bluuebunny/crossref_metadata_2025_split huggingface dataset:
Management of Modular Mega-Implant Infection of the Lower Extremity
Authors: Ghanem Mohamed , Schneider Isabell , Zajonz Dirk , Pempe Christina , Goralski Szymon , Fakler Johannes K. M. , Heyde Christoph-Eckhard , Roth Andreas 
Published: February 2021

Abstract
Introduction Revision arthroplasty involving mega-implants is associated with a high complication rate. In particular, infection is a serious complication of revision arthroplasty of hip and knee joints and has been reported to have an average rate of 18%, and for mega-implants, the range is from 3 to 36%. This study was designed to analyze the strategy of treatment of infection of mega-endoprostheses of the lower extremities in our patient cohort, particularly the management of chronic infection.
Material and Methods This was a retrospective study that focused on the results of the treatment of periprosthetic infections of mega-implants of the lower extremities. We identified 26 cases with periprosthetic infections out of 212 patients with 220 modular mega-endoprostheses of the lower extremities who were treated in our department between September 2013 and September 2019. As a reinfection or recurrence, we defined clinical and microbiological recurrences of local periprosthetic joint infections after an antibiotic-free period.
Results In this study, 200 cases out of 220 were investigated. The average follow-up period was approximately 18 months (6 months to 6 years). Endoprosthesis infections after implantation of mega-implants occurred in 26 cases (13%). This group comprised 2 early infections (within the first 4 weeks) and 24 chronic infections (between 10 weeks and 6 years after implantation). Nineteen cases out of the identified 26 cases with infection (73.1%) belong to the group of patients who were operated on due to major bone loss following explantation of endoprosthetic components due to previous periprosthetic joint infection. The remaining seven cases with infection comprised four cases following management of periprosthetic fracture, two cases following treatment of aseptic loosening, and one case following tumor resection. All infections were treated surgically. In all cases, the duration of continuous antibiotic treatment did not exceed 6 weeks. Both cases with early
infection were treated by exchanging polyethylene inlays and performing debridement with lavage (two cases). In two (7.7%) cases with chronic infection, one-stage surgery was performed. In all remaining cases with chronic infection (22 cases; 84.6%), explantation of all components and temporary implantation of cement spacers were carried out prior to reimplantation.
Conclusion There is still no gold standard therapeutic regimen for the management of periprosthetic infection of mega-implants, though radical surgical debridement and lavage accompanied by systemic antibiotic therapy are the most important therapeutic tools in all cases of periprosthetic infections, regardless of the time of onset. Further studies are needed to standardize management strategies of such infections. Nevertheless, it is not uncommon for compromises to be made based on the particular condition of the individual.
Extended Scalp Flaps for Extensive Soft Tissue Scalp Defects as a Day Surgery Procedure Under Local Anesthetic: A Single Centre Experience
Authors: Malahias Marco , Ackling Edward , Zubair Omer , Harper Natasha , Al-Rawi Haytham , Khalil Haitham 
Published: February 2021

Abstract
Background Cutaneous malignancies are on the rise, associated with an increased number in scalp cancers that require wide local excision (WLE) to ensure clearance; the inelastic nature of the scalp poses a particular challenge when dealing with such large defects.
Case presentation A series of 68 cases with large scalp defects following WLE for the clearance of squamous cell carcinoma, atypical fibroxanthoma, dermatofibrosarcoma protuberans, and melanoma skin cancers are presented. These cases were treated in one center under local anesthesia and underwent extended scalp flaps to close the resulting defect primarily without the use of skin grafts for the flap donor site on the scalp.
Conclusion Extended scalp flap is a safe and reproducible solution for extensive scalp defects, which results in quicker wound healing with cosmetically superior results, and can be performed safely and comfortably under local anesthesia in the day case setting.
Head Injury without Head Blow? A Rare Case of Subdural Hematoma Associated with Minute Arachnoid Cyst in a Teenage Skater
Authors: Szczygielski Jacek , München Dorothea , Ketter Ralf , Ràkàsz Lukas , Schulz-Schaeffer Walter , Oertel Joachim 
Published: February 2021

