bluuebunny/crossref_metadata_2025_split huggingface dataset:
Infant Nutrition
Authors: Lawrence Ruth A. 
Published: December 2021

NORMAL GROWTH IN BREASTFED INFANT
Appropriate growth in a breast-fed infant is comparable to appropriate growth in a bottle-fed infant. An infant who gains steadily is usually not of concern. However, a normal breast-fed infant may lose 5% to 8% of birth weight in the first few days of life and not begin to gain until the fifth to the seventh day, with birth weight being regained at 10 to 14 days. If weight gain is evaluated from the point of regaining birth weight, the curve is a steady one, with a total gain of two pounds in the next four weeks. Infants fed formula often lose only 1% to 2% of body weight and regain birth weight by the first week. A breast-fed infant whose mother is a primipara may lose more weight because the volume of milk does not increase until the fourth day post partum whereas a multipara's milk comes in sooner (in inverse relation to her multiparity).
Ideally, the breast-fed infant gains two pounds per month in the first three months, one pound per month in the second three months, and one-half pound per month for the next six months. The birth weight is doubled at four to five months and tripled at one year. Some available growth curves are based on formula-fed infants, a group that includes a greater number of obese infants.
Androgen Disorders in Children: Too Much, Too Early, Too Little, or Too Late
Authors: Rosenfield Robert L. 
Published: December 2021

Pubarche, used here as synonymous with the onset of sexual hair (Tanner pubic hair stage III), usually follows the onset of true puberty by one to two years. The true status of puberty is best indicated by testicular size in boys and breast development in girls. Departure from this sequence of events, or dissociation of pubic hair from gonadal development are important clues to proper diagnosis when pubarche begins prematurely. Hirsutism or acne in adolescent girls, particularly when associated with menstrual irregularity or obesity, has a high probability of having an androgenic basis. Polycystic ovary syndrome is the most common cause of this situation in teenagers. The pattern of sex hormone levels can be an important clue to the diagnosis of hyperandrogenic disorders, particularly when coupled with a "low-dose," five-day dexamethasone suppression test. Delayed puberty is usually a "constitutional," familial variant of normal development, but can often be distinguished from true hypogonadism by the mid-teenage years using history, examination, steroid 1evels, and a gonadotropin-releasing hormone test.
ANDROGENS
Testosterone and dehydroepian-drosterone-sulfate (DHAS) are the most important androgens in blood (Fig 1). Testosterone is the major potent form of circulating androgen. DHAS is the most abundant circulating 17-ketosteroid. The normal plasma and urine levels of the androgens are shown in Table 1.
Burns in Children
Authors: GUZZETTA PHILIP C. , RANDOLPH JUDSON 
Published: December 2021

One of our readers wrote concerning the article, "Burns in Children," (PIR 4:271, 1983): "There is a difference of opinion between experts regarding early use of colloid solution in treatment of second and third degree burns. Guzzetta and Randolph do not recommend colloid, whereas other experts do. What is the consensus of experts?"
In reply: The use of colloid solution as part of the fluid resuscitation formula in burned children is controversial. Baxter has shown that for the first 24 hours a "capillary leak" exists throughout the body and not just in the burned area. It is difficult to justify using a more expensive volume expander such as albumin, when the capillaries are equally permeable to both the colloid and Ringer's lactate.
Cholestasis of the Newborn (Obstructive Jaundice)
Authors: Gartner Lawrence M. 
Published: December 2021

