bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Growth of Trochlear Dysplasia During Adolescence
Authors: Parikh Shital N. , Rajdev Neil , Sun Qin 
Published: March 2018

Background:
Femoral trochlear dysplasia is a known risk factor for patellar instability. The growth pattern of the normal trochlea is known, but there have been no studies investigating the growth and development of the dysplastic trochlea. The purpose of this study was to assess the growth pattern of trochlear dysplasia in adolescents.

Methods:
In a retrospective analysis, magnetic resonance images of adolescents with patellar instability and trochlear dysplasia were evaluated. These images were measured for lateral and medial condylar height, trochlear height, cartilaginous and bony trochlear bump, and cartilaginous and bony sulcus angle. The type of trochlear dysplasia was classified as per Dejour classification. These measurements were plotted against age, and their growth patterns were evaluated using statistical methods.

Results:
Of 235 knees with patellar instability, trochlear dysplasia was present in 175 knees (74% knees) and these were further analyzed. With increasing age, the mean lateral and medial condylar heights and mean trochlear height showed statistically significant increase (P<0.01). Cartilaginous trochlear bump (slope=0.15, P=0.013) and bony trochlear bump (slope=0.22, P<0.01) increased with age, with some reaching the pathologic value by age of 15.1 years. After age 11 years, there were no significant changes for cartilaginous and bony sulcus angles (cartilage: slope=0.03, P=0.96; bony: slope=−0.90, P=0.11). The mean cartilaginous sulcus angle was significantly greater than the mean bony sulcus angle (P<0.01). All Dejour types of trochlear dysplasia were present across all age groups.

Conclusions:
All linear measurements of trochlear dysplasia (condylar height, trochlear height, trochlear bump) increased with age. However, the shape of trochlear dysplasia, as reflected by sulcus angle and Dejour classification, did not change with increasing age. The shape of trochlear dysplasia is most likely a genetic predisposition and does not necessarily change during skeletal growth.

Level of Evidence:
Level II—diagnostic, cross-sectional.
Power in the Blood
Authors: Harris Marilyn D. 
Published: March 2018

ABSTRACT:
Community blood drives provide a significant quantity of the donated blood needed in the U.S. annually. The American Red Cross collaborates with thousands of blood drive sponsors to make donating easier for individuals. Faith community nurses (FCNs) can promote blood donation by involving churches as sponsors for blood drives. This article shares details on the partnership of the Red Cross and a host church; church member statements about motivation to donate, as well as inability to participate, further inform FCNs.
High-Density Lipoprotein Functionality as a New Pharmacological Target on Cardiovascular Disease: Unifying Mechanism That Explains High-Density Lipoprotein Protection Toward the Progression of Atherosclerosis
Authors: Favari Elda , Thomas Michael J. , Sorci-Thomas Mary G. 
Published: March 2018

Abstract:
The formation of the atherosclerotic plaque that is characterized by the accumulation of abnormal amounts of cholesterol-loaded macrophages in the artery wall is mediated by both inflammatory events and alterations of lipid/lipoprotein metabolism. Reverse transport of cholesterol opposes the formation and development of atherosclerotic plaque by promoting high density lipoprotein (HDL)-mediated removal of cholesterol from peripheral macrophages and its delivery back to the liver for excretion into the bile. Although an inverse association between HDL plasma levels and the risk of cardiovascular disease (CVD) has been demonstrated over the years, several studies have recently shown that the antiatherogenic functions of HDL seem to be mediated by their functionality, not always associated with their plasma concentrations. Therefore, assessment of HDL function, evaluated as the capacity to promote cell cholesterol efflux, may offer a better prediction of CVD than HDL levels alone. In agreement with this idea, it has recently been shown that the assessment of serum cholesterol efflux capacity (CEC), as a metric of HDL functionality, may represent a predictor of atherosclerosis extent in humans. The purpose of this narrative review is to summarize the current evidence concerning the role of cholesterol efflux capacity that is important for evaluating CVD risk, focusing on pharmacological evidences and its relationship with inflammation. We conclude that HDL therapeutics are a promising area of investigation but strategies for identifying efficacy must move beyond the idea of simply raising static HDL–cholesterol levels and toward methods of measuring the dynamics of HDL particle remodeling and the generation of lipid-free apolipoprotein A-I (apoA-I). In this way, apoA-I, unlike mature HDL, can promote the greatest extent of cholesterol efflux relieving cellular cholesterol toxicity and the inflammation it causes.
Effects of Resistance Exercise Training on Doxorubicin-Induced Cardiotoxicity
Authors: Pfannenstiel Keith , Hayward Reid 
Published: March 2018

