bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ineffective esophageal motility assessment in patients with and without pathological esophageal acid reflux
Authors: Pakoz Zehra Betul , Sari Sevil Ozer , Vatansever Sezgin , Uran Berna Nilgun Ozgursoy , Camyar Hakan , Gur Emine Ozlem , Gumus Zeynep Zehra , Akbulut Sabiye 
Published: May 2021

Abstract
Ineffective esophageal motility (IEM), defined as minor esophageal motility disorder, is also the most common esophageal motility disorder. The relationship between gastro-esophageal reflux disease is still controversial. Our aim in this study is to evaluate whether there are differences in terms of demographic, endoscopic, or motility findings between IEM patients with pathological esophageal acid reflux and physiological reflux.
Patients diagnosed with IEM according to the Chicago classification v3 with high-resolution manometry (HRM) before acid monitoring constituted the study group of our investigation. The patients were divided into 2 groups as patients with pathological esophageal reflux and patients with physiological reflux according to 24-hour acid monitoring. Demographic data, endoscopic findings, and HRM findings were compared between 2 groups.
A total of 62 patients who were diagnosed with IEM according to the Chicago classification v3 were included in the study. Patients in the physiological reflux group were 7 years younger on average than the pathological reflux group. Esophagitis rates were significantly higher in the pathological reflux group (P = .033). Lower esophageal sphincter resting pressure, integrated relaxation pressure, and the presence of hernia were found to be similar in the 2 groups (P = 392, P = 182, P = 657, respectively). The rate of severe IEM was also similar between the 2 groups (P = .143).
The fact that the physiological reflux patient group is younger may suggest that the IEM develops in the early period and then reflux accompanies the picture with advancing age.
Gestational obesity and subclinical inflammation
Authors: Rugină Cosmin , Mărginean Cristina Oana , Meliţ Lorena Elena , Huţanu Adina , Ghiga Dana Valentina , Modi Viviana , Mărginean Claudiu 
Published: May 2021

Abstract
Maternal obesity and excessive gestational weight gain (GWG) are associated with pregnancy-related complications, poor birth outcomes, and increased birth weight (BW).

The aims
of this study were to assess the relationship between excessive GWG and gestational inflammatory status in terms of blood parameters, as well as its influence on newborn's outcomes.
We performed a prospective study on 176 pregnant women divided into 2 groups depending on the GWG: group 1—normal GWG, 80 cases; and group 2—high GWG, 96 cases. The statistical analysis was performed using the GraphPad Prism program, trial variant. We performed a thorough anamnesis and clinical examination in all mothers and their newborns, as well as an assessment of multiple laboratory parameters.
The levels of both platelets and triglycerides were significantly higher in pregnant women from high GWG group (P = .0165/P = .0247). The newborns whose mothers presented an excessive GWG were found with a significantly higher BW as compared to those with normal GWG mothers (P = .0023). We obtained a positive correlation between the mothers’ and newborns’ values for hemoglobin, high-density lipoprotein, leucocytes, and platelets/lymphocytes ratio (P = .0002/P = .0313/P = .0137). Moreover, a significant positive correlation was found between GWG and BW (r = 0.2049, 95% CI: 0.0588–0.3425, P = .0064).
Our findings sustain the hypothesis that maternal obesity is a risk factor for macrosomia and childhood obesity since we found a positive correlation between GWG and BW. Women with high GWG expressed significantly higher levels of platelets and triglycerides suggesting a subclinical inflammation associated to excessive fat accumulation. The inflammation transfer from mother to fetus in our study was suggested by the positive correlations between maternal and neonatal leukocytes and platelets/lymphocytes ratio.
Comparison of multiple statistical models for the development of clinical prediction scores to detect advanced colorectal neoplasms in asymptomatic Thai patients
Authors: Soonklang Kamonwan , Siribumrungwong Boonying , Siripongpreeda Bunchorn , Auewarakul Chirayu 
Published: May 2021

