bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intrapartum Test for Detection of Group B Streptococcus Colonization During Labor
Authors: Picchiassi Elena , Coata Giuliana , Babucci Giulia , Giardina Irene , Summa Valentina , Tarquini Federica , Centra Michela , Bini Vittorio , Cappuccini Benito , Di Renzo Gian Carlo 
Published: May 2019

(Abstracted from J Matern Fetal Neonatal Med 2018;31(24):3293–3300)
Maternal colonization with group B streptococcus (GBS) leading to neonatal sepsis remains a predominant cause of neonatal morbidity and mortality in the world. Many countries have adopted screening strategies, such as the antepartum GBS screening culture at 35 to 37 weeks of pregnancy (antepartum culture), to identify women who need intrapartum antibiotic prophylaxis (IAP) in order to avoid the GBS peripartum transmission to the fetus.
Use of biologics in chronic sinusitis with nasal polyps
Authors: Wang Chengshuo , Zhang Luo 
Published: May 2019

Purpose of review
Chronic rhinosinusitis with nasal polyps (CRSwNP) is a heterogeneous inflammatory condition with different endotypes between patients from eastern or western countries. Targeted biologics are currently used to treat CRSwNP, but the outcomes widely vary. This review focuses on the present use of biologics for treating CRSwNP.

Recent findings
Monoclonal biologics have been used as an innovative therapy for multiple allergic diseases and comorbid allergic conditions. Over the past several decades, numerous biomarkers have been investigated and were found to be closely correlated with CRSwNP, improving the understanding of inflammatory patterns and endotype classifications for CRSwNP and prompting discussion regarding the use of biologics in CRSwNP. Efficacies vary in reports of different research groups, but it has been found that patients with TH-2-driven inflammatory patterns respond better to the use of biologics than those with non-TH-2-driven CRSwNP. These findings suggest the importance and urgency of developing criteria for biologics in CRSwNP.

Summary
Precisely determining patient criteria, identifying treatment biomarkers based on endotyping for CRSwNP and determinations of contraindications for long-term utilization may be useful for optimizing treatment strategies and improving the therapeutic efficacy of biologics to achieve long-term control starting at early stages.
Cost Effectiveness of Neonatal Resuscitation at 22 Weeks of Gestation
Authors: Yieh Leah , Dukhovny Dmitry , Zhou Clarice G. , Gievers Ladawna , Caughey Aaron B. 
Published: May 2019

OBJECTIVE:
To evaluate the cost effectiveness of three different approaches to the care of neonates born at 22 weeks of gestation: universal resuscitation, selective resuscitation, or no resuscitation.

METHODS:
We constructed a decision-analytic model using TreeAge to compare the outcomes of death and survival with and without neurodevelopmental impairment in a theoretical cohort of 5,176 neonates (an estimate of the annual number of deliveries that occur in the 22nd week of gestation in the United States). We took a societal perspective using a lifetime horizon, and all costs were expressed in 2017 U.S. dollars. Effectiveness was based on combined maternal and neonatal quality-adjusted life years (QALYs). The incremental cost-effectiveness ratio was determined (cost/QALY) for each additional survivor. The willingness to pay threshold was set at $100,000/QALY. All model inputs were derived from the literature. Deterministic and probabilistic sensitivity analyses were performed to interrogate model assumptions.

RESULTS:
Universal resuscitation would result in 373 survivors, 123 of whom would have severe disability. Selective resuscitation would produce 78 survivors with 26 affected by severe impairments. No resuscitation would result in only eight survivors and three neonates with severe sequelae. Selective resuscitation was eliminated by extended dominance because this strategy had a higher incremental cost-effectiveness ratio than universal resuscitation, which was a more effective intervention. The incremental cost-effectiveness ratio of universal resuscitation compared with no resuscitation was not cost effective at $106,691/QALY. Monte Carlo simulations demonstrated that universal resuscitation is more effective but also more expensive compared with no resuscitation, with only 35% of simulations below the willingness to pay threshold.

