bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transitional fracture of the distal radius: a rare injury in adolescent athletes. Case series and literature review
Authors: Rauer Thomas , Pape Hans-Christoph , Gamble Jamison G. , Vitale Nicolo’ , Halvachizadeh Sascha , Allemann Florin 
Published: June 2020

AbstractBackgroundTransitional fractures are fractures in adolescents where partial closure of the epiphyseal growth plate has occurred. These fractures are most commonly reported in the distal tibia. With respect to the distal radius, only a few case reports describing transitional fractures exist. Furthermore, relatively little is known about epiphyseal closure of the distal radius. A case series of four transitional fractures of the distal radius is presented by comparing non-operative and operative treatment options. At present, this is the largest case series in the literature dealing with this rare injury.Case presentationWe present three cases of four transitional fractures of the distal radius including 1–year follow-up. Patient age ranged from 16 to 18 years including a gender ratio of two males to one female. Clinical and radiographic assessments took place 6 and 12 weeks and 1 year after trauma/surgery. Three transitional fractures were treated with open reduction and internal volar plate fixation followed by functional rehabilitation. One transitional fracture was treated non-operatively. All cases showed an excellent functional outcome.ConclusionsThe primary treatment goal in transitional fractures is anatomic reduction of the articular surface. Non-operative treatment of transitional fractures of the distal radius is the most commonly reported treatment option. Additionally, different fixation options have been described, including the use of Kirschner wires (K-wires) and lag screws. The presented cases demonstrate that volar plate fixation followed by functional rehabilitation is a valuable treatment option in significantly displaced transitional fractures of the distal radius. Furthermore, we discuss the pathogenesis as well as the different treatment options by critical reviewing the literature.
Misdiagnosis of a multi-organ involvement hematogenous disseminated tuberculosis as metastasis: a case report and literature review
Authors: Hang Tian-Xing , Fang Gang , Huang Yan , Hu Chun-Mei , Chen Wei 
Published: June 2020

Abstract
Background
Tuberculosis (TB) is a great mimicker and diagnostic chameleon, and prone to be diagnosed as malignancy. Even though many reports have described the differences between pulmonary TB and lung cancer, the atypical systemic hematogenous disseminated TB (HDTB) is very rare and more confusing in clinical practice.

Case presentation
A 73-year-old man, HIV-negative, was hospitalized to the local county hospital because of chest pain, low-grade fever, asthenia, anorexia and weight loss for the pasting two months. The CT findings of the two lungs showed multiple round or round-like nodules of different sizes, with clear boundaries and partial fusion. The level of serum CA19–9 was significantly higher than normal, and progressively increased. There were multiple enlarged lymph nodes in the neck, mediastinum, abdominal cavity and pelvic cavity. The symptoms were diagnosed as hematogenous spread of gastrointestinal tumor in the local county hospital. However, when transferred to our provincial hospital, through comprehensive dynamic analysis, this patient was diagnosed as atypical systemic HDTB, no cancer at all. Through routine anti-TB therapy for one year, the patient was recovered very well at the follow-up of half year after withdrawal.

Conclusions
In the past, most TB misdiagnosis cases involved in single organ and were finally confirmed through invasive examination. This case enriched clinical experiences in the diagnosis of atypical HDTB. We encouraged clinicians to establish a dynamic thinking for diagnosis and treatment and emphasized the value of biopsy and 18F-FDG-PET in distinguishing TB and cancer.
Transmission characteristics of heterozygous cases of Creutzfeldt-Jakob disease with variable abnormal prion protein allotypes
Authors: Ward Anne , Hollister Jason R. , McNally Kristin , Ritchie Diane L. , Zanusso Gianluigi , Priola Suzette A. 
Published: June 2020

