bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Perioperative Complications Between Anterior Fusion and Posterior Fusion for Osteoporotic Vertebral Fractures in Elderly Patients
Authors: Morishita Shingo , Yoshii Toshitaka , Okawa Atsushi , Inose Hiroyuki , Hirai Takashi , Ogawa Takahisa , Fushimi Kiyohide , Fujiwara Takeo 
Published: April 2020

Study Design:
This was a retrospective cohort study using a nationwide inpatient database.

Objective:
The objective of this study was to evaluate the perioperative complications post–anterior fusion (AF) and posterior fusion (PF) for osteoporotic vertebral fractures (OVFs) with a large National Inpatient Database.

Summary of Background Data:
OVF of the thoracolumbar spine often occur because of bone fragility and low-energy trauma in elderly patients. Though AF and PF are 2 representative surgical methods, there have been few studies focusing on perioperative complications of each method.

Materials and Methods:
The total 2446 (AF: 435 cases, PF: 2011 cases) patients who diagnosed thoracic or lumbar OVF and received either AF or PF were included from 2012 to 2016 with the Diagnosis Procedure Combination (DPC) database. After one-to-one propensity score–matching, total 866 cases were analyzed to evaluate systemic and local complication rates, reoperation rates, costs, and mortality.

Results:
A total of 433 pairs were made between the surgical procedures after matching. At least 1 systemic complication was seen in 26.6% of the AF group compared with 16.9% of the PF group (P=0.001). Specifically, the incidence of pulmonary embolism (P=0.045), urinary tract infection (P=0.012), and pleurisy (P=0.004) were significantly higher in the AF group. Blood transfusion (P=0.007) and the operation for systemic complications (P=0.020) were required more often in the AF group. The cost for hospitalization was also higher in the AF group (P<0.001). There were no differences in the mortality rates between the 2 groups.

Conclusions:
More systemic complications were observed in the AF group. Surgeons need to take careful consideration of the merits and demerits described in this study when deciding the surgical method for OVF.

Level of Evidence:
Level 3.
Global Approaches to the Prevention and Management of Delayed-onset Adverse Reactions with Hyaluronic Acid-based Fillers
Authors: Philipp-Dormston Wolfgang G. , Goodman Greg J. , De Boulle Koenraad , Swift Arthur , Delorenzi Claudio , Jones Derek , Heydenrych Izolda , Trindade De Almeida Ada , Batniji Rami K. 
Published: April 2020

Background:
Delayed-onset adverse reactions to hyaluronic acid (HA) fillers are uncommon but have received increased attention, particularly with regard to late-onset nodules. Globally, there is a need for comprehensive prevention and management strategies.

Methods:
Experts with clinical practices in diverse regions of the world and extensive experience in managing complications related to HA fillers convened to propose and evaluate approaches to prevent delayed-onset adverse reactions after HA filler administration and manage late-onset nodules.

Results:
The expert panel agreed to define delayed-onset adverse reactions as those presenting more than 4 weeks posttreatment, with swelling, induration, and nodulation being the most common clinical signs. The panel recommended 5 general key approaches for the prevention of delayed-onset reactions (patient selection, anatomic location of injection/product selection, aseptic technique, injection procedure/filler, and posttreatment care). Strategies recommended for managing late-onset nodules included oral antibiotics, oral steroids, nonsteroidal anti-inflammatory drugs if needed, hyaluronidase for noninflammatory nodules (recognizing the limitations and regional availability of this treatment), intralesional antibiotics, intralesional immunosuppressive drugs such as steroids and fluorouracil, and surgical excision as a last resort. The panel noted that late-onset nodules may vary in both clinical presentation and etiology, making them challenging to address or prevent, and stressed individualized treatment based on clinical presentation. Regional differences in aseptic protocols, antibiotic selection, and steroid formulations were described.

