bluuebunny/crossref_metadata_2025_split huggingface dataset:
Innervation of the Posterior Hip Capsule: A Cadaveric Study
Authors: Nagpal Ameet S , Brennick Caroline , Occhialini Annette P , Leet Jennifer Gabrielle , Clark Tyler Scott , Rahimi Omid B , Hulk Kendall , Bickelhaupt Brittany , Eckmann Maxim S 
Published: February 2021

Abstract

Objective
Recent studies of hip anatomy have turned to the posterior hip capsule to better understand the anatomic location of the posterior capsular sensory branches and identify nerves with potential for neural blockade. Current literature has shown the posterior hip capsule is primarily supplied by branches from the sciatic nerve, nerve to quadratus femoris, and superior gluteal nerve (1, 2). This cadaveric study investigated the gross anatomy of the posterior hip, while also identifying potential targets for hip analgesia, with emphasis on the superior gluteal nerve and nerve to quadratus femoris.

Design
Cadaveric study.

Setting
UT Health San Antonio Anatomy Lab.

Methods
In total, 10 total cadavers (18 hips total), were posteriorly dissected identifying nerve to quadratus femoris, superior gluteal nerve, and sciatic nerve. Nerves were labeled with radio-opaque markers. Following the dissections, fluoroscopic images were obtained at sequential angles to identify neural anatomy and help expand anatomic knowledge for interventional pain procedures.

Results
The posterior hip capsule was supplied by the sciatic nerve in 1/16 hips, the nerve to quadratus femoris in 15/18 hips, and the superior gluteal nerve in 6/18 hips.

Conclusions
The nerve to quadratus femoris reliably innervates the posterior hip joint. Both the sciatic nerve and superior gluteal nerve have small articular branches that may be involved in posterior hip innervation, but this is not seen commonly. The results of this study may elucidate novel therapeutic targets for treatment of chronic refractory hip pain (i.e., the nerve to quadratus femoris).
Anti-phospholipid syndrome and COVID-19 thrombosis: connecting the dots
Authors: Tung Moon Ley , Tan Bryce , Cherian Robin , Chandra Bharatendu 
Published: February 2021

Abstract
As the coronavirus disease 2019 (COVID-19) pandemic, which is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is spreading rapidly worldwide, it has emerged as a leading cause of mortality, resulting in &gt;1 million deaths over the past 10 months. The pathophysiology of COVID-19 remains unclear, posing a great challenge to the medical management of patients. Recent studies have reported an unusually high prevalence of thromboembolic events in COVID-19 patients, although the mechanism remains elusive. Several studies have reported the presence of aPLs in COVID-19 patients. We have noticed similarities between COVID-19 and APS, which is an autoimmune prothrombotic disease that is often associated with an infective aetiology. Molecular mimicry and endothelial dysfunction could plausibly explain the mechanism of thrombogenesis in acquired APS. In this review, we discuss the clinicopathological similarities between COVID-19 and APS, and the potential role of therapeutic targets based on the anti-phospholipid model for COVID-19 disease.
Clinical significance of E148Q heterozygous variant in paediatric familial Mediterranean fever
Authors: Tirosh Irit , Yacobi Yonatan , Vivante Asaf , Barel Ortal , Ben-Moshe Yishay , Erez Granat Ortal , Spielman Shiri , Semo Oz Rotem , Shinar Yael , Gerstein Maya 
Published: February 2021

Abstract

Objectives
FMF results from mutations in the Mediterranean fever (MEFV) gene. The p. E148Q protein alternation is one of the most frequent in the MEFV gene, yet the exact E148Q genotype–phenotype correlation remains unclear. The aim of this study was to examine clinical significance of heterozygous E148Q variant in a paediatric FMF cohort.

Methods
We compared the clinical manifestations and disease severity score of four genetic subgroups: (group 1) patients harbouring a single heterozygous p. E148Q variant (n = 6); (group 2) patients harbouring a single p. M694V heterozygous variant (n = 88); (group 3) patients harbouring compound heterozygous p. M694V and p. E148Q variants (n = 36); and (group 4) homozygotes for p. M694V variant (n = 160).