Abstract
A good clinical prediction score can help in the risk stratification of patients with colorectal cancer (CRC) undergoing colonoscopy screening. The aim of our study was to compare model performance of binary logistic regression (BLR), polytomous logistic regression (PLR), and classification and regression tree (CART) between the clinical prediction scores of advanced colorectal neoplasia (ACN) in asymptomatic Thai patients.
We conducted a cross-sectional study of 1311 asymptomatic Thai patients to develop a clinical prediction model. The possible predictive variables included sex, age, body mass index, family history of CRC in first-degree relatives, smoking, diabetes mellitus, and the fecal immunochemical test in the univariate analysis. Variables with a P value of .1 were included in the multivariable analysis, using the BLR, CART, and PLR models. Model performance, including the area under the receiver operator characteristic curve (AUROC), was compared between the model types.
ACN was diagnosed in 53 patients (4.04%). The AUROCs were not significantly different between the BLR and CART models for ACN prediction with an AUROC of 0.774 (95% confidence interval [95% CI]: 0.706–0.842) and 0.765 (95% CI: 0.698–0.832), respectively (P = .712). A significant difference was observed between the PLR and CART models in predicting average to moderate ACN risk with an AUROC of 0.767 (95% CI: 0.695–0.839 vs AUROC 0.675 [95% CI: 0.599–0.751], respectively; P = .009).
The BLR and CART models yielded similar accuracies for the prediction of ACN in Thai patients. The PLR model provided higher accuracy for ACN prediction than the CART model.
ST-segment elevation due to myocardial invasion of lung cancer mimicking ST elevation myocardial infarction
Authors: Jung Hae Won 
Published: May 2021

Abstract

Introduction:
When a cancer patient presents with ST-segment elevation on an electrocardiogram (ECG), several causes including acute myocardial infarction (MI) should be considered. Myocardial metastasis is one of the rare causes of ST-segment elevation in cancer patients and its clinical silence makes it difficult to diagnose.

Patient concerns:
A 78-year-old man with lung cancer presented to the emergency room for chest pain. ECG revealed ST-segment elevation in inferior and lateral leads.

Interventions:
After emergent coronary angiography, percutaneous coronary intervention (PCI) on proximal right coronary artery was performed.

Outcomes:
Even 7 days after PCI, ST-segment elevation in inferior and lateral leads still existed. Cardiac markers continued to be within the normal range.

Diagnosis:
We found evidence of metastasis of lung cancer on the inferolateral wall of the myocardium by trans thoracic echocardiogram and positron emission tomography (PET)/computed tomography (CT). We diagnosed myocardial metastasis as the cause of ST-segment elevation in the patient.

Conclusion:
Myocardial metastasis is one of the differential diagnosis of ST-segment elevation in cancer patients. Periodic ECG is necessary for lung cancer patients and rapid cardiac work-up is recommended when ST-segment elevation is newly discovered.
PET/computed tomography in inpatients: part 1, international survey
Authors: Dibble Elizabeth H. , Baird Grayson L. , Fahey Frederic H. , Hyun Hyewon 
Published: May 2021

Purpose
The purposes of this study are to (1) identify patterns of inpatient PET/computed tomography (CT) use in and outside of the USA and (2) characterize inpatient PET/CT use by location and indication.

Materials and methods
The study was deemed exempt by the Institutional Review Board. A survey link through REDCap was emailed to the Society of Nuclear Medicine and Molecular Imaging (SNMMI) members and PET Centers of Excellence members and posted on the SNMMI website. Data were collected from May 2018 to August 2018. Analyses were conducted using SAS Software 9.4 with the NPAR1WAY procedure. Differences were evaluated using the Kruskal–Wallis test with statistical significance defined as P ≤ 0.05.

Results
A total of 124 people responded to the survey, 71.8% (89/124) in the USA, and 26.6% (33/124) outside the USA [1.6% (2/124) no response]. 81.5% (101/124) read inpatient PET/CTs. Median percent of inpatient PET/CTs was 8.0% (range 0–100). Use of inpatient PET/CT was different (P < 0.0001) in the USA (5%, range 0–80%) versus outside USA (17.7%, range 0–100%). Use of inpatient PET/CT was different by institution type: median percent of inpatient PET/CTs in community teaching hospitals was 4.5% (range 0–50) versus 1.1% (range 0–20) in community nonteaching, 10% (range 0–80) in academic medical centers, and 20.0% (range 6.3–40) in government-affiliated institutions (P = 0.0001).