Obstructive jaundice of the newborn is a misnomer as fewer than half of all cases usually referred to as "obstructive jaundice" result from mechanical interference with the flow of bile. In the majority of cases, intrinsic liver disease is the cause of this type of jaundice. The term "cholestasis" more comprehensively describes the various disorders and the pathophysiology, which includes retention of direct-reacting (conjugated) bilirubin, bile acids, and other components of bile.
Direct-reacting hyperbilirubinemia is almost always the first definitive sign of hepatobiliary dysfunction, often appearing during the first weeks of life just as the normally occurring, indirect-reacting (unconjugated) hyperbilirubinemia of physiologic jaundice of the newborn is receding. Initially, there may be uncertainty as to the significance of the persisting or recurring jaundice, particularly whether the direct-reacting fraction is elevated.
As a general rule, when the direct-reacting portion exceeds 2.0 mg/dl and is more than 10% of the total serum bilirubin, it should be considered clinically significant. Although the direct-reacting fraction may occasionally account for 90% of total serum bilirubin, in most cases the direct-reacting portion will range only from 25% to 75%. The degree of variation has no diagnostic significance. As only water-soluble, direct-reacting bilirubin is excreted by the kidney, the presence of bilirubinuria may be used as confirmation of elevation of the direct-reacting fraction.
Scoliosis Screening
Authors: Berwick Donald M. 
Published: December 2021

Scoliosis screening reduces the frequency of scoliosis surgery in a population, and probably leads, through early bracing, to a reduction in the degree of at least some serious curves. Its costs, however, are far from negligible. Even in the best of hands, a screening program induces costs and concerns in follow-up for many more children than it helps, and, if poorly administered, these induced costs can far outweigh the advantages to the screened population.
For the moment, until inexpensive and noninvasive follow-up methods are developed, it is probably advisable that children in the age range of 10 to 14 years be screened competently at least once, but with strict attention to the following principles:
1. Follow-up of those with positive results on screening should be suited to the age, sex, and risk factors for the individual child, and should minimize expense, roentgenogram ex-posure, and concern wherever possible.
2. Screening should be done by well-trained personnel who are fully aware of both the signs of significant curvature and of the costs and risk of inappropriate referral.
3. Screening programs should systematically assess the psychological morbidity of the labeling process in their target populations, and should modify their procedures accordingly if that morbidity is high.
4. Programs should be solidly linked to sound, prompt, and circumspect referral patterns—either primary care or specialty consultants. The mere "detection" of positive screening findings without assuring competent follow-up does not consitute effective screening.
Anemia in the Newborn Infant
Authors: Dickerman Joseph D. 
Published: December 2021

The proper management of anemia in the newborn period, as at any age, requires an accurate diagnosis. It is helpful to divide the many possible etiologies into three major categories: blood loss, increased destruction of red blood cells (hemolysis), and decreased production of red blood cells (bone marrow aplasia or hypoplasia).
DEFINITION
The first step in the diagnosis of neonatal anemia is to define it. Normal hematologic values during the first 2 weeks of life in the term infant are presented in Table 1. Similar values for infants of low birth weight have been published by Stockman and Oski. The more common anemias will be discussed in terms of findings on physical examination, history, ry, laboratory studies, and management with reference to groups of conditions (Tables 2 and 3) rather than to specific disease entities. The less common disorders will be either omitted or described only briefly. The anemia of prematurity will not be covered. A discussion of this topic can be found in the article by Stockman.
Approach to Diagnosis
The usual approach to diagnosis, taking a history and then performing a physical examination, has been reversed in this paper. In most cases, a physician is called to see a neonate suspected of being anemic because of signs and/or symptoms of shock, pallor, or a low hemoglobin concentration, and the physician examines the infant prior to obtaining a history.
Cardiometabolic risk factors in predicting obstructive coronary artery disease in patients with non-ST-segment elevation acute coronary syndrome
Authors: Geltser B. I. , Tsivanyuk M. M. , Shakhgeldyan K. I. , Emtseva E. D. , Vishnevskiy A. A. 
Published: December 2021