Results
Of 646 FMF children from our centre, only 1% (six patients) of our genetically characterized FMF cohort had a single E148Q variant, most presenting with recurrent fevers and abdominal pain. None of the participants was found to harbour homozygous E148Q. Overall, M694V/E148Q compound heterozygosity did not exhibit a more severe phenotype compared with patients with a single M694V variant. The former group were less likely to have abdominal pain and exertional leg pain (P &lt; 0.004 and P &lt; 0.001, respectively) and more likely to have chest pain (P &lt; 0.01). Both subgroups showed milder clinical phenotype compared with patients with M694V homozygosity.

Conclusion
Our findings demonstrate that a single heterozygous E148Q variant is unlikely to cause FMF in children and that E148Q/M694V is clinically indistinguishable from a single M694V variant. Thus, E148Q heterozygosity does not result in clinically meaningful phenotype in children.
Trend in women representation among authors of high rank rheumatology journals articles, 2002–2019
Authors: Levinsky Yoel , Vardi Yoav , Gafner Michal , Cohen Neta , Mimouni Michael , Scheuerman Oded , Furst Daniel E , Amarilyo Gil 
Published: February 2021

Abstract

Objective
The representation of women among authors of peer reviewed scientific papers is gradually increasing. The aims of this study were to examine the trend of the proportion of women among authors in the field of rheumatology during the last two decades.

Methods
Articles published in journals ranked in the top quartile of the field of rheumatology in the years 2002–2019 were analysed. The authorship positions of all authors, country of the article's source and manuscript type were retrieved by specifically designed software.

Results
Overall, 153 856 author names were included in the final analysis. Of them, 55 608 (36.1%) were women. There was a significant rise in the percentage of women authors over time (r = 0.979, P &lt;0.001) from 30.9% in 2002 to 41.2% in 2018, with a slight decline to 39.8% in 2019. There were significantly fewer women in the senior author positions compared with the first author positions (24.3% in senior position vs 40.9% as first author, P &lt;0.001).

Conclusion
The proportion of women among authors of rheumatology articles has increased over the years, both in general and as a first or senior author; however, their proportion is still &lt;50% and there is still a gap between the proportion of women among first authors and the proportion of women among senior authors.
Performance of 2019 EULAR/ACR classification criteria for systemic lupus erythematosus in a paediatric population—a multicentre study
Authors: Levinsky Yoel , Broide Mor , Kagan Shelly , Goldberg Ori , Scheuerman Oded , Tal Rotem , Tirosh Irit , Butbul Yoni , Furst Daniel E , Harel Liora , Amarilyo Gil 
Published: February 2021

Abstract

Objectives
The European League Against Rheumatism and American College of Rheumatology 2019 (EULAR/ACR-19) criteria for the diagnosis of SLE were recently published, with the stated goal of maintaining the level of sensitivity and raising the level of specificity for classification of SLE in adults. The aim of this study is to examine their application to juvenile SLE (jSLE) patients.

Methods
In this multicentre study the charts of jSLE patients from three tertiary medical centres were reviewed and compared with patients with non-jSLE diagnosis. Paediatric rheumatologists, blinded to the original diagnosis, reviewed and diagnosed all cases. Paediatric patients' clinical and laboratory data were retrospectively extracted and then examined with regard to how they met the new and old criteria.

Results
Included were 225 patients (112 jSLE, 113 non-SLE). When applied to juvenile SLE classification, the sensitivity of the new EULAR/ACR-19 criteria was 0.96 (95% CI: 0.9, 0.99) and the specificity was 0.89 (95% CI: 0.82, 0.94). These were comparable to the SLICC criteria. The sensitivity of the EULAR/ACR-19 criteria improves over time and was 0.83 12 months following disease onset, reaching 0.96 after longer than 24 months.

Conclusion
Among a cohort of jSLE patients, sensitivity of the new EULAR/ACR-19 criteria was found to be high and specificity may have improved slightly compared with the SLICC-12 criteria. We support the use of the new classification criteria for paediatric patients in future jSLE studies, but it should be noted that its specificity is lower than for adults.
The effects of high-oleic peanuts as an alternate feed ingredient on performance, ileal digestibility, apparent metabolizable energy, and histology of the small intestine in laying hens
Authors: Redhead Adam K , Sanders Elliot , Vu Thien C , Malheiros Ramon D , Anderson Kenneth E , Toomer Ondulla T 
Published: February 2021