Conclusion:
Insights from global experts on approaches to prevent and manage delayed-onset adverse reactions following HA filler administration, including late-onset nodules, support clinicians worldwide in optimizing patient outcomes and safety.
Functional Validation of a New Alginate-based Hydrogel Scaffold Combined with Mesenchymal Stem Cells in a Rat Hard Palate Cleft Model
Authors: Naudot Marie , Davrou Julien , Djebara Az-Eddine , Barre Anaïs , Lavagen Nolwenn , Lardière Sandrine , Azdad Soufiane Zakaria , Zabijak Luciane , Lack Stéphane , Devauchelle Bernard , Marolleau Jean-Pierre , Le Ricousse Sophie 
Published: April 2020

Background:
One of the major difficulties in cleft palate repair is the requirement for several surgical procedures and autologous bone grafting to form a bony bridge across the cleft defect. Engineered tissue, composed of a biomaterial scaffold and multipotent stem cells, may be a useful alternative for minimizing the non-negligible risk of donor site morbidity. The present study was designed to confirm the healing and osteogenic properties of a novel alginate-based hydrogel in palate repair.

Methods:
Matrix constructs, seeded with allogeneic bone marrow–derived mesenchymal stem cells (BM-MSCs) or not, were incorporated into a surgically created, critical-sized cleft palate defect in the rat. Control with no scaffold was also tested. Bone formation was assessed using microcomputed tomography at weeks 2, 4, 8, and 12 and a histologic analysis at week 12.

Results:
At 12 weeks, the proportion of bone filling associated with the use of hydrogel scaffold alone did not differ significantly from the values observed in the scaffold-free experiment (61.01% ± 5.288% versus 36.91% ± 5.132%; p = 0.1620). The addition of BM-MSCs stimulated bone formation not only at the margin of the defect but also in the center of the implant.

Conclusions:
In a relevant in vivo model of cleft palate in the rat, we confirmed the alginate-based hydrogel’s biocompatibility and real advantages for tissue healing. Addition of BM-MSCs stimulated bone formation in the center of the implant, demonstrating the new biomaterial’s potential for use as a bone substitute grafting material for cleft palate repair.
Three-dimensional Cryolipolysis for Submental and Lateral Neck Fat Reduction
Authors: Rodopoulou Stavroula , Gavala Maria-Ioanna , Keramidas Evangelos 
Published: April 2020

Summary:
Median and lateral neck areas are quite challenging to improve. Three-dimensional cryolipolysis is a noninvasive technique for localized fat reduction. We investigated the efficacy and safety of the technique when applied to these areas. A prospective study of patients treated with one session of 3-dimensional (3D) cryolipolysis is performed. Clinical outcomes are assessed using caliper measurements, patient surveys, and independent, blinded plastic surgeons’ photographic evaluation. The studies are conducted using a commercially available noninvasive medical device for 3D cryolipolysis. All patients received gentle massage of the treated areas for 3 minutes, and the final follow-up is after 3 months. Thirty-nine patients are enrolled in our study from June 2018 to December 2018. All 39 subjects received treatment on at least one intended area (median, right, and left lateral neck). Comparison of the pre- and posttreatment caliper measurements demonstrated a significant reduction of the treated areas at 3 months. Posttreatment, 82.05% of patients marked the results of fat reduction as exceptional or very improved, 12.82% as improved, 5.13% as no result, and 0% as worse. Improved patients and the blinded plastic surgeons noticed at these patients’ groups a bonus tightening effect. No serious adverse reactions are observed; thus, 3D cryolipolysis considered as a safe and effective noninvasive localized fat reduction technique with an extra, almost regularly observed, tightening effect.
Frontal Trigger Site Deactivation for Migraine Surgical Therapy
Authors: Raposio Edoardo , Simonacci Francesco 
Published: April 2020

Background:
The World Health Organization ranked migraine as the 19th worldwide disease causing disability. Recent insights into the pathogenesis of migraine headache substantiate a neuronal hyperexcitability and inflammation involving compressed peripheral craniofacial nerves, and these trigger points can be eliminated by surgery. In this study, we report our experience with minimally invasive surgical procedures for frontal migraine headache treatment.

Methods:
From June 2011 to May 2019, we performed 70 frontal migraine decompression surgeries of both supratrochlear and supraorbital nerves (65 bilateral and 5 unilateral) by an endoscopic or transpalpebral approach. In 24 patients (34.2%), frontal migraine emerges as a secondary trigger point following primary occipital and/or temporal migraine surgery.

Results:
After a mean follow-up of 24 months (range, 3–97 months), patients with frontal trigger site migraine reported a 94% positive response to surgery (32% complete relief and 62% significant improvement); 6% had no change in their symptoms.