Aim. To develop predictive models of obstructive coronary artery disease (OPCA) in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) based on the predictive potential of cardiometabolic risk (CMR) factors.Material and methods. This prospective observational cohort study included 495 patients with NSTE-ACS (median age, 62 years; 95% confidence interval [60; 64]), who underwent invasive coronary angiography (CAG). Two groups of persons were identified, the first of which consisted of 345 (69,6%) patients with OPCA (stenosis ≥50%), and the second — 150 (30,4%) without OPCA (<50%). The clinical and functional status of patients before CAG was assessed including 29 parameters. For data processing and analysis, the Mann-Whitney, Fisher, chi-squared tests and univariate logistic regression (LR) were used. In addition, for the development of predictive models, we used multivariate LR (MLR), support vector machine (SVM) and random forest (RF). The models was assessed using 4 metrics: area under the ROC-curve (AUC), sensitivity, specificity, and accuracy.Results. A comprehensive analysis of functional and metabolic status of patients made it possible to identify the CMR factors that have linear and nonlinear association with OPCA. Their weighting coefficients and threshold values with the highest predictive potential were determined using univariate LR. The quality metrics of the best predictive algorithm based on an ensemble of 10 MLR models were as follows: AUC — 0,82, specificity and accuracy — 0,73, sensitivity — 0,75. The predictors of this model were 7 categorical (total cholesterol (CS) ≥5,9 mmol/L, low-density lipoprotein cholesterol >3,5 mmol/L, waist-to-hip ratio ≥0,9, waist-to-height ratio ≥0,69, atherogenic index ≥3,4, lipid accumulation product index ≥38,5 cm*mmol/L, uric acid ≥356 pmol/L) and 2 continuous (high density lipoprotein cholesterol and insulin resistance index) variables.Conclusion. The developed algorithm for selecting predictors made it possible to determine their significant predictive threshold values and weighting coefficients characterizing the degree of influence on endpoints. The ensemble of MLR models demonstrated the highest accuracy of OPCA prediction before the CAG. The predictive accuracy of the SVM and RF models was significantly lower.
Effectiveness of immunosuppressive therapy for lymphocytic myocarditis according: data from actual clinical practice
Authors: Mairina S. V. , Titov V. A. , Mitrofanova L. B. , Pavlova E. S. , Bortsova M. A. , Semenov A. P. , Moiseeva O. M. 
Published: December 2021

Aim. To compare the effectiveness of standard heart failure therapy with and without combined immunosuppressive therapy in patients with documented lymphocytic myocarditis (LM) based on data from actual clinical practice.Material and methods. This observational study included 70 patients with documented LM, 40% (n=28) of whom received immunosuppressive therapy. All patients underwent standard echocardiographic and laboratory investigations, endomyocardial biopsy with histological, immunohistochemical and molecular genetic analysis. Contrast-enhanced cardiac magnetic resonance imaging was performed in 74% of patients. All patients received standard therapy for heart failure at baseline.Results. The groups did not differ in demographic and echocardiographic characteristics. The appointment of immunosuppressive therapy was accompanied by an increase in ejection fraction by 12,2% compared to 6,4% (p=0,02). There were no significant differences in combined endpoints (survival and the need for heart transplantation) depending on therapy regimen (log-rank p=0,97).Conclusion. The prognosis of patients with chronic LM depends on the process activity, the severity of impaired hemodynamics and ventricular arrhythmias, as well as on the presence of persistent viral infection. Compliance with patient selection algorithm before prescribing immunosuppressive therapy is associated with the improvement in myocardial global contractility.
What is the role of profibrogenic and proinflammatory factors in developing atrial fibrillation associated with metabolic syndrome components?
Authors: Ionin V. A. , Barashkova E. I. , Pavlova V. A. , Borisov G. I. , Averchenko K. A. , Zaslavskaya E. L. , Baranova E. I. 
Published: December 2021