AbstractIn the human prion disease Creutzfeldt-Jakob disease (CJD), different CJD neuropathological subtypes are defined by the presence in normal prion protein (PrPC) of a methionine or valine at residue 129, by the molecular mass of the infectious prion protein PrPSc, by the pattern of PrPSc deposition, and by the distribution of spongiform change in the brain. Heterozygous cases of CJD potentially add another layer of complexity to defining CJD subtypes since PrPSc can have either a methionine (PrPSc-M129) or valine (PrPSc-V129) at residue 129. We have recently demonstrated that the relative amount of PrPSc-M129 versus PrPSc-V129, i.e. the PrPSc allotype ratio, varies between heterozygous CJD cases. In order to determine if differences in PrPSc allotype correlated with different disease phenotypes, we have inoculated 10 cases of heterozygous CJD (7 sporadic and 3 iatrogenic) into two transgenic mouse lines overexpressing PrPC with a methionine at codon 129. In one case, brain-region specific differences in PrPSc allotype appeared to correlate with differences in prion disease transmission and phenotype. In the other 9 cases inoculated, the presence of PrPSc-V129 was associated with plaque formation but differences in PrPSc allotype did not consistently correlate with disease incubation time or neuropathology. Thus, while the PrPSc allotype ratio may contribute to diverse prion phenotypes within a single brain, it does not appear to be a primary determinative factor of disease phenotype.
Weathering mechanism of red discolorations on Limestone object: a case study from Lingyan Temple, Jinan, Shandong Province, China
Authors: Zha Jianrui , Wei Shuya , Wang Chuanchang , Li Zhimin , Cai Youzhen , Ma Qinglin 
Published: June 2020

Abstract
Red discolorations are an effloresce phenomenon detect on the surface of stone objects and considered as damage factor in both esthetic and conservation points of view. It is very difficult to remove and seldom report about their weathering mechanism. Recently, numerous of red discolorations have affected the limestone objects of Lingyan Temple in Shandong province, one of the most important building materials in China. In order to set up the appropriate conservation remedy, it is essential to identify the origin, characteristics, composition, and the formation process of red discolorations. Several analytical and investigation techniques, such as X-ray fluorescence spectroscopy (XRF), X-ray diffraction (XRD), Micro-Raman spectroscopy (Raman), Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM) equipped with energy dispersive spectrometer (EDS) were used to better understand the red discolorations. The results demonstrated that the discolorations on limestone surface have been caused by carbonic acid weathering process. The red discolorations consisted mainly of kutnohorite (Ca(Fe,Mg,Mn)CO3) and iron oxides. They showed tabular, lamellar, and granular morphologies, which originated from the in situ carbonic acid weathering of kutnohorite. After rainfall, the Ca, Mg, Mn ions with relatively high solubility were primarily leached from carbonatite phases. It was resulting in the sedimentation of red iron oxides through a chemical reaction and physical adhesion. Based on those analyses, a chelating agent (ethylenediamine tetraacetic acid disodium salt) was chosen to remove theses red discolorations on the stone object.
Innovative Thermobalancing therapy and Dr Allen’s Device for the first time employ body energy to treat chronic prostatic diseases effectively
Authors: Allen S. 
Published: June 2020

Abstract
Benign prostatic hyperplasia (BPH) and chronic prostatitis / chronic pelvic pain syndrome (CP/CPPS) are common chronic diseases. None of the available treatments are effective in the management of these diseases. The purpose of this study was to assess the efficacy of Thermobalancing therapy (TT) with therapeutic Dr Allen's Device (DATD) for the treatment of BPH and CP/CPPS. Retrospective analysis of 2 clinical studies employing 6-month TT for the treatment of BPH (n = 124) and CP/CPPS (n = 45) was conducted. The efficacy of the TT with DATD was assessed using validated and widely accepted parameters. Results were compared with corresponding control groups comprising of subjects who did not receive any treatment. In BPH treatment group, urinary symptoms decreased (14.3 to 4.7) and QoL improved (3.9 to 1.39). In CP/CPPS treatment group, pain score decreased (10.3 to 3.5) and QoL improved (8.1 to 2.9). The results in the 2 treatment groups were statistically significantly better than the results obtained for the corresponding control groups (P < 0.001). Innovative TT with DATD provides an effective treatment that uniquely employs body energy for the management of BPH and CP/CPPS.
Factorial validity and measurement invariance across gender groups of the German version of the Interpersonal Reactivity Index
Authors: Grevenstein Dennis 
Published: June 2020