Conclusions:
Based on our experience, the operation has not caused any serious complication or side effects, and surgical decompression of supraorbital and supratrochlear nerves might be recommended to patients who suffer from a moderate to severe chronic frontal migraine not responding to conventional therapy.
OPTICAL COHERENCE TOMOGRAPHY AND OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY PARAMETERS IN PATIENTS WITH PHACOMATOSIS
Authors: Marta Ana , Malheiro Luísa , Coelho João , Poças João , Gonçalves Nadine , Sousa Paulo , Figueiredo Ana , Araújo Maria , Maia Sofia , Miranda Vasco , Parreira Ricardo , Menéres Pedro 
Published: April 2020

Purpose:
To compare the retinal vasculature characteristics between eyes of patients with and without phacomatosis.

Methods:
Case–control observational study with retinal vasculature evaluation by optical coherence tomography and optical coherence tomography angiography of the macula and disk.

Results:
The study included 80 eyes. Neurofibromatosis Type 1 patients presented with a higher central macular thickness (P = 0.007), a lower optical disk nervous fiber layer (P = 0.006), a lower perimeter, area, and circularity of the foveal avascular zone (P < 0.05), a higher vascular density of macular avascular layer (AMVD) (P = 0.004), and a lower papillary vascular density of superficial capillary plexus (SPVD) (P = 0.048). Patients with tuberous sclerosis presented with an increase in central macular thickness (P = 0.024) and in vascular densities (P < 0.05) [except for macular vascular density of deep capillary plexus (PMVD), AMVD, and SPVD]. Patients with Sturge–Weber syndrome showed a decrease in optical disk nervous fiber layer (P < 0.001), subfoveal choroid thickness (P = 0.011), macular vascular density of superficial capillary plexus (SMVD) (P = 0.036), and SPVD (P < 0.001).

Conclusion:
Phacomatosis patients showed statistically significant differences of retinal vasculature characteristics, compared to eyes without pathology. Further studies are needed to determine when and if these parameters change with the course of the disease and if they can be used as biomarkers for disease severity or progression.
IMPLICATIONS OF THE MORPHOLOGIC PATTERNS OF TYPE 1 MACULAR NEOVASCULARIZATION ON MACULAR ATROPHY GROWTH ON PATIENTS UNDER ANTI–VASCULAR ENDOTHELIAL GROWTH FACTOR TREATMENT
Authors: Cabral Diogo , Coscas Florence , Pereira Telmo , Laiginhas Rita , Rodrigues Catarina , Français Catherine , Nogueira Vanda , Falcão Manuel , Miere Alexandra , Lupidi Marco , Coscas Gabriel , Souied Eric 
Published: April 2020

Purpose:
To evaluate the correspondence between macular atrophy (MA) progression and Type 1 macular neovascularization morphology during long-term anti–vascular endothelial growth factor treatment for exudative neovascular age-related macular degeneration.

Methods:
Retrospective review of consecutive patients with complete retinal pigment epithelium and outer retina atrophy overlying or in the proximity of macular neovascularization. The assessment of MA was based on spectral domain optical coherence tomography, en-face near infra-red imaging and fundus autofluorescence. Macular neovascularization blood flow morphology was evaluated by swept-source optical coherence tomography-angiography. Qualitative features were categorized per ETDRS sector as: immature, mature; and hypermature pattern. An automatic analysis was designed in MATLAB coding language to compute MA per ETDRS. Measurements were compared between the baseline and the last follow-up visit.

Results:
Twenty eyes from 20 patients were included; the mean age was 85.4 (8.3) years. The median follow-up was 1.85 (1.0–2.4) years and the median anti–vascular endothelial growth factor injection rate during follow-up was 4.0 (2.0–5.0) injections/year. During follow-up, sectors with persistence of an immature blood flow pattern had a lower MA growth rate than sectors with mature macular neovascularization flow patterns (P = 0.001).

Conclusion:
The presence of an immature blood flow pattern on optical coherence tomography-angiography is associated with a lower progression rate of MA.
Ultrasound-guided dextrose injection treatment for chronic myofascial pain syndrome: A retrospective case series
Authors: Chou Yen , Chiou Hong-Jen , Wang Hsin-Kai , Lai Yi-Chen 
Published: April 2020

Background:
Due to the lack of an evidence-based consensus, managing refractory myofascial pain syndrome is challenging for clinicians. Dextrose injection (dextrose prolotherapy) emerged as a promising, cost-effective treatment. This study evaluated the efficacy of targeted ultrasound-guided dextrose injection for localized myofascial pain syndrome.