Conclusions
Most US and non-US respondents read inpatients PET/CTs. Non-US respondents read a higher percentage of inpatient PET/CTs than US respondents. Respondents in government-affiliated institutions read the highest percent of inpatient PET/CTs and community nonteaching institutions the least. Results of this survey may help physicians evaluate whether their practice of providing inpatient PET/CT fits with current practice patterns.
Simulation of the distribution of astatine-211 solution dispersion in a lab room
Authors: Kubo Hitoshi , Takahashi Kazuhiro , Shimoyama Saki , Zhao Songji , Ukon Naoyuki , Ito Hiroshi 
Published: May 2021

Objective
This study aimed to evaluate the distribution of Astatine-211 (211At) solution dispersion in a small animal cage using autoradiography imaging to simulate the dispersion of 211At in a lab room to eventually prevent user’s risk of internal exposure in terms of radiation safety.

Methods

211At radiation sources with two chemical properties (Na211At and Free 211At) were prepared. The solutions of 211At were placed onto a dish with paper, and then, it was placed in a small animal cage for 3 h. After removing the dish, an imaging plate with attaching reference sources was placed at four walls of the cage for 15 h in a lead box. Imaging plates were read, and all pixel data were calculated using Microsoft Excel 2016 to obtain three-dimensional (3D) distribution. Calculated results were depicted using a 3D sphere model.

Results
The mean activity of Free 211At was 2.3 times higher than that of Na211At on all autoradiography images. In the cage, the shape of the dispersion of Na211At was almost homogeneous, whereas that of Free 211At was more heterogeneous.

Conclusion
We found that the solution of 211At vaporized naturally and was distributed heterogeneously in the cage, and the chemical properties of 211At influenced their behaviors. These results must be considered to minimize the risks of radiation safety.
Subdorsal Z-flap: a modification of the Cottle technique in dorsal preservation rhinoplasty
Authors: Kovacevic Milos , Veit Johannes A. , Toriumi Dean M. 
Published: May 2021

Purpose of review
To present the novel technique of subdorsal Z-flap in dorsal preservation rhinoplasty and give an overview on current available dorsal preservation techniques in the literature.

Recent findings
The subdorsal Z-flap combines the advantages of the high and low septal strip techniques in dorsal preservation rhinoplasty and ensures well tolerated treatment of the dorsal hump and structural stability.

Summary
The technique and concept of Dorsal Preservation Rhinoplasty (DPR) has been used for more than a century but only recently gained significant popularity along with specific technical refinements. The advantage of DPR lies in the preservation of the delicate triangular cartilaginous unity of the septal and upper lateral cartilages with its functional and esthetic implications in contrast to all resecting techniques. A variety of modifications of DPR have been published in recent years, each with advantages and disadvantages. The issue of hump recurrence remains a major concern in DPR. We describe the ‘subdorsal Z-flap’ and related techniques of DPR in detail, present two clinical case studies and discuss alternative technical modifications. The ‘subdorsal Z -flap’ combines the advantages of the high septal strip procedure with the advantages of the traditional ‘low septal strip’ or Cottle technique. By starting the incision at a high level, final septal height can be adjusted precisely. By creating a triangular shape with a vertical cut below the K-Area, which is usually the highest point of the hump, significant leverage can be applied from below the hump and the septal overlap may be sutured securely for a stable correction. In combination with Piezo osteotomy and full open approach, great precision and predictability can be achieved. In a recent publication, we presented more than 100 consecutive cases of subdorsal Z-flap DPR with good functional and esthetic outcomes. The subdorsal Z-flap modification is a combination of two popular DPR techniques, fusing their advantages while minimizing risk profile. A slightly higher degree of technical difficulty and necessary tissue dissection provides the benefits of better predictability and reduction of adverse outcomes.
Surgical management of the orbit in thyroid eye disease: lateral orbital decompression
Authors: Williams Jonathan S. , Sahu Priya D. 
Published: May 2021

Purpose of review
Lateral orbital wall decompression is one of many well established techniques available to surgeons in management of patients with clinically significant thyroid eye disease (TED). Several different surgical approaches have been described in the literature and are reviewed herein.