AbstractThe Interpersonal Reactivity Index (IRI) is the most widely used measure of empathy, but its factorial validity has been questioned. The present research investigates the factorial validity of the German adaptation of the IRI, the “Saarbrücker Persönlichkeitsfragebogen SPF-IRI”. Confirmatory Factor Analyses (CFA) and Exploratory Structural Equation Modeling (ESEM) were used to test the theoretically predicted four-factor model. Across two subsamples ESEM outperformed CFA. Substantial cross-loadings were evident in ESEM. Measurement invariance (MI) across gender groups was tested using ESEM in the combined sample. Strict MI (invariant factor loadings, intercepts, residuals) could be established, and variances and covariances were also equal. Differences for latent means were evident. Women scored higher on fantasy, empathic concern, and personal distress. No significant differences were found for perspective taking. Mean differences were due to real differences on latent variables and not a result of measurement bias. Results support the factorial validity of the German SPF-IRI. The heterogeneity of empathy and the unclear differentiation between cognitive and emotional aspects might be a source for the unclear differentiation of scales.
Value of susceptibility-weighted MR imaging (SWI) in the detection of developmental venous anomaly
Authors: Abdelgawad Mohamed Saied , Aly Rasha Abdelhafiz 
Published: June 2020

Abstract
Background
Developmental venous anomaly (DVA) is probably the most common anomaly of the intracranial vasculature. DVAs consist of multiple, radially oriented dilated medullary veins that converge into a transcerebral vein. Susceptibility-weighted imaging (SWI) is a high spatial resolution 3D gradient-echo MRI sequence with phase post-processing that accentuates the paramagnetic properties of blood products such as deoxyhemoglobin, intracellular methemoglobin, and hemosiderin. Its high sensitivity to hemorrhagic particles by means of susceptibility dephasing effects within the veins allow for the accurate detection, grading, and monitoring of brain venous anomalies. In this review, we evaluated the prevalence of the brain DVAs identified by SWI in many patients who had undergone magnetic resonance imaging (MRI) with contrast administration. All images were independently reviewed by two radiologists who were blinded to other MR imaging finding. It is hoped that as SWI becomes more widely available, it will provide additional diagnostic and prognostic information that will improve the care and outcome of patients with DVAs.

Results
A total of 29 DVAs were observed with its prevalence 2.8%. The DVA caputs had mostly deep localization in about 44.8% of our DVA cases. SWI proved excellent demonstration of DVAs with the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were significantly higher than the other non-contrast MR sequences. On SWI, DVA is delineated as a signal void lesion with the normal cerebral veins.

Conclusion
Susceptibility-weighted imaging (SWI) is valuable in the diagnosis of DVA and should be included in routine MR assessment of the brain.
Efficacy of perforator CTA of deep inferior epigastric artery perforator flap in preoperative planning of breast reconstruction: comparative study with CDUS
Authors: Soliman Hazem Hamed , Abozeid Mohamed F. , Moustafa Maged Abdelrahman 
Published: June 2020

Abstract
Background
The aim of the study is to compare the efficacy of perforator computed tomographic angiography (P-CTA) and color Doppler ultrasonography (CDUS) in preoperative planning of breast reconstruction with deep inferior epigastric artery perforator (DIEAP) flaps. From October 2018 to August 2019, 42 patients performed breast reconstruction with DIEAP flap procedures. All cases performed CDUS and multidetector perforator CT angiography (P-CTA) within 1 week prior to reconstructive surgery. The CDUS and P-CTA images were interpreted by two experienced vascular radiologists with 8- and 10-year experience, respectively, and compared with the surgical results.

Results
There were statistically significant differences (P = 0.0025) between CDUS and P-CTA in the detection of the number of perforators with P-CTA being more accurate than CDUS. There were significant differences between the P-CTA and surgical findings in measuring the caliber of dominant perforators (P = 0.002). CDUS was more accurate than P-CTA in this parameter showing sensitivity and specificity of 94 and 96%, respectively. There were significant differences between CDUS and surgical findings in the detection of the course of the intramuscular segment of the perforator (P = 0.0028). P-CTA was more accurate than CDUS in this parameter showing sensitivity and specificity of 96 and 97%, respectively.

