bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of Chronic Ankle Instability in French Paratroopers
Authors: Schmitt Marion , Marchi Joffrey , Jouvion Arnaud , Trappier Thomas , Reyes-Rivet Lisa , De Brier Gratiane , Thefenne Laurent 
Published: December 2019

AbstractIntroductionAnkle sprain is the most common musculoskeletal injury in the physically active population (up to 50% of sports injuries) and is common in the general population with about one ankle sprain per 10 000 person-days worldwide. It is an even more frequent pathology in the military population with a prevalence of five to eight times higher than in the civilian population. In the general population, 20 to 74% of sprains are complicated by chronic ankle instability. No studies estimate this prevalence in a French military population. The main objective of our study was, therefore, to estimate the prevalence of chronic ankle instability in French paratroopers.Materials and MethodsThe study was carried out in a French parachute regiment over a period of 1 year during periodic medical examinations. To diagnose chronic ankle instability, we used the criteria defined by the International Ankle Consortium in 2013 and two questionnaires that this consortium recommended (FAAM and IdFAI).ResultsChronic ankle instability has a prevalence of 43.1% after an ankle sprain with a total of 2.3% among paratroopers, which is comparable to data in the literature. After their first sprain, 23.1% of subjects did not consult a health professional and 47.6% of subjects did not receive physiotherapy.ConclusionsPhysiotherapy is the basis of care, both for prevention and treatment of chronic ankle instability. It is necessary to raise awareness of this injury among the military and to encourage their adherence to treatment in order to preserve the operational capabilities of combat units. Subsequently, further studies are needed to expand the study population to provide a more comprehensive view of the impact of this injury on the military. Studies concerning the management of chronic ankle instability adapted to the military population would also be relevant.
Le dépistage et la prise en charge des nouveau-nés à risque d’hypoglycémie
Authors: Narvey Michael R , Marks Seth D 
Published: December 2019

RésuméL’hypoglycémie entre les premières heures et les premiers jours suivant la naissance demeure l’une des principales affections qu’observent les praticiens du Canada qui s’occupent de nouveau-nés. Bien des cas vivent une transition physiologique normale à la vie extra-utérine, mais un groupe présente une hypoglycémie pendant une plus longue période. Le présent document de principes expose les principaux enjeux auxquels sont exposés les dispensateurs de soins néonatals, y compris la définition d’hypoglycémie, les facteurs de risque, les protocoles de dépistage, les valeurs de glycémie nécessitant une intervention et la gestion des soins pour cette affection. Les auteurs passent en revue le dépistage, la surveillance et les protocoles d’intervention pour mieux distinguer, prendre en charge et traiter les nouveau-nés à risque d’hypoglycémie persistante, récurrente ou marquée. Ils abordent également le rôle des gels de dextrose pour accroître la glycémie ou prévenir une hypoglycémie plus persistante, de même que les précautions à prendre pour réduire les risques de récurrence après le congé de l’hôpital. Le présent document de principes distingue les approches des soins de l’hypoglycémie pendant la « phase de transition » (les 72 premières heures de vie) de celles de l’hypoglycémie persistante, qui se manifeste ou est constatée pour la première fois après cette période.
Les changements climatiques mondiaux et la santé des enfants canadiens
Authors: Buka Irena , Shea Katherine M 
Published: December 2019

Abstract
Les changements climatiques sont une réalité. De nombreuses autorités insistent sur la nécessité de déployer et d’adapter les efforts environnementaux en vue de protéger la santé des êtres humains. Les changements climatiques s’accélèrent, et les pays situés à des latitudes élevées, comme le Canada, les subissent de manière plus directe. De plus, certains paramètres sont plus spectaculaires que dans les pays situés à des latitudes moyennes ou faibles. Les enfants sont vulnérables aux effets des changements climatiques sur la santé, et les médecins et autres dispensateurs de soins doivent être prêts à en détecter, en gérer et en prévenir les dangers. Le présent point de pratique fait ressortir certaines menaces précises des changements climatiques sur la santé des enfants et des adolescents et fournit des ressources pour les professionnels de la santé. Les défis climatiques et leurs effets sur la santé des enfants sont décrits en tenant compte de rapports canadiens importants et d’information prouvée scientifiquement. S’ils connaissent mieux les effets immédiats et à long terme des changements climatiques sur la santé des enfants, les médecins et les autres dispensateurs de soins pourront conseiller les familles et mener leur pratique avec plus d’efficacité.
CLINICAL CHARACTERISTICS AND OUTCOME OF POSTERIOR CYSTOID MACULAR DEGENERATION IN CHRONIC CENTRAL SEROUS CHORIORETINOPATHY
Authors: Mohabati Danial , Hoyng Carel B. , Yzer Suzanne , Boon Camiel J. F. 
Published: December 2019