Recent findings
Lateral orbital wall decompression remains a popular technique for surgical management of TED, with a recent American Society of Ophthalmic Plastic and Reconstructive Surgery survey showing that 22.6% of respondents preferred a single-wall procedure, with 36.8% of that subset preferring lateral wall decompression alone. Surgical techniques for lateral orbital wall decompression differ based on several steps, such as the incisional approach, whether to take an ab-interno versus ab-externo approach, and whether to remove orbital fat to achieve further decompression. In addition, technological advances have produced an array of tools available to the orbital surgeon to achieve efficient and accurate bone removal.

Summary
Lateral orbital wall decompression for TED, despite being an older technique, remains a popular and well established procedure for orbital decompression. Though no randomized controlled clinical trial supports one decompression technique over another for TED, lateral orbital wall decompression offers many benefits such as its ease of access and visualization of the orbital space.
Novel treatments for pediatric atopic dermatitis
Authors: Scott Jennifer B. , Paller Amy S. 
Published: May 2021

Purpose of review
To describe new and emerging therapies for pediatric atopic dermatitis (AD).

Recent findings
Recent investigations have highlighted the importance of type 2 immunity and interrelationships among the skin immune system, epidermal barrier, and microbiome in the pathogenesis of AD, including in infants and children. These discoveries have translated into more targeted therapy. Crisaborole ointment, a topical phosphodiesterase 4 (PDE4) inhibitor, and dupilumab, a subcutaneously injected interleukin (IL)-4 receptor inhibitor, are now Food and Drug Administration-approved. Topical agents under investigation for use in the pediatric population include Janus kinase (JAK) inhibitors, PDE4 inhibitors, an aryl hydrocarbon receptor agonist, an antimicrobial peptide, and commensal skin bacteria. Emerging systemic agents for pediatric AD include biologics targeting IL-13, the IL-31 receptor, and the IL-5 receptor, as well as oral JAK inhibitors.

Summary
Increased understanding of AD pathogenesis has resulted in the development of new, more targeted therapies that show promising safety and efficacy results in Phase 2 and 3 clinical trials, although long-term safety remains to be evaluated. AD is a heterogeneous disease and having choices of therapies with different mechanisms of action will allow a broader group of children and adolescents with moderate-to-severe disease to achieve disease control.
Unusual Clinical Presentation of Hodgkin Lymphoma in a Child: Both Spinal Cord Compression and Hydronephrosis
Authors: Bayram Nihan , Yaman Yontem , Elli Murat , Dogan Mehmet S. , Ayyildiz Suat , Telhan Leyla , Çakir Asli , Unal Dilek , Sebirli Fatih , Anak Sema 
Published: May 2021

Background:
Hodgkin lymphoma (HL) is predominantly a nodal disease with extranodal presentation being uncommon. Presentation with neurological symptoms is not uncommon in adult patients with HL. Subdiaphragmatic involvements are less common especially in childhood. In the literature, there has been no case which presented with both spinal cord compression and bilateral hydronephrosis in pediatric patients with HL.

Observation:
We report a 9-year-old boy diagnosed with HL who presented with bilateral hydronephrosis and epidural involvement.

Conclusion:
Differential diagnosis of abdominal mass in patients presenting with spinal cord compression and/or hydronephrosis should include HL. Retrograde J ureteral stenting is the treatment of choice for malignant ureteral obstruction.
Gonadotrophin-independent Precocious Puberty Secondary to an Estrogen Secreting Adrenal Tumor
Authors: Tseretopoulou Xanthippi , Murray Matthew J. , Buck Jackie , Hook C. Elizabeth , Jackson Claire , Kosmoliaptsis Vasilis , Hughes Jacqueline , Gorman Samantha , Williams Rachel M. 
Published: May 2021

Background:
Adrenal masses are rare in children and most commonly present with clinical features of virilization in the absence of activation of the pituitary axis—gonadotrophin-independent precocious puberty.