Abstract:Although highly effective, doxorubicin (DOX) use is limited by a dose-dependent cardiotoxicity. The purpose of this study was to determine whether resistance training (RT) would protect against DOX-induced cardiac dysfunction and determine whether any observed functional preservation is a result of reduced lipid peroxidation or a preservation of the cardiac myosin heavy chain (MHC) isoform distribution. Rats were resistance-trained or remained sedentary for 12 weeks, then treated with 12.5 mg/kg DOX or 0.9% saline. Five days after DOX exposure, cardiac function, lipid peroxidation, and MHC isoform expression were quantified. RT preserved cardiac function and attenuated the α-to β-MHC shift that occurs with DOX treatment. No significant differences in lipid peroxidation were observed between sedentary and RT animals treated with DOX. These data suggest that resistance-type exercise can provide protection against DOX-induced cardiac dysfunction, which may be a result of a preservation of the cardiac MHC isoform distribution.
NOVEL ENDOSCOPE-ASSISTED VITREOUS SURGERY COMBINED WITH ATMOSPHERIC ENDOSCOPIC TECHNIQUE AND/OR SUBRETINAL ENDOSCOPIC TECHNIQUE FOR RHEGMATOGENOUS RETINAL DETACHMENT WITH GRADE C PROLIFERATIVE VITREORETINOPATHY
Authors: Kaga Tatsushi , Yokoyama Sho , Kojima Takashi , Mitamura Hayato , Mori Toshio , Matsuda Taisuke , Sato Hiroyuki , Yoshida Norihiko , Ichikawa Kazuo 
Published: March 2018

Purpose:
The purpose of this study was to investigate the clinical outcomes of novel endoscope-assisted vitreous surgery techniques in patients with rhegmatogenous retinal detachment complicated by Grade C proliferative vitreoretinopathy.

Methods:
Eight consecutive patients who had undergone endoscope-assisted vitreous surgery for rhegmatogenous retinal detachment complicated by Grade C proliferative vitreoretinopathy were investigated. The peripheral vitreous was cut under air with the aid of endoscopic view (atmospheric endoscopic technique), and the subretinal proliferation was removed under subretinal endoscopic observation (subretinal endoscopic technique).

Results:
Retinal reattachment was achieved after the primary surgery without a large retinotomy and scleral buckling in each case. The mean follow-up was 16.8 months (range, 8–28 months). Atmospheric endoscopic technique was performed in all cases, and subretinal endoscopic technique was performed in three cases. After surgery, the mean best-corrected visual acuity significantly improved from 20/778 to 20/111 (P = 0.014). Although microretinal breaks occurred during the removal of vitreous using atmospheric endoscopic technique in all cases, there were no severe postoperative complications, such as retinal detachment or proliferative vitreoretinopathy.

Conclusion:
Endoscope-assisted vitreous surgery with atmospheric endoscopic technique and/or subretinal endoscopic technique is safe and effective in the treatment of rhegmatogenous retinal detachment with Grade C proliferative vitreoretinopathy.
Empowered to Serve: Implementing Community Stroke Outreach Using Peer Educators to Improve Readiness to Act Among Local Community Members
Authors: Omelchenko Nataliya , Saban Karen L. , Andresen Pamela , Klopp Audrey , Lau Janice 
Published: March 2018

ABSTRACT
The purpose of this project was to develop a community-based volunteer group of peer educators to provide stroke education to local residents aimed at increasing stroke awareness and action readiness using the American Heart Association and American Stroke Association’s “Empowered to Serve” evidence-based curriculum. The “Don’t Miss a Stroke” module addresses the recognition of stroke warning signs, actions to take during a stroke, and stroke prevention. A total of 16 volunteers were recruited and subsequently trained. Six volunteers organized community events during the initial 3 months of the project, reaching more than 300 community members. Most participants (84.9%) identified as female, with a mean age of 63 years. Analysis of variance revealed significant improvements in knowledge regarding stroke immediately after the class, which was present 1 month later (F
2,144 = 4.832, P = .009). This approach to raising community awareness about stroke emergencies was effective and did not require significant financial investment. Easy access to the curriculum and availability of free printed materials minimized the overall program costs and enhanced the quality of the educational content.
Paroxysmal Sympathetic Hyperactivity and Environmental Factors: A Pilot Study
Authors: Letzkus Lisa , Addison Nancy , Turner Lauren , Conaway Mark , Quatrara Beth 
Published: March 2018