Abstract
Background Skateboarding has been reported to cause diverse kinds of injuries, including head trauma. However, the risk of brain injury without direct blow to the head seems to be underestimated. In particular, the impact of the inertial forces related to the vigorous character of skateboarding tricks is not sufficiently recognized.
Case Description In our report, we demonstrate a case of chronic subdural hematoma developing without previous blow to the head in a 17-year-old skater bearing small frontal convexity arachnoid cyst.
Conclusion Based on the described case, the possibility of acceleration and angular forces related to skate park leisure activities resulting in subdural hematoma needs to be discussed. This risk should be critically appraised in patients carrying arachnoid cyst as a malformation predisposing to develop subdural bleeding.
Factores asociados a complicaciones infecciosas posoperatorias en pacientes con urolitiasis
Authors: Osorio-Manrique Javier , Ramos-Castaneda Jorge Andres , Garcia-Landazabal Elsa , Molano-Garcia Maria Paula 
Published: February 2021

Resumen
Introducción Se encuentran múltiples tratamientos para la urolitiasis, los cuales dependen en gran medida del tamaño y la ubicación de la litiasis. Dentro de las opciones terapéuticas se encuentran la expulsión activa, utilización de ondas de choque, las ureterolitotomias, y procedimientos endoscópicos, todas con diferentes tasas de efectividad y riesgo de complicación infecciosa. El objetivo del estudio fue evaluar los factores asociados a la complicación infecciosa posterior al procedimiento urológico en pacientes con urolitiasis.
Métodos Estudio de casos y controles anidado a una cohorte de pacientes programados para procedimientos urológicos como tratamiento para la urolitiasis durante el periodo 2015 - 2019. Se consideraron casos, aquellos con complicación infecciosa posoperatoria dentro de los 30 días posteriores al procedimiento urológico. Los controles se seleccionaron de la cohorte inicial y fueron los pacientes que no presentaron complicación infecciosa.
Resultados En el periodo de estudio, fueron atendidos 350 pacientes con litiasis renal, con un total de 1258 cálculos. El número promedio de cálculos por paciente fue de 3,59; la prevalencia de litiasis bilateral fue del 57%, siendo similar la cantidad de cálculos en el lado izquierdo (promedio = 1,4) y en el derecho (promedio = 1,44).La tasa de complicación infecciosa posquirúrgica fue del 4% (n= 14) y se asoció con la presencia de al menos un cálculo mayor de 20 mm (OR 4,49 IC95% 1,39–14,52).
Conclusión La tasa de complicación infecciosa posoperatoria en pacientes con urolitiasis y programados para procedimientos urológicos es baja. Una longitud del cálculo mayor de 20 mm es un factor asociado a la infección posoperatoria.
Complicaciones de la linfadenectomía retroperitoneal postquimioterapia en pacientes con tumor germinal de origen testicular: Experiencia de 12 años en un centro de referencia en Colombia
Authors: Torres Lynda , Ramos José Gustavo , Varela Rodolfo , Cabrera Marino , Orrego Paola Andrea , Mosquera Aysa Vanessa , Vecino Sandra Viviana Pulido 
Published: February 2021

Resumen
Objetivo El objetivo de este estudio, fue describir las complicaciones intraoperatorias y postoperatorias, así como la necesidad de cirugías concomitantes en la linfadenectomía retroperitoneal postquimioterapia en un centro de referencia de manejo de cáncer.
Métodos Se recolectaron datos de una cohorte retrospectiva de pacientes con diagnóstico de tumor germinal de origen testicular que hubiesen recibido quimioterapia y en quienes se documentó tumor residual retroperitoneal y fueron sometidos a LRP-PC durante 12 años en un centro de referencia de manejo de cáncer.
Resultados Se practicó LRP-PC a 64 pacientes. La edad promedio al momento de la cirugía fue 28,1 años (18-47 años). El tamaño promedio de la masa retroperitoneal post quimioterapia fue 6,7 (1–28 cm). La estancia hospitalaria promedio fue 7,9 días (rango 1-99 días), la tasa de cirugías adicionales fue del 20%. La tasa de complicaciones mayores fue de 7,8%. Tener seminoma en la histología testicular inicial se asoció con un mayor sangrado y el tamaño de la masa retroperitoneal residual se asoció con la necesidad de cirugías concomitantes.
Conclusiones La LRP-PC es una cirugía de alto nivel de complejidad que se asocia a complicaciones mayores y a la necesidad de cirugías concomitantes. Esta cohorte de pacientes muestra desenlaces similares a los descritos en la literatura, recalcando el hecho de que esta cirugía, debería ser realizada en centros de referencia de manejo del cáncer.
Bloqueo nervioso corticoideo-bupivacaína: ¿La mejoría post-procedimiento inmediato predice el éxito terapéutico a mediano plazo?
Authors: Cobeñas Ricardo , Flórez Juan , Chiaradia Pablo , Salgado Kelly Ruiz , Vedia María De , Paba Mariángela , Pinzón Jairo Hernández 
Published: February 2021