Methods:
We retrospectively reviewed the clinical outcomes of 45 patients with myofascial pain syndrome refractory to alternative treatments with targeted ultrasound-guided dextrose injection. Pretreatment symptom severity and symptomatic response 1 month after treatment were statistically analyzed using a visual analog scale (VAS)-based scoring system.

Results:
Of 45 patients, 8 (24.4%) reported complete resolution of symptoms at the treated site. In total, 36 (80.0%) patients reported greater than 50% improvement in their symptoms. The mean pretreatment and posttreatment VAS scores were 7.0 and 2.44 (p < 0.001), indicating an overall 65.0% reduction in symptom severity.

Conclusion:
Targeted ultrasound-guided dextrose injection was remarkably effective for refractory localized myofascial pain syndrome, significantly reducing symptom intensities in the majority of treated patients within 1 month after a single injection.
Rosai-Dorfman Disease—Utility of 18F-FDG PET/CT for Initial Evaluation and Follow-up
Authors: Mahajan Sonia , Nakajima Reiko , Yabe Mariko , Dogan Ahmet , Ulaner Gary A. , Yahalom Joachim , Noy Ariela , Diamond Eli L. , Schöder Heiko 
Published: April 2020

Background
The role of imaging in the management of Rosai-Dorfman disease (RDD), a rare non-Langerhans cell histiocytosis, is not clearly defined. We present an analysis of FDG PET/CT findings obtained for initial disease characterization, follow-up evaluation, and treatment planning for this disease.

Methods
From an institutional pathology database (2001–2018), we identified RDD patients who underwent FDG PET/CT scans either as part of clinical care or when done as part of clinical trials. For all scans, sites of abnormal FDG uptake were assessed, and SUVmax was measured. Comparison of PET/CT findings was made with anatomic (CT/MRI-based) imaging, where available. Instances of changing treatment based on PET/CT were recorded.

Results
We reviewed 109 FDG PET/CT scans in 27 patients with RDD. Five of 27 patients had only nodal/cutaneous disease, whereas 22 patients had extranodal disease, most commonly in bone (n = 9) and central nervous system (n = 7). PET/CT identified sites of active disease in 24 of 27 patients. All identified bone and extraskeletal lesions, except for a brain lesion in 1 patient, were FDG-avid. In 6 of 20 patients (30%) with available prior CT or MRI, PET/CT demonstrated additional RDD lesions (bones: n = 5, pleura: n = 1) that were not apparent on anatomic imaging; 3 of these lesions were outside the CT field of view, and 3 were not recognized on CT. Overall, 13 of 109 PET/CT scans led to a change in management, affecting 41% (11/27) of patients.

Conclusion
FDG PET/CT was valuable in defining disease extent and optimizing treatment strategy in patients with RDD.
Combined 68Ga-DOTATOC and 18F-FDG PET Predicts a Double Component With Different Grade of a Pancreatic Neuroendocrine Tumor in a Patient With Multiple Endocrine Neoplasia Type 1
Authors: Paepegaey Anne-Cécile , Gaujoux Sébastien , Meyer Céline , Rouquette Alexandre , Libé Rossella 
Published: April 2020

Abstract
Managing decisions of pancreatic neuroendocrine tumors (pNETs) can be challenging because of different clinical presentations and prognosis. A 31-year-old woman with multiple endocrine neoplasia type 1, including a suspicious pNET, was assessed with 68Ga-DOTATOC and 18F-FDG PET. A high 68Ga-DOTATOC uptake was visualized in the entire pNET, whereas a high 18F-FDG PET uptake was present only in the upper part of the tumor. After surgery, pathology confirmed the pNET with a double component: an upper grade 2 with a Ki67 of 11% with the high 18F-FDG PET uptake, and a lower grade 1 with a Ki67 of 2%. Combined 68Ga-DOTATOC/18F-FDG PET predicts the grade in heterogeneous pNETs.
PET/CT in Evaluation of Low Backache Due to Sacral Nerve Root Involvement
Authors: Yadav Divya , Angamuthu Meivel , Subudhi T. Kishan , Das Chandan J. , Kumar Rakesh 
Published: April 2020