Conclusion
The pre-operative mapping of perforators by CDUS and P-CTA proved to be effective and complementary to each other in the localization and vascular mapping of deep inferior epigastric artery perforators, thus greatly helping vascular surgeons in performing this surgical procedure.
Evaluation of axonal loss in ulnar sensory nerve fibers recorded from ring and little fingers secondary to idiopathic carpal tunnel syndrome in Egyptian patients
Authors: El-Hady Aliaa Omar , El Molla Soad Said Ahmed , Ibrahim Rehab Ali 
Published: June 2020

Abstract
Background
The association between carpal tunnel syndrome (CTS) and ulnar nerve entrapment is unclear, and the extra-median paresthesia in the ulnar nerve territory innervation in CTS is unexplained. Our purpose is to evaluate the neurophysiologic changes in ulnar nerve sensory fibers secondary to idiopathic CTS in comparison to normal subjects, and their relation to the severity of CTS.

Results
The difference between CTS and control hands regarding all parameters of ulnar motor nerve conduction studies (MNCS) was not statistically significant (p > 0.05). There was a statistically significant difference in all parameters of median sensory conduction study (SCS) and MNCS between CTS and control hands (p < 0.0001) except for conduction velocity and in all parameters of median and ulnar SCS recording digit 4 (D4) (p < 0.05). The mean value of abnormalities of ulnar SCS recording D4 and digit 5 (D5) was significantly higher in moderate and severe CTS hands (p < 0.05). There were significant negative correlations between median motor and sensory latency and ulnar sensory amplitude recording D4 and D5.

Conclusion
Ulnar sensory nerve abnormalities exist among CTS patients, which were more in moderate and severe grades. The drop in amplitude of ulnar nerve sensory response argues in favor of the possible impact of CTS on the ulnar nerve and did not indicate axonal deterioration of the ulnar nerve.
Bone Evaluation by High-Resolution Peripheral Quantitative Computed Tomography in Patients With Adrenal Incidentaloma
Authors: Moraes Aline Barbosa , de Paula Marcela Pessoa , de Paula Paranhos-Neto Francisco , Cavalari Emanuela Mello Ribeiro , de Morais Felipe Fernandes Cordeiro , Curi Daniel Silva Carvalho , Lima Luis Felipe Cardoso , de Mendonça Laura Maria Carvalho , Farias Maria Lucia Fleiuss , Madeira Miguel , Vieira Neto Leonardo 
Published: June 2020

AbstractContextData regarding high-resolution peripheral quantitative computed tomography (HR-pQCT) in patients with adrenal incidentaloma (AI) are unknown.PurposeTo evaluate the areal bone mineral density (aBMD), microstructure, and fractures in patients with nonfunctioning AI (NFAI) and autonomous cortisol secretion (ACS).MethodsWe evaluated 45 patients with NFAI (1 mg dexamethasone suppression test [DST] ≤1.8 µg/dL) and 30 patients with ACS (1 mg DST 1.9-5.0 µg/dL). aBMD was measured using dual-energy X-ray absorptiometry; vertebral fracture by spine X-ray; and bone geometry, volumetric bone mineral density (vBMD), and microstructure by HR-pQCT.ResultsPatients with ACS showed lower aBMD values at the spine, femoral neck, and radius 33% than those with NFAI. Osteoporosis was frequent in both groups: NFAI (64.9%) and ACS (75%). Parameters at the distal radius by HR-pQCT were decreased in patients with ACS compared to those with NFAI: trabecular vBMD (Tb.vBMD, P = 0.03), inner zone of the trabecular region (Inn.Tb.vBMD, P = 0.01), the bone volume/tissue volume ratio (BV/TV, P = 0.03) and trabecular thickness (P = 0.04). As consequence, a higher ratio of the outer zone of the trabecular region/inner zone vBMD (Meta/Inn.vBMD, P = 0.003) was observed. A correlation between the cortisol levels after 1 mg DST and Meta/Inn.vBMD ratio was found (r = 0.29; P = 0.01). The fracture frequency was 73.7% in patients with ACS vs 55.6% in patients with NFAI (P = 0.24).ConclusionOur findings point to an association between trabecular bone microarchitectural derangement at the distal radius and ACS. Our data suggest that AI have a negative impact on bone when assessed by HR-pQCT, probably associated to subclinical hypercortisolism.
A Role for GLP-1 in Treating Hyperphagia and Obesity
Authors: Grill Harvey J 
Published: June 2020