Resumen
Objetivo Establecer la relación entre la reducción inmediata de los síntomas post bloqueo nervioso lumbar guiado por tomografía computada (TC) y la mejoría tras un lapso de tiempo de un mes.
Materiales y métodos Se analizaron datos sobre 46 procedimientos de bloqueos lumbares radiculares y epidurales guiados por TC realizados entre diciembre de 2018 y marzo de 2019. Los pacientes firmaron consentimiento informado y el Comité de Ética en Investigación de nuestra institución aprobó el estudio. Se colectó, mediante un cuestionario dicotómico, información acerca de los síntomas iniciales, los cambios inmediatos al procedimiento y los síntomas tras un mes del mismo.
Resultados Inmediatamente post-bloqueo, 30 pacientes (65%) mostraron mejoría o ausencia de síntomas y seis de ellos manifestaron persistencia de los síntomas al mes. Post-procedimiento inmediato, 16 pacientes (34%) no presentaron ningún cambio en la sintomatología. De estos, siete presentaron mejoría al mes. La razón de momios para la persistencia del efecto analgésico al mes en los casos en los que el paciente manifestó alivio inmediato después del procedimiento fue de 5,1 (95% IC 1.128 a 24.031). La prueba de McNemar para determinar si esta diferencia en la proporción de pacientes con alivio inmediato posterior a la punción y persistencia del efecto analgésico arrojó un p value de 0,08.
Conclusión Existió asociación positiva entre la mejoría inmediata y la ausencia de síntomas al mes. Sin embargo, el análisis estadístico de antes y después insinúa que estos resultados pudieron ser por el azar.
Use of Hormone Therapy in Women with Early Menopause and Premature Ovarian Insufficiency
Authors: Lersten Ivy , Clain Elizabeth , Santoro Nanette 
Published: February 2021

AbstractWomen with early menopause or primary ovarian insufficiency (POI) experience a menopausal state a decade or more earlier than their peers. The health consequences for POI are vast and varied with detrimental effects seen on neurological, psychological, bone, and cardiovascular systems. The risk profile of POI patients requires special attention, as they differ from a typical menopausal population. This review will explore the health risks associated with POI and examine the various treatment options and also the risks associated with hormone therapy. Given the risks and benefits, POI patients should be strongly encouraged to start hormone therapy until the median age of menopause.
Treatment of Increased Intracranial Pressure and Vasospasm after Subarachnoid Hemorrhage in a 9-Year-Old Child—A Case Report
Authors: Müller Sarah-Hélène , Taschner Christian , Meckel Stephan , Mayerhofer Ernst , Roelz Roland , Bansbach Joachim 
Published: February 2021

AbstractIn this article, we reported a 9-year-old male child patient who suffered severe subarachnoid hemorrhage due to ruptured dissecting aneurysm of the left parieto-occipital artery. After endovascular occlusion of the aneurysm, increased intracranial pressure refractory to noninvasive therapy required secondary decompressive hemicraniectomy. Critical vasospasm and delayed neurological deterioration were treated by oral nimodipine and successful endovascular rescue therapy consisting of intra-arterial balloon dilatation.
Functional Outcomes and Postoperative Cerebral Venous Sinus Thrombosis after Translabyrinthine Approach for Vestibular Schwannoma Resection: A Radiographic Demonstration of Anatomic Predictors
Authors: Gerges Christina , Malloy Patrick , Rabah Nicholas , Defta Dana , Duan Yifei , Wright Christina H. , van Keulen Marte , Wright James , Mowry Sarah , Megerian Cliff A. , Bambakidis Nicholas 
Published: February 2021

