bluuebunny/crossref_metadata_2025_split huggingface dataset:
COMPARATIVE STUDY OF ANTICONVULSANT EFFECT OF THE LEAVES OF SAPINDUS EMARGINATUS AND ACORUS CALAMUS IN EXPERIMENTALLY INDUCED ANIMAL MODELS OF EPILEPSY
Authors: SHOUGRAKPAM PRIYADARSHINI , BHATTACHARJEE ABHISHEK , GUNINDRO NGANGOM , RITA SANJENBAM 
Published: January 2021

Objective: To compare anticonvulsant activity of methanol extracts of Sapindus emarginatus (MESE) and Acorus calamus (MEAC) in experimental seizure models in mice.
Methods: Hind limb tonic extension (HLTE) in Maximal electroshock (MES) seizure and clonic seizure in Pentylenetetrazol (PTZ) seizure models were assessed. Group I (control) mice received 1% gum acacia in distilled water (1 ml/100 g). Topiramate (50 mg/kg) was administered in group II (standard) animals. Group III and IV mice were treated with 200 and 400 mg/kg of MESE, respectively. Mice in group V and VI were given MEAC at the dose of 200 and 400 mg/kg, respectively. Drugs were given orally suspended in 1% gum acacia suspension (1 ml/100 g) for 7 d. Next day after 1 h of drug administration, the seizure was induced for evaluation.
Results: Anticonvulsant property of both extracts was confirmed by reduction (p<0.001) in HLTE phase in MES model; delayed onset of the clonic seizure (p<0.001) and its shortened phase (p<0.001) in PTZ model when compared with the control. MESE-200 mg/kg produced significantly longer (p<0.001) HLTE phase with lower protection (40.34%) among the different doses of the extracts. Clonic seizure onsets and durations in PTZ model were comparable among the different extract-treated groups; however, mortality was higher (66.6%) with MESE-200 mg/kg.
Conclusion: Anticonvulsant activity of MESE and MEAC was evident; however, MESE at the dose of 200 mg/kg was less effective.
Association of thoracic aorta elasticitychanges and severity of coronary atherosclerosis
Authors: Mushkambarov I. N. , Beresten N. F. , Tkachenko S. B. 
Published: January 2021

Introduction. Became possible to evaluate association between the elasticity of aorta and coronary atherosclerosis using echocardiography.Purpose. To evaluate the association between worsening of the local thoracic aorta elasticity and the severity of coronary atherosclerosis.Material and methods. With the application of echocardiography and coronarography there were examined 109 patients.Results. With stenosis >70%, occlusion or lesion of 2 or more coronary arteries, statistically significant differences were revealed.Conclusion. Worsening of thoracic aorta local elasticity in patients with coronary atherosclerosisis associated with the severity of coronary atherosclerosis.
Ultrasound examination of the liver: the search for the most reproducible and easy to operate measuring method of the right lobe oblique craniocaudal diameter
Authors: Stepanyan I. A. , Izranov V. A. , Gordova V. S. , Beleckaya M. A. , Palvanova U. B. 
Published: January 2021

Introduction. Mismatching of the organ sizes to the standard measurements is the sign of pathology, so it is important to make measurements using the same method for the same type of assessment.Goal: to evaluate the intra- and inter-research reproducibility of the oblique craniocaudal diameter measurement of the right liver lobe with the application of Russian and European methods by different operators, and find out which of the methods is the most convenient for practical application.Materials and methods. 47 healthy volunteers and 3 operators were participated in the study. One of the operators participated in both stages of study.Results. Keeping conditions such as quiet breathing and longitudinal scanning in the anterior axillary line from the VII-X intercostal spaces increases reproducibility and provides well visualization of the lobe even if the patient is not prepared for the study.Conclusion. The oblique size of the right lobe is highly reproducible for both methods, but the European method (longitudinal scanning of right lobe) is more convenient for the practical application.
Strategic Priorities of Municipal Development Based on Identifying the Interests of Stakeholders: Methodological Approaches and Practical Implementation
Authors: Kuznetsov S. V. , Sviridenko M. V. , Shamakhov V. A. 
Published: January 2021