AbstractWe aimed to determine the effects of feeding a high-oleic peanut (HOPN) diet to egg-producing laying hens on egg quality, digestibility, and feed conversion. Three isonitrogenous and isocaloric dietary treatments were formulated with 1) Control diet (CON)—a corn-soybean meal conventional diet with 7.8 % added poultry fat, 2) HOPN diet—dietary inclusion of ~20% coarse-ground whole HOPN, and 3) oleic acid (CON-OA) diet—a control diet supplemented with 2.6% oleic fatty acid oil. Ninety-nine 57-wk-old brown Leghorn laying hens were randomly assigned to 33 animals per treatment. Animals were housed individually for 8 wk. Body and feed weights were recorded weekly and feed conversation ratio was calculated. Bi-weekly, shell eggs were analyzed for quality (yolk color, albumen height, and Haugh unit [HU]). Jejunum samples were collected at week 8 for histomorphometric analysis. Analysis of variance was performed on all variables using a general linear mixed model. Laying hens fed the CON-OA diet produced greater number of eggs relative to those fed the HOPN and control diets (P &lt; 0.05). The roche yolk color value was higher (P &lt; 0.001) in eggs from hens fed the HOPN diet. There were no differences in laying hen performance, eggshell color, eggshell strength, eggshell elasticity and egg albumen height, or egg HU, ileal fat digestibility, or villi surface among treatment groups. However, the apparent metabolizable energy (P &lt; 0.01) and ileal protein digestibility (P = 0.02) were greater in laying hens fed the HOPN diet relative to the CON diet. This study suggests that whole unblanched high-oleic peanuts may be an acceptable alternative feed ingredient for laying hens.
Paediatric allergy practice in the era of coronavirus disease 2019
Authors: Mustafa S. Shahzad , Shaker Marcus S. , Munblit Daniel , Greenhawt Matthew 
Published: February 2021

Purpose of review
To summarize the impact of the COVID-19 pandemic on the practice of paediatric allergy.

Recent findings
Given significant overlap in symptoms, care must be taken to differentiate routine allergic conditions from COVID-19 infection but it appears that most allergic diseases are not risk factors for a severe COVID-19 course. The full impact of restricted allergy/immunology ambulatory services will take months to years to fully understand. One benefit of having to adapt practice style is greater awareness and acceptance of shared decision-making and recognition of preference-sensitive care options in food allergy, in particular for approaches towards allergy prevention, treatment, and anaphylaxis care. Social distancing and masks have helped reduce spread of common respiratory viruses, which may be helping to lower the incidence of viral-associated wheezing episodes, enhancing evidence of the effects of preventing exposure of young children to respiratory viruses on asthma pathogenesis, as well as on allergic rhinitis. There has been a revolution in the rise of telemedicine to increase access to high-quality allergy/immunology specialty care.

Summary
Although the field has adapted to remain operational in the face of a significant challenge, it is important to apply lessons learned to evolve patient care and optimize treatment in the aftermath of the pandemic.
Factors Influencing Outcomes of the Dysplastic Hip in Nonambulatory Children With Cerebral Palsy
Authors: Carroll Kristen L. , Stotts Alan K. , Baird Glen O. , Thorman Alyssa L. , Talmage Matthew , Moss Whitney D. , McMulkin Mark L. , MacWilliams Bruce A. 
Published: February 2021

Background:
Hip dysplasia in the nonambulatory child with spastic cerebral palsy (CP) is a common condition not always effectively treated with conservative measures even when recognized early. Optimal surgical intervention strategies and timing are not clear from previous studies. Contralateral hips with less severe subluxation in these patients also often undergo surgery and little is known of outcomes of these less severe hips. This study aims to clarify treatment factors related to long term success following hip surgery for subluxation in nonambulatory children with CP.

Methods:
A total of 183 nonambulatory subjects with CP and a minimum of 2-year follow-up were included. All subjects underwent varus rotational osteotomy of the femur; other surgical factors considered were addition of pelvic osteotomy (PO), capsulorrhaphy, and soft tissue releases. Additional factors studied were age at index surgery, sex, and unilateral versus bilateral surgery. Severely subluxated (SS) hips, defined as having >50% migration, were studied separately from contralateral nonsevere hips. Surgeries were deemed successful if final follow-up indicated a migration of <25%; patients with any revision surgeries or >25% migration were categorized as failures.