Purpose:
To assess clinical characteristics and visual outcome in chronic central serous chorioretinopathy patients with posterior cystoid retinal degeneration (PCRD).

Methods:
Patients' medical records were reviewed retrospectively in 62 cases (83 eyes, mean age = 59 years, 88% male). Data were collected at central serous chorioretinopathy diagnosis, at PCRD manifestation, and at final visit. All treatment modalities were reviewed. Main outcome measures were treatment efficacy in achieving PCRD resolution, and final best-corrected visual acuity.

Results:
In 63 eyes (76%), subretinal fluid was present at first PCRD manifestation, whereas fluorescein angiography showed active focal or diffuse leakage in 65 eyes (78%). Seventy-six eyes (81%) received treatment, and PCRD had resolved completely in 31 eyes (37%) at the final visit. Photodynamic therapy was most successful in achieving a complete PCRD resolution. Best-corrected visual acuity did not improve, even after complete PCRD resolution (mean baseline best corrected visual acuity = 69 ± 19, and mean final best corrected visual acuity = 67 ± 20 ETDRS letters [20/40 and 20/50 in Snellen equivalent respectively], P = 0.354).

Conclusion:
Posterior cystoid retinal degeneration is a relatively common finding in chronic central serous chorioretinopathy, which is often accompanied by active subretinal fluid leakage. Treatment may be beneficial to stop the subretinal fluid leakage component, but is less likely to result in a complete PCRD resolution and/or a best-corrected visual acuity improvement.
Comparison of Neuroborreliosis Between Children and Adults
Authors: Krawczuk Katarzyna , Czupryna Piotr , Pancewicz Sławomir , Ołdak Elżbieta , Król Monika , Moniuszko-Malinowska Anna 
Published: December 2019

Background:
Lyme neuroborreliosis (NB) is a tick-borne infectious disorder of the nervous system caused by Borrelia burgdorferi spirochetes. There are not many data available regarding the differences in the course of NB in children and adults. The aim of our study was to compare the clinical course of NB between children and adults.

Methods:
Retrospective analysis of medical documentation of 181 patients with NB was performed. The patients were divided into 2 groups: Group I: 57 children with NB; Group II: 124 adults with NB. Medical data, such as patients’ age, sex, place of living (residence), time from a tick bite, subjective complaints, general examination results, laboratory parameters and treatment were analyzed.

Results:
In children, the most common symptoms were headache (89.5%), neck stiffness (64.9%) and nausea and vomiting (56.1%). In adults, the most common symptoms were headache (77.4%), facial nerve palsy (59.7%), neck stiffness (59.7%), vertigo (41.9%) and lumbosacral region pain (37.1%). Bannwarth’s syndrome was observed in 10.5% of children and 36.3% of adults. In cerebrospinal fluid (CSF) in children, the pleocytosis at admission was higher than in adults, but protein concentration was significantly lower. There were no differences in percentage of mononuclear cells in CSF smear between the groups. In CSF examination after treatment, a decrease in pleocytosis and protein concentration was observed in both groups. Analysis of effectiveness of treatment mostly with third generation cephalosporins (defined as complete recovery) between the groups, calculated by the Kaplan–Meier method and compared with the use of the log-rank test, showed no significant differences between children and adults (log-rank P = 0.619).