The formation of documents for strategic planning of socio-economic development is the most important task of regional and municipal governments. It can be stated that strategic planning processes have been launched throughout the country and the process of forming these documents is active at both the regional and municipal levels. However, the issues of determining, studying, and taking into account the views of interested parties when forming the goals and priorities of socio-economic development of administrative-territorial entities require methodological support and recommendations for practical implementation. In this article, an attempt is made to reveal methodological approaches and solve issues of practical implementation of identifying the interests of stakeholders on the example of a specific municipality.The proposed material is an example of determining and scientifically substantiating the strategic priorities of a municipality on identifying the interests of stakeholders.The study of the processes of formation and determination of strategic priorities for the development of a municipality based on the identification of the interests of all interested parties should become the task of further research.
Time to Get It Right: An Examination of Post-Acquisition Fair Value Adjustments
Authors: Kubic Matthew 
Published: January 2021

ABSTRACT
I examine the role of preparer information gathering and processing constraints in fair value measurement. Using two business combination samples, I investigate whether acquirers adjust the initial fair value measurements of identifiable assets and liabilities during the one-year measurement period permitted by FASB Statement 141(R). Empirical proxies for preparers' information gathering and processing costs explain variation in the incidence and magnitude of measurement period adjustments (MPAs). I classify abnormally large MPAs that allow firms to exceed the consensus analyst forecast as suspect adjustments. Suspect adjustments exhibit little association with earnings management incentives and no association with future goodwill impairment. Overall, the results suggest that acquirers use the measurement period when there are concerns about the quality or availability of information, consistent with the FASB's intentions.
Surgical Treatment for Hepatocellular Carcinoma in the Era of Multiple Staging and Algorithm
Authors: Yamashita Suguru , Joechle Katharina , Vauthey Jean-Nicolas 
Published: January 2021

A plethora of staging systems for hepatocellular carcinoma (HCC) has existed, as the management for HCC is made complex by the interplay of tumor characteristics and the health and underlying functions of both the patient and the liver. The majority of patients with HCC have nonsurgical HCC. The Barcelona Clinic Liver Cancer (BCLC) classification has been regarded as the optimal staging system and treatment algorithm for HCC. However, even in patients with intermediate or advanced stage in BCLC classification, who had not been originally recommended to undergo surgery, some could benefit in terms of long-term survival by surgical treatments. An expert panel on HCC has stated that the American Joint Committee on Cancer staging system, whose predictive power on the outcome have been improved by continuous amendments, should be applied for patients undergoing surgery. Herein, we review the recent staging system focusing on patients with HCC undergoing surgery.

This review contains 5 figures, 3 tables and 34 references
Key Words: American Joint Committee on Cancer, Barcelona Clinic Liver Cancer, hepatic resection, hepatocellular carcinoma, orthotopic liver transplantation
Squamous Cell Carcinoma: Epidemiology, Risk Factors, and Treatment Options
Authors: Farma Jeffrey M , Lamb Elena P 
Published: January 2021

Ultraviolent (UV) solar radiation is considered to be the dominant risk factor for development of squamous cell carcinoma (SCC). The development of SCC appears to be linked to the cumulative dose of UV radiation over time. Identifying patients with high-risk factors for developing SCC includes chronic immunosuppression, exposure to ionizing radiation, and certain genetic syndromes. Primary treatment goals of cutaneous SCC include cure of tumor with maximal preservation of function. Treatment options should be stratified for low- and high-risk SCC. Primary treatment options for low-risk SCC include (1) curettage and electrodesiccation, (2) excision with postoperative margin assessment (POMA) with 4 to 6 mm margins, and (3) radiation therapy (RT) for nonsurgical candidates. Options for high-risk SCC lesions include (1) Mohs surgery or resection with complete circumferential peripheral and deep margin assessment, (2) excision with POMA with wider surgical margins and primary or delayed repair, and (3) RT for nonsurgical candidates.
This review contains 4 figures, 5 tables, and 32 references.
Key words: cutaneous squamous cell carcinoma, Mohs micrographic surgery, pathologic risk factors, radiation therapy, surgical margins
Dermatofibrosarcoma Protuberans
Authors: Deschner Benjamin , Wayne Jeffrey 
Published: January 2021

Dermatofibrosarcoma protuberans (DFSP) is a rare malignant cutaneous tumor with an annual incidence of 4.2 per million. The tumor typically grows slowly and has a proclivity toward local invasiveness and away from distant metastasis. The mainstay of treatment is complete surgical resection, which is curative in almost all cases. The tumor’s characteristics make this difficult, however, and reexcision to negative margins can be challenging. DFSP can also present with or develop fibrosarcomatous change (DFSP-FS), a more aggressive variant. Thus, these tumors require thoughtful management. In this review, we discuss the biologic background of DFSP, describe the tumor’s behavior and presentation, and discuss current concepts in management.