CONCLUSION:
In our model, neither selective nor universal resuscitation of 22-week neonates is a cost-effective strategy compared with no resuscitation.
Pharmacist Provision of Hormonal Contraception in the Oregon Medicaid Population
Authors: Anderson Lorinda , Hartung Daniel M. , Middleton Luke , Rodriguez Maria I. 
Published: May 2019

OBJECTIVE:
To describe early utilization of pharmacist prescription of contraception in Oregon's Medicaid program.

METHODS:
Using Oregon Medicaid claims data, we conducted a retrospective analysis and quantified overall and monthly trends in pharmacist-prescribed contraceptives from January 1, 2016, to December 31, 2017. Our population was restricted to patients obtaining a new prescription for oral and transdermal methods and who had continuous Medicaid coverage during the study period. We summarized demographic and utilization characteristics, including whether patients were continuing or switching methods or initiating contraception. New prescriptions were those written to patients who did not have one for hormonal contraception in the prior 30 days. To assess program safety, we examined rates of prescriptions to patients with medical contraindications to contraceptive use.

RESULTS:
Among the 3,614 patients receiving a new prescription for oral or transdermal contraceptives in the Oregon Medicaid program from all health care providers, 367 (10%) received their prescription from a pharmacist. Five months after implementation, pharmacists filled an average of 61 prescriptions per month as the prescriber. Most claims originated from retail chain pharmacies (94%) in urban locations (71%). The majority of patients who were prescribed contraception by pharmacists (73.8%) had no history of contraceptive prescriptions in the preceding 30 days (n=252). Ages ranged from 13 to 49 years, fewer patients lived in a rural location (35.7%), most received a combined hormonal pill (90.5%), and the average day's supply dispensed was 65 (range of 21–364 days). Fewer than 5% (12) of patients had a diagnostic code indicating a possible contraindicating comorbidity.

CONCLUSION:
Among Medicaid enrollees, we found that 10% of all new oral and transdermal contraceptive prescriptions were written by pharmacists.
Treating Myomatous Erythrocytosis Syndrome With Uterine Artery Embolization
Authors: Gordon Brian , Fischbeck Tucker , Salamo Russell , Schroff Stuart 
Published: May 2019

BACKGROUND:
Myomatous erythrocytosis syndrome, a form of secondary polycythemia associated with uterine leiomyomas, increases the risk of thrombosis and traditionally has been treated with hysterectomy.

CASE:
The patient is a 68-year-old woman with 7-year history of polycythemia initially thought to be secondary to a gastrointestinal stromal tumor that persisted after resection. A subsequent search for an alternative etiology led to the discovery of an 11.2-cm submucosal leiomyoma and likelihood of myomatous erythrocytosis syndrome. The patient declined surgical management and continued to undergo recurrent phlebotomy to maintain a hematocrit of less than 45% until consultation with an interventional radiology specialist. She underwent uterine artery embolization in July 2017, and her hematocrit has remained within normal limits through 17 months of follow-up.

CONCLUSION:
Uterine artery embolization is an effective alternative treatment modality for myomatous erythrocytosis syndrome.
Softer Tissue Issues in Orthopaedic Trauma
Authors: Nauth Aaron , Egol Kenneth A. , Walden Timothy , Boyer Martin , Anglen Jeffrey , Broekhuyse Henry M. 
Published: May 2019

Summary:
There are number of significant issues outside of the bone and/or fracture that are important to consider in the treatment of orthopaedic trauma. Joint contractures, heterotopic bone formation, managing a traumatized soft-tissue envelope or substantial soft-tissue defects represent a few of these important issues. This article reviews these issues, including the best available evidence on how to manage them.
Previous Implant Fractures: A New Descriptive Classification System
Authors: Egol Kenneth A. , Carlock Kurtis D. , Kelly Erin A. , Seetharam Abhijit , Mullis Brian H. , Marcantonio Andrew J. , Bramlett Kasey J. , Nchako Corbyn M. , Watson J. Tracy , Cannada Lisa K. , Konda Sanjit R. 
Published: May 2019

Objectives:
To propose a previous implant fractures (PIFs) classification system with good interobserver reliability.