Conclusions:
In children, NB more frequently presented as meningitis, and in adults in the form of Bannwarth’s syndrome. CSF pleocytosis in children with NB was higher than in adults, while the protein concentration in children was lower. Outcomes in children and adults were favorable and did not differ after standard NB treatment.
Increased T-helper Cell 2 Response in Infants With Respiratory Syncytial Virus Bronchiolitis Hospitalized Outside Epidemic Peak
Authors: Nenna Raffaella , Fedele Giorgio , Frassanito Antonella , Petrarca Laura , Di Mattia Greta , Pierangeli Alessandra , Scagnolari Carolina , Papoff Paola , Schiavoni Ilaria , Leone Pasqualina , Moretti Corrado , Midulla Fabio 
Published: December 2019

Aim:
To test the hypothesis that the balance of type-1/type-2 immune response differs between infants hospitalized with respiratory syncytial virus (RSV) bronchiolitis during the peak months and those during the nonpeak months.

Methods:
We prospectively enrolled 90 unrelated full-term previously healthy infants hospitalized during the first year of life for RSV sole bronchiolitis over 2 epidemics (November 2016 to April 2017 and October 2017 to April 2018). We stratified infants as follows: hospitalized during the peak months (n: 71) and during the nonpeak months (n: 19). The frequencies of CD4+ producing interferon (IFN)-γ and interleukin (IL)-4 and of CD8+ producing IFN-γ T cells were measured by flow cytometry from infant peripheral whole blood. The T-helper cell (Th2) polarization index was calculated as the ratio between CD4+ T cells producing IL-4 and CD4+ T cells producing IFN-γ.

Results:
Infants hospitalized during nonpeak months were significantly less frequently breast-fed, had a higher eosinophils count, a significantly higher percentage of CD4+ T cells producing IL-4 and higher Th2 polarization index than infants hospitalized during the peak months.

Conclusions:
We elucidated the presence of different endotypes in infants with RSV sole bronchiolitis. Previously healthy full-term infants hospitalized during the nonpeak months seem to be more likely those with a possible predisposition to atopy.
Prophylactic Paracetamol After Meningococcal B Vaccination Reduces Postvaccination Fever and Septic Screens in Hospitalized Preterm Infants
Authors: Dubus Magali , Ladhani Shamez , Vasu Vimal 
Published: December 2019

Background:
Following the introduction of the 4CMenB (Bexsero, GlaxoSmithKline, Rixensart, Belgium) vaccine against Meningococcal B into the UK vaccination schedule, Public Health England advised paracetamol to be given prophylactically with the vaccine. This was based on observations of increased postvaccination febrile reactions in term infants. Evidence in preterm infants was lacking. We aimed to evaluate whether (i) 4CmenB is associated with an increase in adverse events (AEs) in the 48 hours after vaccination in preterm infants and (ii) the impact of prophylactic paracetamol on AEs.

Methods:
Retrospective case-note review of preterm infants, within a UK level 3 neonatal unit, receiving first or second 4CMenB vaccination, within 3 periods; (i) period 1 (pre-4CMenB): September 2014–September 2015; (ii) period 2 (4CMenB without prophylactic paracetamol): September 2015–March 2016 and (iii) period 3 (4CMenB with prophylactic paracetamol): June 2016–May 2018. Data were collected on a predefined list of postvaccination AEs within 48 hours of vaccination: (i) number (%) of infants with temperature >37.5°C; (ii) highest temperature (°C); (iii) number (%) of infants receiving evaluation for sepsis and (iv) number (%) of infants receiving intravenous antibiotics.

Results:
Ninety-five vaccination episodes were included. Compared with the pre-4CMenB (period 1), more infants developed temperature >37.5°C, needed partial septic screens and had intravenous antibiotics when 4CMenB was introduced without paracetamol prophylaxis (period 2). Paracetamol prophylaxis (period 3) with 4CMenB resulted in fewer infants experiencing postvaccination fever and antibiotic administration comparable to period 1.

Conclusions:
4CMenB is associated with AEs in hospitalized preterm infants. Prophylactic paracetamol administration attenuates this.
The efficiency of continuous positive airway pressure therapy in carbon monoxide poisoining in the emergency department
Authors: Bal Uğur , Sönmez Bedriye Müge , Inan Selim , Işcanli Murat Doğan , Yilmaz Fevzi 
Published: December 2019

Objective
To determine whether oxygen therapy with continuous positive airway pressure (CPAP) is superior to normobaric oxygen therapy in carbon monoxide poisoning.