This review contains 5 figures, 4 tables and 28 references
Key words: dermatofibrosarcoma protuberans, fibrosarcomatous change, imatinib, local recurrence, micrographic surgery, nonmelanoma, radiation, sarcoma, skin cancer, surgical excision
Supraventricular Tachycardia
Authors: Epstein Laurence M. 
Published: January 2021

Supraventricular tachycardias (SVTs) comprise a group of arrhythmias for which the atria and/or atrioventricular (AV) node are integral to sustaining the rhythm. These arrhythmias typically have a benign natural history but account for a considerable proportion of patients presenting with symptoms including palpitations, shortness of breath, chest discomfort, dizziness, and, on occasion, syncope. They affect a broad range of patients, from young, otherwise healthy adults and children to elderly patients with multiple comorbidities. Although medical management with AV nodal blocking medications or antiarrhythmic medications is a reasonable first-line approach, catheter ablation is a definitive, most often curable option that has minimal risk and offers the chance of avoiding long-term medications. This chapter covers the epidemiology, diagnosis, and management of SVTs, which include atrioventricular nodal reentrant tachycardia (AVNRT), atrioventricular reentrant tachycardia (AVRT), atrial tachycardia (AT), and others (atrial flutter, inappropriate sinus tachycardia, and junctional tachycardia). Atrial fibrillation, which is more prevalent than all other SVTs combined, are discussed elsewhere. Figures describe the differential diagnosis of tachycardia with narrow and wide QRS complexes, the relationship between the response to intravenous adenosine and the cause of tachycardia, the mechanism of tachycardia induction in patients with dual AV node conduction pathways, and the management of atrial flutter. Electrocardiograms illustrate features of various forms of SVT.
This review contains 11 highly rendered figures (included 6 twelve-lead ECGs), 1 table, and 69 references.
Immunosuppression for the Transplant Surgical Patient
Authors: Ravichandran Bharath R. , Sparkes Tracy M. , Casale Jillian P. , Hammad Sara , Clark Jacqueline E. , Freedman Sari R. , Masters Brian M. 
Published: January 2021

Immunosuppression brings with it many additional challenges in the management of the surgical patient already fraught with complexity. Given advances in surgery and medicine, transplantation has become a therapeutic option for patients once considered too ill. In the medical management of these patients, it is always most important to take into account the clinical status of the patient to balance the risk of infection and rejection. The management of immunosuppression in the surgical patient is challenging depending on the clinical scenario. In addition to patient-specific factors, there are many medication-related factors to consider, including toxicity, interactions, and pharmacokinetics. It is always important to consult a transplant specialist prior to initiating or reinitiating immunosuppression in these patients as the therapeutic goals are likely to be modified. Additionally, consideration of the patient’s history as it pertains to infection, rejection, and malignancy is highly pertinent in their immunosuppression management. Appropriate management and augmentation of immunosuppression are critical to the success of these patients, both at the time of transplantation and in the years that follow. The goal of this review is to provide a basis for the understanding of the complexities of immunosuppression in the surgical transplant patient.
This review contains 5 figures, 7 tables, and 54 references.
Key Words: immunosuppression; infection; rejection; solid-organ transplantation
Acute Liver Failure
Authors: DellaVolpe Jeffrey , Al Khafaji Ali 
Published: January 2021