Results:
A 60% success rate was found in SS hips and a 68% success rate in nonsevere hips. Age at index surgery did not influence success rates in SS hips. In the nonsevere hips, success was associated with index surgery at older age. The addition of a PO was the only concomitant procedure demonstrated to improve outcomes. In SS hips, those with a successful outcome were 2.5 times more likely to have had a PO. The addition of capsulorrhaphy had a negative effect on the entire group, reducing odds of success to 0.8. No other factors were significant.

Conclusions:
The findings from this multicenter retrospective study suggest that PO be added to varus rotational osteotomies in patients with severe hip subluxation. Surgery should be undertaken for severe dysplasia without concern for age. The addition of capsulorrhaphy does not improve rate of success.

Level of Evidence:
Level III—retrospective comparative study.
Professor D.M. Davies, founder of Adverse Drug Reaction Bulletin: a tribute on the 50th anniversary of Adverse Drug Reaction Bulletin
Authors: Routledge Philip A. 
Published: February 2021

Summary
The Adverse Drug Reaction Bulletin has been published bimonthly for the last 50 years. The format has remained the same with four sides of approximately 2000 words on an important adverse reaction, but has grown from sheets stencilled for distribution locally to a bulletin with a large circulation both in English and Italian. Its aim remains, as then, to provide a succinct summary of the causes and mechanisms of a particular adverse reaction, or the types of reactions which affect a particular system organ class.
Achieving Predictability in Augmentation Mastopexy: An Update
Authors: Xue Amy S. , Dayan Erez , Rohrich Rod J. 
Published: February 2021

Background:
One-stage augmentation mastopexy is a challenging procedure, with the highest cited revision rates in plastic surgery. This is because when mastopexy and augmentation are performed together, they lead to opposing forces, which must be balanced carefully to avoid complications. The goal of this study was to revisit a previously described predictable and safe approach to one-stage augmentation mastopexy, and provide long-term updated results.

Methods:
One hundred seventy-one patients who underwent augmentation mastopexy, performed by a single surgeon (R.J.R.), were included in this retrospective review between January 2005 and January 2019. Wise pattern mastopexy with wide pedicle was performed before placement of a small subpectoral implant. Demographic information, preoperative breast measurements, intraoperative technique, implant choice, and postoperative complications were analyzed. Specifically, postoperative measurement of vertical limbs was performed to assess long-term elongation of the lower breast pole.

Results:
Cumulative complication rate was 11.7%. This rate decreased to 6% in the last 88 patients in this series as the technique matured. The most common complication was revision for implant size exchange. Long-term follow-up demonstrated elongation of nipple-to-inframammary fold distance by 1.0–2.2 cm. There was no recurrence of ptosis requiring reoperation.

Conclusions:
This one-stage augmentation mastopexy technique provides a safe and reliable surgical approach with predictable and minimal elongation of the lower breast pole. The reoperation rate of this technique is less than half of >20% revision rate currently cited in the literature.
Tubed Anterolateral Thigh Free Flap for Pharyngoesophageal Reconstruction
Authors: Kuta Victoria , French Daniel , Al Afif Ayham , Trites Jonathan R.B. , Rigby Matthew H. 
Published: February 2021

Summary:
Caustic ingestions can severely injure the upper and lower aerodigestive tract, resulting in detrimental mucosal changes both acutely and chronically. Injuries are most severe following alkaline ingestion. Esophagectomy is often recommended in patients with high-grade esophageal injuries to mitigate the risk of perforation. Esophageal reconstruction after these injuries is often delayed, and staged, allowing adequate tissue stabilization before further manipulation. Here, we report on a 25 year-old woman who presented with a high-grade caustic esophageal injury following the ingestion of an alkaline drain cleaner. She underwent an emergent thoracic esophagectomy, gastrectomy and a cervical salivary esophagostomy. Post-operatively, she developed supraglottic and hypopharyngeal strictures, but maintained a functional larynx. She subsequently underwent a staged, extrathoracic total esophageal reconstruction using an anterolateral thigh (ALT) myocutaneous free flap with laryngeal preservation. Although serial esophageal dilatations and trans-oral laser procedures for pharyngeal strictures were required, she was able to maintain the ability to swallow.
Anaphylactic Reaction to Lymphazurin 1% during Breast Reconstruction Surgery: An Uncommon but Serious Complication
Authors: Krishna Vikram , Muetterties Corbin , DiNome Maggie L. , Tseng Charles Y. 
Published: February 2021