ABSTRACT

Problem: Paroxysmal sympathetic hyperactivity (PSH) is a complicated phenomenon that presents as autonomic instability and muscle overactivity in individuals who experience severe brain injury. Identifying potential modifiable environmental nociceptive stimuli is necessary for developing interventions that impact clinical outcomes. Objective: The aim of this study was to identify physical environmental nociceptive stimuli that could hinder recovery for children who experience PSH after severe brain injury. Methodology: This study measured quantitative physical characteristics coupled with data from semistructured interviews, with parents and clinical nurses, to explore the elusive PSH phenomenon after severe brain injury in children. Results: Eight subjects were enrolled in the cohort study. Temperature showed a statistically significant association with PSH (P = .02), with lower temperatures associated with an increased chance of PSH. Blankets were also associated with PSH (P = .009), with the use of blankets associated with a greater chance of PSH. Persons, gown, position, head-of-bed elevation, incontinence of urine and stool, light level, and noise level did not point to a statistically significant association with PSH. Six nursing interviews were conducted with 2 guardian interviews. Themes that are emerging from the qualitative interviews included the priorities of strategies to target auditory, tactile, and visual stimuli. Conclusion: Paroxysmal sympathetic hyperactivity environmental strategies need to be explored further in subsequent studies. Environmental interventions could complement pharmacological strategies for the management of this elusive phenomenon with the goal of improving outcomes in children who experience severe brain injury and show PSH.
An Unreported Cause of Intrathecal Baclofen Withdrawal Symptoms in a Woman With Spastic Cerebral Palsy Who Received Intrathecal Gablofen
Authors: Duraski Sylvia A. , Sayyad Anjum 
Published: March 2018

ABSTRACT
This article details an unreported potential cause of withdrawal symptoms in a patient with cerebral palsy who experienced intrathecal baclofen withdrawal shortly after placement of a baclofen pump with subsequent refill with Gablofen. Initial implantation of the baclofen pump with Lioresal occurred after a successful hospital trial of intrathecal injection via lumbar puncture. However, later, the patient did experience signs and symptoms of baclofen withdrawal after a pump refill was performed with Gablofen.
Predicting mortality in patients with spontaneous bacterial peritonitis using routine inflammatory and biochemical markers
Authors: Iliaz Raim , Ozpolat Tahsin , Baran Bulent , Demir Kadir , Kaymakoglu Sabahattin , Besisik Fatih , Akyuz Filiz 
Published: March 2018

Objectives
Spontaneous bacterial peritonitis (SBP) is a common and high-mortality infectious complication of patients with cirrhosis. New inflammatory markers are associated with morbidity/mortality in various diseases. The aim of our study was to find the 30-day mortality rate of SBP and their predictors.

Patients and methods
Seventy patients with cirrhosis complicated with SBP and 55 non-SBP controls were enrolled into the study, and patients were evaluated for mortality rate and its predictors.

Results
The 30-day and 3-month mortality rates in the SBP group were 26.1 and 50.7%, respectively. Mortality rates were higher in the SBP group than in the controls. Symptoms at hospital admission and cell counts in ascitic fluid made no difference in predicting 30-day mortality. Patients with SBP with high serum neutrophil counts, high neutrophil–lymphocyte ratio, high C reactive protein (CRP)/albumin ratio, and high model for end-stage liver disease (MELD) score had higher 30-day mortality rates. We determined optimal cutoff values of MELD scores and serum neutrophil counts for predicting 30-day mortality as 20.5 and 6850/mm3, respectively. The sensitivity and specificity for the MELD cutoff value were 83.3 and 80.4%, respectively. We also followed up patients for 60 months after SBP; the patients with high inflammatory markers and MELD scores at the time of SBP diagnosis had worse survival compared with the group with lower levels.