Acute liver failure (ALF) can be challenging to manage due to the effect of liver failure on other organs and the severity of illness that ensues. Both the practicing surgeon and the intensivist should be aware of the manifestations, workup, and management implications as ALF is not uncommon to many intensive care settings. ALF precipitates a severe multiorgan dysfunction syndrome in a majority of cases, with high rates of complications and an elevated risk of death. Management requires a systemic approach in addition to the collaboration of a multidisciplinary team with an emphasis on early recognition, prompt management of complications, and timely transfer to a transplant center. In the absence of spontaneous recovery, transplantation is the only definitive management option and may not always be feasible or immediately available. The continuing search to develop alternatives is essential.
This review contains 2 figures, 9 tables and 70 references
Keywords: acetaminophen, acute liver failure, cerebral edema, coagulopathy, hepatitis, jaundice, N-acetylcysteine, transplantation
Pathologic Evaluation of Soft Tissue Sarcoma
Authors: Agaram Narasimhan P. 
Published: January 2021

Soft tissue sarcomas are rare tumors and are mostly managed in tertiary care centers. They are broadly classified based on their differentiation into multiple different types. They affect patients of all ages and mostly occur in the extremities. Pathologic examination of the biopsy or resection of the tumor is an extremely important aspect in the diagnosis of these tumors and appropriately guiding the clinical team in the management of these rare tumors. This review focuses on the aspects of pathologic evaluation of these tumors and discusses the morphologic aspects of the predominant soft tissue sarcomas based on differentiation. The review also highlights the latest molecular diagnostic studies that are used in the accurate subtyping of these tumors.
This review contains 12 figures, 2 tables, and 28 references.
Key words: angiosarcoma, fibromatosis, fibrous, liposarcoma, myxoid, nerve sheath tumor, sarcoma, synovial sarcoma
Rare Fibroblastic and Myofibroblastic Tumors
Authors: Zheleva Vasilena , Liang Yu , Melstrom Laleh 
Published: January 2021

This review discusses the clinical presentation, histopathologic characteristics, and diagnostic and treatment algorithms for several distinct fibroblastic and myofibroblastic tumor subtypes. Low-grade fibromyxoid sarcomas typically arise in the deep soft tissues of the proximal extremities or trunk in young adults. They tend to have a high local recurrence rate, although some may have distant metastases. Histologically, they consist of bland fibroblasts with a whorled or linear arrangement alternating with hypocellular myxoid stroma. Sclerosing epithelioid fibrosarcomas typically arise in the deep soft tissues of the lower extremities of middle-aged adults. They tend to be slow growing but clinically aggressive, with a high propensity for local recurrence and distant metastases. Classic histologic features include the presence of small, uniform, ovoid epithelioid cells with sparse cytoplasm, arranged in cords within a sclerotic fibrous stroma. Myxoinflammatory fibroblastic sarcomas mainly affect the hands and feet. They are prone to local recurrence, with a very low likelihood of distant metastasis. Histologically, they have nodular architecture and highly cellular areas with an abundance of inflammatory cells, among which characteristic large Reed-Sternberg–like and lipoblast-like cells and hypocellular areas rich in myxoid stroma can be seen. Inflammatory myofibroblastic tumors typically occur in children and young adults, with common anatomic locations being the omentum, mesentery, retroperitoneum, and lung. Histologically, they are composed of myofibroblastic spindle cells accompanied by a lymphoplasmacytic inflammatory infiltrate. Surgical resection is the mainstay of treatment for all of the above tumor types. Radiation therapy may be used as adjuvant therapy for tumors with a high risk of local recurrence, in the setting of positive margins, or for unresectable primary or metastatic disease. There is no definite role for standard chemotherapy, but in certain cases, targeted therapy may be of use, such as ALK inhibitors in ALK-positive inflammatory myofibroblastic tumors.
Key words: inflammatory myofibroblastic sarcoma, low-grade fibromyxoid sarcoma, myxoinflammatory fibroblastic sarcoma, sclerosing epithelioid fibrosarcoma
Hernias in the Emergency Department
Authors: Berhanu Daniel , Barclay-Buchanan Ciara J. , Westergaard Mary C. 
Published: January 2021