Aim. To determine the concentration of blood fibrotic and inflammatory biomarkers in patients with atrial fibrillation (AF) associated with metabolic syndrome (MS) components.Material and methods. The study included 646 patients aged 35-65 years: patients with AF and MS (n=142), those with AF and without MS (n=113), those with MS and without AF (n=175) and the control group consisted of healthy subjects without cardiovascular and metabolic diseases (n=107). All participants underwent anthropometric and laboratory investigations. Profibrogenic (aldosterone, galectin-3, TGF-beta1, CTGF) and proinflammatory (CT-1, IL-6) factors were determined in serum and plasma by ELISA. Statistical analysis was performed using IBM SPSS Statistics software (version 22.0).Results. The highest concentrations of fibrotic and inflammatory biomarkers were found in patients with AF in combination with MS. In MS patients without AF, the concentration of aldosterone, galectin-3, TGF-beta1, CTGF, CT-1, and IL-6 was also higher than in healthy subjects. The levels of aldosterone, CT-1 and IL-6 in patients with AF were higher in the presence of three or more MS components, while the highest values of these parameters were found in patients with five MS components. The lowest concentrations of galectin-3, CTGF, and CT-1 in patients with AF were found in patients without MS components, and in the presence of even 1 MS component, they were significantly higher. Correlation analysis made it possible to establish a stronger relationship between aldosterone and TGF-betal with systolic blood pressure (p=0,493, p<O,O001 and p=0,530, p<O,O001), and CT-1, CTGF and IL-6 in a greater degree correlated with waist circumference (p=0,563, p<0,0001; p=0,626, p<0,0001; p=0,480, p<O,O001). The concentrations of galectin-3 and CTGF were more positively correlated with an increase in the number of MS components. In patients with AF and hypertension (HTN), but without abdominal obesity (AO), higher values of aldosterone (108,1±70,3 pg/ml and 89,3±32,2 pg/ml, p=0,003) and TGF-beta1 (3680,1±1863,3 pg/ml and 1968,1±1611,5 pg/ml, p=0,015) in serum than in AF patients without HTN and without AO. In the group of patients with AF and AO, but without HTN, higher concentrations of IL-6 (2,9±0,7 pg/ml and 1,9±0,6 pg/ml, p=0,001) and CTGF (162,9±92,2 pg/ml and 116,3±63,4 pg/ml, p=0,0001).Conclusion. It can be assumed that hypertension through the aldosterone system and TGF-beta1, as well as abdominal obesity through the cytokine system CT-1 and IL-6 activate various mechanisms and pathways for myocardial remodeling. Integral molecules galectin-3 and CTGF mediate their interactions, in particular in patients with a combination of several MS components and contribute to a higher AF risk.
Analysis of relapse-free and overall survival in oncoplastic and organ-preserving surgeries in patients with breast cancer
Authors: Babayeva O. G. , Sidorov S. V. , Novikov S. S. , Kvon T. E. , Shevchenko K. E. 
Published: December 2021

Purpose of the study. To study the results of relapse-free and overall survival during organ- preserving and oncoplastic surgeries in patients with breast cancer.Materials and methods. A prospective clinical study of 84 patients was carried out in the mammology department on the basis of GBUZ NSO "GKB № 1". The first group of patients (40 patients) underwent OPR with ALAE - oncoplastic resection of the mammary gland with axillary lymphadenectomy. The second group (44 patients) WSR with ALAE - wide sector resection of the mammary gland with axillary lymphadenectomy.During the study, the patients were comparable in age, stage (TNM), histological type, and morphogenetic data. The survival rate was studied by the number of local relapses and distant metastases, using laboratory and instrumental studies. The quality of life was assessed on the basis of anamnestic data (Karnofsky index, ECOG scale).Results. In the first group of patients, disease-free and overall survival rate was 97.5 %. At the same time, a local recurrence was found in a patient with a triple negative tumor type, distant metastases to the lungs in a patient with a HER2/neu-positive type. In the second group, relapse-free survival was 95.4 %, overall - 97.7 %. Relapses in two patients with HER2/neu-positive type, metastases to the lungs in a patient with triple negative type.Conclusion. Relapse-free survival rates are 2.1 % higher in group I patients who underwent oncoplastic resection with axillary lymphadenectomy. And the indicators of overall survival in patients of both groups do not differ relatively.
A rare case of solitary fibrous tumor of the liver and highly differentiated rectal adenocarcinoma
Authors: Shinkarev S. A. , Lando M. N. , Brykin V. N. , Zhinkin R. V. , Pestryakov O. E. , Odegov D. A. 
Published: December 2021