Abstract
Introduction While regarded as an effective surgical approach to vestibular schwannoma (VS) resection, the translabyrinthine (TL) approach is not without complications. It has been postulated that postoperative cerebral venous sinus thrombosis (pCVST) may occur as a result of injury and manipulation during surgery. Our objective was to identify radiologic, surgical, and patient-specific risk factors that may be associated with pCVST.
Methods The Institutional Review Board (IRB) approval was obtained and the medical records of adult patients with VS who underwent TL craniectomy at University Hospitals Cleveland Medical Center between 2009 and 2019 were reviewed. Demographic data, radiographic measurements, and tumor characteristics were collected. Outcomes assessed included pCVST and the modified Rankin score (mRS).
Results Sixty-one patients ultimately met inclusion criteria for the study. Ten patients demonstrated radiographic evidence of thrombus. Patients who developed pCVST demonstrated shorter internal auditory canal (IAC) to sinus distance (mean: 22.5 vs. 25.0 mm, p = 0.044) and significantly smaller petrous angles (mean: 26.3 vs. 32.7 degrees, p = 0.0045). Patients with good mRS scores (<3) appeared also to have higher mean petrous angles (32.5 vs. 26.8, p = 0.016). Koos' grading and tumor size, in our study, were not associated with thrombosis.
Conclusion More acute petrous angle and shorter IAC to sinus distance are objective anatomic variables associated with pCVST in TL surgical approaches.
Ovine Biosynthetic Grafts for Aortoiliac Reconstructions in Nonsterile Operative Fields
Authors: El Beyrouti Hazem , Izzat Mohammad Bashar , Kornberger Angela , Halloum Nancy , Dohle Kathrin , Trinh Tran Tong , Vahl Christian-Friedrich , Dorweiler Bernhard 
Published: February 2021

Abstract
Background Prosthetic vascular grafts placed surgically or via endovascular techniques can be subject to the risk of life-threatening graft infections. The Omniflow II vascular prosthesis is a biosynthetic graft that was reported to have favorable properties in resisting infections.
Materials and Methods We retrospectively reviewed our 3 years' experience of using the Omniflow II prostheses for aortoiliac reconstructions in patients considered to carry a substantial risk of subsequent prosthetic graft infections (prevention group) as well as in patients with actively infected prosthetic vascular grafts (treatment group).
Results Aorto-bi-iliac (n = 4) and aortobifemoral (n = 12) vascular reconstructions were performed using bifurcated Omniflow II prostheses in nine patients in the prevention group and seven patients in the treatment group. During mean follow-up of 28.6 ± 17.2 months, there was one case of graft infection (6.3%) and graft thrombosis (6.3%) with subsequent successful thrombectomy. Early and late surgical revisions were required in eight (50%) and two (12.6%) patients, respectively. All graft prostheses were patent at last follow-up.
Conclusion Using bifurcated Omniflow II vascular prostheses in patients with or at a high risk of vascular graft infection is advisable, and is associated with acceptable reinfection and patency rates.
Use of Thromboelastography Platelet Mapping for Assessment of Individual Platelet Response Secondary to Oral Antiplatelet Therapy after Percutaneous Coronary Intervention: An Attempt to Start Personalized Antiplatelet Therapy in India
Authors: Datta Suvro Sankha , De Dibyendu , Muslim Nadeem Afroz 
Published: February 2021

AbstractHigh on-treatment platelet reactivity (HPR) with P2Y12 receptor antagonists in patients treated with dual antiplatelet therapy (DAPT) is strongly associated with adverse ischemic events after percutaneous coronary intervention (PCI). This prospective study was conducted to assess individual platelet response and HPR to antiplatelet medications in post-PCI cases by thromboelastography platelet mapping (TEG-PM). Total 82 patients who were on aspirin and on either clopidogrel, prasugrel, or ticagrelor were evaluated. The percentage of platelet inhibition to arachidonic acid (AA) and adenosine disdiphosphate (ADP) was calculated by [100-{(MA ADP/AA–MA Fibrin) / (MA Thrombin–MA Fibrin) × 100}], taking 50% response as cut-off for HPR. HPR to clopidogrel and prasugrel was 14.29 and 12.5%, respectively. No HPR was detected to aspirin and ticagrelor. The mean percentage of platelet inhibition was significantly higher in patients with ticagrelor 82.99, 95% confidence interval (CI) of [77.3, 88.7] as compared with clopidogrel 72.21, 95% CI of [65.3, 79.1] and prasugrel 64.2, 95% CI of [52.5, 75.9] (p-value of 0.041 and 0.003, respectively). Aspirin along with ticagrelor is associated with a higher mean percentage of platelet inhibition, and lower HPR as compared with the usage of aspirin combined with clopidogrel or prasugrel. Additionally, it might also be concluded that TEG-PM could be used effectively to measure the individual platelet functions which would make oral antiplatelet therapy more personalized for cardiac patients.
Vertical silicon etching by using an automatically and fast-controlled frequency tunable rf plasma source
Authors: Hanaoka Kengo , Takahashi Kazunori 
Published: February 2021