Methods
The study participants were 43 patients diagnosed with carbon monoxide poisoning between the dates 15 March and 30 June 2016 at the emergency department of an urban teaching hospital. The control group comprised patients who received normobaric oxygen therapy. The case group consisted of patients who underwent one-hour CPAP therapy. The primary outcome was the determination of the half-life of carboxyhemoglobin (COHb) with CPAP treatment. The CPAP and control groups were compared in terms of the reduction in COHb levels after 60 minutes of therapy.

Results
The COHb level among patients in the CPAP group was lower in the 30th and 60th minutes. The half-life of COHb was apparently decreased in the CPAP group compared with the control group (control and case groups mean plasma half-life of COHb were 80.26 ± 12.70 and 36.20 ± 4.58 minutes, respectively).

Conclusion
The results of the present study demonstrate that CPAP therapy may be an effective option for oxygen therapy among patients with carbon monoxide intoxication; this is achieved by decreasing the half-life of COHb.
Pediatric acute myeloid leukemia: updates on biology, risk stratification, and therapy
Authors: Elgarten Caitlin W. , Aplenc Richard 
Published: December 2019

Purpose of reviewDespite advances in therapy over the past decades, overall survival for children with acute myeloid leukemia (AML) has not exceeded 70%. In this review, we highlight recent insights into risk stratification for patients with pediatric AML and discuss data driving current and developing therapeutic approaches.Recent findingsAdvances in cytogenetics and molecular profiling, as well as improvements in detection of minimal residual disease after induction therapy, have informed risk stratification, which now relies heavily on these elements. The treatment of childhood AML continues to be based primarily on intensive, conventional chemotherapy. However, recent trials focus on limiting treatment-related toxicity through the identification of low-risk subsets who can safely receive fewer cycles of chemotherapy, allocation of hematopoietic stem-cell transplant to only high-risk patients and optimization of infectious and cardioprotective supportive care.SummaryFurther incorporation of genomic and molecular data in pediatric AML will allow for additional refinements in risk stratification to enable the tailoring of treatment intensity. These data will also dictate the incorporation of molecularly targeted therapeutics into frontline treatment in the hope of improving survival while decreasing treatment-related toxicity.
Rethinking clinical endpoints in kidney transplant trials
Authors: Maggiore Umberto , Leventhal Jeremy , Cravedi Paolo 
Published: December 2019

Purpose of review
Clinical trials testing novel kidney transplant therapies are challenged by low rates of long-term clinical outcomes such as death and graft loss. Herein, we critically review traditional and more recent strategies to expedite new therapies by minimizing sample size and follow-up duration using surrogates (alone or in the context of composite endpoints), or using different clinical endpoints.

Recent findings
Multiple surrogate endpoints are increasingly important for organ transplantation trial design: glomerular filtration rate slope, albuminuria, donor-specific alloantibodies, and histological score at graft protocol biopsies. However, surrogate endpoint use is limited by bias when data are missing. Hierarchical multiple primary endpoints – that are successfully used in other settings and frequently utilize surrogate endpoints – have not yet been integrated into kidney transplant studies. New clinical endpoints, focusing on treatment safety and patient quality of life have been recently standardized and should be reported regardless of the primary endpoint of any randomized controlled trial.

Summary
Defining surrogates, standards for outcome reporting, and statistical strategies to appropriately analyze them are critical to effectively testing and implementing novel therapeutic strategies to improve long-term clinical outcomes in kidney transplantation.
A Retrospective Analysis of Invasive Fungal Diseases (IFD) of the Central Nervous System in Children With Lymphoid Malignancies
Authors: Ramanathan Subramaniam , Kate Shruti , Kembhavi Seema , Cheriyalinkal Parambil Badira , K. C. Anand , Bhat Vasudeva , Prasad Maya , Moiyadi Aliasgar , Biswas Sanjay , Narula Gaurav , Banavali Shripad 
Published: December 2019

Background:
Outcomes of childhood hematolymphoid malignancies have improved several fold because of immunosuppressive chemotherapy and broad-spectrum antibiotics for managing febrile neutropenia. An apparent trade-off has been an increase in invasive fungal disease (IFD), affecting multiple organs. We report the diagnostic and therapeutic challenges in 8 children with lymphoid cancers who developed intracranial (IC) fungal abscesses between 2010 and 2017.