Summary:
Lymphazurin 1% (isosulfan blue dye) is the most frequently used blue dye in the United States, and it is commonly used for sentinel node biopsy in breast cancer patients. Although cases of allergic reaction to lymphazurin have been reported in the general surgery literature, to our knowledge, no cases of an adverse reaction to isosulfan blue have been reported in the plastic surgery literature. We describe a case of an intraoperative biphasic anaphylactic reaction to isosulfan blue in a female patient undergoing bilateral mastectomy and immediate bilateral DIEP breast reconstruction. The severity of her anaphylactic reaction required that we stop flap dissection and abort the reconstruction. Although an allergic reaction is uncommon, recognizing the signs of an acute hypersensitivity reaction is critical to good outcomes in these situations. Given the volume of combined breast oncologic and breast reconstruction surgeries and the increasing number of vascularized lymph node transfer and lymphovenous anastomosis performed annually, it is essential for the plastic surgeon to be cognizant of this rare hypersensitivity reaction.
A Navajo Patient with Morbihan’s Disease: Insight into Oculoplastic Treatment of a Rare Disease
Authors: Pflibsen Lacey R. , Howarth Ashley L. , Meza Rochin Ana , Decapite Tim , Casey William J. , Mansueto Lisa A. 
Published: February 2021

Summary:
Morbihan’s disease is classically defined as primarily a Caucasian disease of chronic, recurrent erythema and nonpitting edema of the middle and upper thirds of the face. The disease is often difficult to diagnose and challenging to treat. Medical management is the primary treatment modality; however, if there is progression of the disease that causes visual impairment, surgical debulking is often required. We present the first reported case of Morbihan’s disease in a Navajo patient in conjunction with a review of the literature on surgical management of this challenging disease.
Radial to Axillary Nerve Transfer Outcomes in Shoulder Abduction: A Systematic Review
Authors: Wells Matthew E. , Gonzalez Gilberto A. , Childs Benjamin R. , Williams Matthew R. , Nesti Leon J. , Dunn John C. 
Published: February 2021

Background:
Brachial plexus and axillary nerve injuries often result in paralysis of the deltoid muscle. This can be functionally debilitating for patients and have a negative impact on their activities of daily living. In these settings, transferring the branch of the radial nerve innervating the triceps to the axillary nerve is a viable treatment option. Additional nerve transfers may be warranted. This study sought to determine the efficacy of nerve transfer procedures in the setting of brachial plexus and axillary nerve injuries and factors affecting clinical outcomes.

Methods:
The U.S. National Library of Medicine’s website “PubMed” was queried for “radial to axillary nerve transfer” and “brachial plexus nerve transfer.” An initial review by two authors was performed to identify relevant articles followed by a third author validation utilizing inclusion and exclusion criteria. Individual patient outcomes were recorded and pooled for final analysis.

Results:
Of the 80 patients, 66 (82.5%) had clinical improvement after surgical nerve transfer procedures. Significant difference in clinical improvement following nerve transfer procedures was correlated with patient age, mechanism of injury, brachial plexus vs isolated axillary nerve injuries, multiple nerve transfers vs single nerve transfers, and surgery within the first 7 months of injury. The branch of the radial nerve supplying the triceps long head showed improved clinical results compared with the branch of the radial nerve supplying the triceps medial head and anconeus.

Conclusion:
Nerve transfers have been shown to be effective in restoring shoulder abduction in both isolated axillary nerve injuries and brachial plexus injuries.
Thumb Reconstruction after Severe Trauma Using the Masquelet Technique and the Foucher Neurovascular Flap
Authors: Luttenberger Martin , Taqatqeh Feras , Dragu Adrian , Bota Olimpiu 
Published: February 2021

Summary:
Complex injuries of fingers with bone and soft tissue loss often result in amputation. We present here a case of thumb reconstruction in a severely injured thumb with bone and dorsal soft tissue loss. Primarily a radical debridement of devascularized tissue was performed and a spacer was implanted, to ensure tissue decontamination and induce a Masquelet’s bone membrane. After 6 weeks the spacer was replaced with autologous cancellous bone and a pedicled Foucher neurovascular flap was used to augment the soft tissues. Eight months postoperatively the patient showed a great outcome with thumb length preservation, excellent range of motion and aesthetics. This novel technique facilitates finger and especially thumb preservation without the risk of infection. The Masquelet technique can hereby be safely used for reconstruction of finger injuries and the microsurgical flap coverage can be postponed for the secondary procedure, without compromising the bone regeneration.