Observations:
We report an unusual case of a 7-year-old girl who presented with clinical signs suggestive of exposure to both androgens and estrogens. Imaging revealed a left-sided adrenal mass with no evidence of metastasis. She underwent successful laparoscopic unilateral adrenalectomy. Histology confirmed an adrenal adenoma.

Conclusion:
We conclude that adrenocortical tumors should be considered in children presenting with gonadotrophin-independent precocious puberty and raised estrogens.
Outcomes of orthopaedic trauma surgery in COVID-19 positive patients
Authors: Al-Humadi Samer M. , Tantone Ryan , Nazemi Alireza K. , Hays Thomas , Pawlak Amanda , Komatsu David E. , Namm Joshua D. 
Published: May 2021

Abstract

Objectives:
To investigate outcomes for operative orthopaedic trauma in patients who tested positive for coronavirus disease 2019 (COVID-19) during the height of the COVID-19 pandemic in New York.

Design:
Retrospective case series.

Setting:
Urban Level-1 academic trauma center.

Patients/participants:
Thirteen patients diagnosed with COVID-19 who underwent surgical management for orthopaedic trauma between January 21, 2020 and May 11, 2020.

Intervention:
Does not apply to this study.

Main outcome measurements:
Complications including death, coma lasting more than 24 hours, prolonged mechanical ventilation, unplanned intubation, blood transfusion, postoperative pneumonia, cerebrovascular event, thromboembolic event, myocardial infarction, urinary tract infection, acute renal failure, septic shock, return to the operating room, wound dehiscence, surgical site infection, graft/prosthesis/flap failure, and peripheral nerve injury.

Results:
Two (18%) patients had symptoms of COVID-19 (cough, shortness of breath, fevers, chills, nausea/vomiting, diarrhea, abdominal cramps/pains) on admission. Average length of stay (standard deviation) was 6.6 (4.31) days. Average time to follow up was 29 (10.77) days. Three (27%) patients developed pneumonia postoperatively and 1 (9%) underwent unplanned intubation. One (9%) patient was intubated for greater than 48 hours. Two (18%) patients developed postoperative deep venous thromboembolism. Three (27%) patients developed acute renal failure postoperatively. Six (55%) patients underwent blood transfusion intraoperatively or postoperatively. Two (18%) patients died postoperatively.

Conclusion:
In this small series surgical management in Coronavirus-19 positive patients with skeletal injuries was successfully accomplished with patient anticoagulation, hematologic, and pulmonary status in mind. Therapeutic anticoagulation and patient hematologic status were optimized prior to the operating room to minimize development of venous thromboembolism and avoid blood transfusion.

Level of evidence:
Level IV prognostic
Core Stability Exercises Yield Multiple Benefits for Patients With Chronic Stroke
Authors: Karthikbabu Suruliraj , Ganesan Sailakshmi , Ellajosyula Ratnavalli , Solomon John M. , Kedambadi Rakshith C. , Mahabala Chakrapani 
Published: May 2021

Objective
This study examined the effect of core stability exercises on trunk control, core muscle strength, standing weight-bearing symmetry, and balance confidence of people with chronic stroke.

Design
This was an assessor-blinded randomized controlled trial involving 84 ambulatory patients with middle cerebral artery stroke, randomly assigned to three training groups. Two experimental groups practiced core stability exercises either on stable or on unstable support surfaces. In contrast, the control group received standard physiotherapy. All the participants underwent an hour-long training session a day, thrice a week over a 6-wk duration, and followed-up after 12 mos. Trunk Impairment Scale, core muscle strength, weight-bearing asymmetry in standing, and Activities-specific Balance Confidence scale were the outcome measures.

Results
Compared with the control group, the two experimental groups demonstrated a significant improvement on all the outcome measures from baseline to posttraining and from baseline to 12-mo follow-up (P < 0.001). The two experimental groups demonstrated no significant difference between them on all the measures (P > 0.05).

Conclusions
Core stability exercises on stable and unstable support surfaces are equally beneficial in improving trunk control, core muscle strength, standing weight-bearing symmetry, and balance confidence of ambulatory patients with chronic stroke than the standard physiotherapy.