Conclusion
Our results suggest that SBP has high 30-day mortality. MELD scores and inflammatory markers (CRP, CRP albumin ratio, neutrophil–lymphocyte ratio) may be used to predict mortality in patients with SBP.
Hand of FATe: lipid metabolism in hematopoietic stem cells
Authors: Lee Man K.S. , Al-sharea Annas , Dragoljevic Dragana , Murphy Andrew J. 
Published: March 2018

Purpose of review
Hematopoietic stem cells (HSCs) reside in the bone marrow and are important in replenishing all cells in the blood through a process termed hematopoiesis. One of the defining characteristics of HSCs is that they must be able to balance their self-renewal capacity with their differentiation into committed blood cells in various blood lineages. For these events to occur, HSCs must be tightly regulated in the bone marrow by intrinsic and extrinsic factors to maintain steady hematopoiesis.

Recent findings
Recently, the effect on how metabolism regulates HSC function has received a great amount of attention. In particular, lipids have been found to participate in mitochondrial activity to maintain HSCs, a role previously overlooked due to HSCs being thought of as mostly glycolytic. Moreover, there has been a re-emergence of how adipocytes in the bone marrow can regulate HSCs.

Summary
As these areas evolve, more studies are required to determine the exact contribution of lipids toward HSC maintenance. These studies will allow newer therapeutic targets to help reduce abnormal hematopoiesis such as myelopoiesis, which contributes to many metabolic diseases.
Approach to pulmonary vascular disease in the ICU
Authors: Brown Georgia , Humpl Tilman 
Published: March 2018

Purpose of review
Pulmonary vascular disease (PVD) complicates the course of many cardiovascular, pulmonary and other systemic diseases in children. The physiological sequelae (pulmonary hypertension and elevated pulmonary vascular resistance) can overwhelm the right ventricle and lead to circulatory collapse. Despite the common end-point, the preceding pathophysiology is complex and variable and requires a tailored approach to diagnosis and management. In this article, we will review the most recent evidence and explore an approach to current controversies in the diagnosis and management of common or challenging patient subgroups.

Recent findings
New methods of interpreting data derived from echocardiography and cardiac magnetic resonance imaging may assist in risk stratification and response to therapy. In specific patient subgroups, standard pharmacological therapies to reduce right ventricle afterload may be overutilized, ineffective and in some cases harmful. In the patient failing pharmacological therapy, new and novel techniques are being explored including temporary extracorporeal mechanical circulatory support, pumpless lung assist devices and novel surgical and catheterization procedures.

Summary
PVD is a diverse entity, and attention to the underlying pathophysiology is essential for appropriate management. Despite significant advances in our understanding, the majority of data comes from small uncontrolled studies and must be interpreted with caution.
Stroma — A Double-Edged Sword in Pancreatic Cancer
Authors: Gu Jichun , Saiyin Hexige , Fu Deliang , Li Ji 
Published: March 2018

Abstract
Pancreatic cancer is a uniformly lethal malignancy with an abundant dense desmoplastic stroma. Because of its dense stroma, conventional drugs were considered to not penetrate this physical barrier, and this caused a systemic drug resistance. Thus, abolishing this barrier with targeted agents is considered to improve the efficiency of chemotherapeutic treatment. The Hedgehog (Hh) signaling pathway is a critical regulator of pancreas development and plays diversified roles in pancreatic cancer stroma and neoplastic cells. Increasing Hh expression in neoplastic cells added desmoplastic stroma accumulation in orthotopic tumors, and Hh inhibitors that target the stroma have an ability to prolong the overall survival of Pdx-1-Cre/KrasG12D/p53R172H mice models via deleting the stromal components and increasing vascularity in pancreatic tumor. However, the failure of translation from bench to bedside indicate the complexity of the relationship between Hh signaling and desmoplastic stroma, and more insights into the complex relationships between Hh signaling pathway and stroma, even tumor cells, might help redesign Hh-targeted therapy. In this review, we discuss the possible mechanism of translation of Hh inhibitor in the clinic from pathology to molecular mechanism.
Root Fracture as Complication of Surgically Assisted Rapid Maxillary Expansion
Authors: Carvalho Pedro Henrique de Azambuja , Garcia Robson Rodrigues , Estrela Cristiane Bonanato , Pereira Filho Valfrido Antônio 
Published: March 2018