Abstract
Low back pain with radiation to lower limbs is due to nerve root impingement or involvement in most cases. 18F-FDG PET/CT has shown sacral nerve root involvement in several peripheral nerve pathologies, including neurolymphomatosis, peripheral nerve sheath tumor, and plexopathies. We present 2 cases of a low back pain with ulcerative colitis and metastatic neuroendocrine tumor who underwent 18F-FDG PET/CT and 68Ga-DOTANOC PET/CT, respectively. PET/CT can be used as an adjunct tool to evaluate sacral nerve root involvement to look for malignant or inflammatory nerve involvement.
Reliability and Versatility of Reverse Sural Island Neurofasciocutaneous Leg Flaps
Authors: Stevanovic Goran R. , Dakovic-Bjelakovic Marija Z. , Paravina Jadranka M. , Momčilović Stefan , Golubovic Ivan Z. , Ignjatovic Nebojsa S. , Jankovic Irena D. , Radojkovic Milan , Nestorovic Milica , Rancic Dejan , Rancic Zoran 
Published: April 2020

Background
Distally based sural neurofasciocutaneous (NFC) flaps are a commonly used method for foot and ankle reconstruction given that they are much simpler and, at the same time, still efficient alternative to perforator flaps and free style free flaps.

Objective
This study aims to evaluate the reliability and versatility of reverse sural island NFC flaps as a powerful and efficient method that can be used for repair of lower leg skin defects. This method does not require microsurgical facilities or extensive training.

Methodology
Patients with soft tissue defects of the distal third of the leg and ankle region received reverse sural island NFC flaps. Inclusion criteria included an absence of damage to the sural neurovascular axis or communicating perforators, absence of peripheral vascular disease, and the presence of soft tissue defects deep enough to expose tendon or bone. Patients were assessed for flap (defect) size, pedicle length and location of defects, postoperative flap survival rates, and complications. Donor sites were closed directly or skin grafted.

Results
Of 24 consecutive patient (20 male; 4 female), all flaps except 1 (4.16%), survived, although partial necrosis was observed in 2 patients (8.33%). The overall major complication rate was 12.50%. Epidermolysis was noted in 1 patient (4.16%). Three cases of transient venous congestion resolved without additional complications. The overall minor complication rate was 16.66%. Minimal complications were associated with healing of donor sites.

Conclusions
Reverse sural island NFC flaps provide adequate and aesthetically very acceptable coverage of soft tissue defects of the distal lower leg and proximal foot with no functional impairment.
A Simplified Approach to Myelomeningocele Defect Repair
Authors: Brown Owen H. , Makar Katelyn G. , Ulma Raquel M. , Buchman Steven R. , Kasten Steven J. , Muraszko Karin M. , Vercler Christian J. 
Published: April 2020

Background
Repair of the soft tissue defect in myelomeningoceles remains challenging. The literature currently lacks a systematic approach, reporting high rates of complications. We present outcomes from the largest series to date and describe a simplified approach that minimizes morbidity and streamlines decision making.

Methods
Patients 1 year or younger who underwent myelomeningocele repair between 2008 and 2018 were reviewed. Flap types were categorized by tissue composition. Complications were dichotomized into early and late (<30 days and >30 days postoperative, respectively). Logistic regression was used to measure the impact of flap tissue composition and skin closure technique on odds of postoperative complications.

Results
Ninety-seven patients met inclusion criteria. Reoperation was required in only 3 (3.0%) patients—1 for wound dehiscence and 2 for surgical site infections. Zero cases of tethered cord or cerebrospinal fluid leak occurred. The most common minor complications were early wound complications (n = 18, 18.6%) and early infection (n = 5, 5.2%). Fascia-only flaps and muscle + other tissue flaps were not associated with higher odds of complications compared with muscle-only flaps (odds ratio [OR], 2.13; 95% confidence interval [CI], 0.53–8.50, P = 0.29; OR = 2.87, 95% CI 0.66–12.51, P = 0.16, respectively). Rhomboid flaps for skin closure were associated with higher odds of complications (OR, 4.47; 95% CI, 1.00–19.97; P = 0.05).

Conclusions
Our approach to myelomeningocele repair demonstrated no cases of secondary tethered cord or cerebrospinal fluid leak, and reoperative rates were extremely low. Because complications were unrelated to flap type, we recommend a simplified approach using any tissue type for dural coverage and 2-layer primary closure of the skin.