An automatically and fast-controlled frequency tunable radiofrequency (rf) system is employed to a plasma etching device, where the rf system contains two rf amplifiers operational in 37 MHz–43 MHz for a plasma source and a wafer stage. Both impedance matching circuits for the source and the wafer stage have no variable capacitors, leading a compact design of the rf system; the power reflection can be minimized by adjusting the frequencies. The rf frequency and the output power are automatically controlled so as to minimize a reflection coefficient and to maintain a constant net power corresponding to a forward power minus a reflected power for both the source and the stage. The source is operated with SF6 and C4F8 gases for silicon etching and passivation in the Bosch process, respectively. For both the cases, the impedance tuning can be accomplished within several ms and the net power is maintained at a constant level. By alternatively switching the SF6 and C4F8 plasmas with pulse widths of 5 s and 2 s, respectively, a vertical silicon etching is performed, where a scallop structure is clearly formed on the etching side wall. By shortening the pulse widths down to 1 s and 0.4 s for the SF6 and C4F8 plasmas, the size of the scallop structure is significantly reduced; the usability of the automatically and fast-controlled rf plasma source for the Bosch process is demonstrated.
On-chip thin-film microtransformer with improved coupling factor for high frequency data transmission
Authors: Dinulovic Dragan , Shousha Mahmoud , Haug Martin 
Published: February 2021

An on-chip thin-film microtransformer with an improved coupling factor is shown in this paper. In addition to the development of this component, the characterization of the microtransformer and its use in the data transmission application are presented. In comparison to previous work, this microtransformer device shows an improved coupling factor. The microtransformer is fabricated on silicon substrate using thin-film technology. The fabrication is based on damascene process and combines material deposition using only sputtering PVD (physical vapor deposition) or CVD a (chemical vapor deposition) processes and chemical-mechanical polishing (CMP) process for patterning. The microtransformer design is a solenoid type device with a magnetic bar core and interleaved winding style. For a magnetic core a CoFeB material is applied. As insulation materials, silicon dioxide and silicon nitride are implemented. The device chip size is 1.6 mm x 0.8 mm. A turns ratio of the microtransformer is 1:1, and the device shows a self-inductance of about 25 nH and an improved coupling factor with a value of 60%.
Super Hamiltonian in superspace for incommensurate superlattices and quasicrystals
Authors: Valiente M , Duncan C W , Zinner N T 
Published: February 2021

Abstract
Infinite quasiperiodic arrangements in space, such as quasicrystals, are typically described as projections of higher-dimensional periodic lattices onto the physical dimension. The concept of a reference higher-dimensional space, called a superspace, has proved useful in relation to quasiperiodic systems. Although some quantum-mechanical systems in quasiperiodic media have been shown to admit quasiperiodic states, any sort of general Hamiltonian formalism in superspace is lacking to this date. Here, we show how to extend generic quantum-mechanical Hamiltonians to higher dimensions in such a way that eigenstates of the original Hamiltonian are obtained as projections of the Hamiltonian in superspace, which we call the super Hamiltonian. We apply the super Hamiltonian formalism to a simple, yet realistic one-dimensional quantum particle in a quasiperiodic potential without the tight-binding approximation, and obtain continuously labelled eigenstates of the system corresponding to a continuous spectrum. All states corresponding to the continuum are quasiperiodic. We also obtain the Green’s functions for continuum states in closed form and, from them, the density of states and local density of states, and scattering states off defects and impurities. The closed form of this one-dimensional Green’s function is equally valid for any continuum state in any one-dimensional single-particle quantum system admitting continuous spectrum. With the basis set we use, which is periodic in superspace, and therefore quasiperiodic in physical space, we find that Anderson-localised states are also quasiperiodic if distributional solutions are admitted, but circumvent this difficulty by generalising the superspace method to open boundary conditions. We also obtain an accurate estimate of the critical point where the ground state of the system changes from delocalised to Anderson localised, and of the critical exponent for the effective mass. Finally, we calculate, within the superspace formalism, topological edge states for the semi-infinite system, and observe that these exist, in the delocalised phase, within all spectral gaps we have been able to resolve. Our formalism opens up a plethora of possibilities for studying the physics of electrons, atoms or light in quasicrystalline and other aperiodic media.