Solitary fibrous tumors (SFT) are rare spindle cell mesenchymal neoplasms of presumably fibroblastic origin with undefined malignancy potential and rare metastasis. Their most frequent localization is in the pleura, where they have been first described. The incidence of solitary fibrous tumors localized in liver is extremely low. The clinical picture of SFT is nonspecific and is not due to the anatomical location of the tumor and it's size.In the majority of cases these tumors are benign. However, a number of them still may have signs of malignancy: an aggressive course with possible local recurrence and distant metastasis. The main method of treatment of hepatic solitary fibrous tumor (as well as SFT of other localization) with it's resectability is surgery. Radical removal of the tumor in the majority of cases leads to recovery. Subsequently, the operated patients should be subjected to strict dynamic observation with regularity as in malignant neoplasms (MN).The importance for chemotherapy and radiation therapy in the treatment of hepatic solitary fibrous tumor has not been determined in clinical guidelines to date.There are isolated reports of the use of chemotherapy or radiation therapy for the treatment of cases when tumor resection is not radical or there are signs of malignant neoplasm.In literature, there are numerous reports of a combination of a solitary fibrous tumor of any localization with malignant neoplasms of other organs in the same patients.In this report, we represent a clinical case of a 64-year-old woman, who had a solitary fibrous tumor of the liver and highly differentiated rectal adenocarcinoma. The patient underwent resection of the first segment of the left lobe of the liver. After a month and a half, transanal excision of the villous tumor of the rectum. The pathologic and immunohistochemical examination of the liver tumor revealed a malignant solitary fibrous tumor. After researching villous tumor of the rectum - a highly differentiated adenocarcinoma with a depth of invasion of the submucous layer of the intestinal wall up to 1/3 (T1sm1 according to Kikuchi). During dynamic observation for twenty-five months after the operation, the patient has no signs of tumor recurrence and metastasis.
Improved cardiovascular risk stratification with PET: [18F]meta-fluorobenzylguanidine as a potential cardiac radiotracer
Authors: Meyer Austin , Snyder Scott 
Published: December 2021

Background and Hypothesis:
Cardiovascular disease is the leading cause of death in the United States each year, exceeding 600,000 deaths and costing over $200B. Sympathetic dysfunction in cardiac tissue has been shown to occur in patients with recent cardiac injury or longstanding disease. The SPECT radiotracer, meta-[123I]iodobenzylguanidine (MIBG), has been used to image neuroendocrine tumors as well as global cardiac sympathetic tone through the human norepinephrine transporter-1. We will determine the utility and improved imaging the PET radiotracer meta-[18F]fluorobenzylguanidine (MFBG) can afford in cardiac care. MFBG has shown several improvements over MIBG in neuroendocrine tumors but has proven difficult to reliably synthesize.
Project Methods:
A novel synthetic pathway of MFBG utilizing copper accelerated Sandmeyer fluorination conditions is being developed to streamline its radiosynthesis from seven manipulations and an unstable precursor to four with more stable intermediates.
We also explored where MFBG may be useful in cardiology by performing a literature review through the PubMed MeSH database published after 2010.
Results:
We have developed a new MFBG precursor in one step from commercially available compounds and a one-pot automated radiosynthesis is currently in development. This improves upon current methods and may provide increased clinical availability of MFBG for future studies.
MIBG has shown prognostic value for the incidence of severe cardiac events but cannot provide any local innervation data. The PET radiotracer, [11C]hydroxyephedrine, can display local denervation within the myocardium. However, its 20.3 minute half-life prevents its widespread use beyond hospitals with direct access to a radiochemistry laboratory. To our knowledge, no cardiac imaging has been investigated using MFBG.
Conclusion and Potential Impact:
We believe MFBG could provide similar improvements to cardiac imaging as in neuroendocrine tumors. With a novel synthetic method being developed, we hope to begin pre-clinical imaging studies and provide future cardiologists with a new prognostic imaging modality which can direct personalized care to patients with cardiovascular disease.