Hernia is defined as an abnormal protrusion of an organ or tissue through a pathologic defect in its surrounding wall. Overall, hernia is common and is generally believed to be a benign condition associated with some morbidity, although it is not thought to be associated with significant mortality. Between 2001 and 2010, 2.3 million inpatient abdominal hernia repairs were performed in the United States, of which 567,000 were performed emergently. In some cases, a hernia can be a deadly condition. In 2002, hernia was listed as the cause of death for 1,595 US citizens. This review covers the pathophysiology, stabilization and assessment, diagnosis and treatment, and disposition and outcomes of hernia. Figures show anatomic locations of the various abdominal wall, groin, lumbar, and pelvic floor hernias; a direct inguinal hernia; an indirect inguinal hernia; point-of-care sonograms showing a ventral wall hernia and an abdominal wall hernia; and the differential diagnosis of an abdominal mass based on anatomic location. Tables list risk factors for the development of inguinal hernia, sex-based differences in inguinal hernia development, risk factors for the development of incisional hernia, factors to consider when assessing the patient for a hernia, and factors associated with the highest rates of incarceration in patients with groin hernia.
Key words: emergent hernia, hernia incarceration, incisional hernia, inguinal hernia, strangulated hernia
This review contains 6 highly rendered figures, 5 tables, and 66 references.
Shock: Pathophysiology and Management
Authors: Shokoohi Hamid , Armstrong Paige 
Published: January 2021

Shock is a serious clinical condition in which tissue perfusion is inadequate to meet oxygen demand, resulting in tissue hypoxia. Shock is categorized based on the primary process leading to hemodynamic instability. There are five main classifications: cardiogenic, distributive, hypovolemic, obstructive, and dissociative. Regardless of etiology, the diagnosis and initial care of patients with shock must be prompt and directed towards reversing the tissue ischemia and preventing its consequences. Often initial evaluation, diagnosis, and resuscitation occur simultaneously. The first goal is to accurately identify the etiologic cause and initiate therapy before there is irreversible damage to end vital organs.
This review focuses on the pathophysiology and management of shock and addresses a number of new developments that have profoundly altered the treatment paradigms. A number of protocols have been developed in the arena of shock resuscitation. Focused ultrasonography is recommended for the prompt recognition of complicating physiology in patients with hypotension and shock, especially in unstable patients. Tables outline classification systems for different types of shock as well as appropriate first and second line vasopressors indicated in each.
Key words: Hypovolemic shock, cardiogenic shock, obstructive shock, distributive shock, dissociative shock, point-of-care ultrasonography, cardiac ultrasonography, vasopressors
This review contains 5 highly rendered figures, 8 tables, and 64 references.
Pediatric Trauma
Authors: Bryant Kathleen , Smith Jeremiah , Gibbs Michael 
Published: January 2021

Children have unique anatomy and physiologic responses to trauma that create different challenges for their management. It is important to follow the Advanced Trauma Life Support (ATLS) algorithm for assessing and treating a pediatric trauma patient, paying close attention to the primary survey. Once the primary survey is accomplished with adequate stabilization, the secondary survey proceeds with a focus on specific injuries. Head trauma is the leading cause of morbidity and mortality (M+M) in children. Early identification and prevention of secondary injury are important to optimize outcomes. The head and neck anatomic differences in a child cause a higher fulcrum of their cervical spine, leading to higher cervical spine injuries (CSIs). CSI is rare but carries a higher M+M due to higher spinal cord injuries. The National Emergency X-radiography Utilization Study (NEXUS) and Canadian C-spine Rule (CCR) are useful decision rules to clear cervical spines in adults but have limited strength in young children. PECARN has derived a pediatric cervical spine clearance rule, but this has yet to be prospectively validated. Similar to CSIs, thoracic injuries in children are rare but carry a higher M+M due to anatomic differences in children. A child’s chest anatomy and increased compliance cause more difficulty in injury identification. Abdominal trauma is common in children and can also be difficult to identify. Unlike adults, children can compensate for blood loss much longer while maintaining their blood pressure. Serial abdominal examinations are useful when imaging is negative and a patient has persistent symptoms.
This review contains 5 highly rendered figures, 18 tables, and 92 references.
Key words: abdominal trauma, Advanced Trauma Life Support (ATLS), cervical spine injury, head trauma, National Emergency X-radiography Utilization Study (NEXUS), Pediatric Emergency Care Applied Research Network (PECARN), thoracic trauma, traumatic brain injury