stop the epidemic spread of the virus.
Does BCG protect against SARS-CoV-2 infection ?: elements of proof
Authors: Ouanes Yassine , Bibi Mokhtar , Baradai Nesrine , Boukhris Marouane , Chaker Kays , Kacem Aziz , Hedhli Houcem , Deli Kheireddine Mrad , Sellami Ahmed , Rhouma Sami Ben , Nouira Yassine 
Published: May 2020

ABSTRACTBackgroundThere are several factors explaining the difference in the spread of SARS-CoV-2 infection including the BCG vaccination. This fact is supported by the concept of beneficial non specific effect of this live vaccine associated to its interaction with the immune system.Our study aims to identify the correlation between the universal BCG vaccination policy and the mortality attributed to COVID-19.MethodsWe conducted an epidemiological study in which we collected COVID-19 pandemic data of April 11th, 2020 from the web site worldometers.info. The exclusion criteria for our study were a number of inhabitants less than one million, low-income countries according to the World Bank classification, a total number of infection cases less than 500 and countries that have performed less than one hundred tests per million inhabitants.ResultsCountries that never had universal BCG vaccination policy have a higher mortality (correlated to performed diagnostic tests) attributed to SARS-CoV-2 infection (p<0.001).We found that the year of introduction of vaccination influenced significantly the mortality. Countries that started immunization policy before 1960 had more favorable results (p=0.049).For countries that started the BCG vaccination after 1960, countries with current policies have lower mortality attributed to SARS-CoV-2 infection than countries that have stopped immunization (p=0.047).ConclusionsCountries that have a BCG vaccination policy have a lower mortality attributed to SARS-CoV-2 infection. The populations of countries that applied this immunization before 1960 are more protected even if this universal policy has been interrupted.