Abstract
A 23 year old male patient was submitted to surgical assisted rapid maxillary expansion (SARME). There were any postoperative complications until the finish of orthodontic expansion process. However, in the 30th postoperative day, patient mentioned pain in upper central incisor. Periapical radiography evidenced a root fracture of central upper right incisor. After endodontic treatment, the fractured apex was removed. After 3 years of follow-up, the patient finished orthodontics, and the damaged tooth was in good aspect. Apical fracture is an unexpected complication of SARME. However, follow-up and correct treatment lead to a good prognosis for tooth maintenance.
Delayed Diagnosis of Gorlin–Goltz Syndrome: The Importance of the Multidisciplinary Approach
Authors: Figueira Jéssica Araújo , Batista Fábio Roberto de Souza , Rosso Karina , Veltrini Vanessa Cristina , Pavan Angelo José 
Published: March 2018

Abstract
Gorlin–Goltz syndrome (GGS), also known as nevoid basal cell carcinoma syndrome, is an autosomal dominant inherited disorder with high penetrance and variable expressivity. The classic triad originally described by Gorlin and Goltz in 1960 is composed of multiple nevoid basal cell carcinomas (NBCCs), odontogenic keratocysts (OKCs) in the jaws and bifid ribs. in 1977, this triad was modified by Rayner et al, and to GGS diagnosis, the OKCs had to appear in combination with calcification of the cerebellar falx or palmar and plantar pits. It may occur that although GGS syndrome is a well-known condition, only the specific symptom could be observed by different specialists. Therefore, the patient cannot be placed in an always complex clinical panel. The authors introduce an example in this report. In the present case, the patient had NBCCs, OKCs, and probably other signs of GGS since 1998, and has been treated for this conditions separated, without a diagnosis of a syndromic condition. A 54-year-old white woman was referred to the oral medicine service due to cyst located in the right mandibular body. She had history of skin cancer and undergone surgeries and radiotherapies for the lesions treatment, scars on the skin face due to the lesions removed, and a new ulcerated lesion on the back of was diagnosed. In addition, the patient presented frontal and parietal bossing leading to increased cranial circumference, hypertelorism, strabismus, broad base, and mandibular prognathism. To the image examination, skull radiography revealed calcification of the falx cerebri; on chest X-ray bifid rib was observed and spine radiography showed vertebral osteophytes. Panoramic radiograph showed a well-defined bilocular radiolucent image located in posterior and anterior mandibular region. The whole elements induced us to investigate the patient's past medical history, which revealed that since 1998 had the diagnosis of NBCC and OKC. A multidisciplinary approach becomes necessary for the diagnosis and follow-up of patients with GGS, considering the complexity of the clinical manifestations. Therefore, it is of primary importance for dental surgeons and dermatologists to know the signs and symptoms of GGS to perform early diagnosis and to avoid progression of the oral cysts or metastasis of the skin lesions.
Antral Wall Approach for Reconstruction of Orbital Floor Fractures Using Anterior Maxillary Sinus Bone Grafts
Authors: Emodi Omri , Nseir Saleh , Shilo Dekel , Srouji Hanna , Rachmiel Adi 
Published: March 2018

Abstract
Isolated orbital wall fractures account for 4% to 16% of all facial fractures. Even a modest change in the position of the bony walls can have a significant impact on orbital volume and globe position. Alloplastic materials or autogenous bone grafts such as the antral maxillary wall can be used to reconstruct small- to medium-size orbital fractures. The main advantage of an antral wall graft is the intraoral approach with minimal morbidity. Nine patients underwent repair of orbital floor fractures using the extraoral and the intraoral antral wall approach. The patients underwent preoperative computed tomography imaging and a minimum of 1 year follow-up. The size of the defects ranged from 0.5 to 1.4 cm. Two patients experienced minor immediate postoperative complications; infraorbital hypoesthesia. On follow-ups, none of our patients suffered from ocular movement restrictions or complications regarding the maxillary antral wall approach. The use of harvested bone grafts from the anterolateral wall of the maxillary sinus is a promising approach for the reconstruction of small- to mid-size orbital floor defects with minimal complications and excellent cosmetic and functional results.