Methods:
Children below 15 years of age undergoing treatment for leukemia/lymphoma with clinicoradiologic and microbiologic evidence of IC fungal abscess were included. Demographic details, clinical profile, and management were retrospectively audited. Treatment was guided by European Organization for Research and Treatment of Cancer/Mycoses Study Group (EORTC/MSG) definitions for IFD with therapeutic drug monitoring (TDM)-directed azole dosing, and surgical intervention.

Results:
Eight patients (4 B-cell acute lymphoblastic leukemia, 2 relapsed B-cell acute lymphoblastic leukemia, and 2 non-Hodgkin lymphoma) were eligible for analysis. Proven, probable, and possible IFDs were seen in 2 (25%), 4 (50%), and 2 (25%) patients, respectively. Proven IFDs were invasive mucormycosis with remaining having mold infections. Cerebrospinal fluid galactomannan was positive in all 4 patients in whom it was tested. TDM was possible in 5/8 (63%) patients. Antifungal therapy was given for a median period of 4.2 months with 5 (63%) patients having complete resolution. Three (37%) patients expired, of which 2 were attributable to IFDs.

Conclusions:
IC fungal abscesses in children can cause significant morbidity and mortality in children with hematolymphoid cancers. Evaluation of cerebrospinal fluid galactomannan may help in early diagnosis and therapy. Prolonged antifungal therapy steered by TDM can help achieve resolution in some cases.
The development of the social brain in baby siblings of children with autism
Authors: Dean Douglas C. , Freeman Abigail , Lainhart Janet 
Published: December 2019

Purpose of review
Impairments in social interaction/communication become apparent after 12 months of age in children who develop Autism spectrum disorder (ASD). Studies of baby siblings of children with ASD provide the means to detect changes in the brain that are present before behavioral symptoms appear. In this review, advances from brain imaging studies of infant siblings over the past 18 months are highlighted.

Recent findings
During the first 2 months of life, functional differences in social brain regions and microstructural differences in dorsal language tracks are found in some high-risk baby siblings. At 4–6 months of age, differences in subcortical and cerebellum volumes and atypical cortical responses to social stimuli are evident. At 6 months, extra-axial cerebrospinal fluid is increased, and at 8 months there is evidence of cortical hyper-reactivity. Patterns of functional connectivity are distinct in infant siblings and suggest dysfunctional activation and integration of information across the cortex and neural networks underlying social behaviors.

Summary
Further replication in very large independent samples is needed to verify the majority of the findings discussed and understand how they are related within individual infants. Much more research is needed before translation to clinical practice.
PSA and VIM DBS efficiency in essential tremor depends on distance to the dentatorubrothalamic tract
Authors: Dembek Till A. , Petry-Schmelzer Jan Niklas , Reker Paul , Wirths Jochen , Hamacher Stefanie , Steffen Julia , Dafsari Haidar S. , Hövels Mauritius , Fink Gereon R. , Visser-Vandewalle Veerle , Barbe Michael T. 
Published: December 2019

AbstractObjectiveTo investigate the relation between deep brain stimulation (DBS) of the posterior-subthalamic-area (PSA) and the ventral-intermediate-nucleus (VIM) and the distance to the dentatorubrothalamic tract (DRTT) in essential tremor (ET).MethodsTremor rating scale (TRS) hemi-scores were analyzed in 13 ET patients, stimulated in both the VIM and the PSA in a randomized, crossover trial. Distances of PSA and VIM contacts to population-based DRTTs were calculated. The relationships between distance to DRTT and stimulation amplitude, as well as DBS efficiency (TRS improvement per amplitude) were investigated.ResultsPSA contacts were closer to the DRTT (p=0.019) and led to a greater improvement in TRS hemi-scores (p=0.005) than VIM contacts. Proximity to the DRTT was related to lower amplitudes (p<0.001) and higher DBS efficiency (p=0.017).ConclusionsDifferences in tremor outcome and stimulation parameters between contacts in the PSA and the VIM can be explained by their different distance to the DRTT.