AbstractObesity is a chronic recurring disease whose prevalence has almost tripled over the past 40 years. In individuals with obesity, there is significant increased risk of morbidity and mortality, along with decreased quality of life. Increased obesity prevalence results, at least partly, from the increased global food supply that provides ubiquitous access to tasty, energy-dense foods. These hedonic foods and the nonfood cues that through association become reward predictive cues activate brain appetitive control circuits that drive hyperphagia and weight gain by enhancing food-seeking, motivation, and reward. Behavioral therapy (diet and lifestyle modifications) is the recommended initial treatment for obesity, yet it often fails to achieve meaningful weight loss. Furthermore, those who lose weight regain it over time through biological regulation. The need to effectively treat the pathophysiology of obesity thus centers on biologically based approaches such as bariatric surgery and more recently developed drug therapies. This review highlights neurobiological aspects relevant to obesity causation and treatment by emphasizing the common aspects of the feeding-inhibitory effects of multiple signals. We focus on glucagon like peptide-1 receptor (GLP-1R) signaling as a promising obesity treatment target by discussing the activation of intestinal- and brain-derived GLP-1 and GLP-1R expressing central nervous system circuits resulting from normal eating, bariatric surgery, and GLP-1R agonist drug therapy. Given the increased availability of energy-dense foods and frequent encounters with cues that drive hyperphagia, this review also describes how bariatric surgery and GLP-1R agonist therapies influence food reward and the motivational drive to overeat.
Tolvaptan Versus Fluid Restriction in the Treatment of Hyponatremia Resulting from SIADH Following Pituitary Surgery
Authors: Kleindienst Andrea , Georgiev Simeon , Schlaffer Sven Martin , Buchfelder Michael 
Published: June 2020

Abstract

Context
The relevance of hyponatremia has been acknowledged by guidelines from the United States (2013) and Europe (2014). However, treatment recommendations differ due to limited evidence.

Objective
In hyponatremia following pituitary surgery—caused by the syndrome of inappropriate antidiuretic hormone (SIADH) secretion—we compared fluid restriction with the pharmacological increase of water excretion by blocking the vasopressin 2 receptors with tolvaptan at a low and a moderate dose.

Design
Prospective observational study.

Setting
Neurosurgical Department of a University hospital with more than 200 surgical pituitary procedures per year.

Patients
Patients undergoing pituitary surgery and developing serum sodium below 136 mmol/L. The diagnosis of SIADH was established by euvolemia (daily measurement of body weight and fluid balance), inappropriately concentrated urine (specific gravity), and exclusion of adrenocorticotropic and thyroid-stimulating hormone deficiency.

Intervention
Patients were treated with fluid restriction (n = 40) or tolvaptan at 3.75 (n = 38) or 7.5 mg (n = 48).

Main Outcome Measures
Treatment efficacy was assessed by the duration of hyponatremia, sodium nadir, and length of hospitalization. Safety was established by a sodium increment below 10 mmol/L per day and exclusion of side effects.

Results
Treatment with 7.5 mg of tolvaptan resulted in a significant attenuation of hyponatremia and in a significant overcorrection of serum sodium in 30% of patients. The duration of hospitalization did not differ between treatment groups.

Conclusions
Tolvaptan at a moderate dose is more effective than fluid restriction in the treatment of SIADH. Overcorrection of serum sodium may be a side effect of tolvaptan even at low doses.