Design:
Retrospective classification.

Setting:
Four academic medical centers.

Patients/Participants:
A retrospective review of PIFs treated at 4 academic medical centers over 10 years was performed. Data collected included initial implant and PIF radiographs. There were 103 PIFs in 96 patients during the study period. Seventy-three (70.9%) were about plate/screw (PS) constructs and 30 (29.1%) were about intramedullary (IM) devices.

Intervention:
Assignment of PIF classification.

Main Outcome Measurements:
PIFs were classified based on initial implant (PS or IM) and fracture location with respect to the initial implant (proximal or distal to the implant, at the tip of the construct, or within the construct). Reliability of this scheme was assessed among 5 observers using Fleiss' kappa tests.

Results:
Of PIFs about plate/screw constructs, 26.0% were proximal/distal to the implant (classification: PS1), 57.5% involved bone between the most proximal/distal screw and the same end of the plate (classification: PS2), and 16.4% involved only bone between the most proximal and distal screws (classification: PS3). Of PIFs about IM, 43.3% were distal to the device (classification: IM1), 46.7% involved bone between the most proximal/distal locking bolt and the same end of the device (classification: IM2), and 10.0% involved only bone between locking bolts (classification: IM3). Interobserver reliability for the classification system was excellent between observers, κ = 0.839, P < 0.0005.

Conclusions:
The proposed system offers a simple method to classify and describe fractures that occur about a previously implanted fracture device. Development of a classification system will allow for comparison of treatment modalities between injury types.
Erythropoietin Improves Cardiovascular Function in Adult Rats After Acute Hemorrhage
Authors: Puchulu María B. , Arreche Noelia , Zotta Elsa , Donato Martin , Ogonowski Natalia , Fellet Andrea , Balaszczuk Ana M. 
Published: May 2019

Abstract:
Erythropoietin (EPO) has been linked to cardioprotective effects. However, its effects during the aging process are little known. We investigated the effect of EPO administration on hemodynamic parameters, cardiac function, oxidative damage, and erythropoietin receptor (EPOR) expression pattern in the hypovolemic state. EPO was administered (1000 IU/kg/3 days) and then acute hemorrhage (20% blood loss) was induced in young and adult rats. There was no difference in plasmatic EPO in either age group. The hemodynamic basal condition was similar, without alterations in renal function and hematocrit, in both age groups. After bleeding, both EPO-treated age groups had increased blood pressure at the end of the experimental protocol, being greater in adult animals. EPO attenuated the tachycardic effect. Ejection fraction and fractional shortening were higher in adult EPO-treated rats subjected to hemorrhage. In the left ventricle, young and adult EPO-treated rats subjected to bleeding showed an increased EPOR expression. A different EPOR expression pattern was observed in the adult right atrial tissue, compared with young animals. EPO treatment decreased oxidative damage to lipids in both age groups. EPO treatment before acute hemorrhage improves cardiovascular function during the aging process, which is mediated by different EPOR pattern expression in the heart tissue.
Quantification of the Plasma Concentration of Apatinib by 2-Dimensional Liquid Chromatography
Authors: Yu Yue , Shi Jing , Wang Feng , Tang Xiao-hui , Liu Yu-guo 
Published: May 2019

Background:
Apatinib is a new oral micromolecular tyrosine kinase inhibitor, which is mainly used as a third-line treatment for chemotherapy-refractory advanced metastatic gastric cancer patients. However, apatinib has shown dose titration and severe adverse reactions in clinical practice. Quantification of plasma concentrations of apatinib may be an effective method to balance the clinical efficacy and adverse reactions. The purpose of this study was to develop and validate a 2-dimensional liquid chromatography method for the measurement of apatinib in plasma.

Methods:
The analysis of apatinib was performed using a 2-dimensional high-performance liquid chromatography system. We precipitated the proteins with acetonitrile. The mobile phases consisted of a first-dimensional mobile phase (acetonitrile:methanol:25 mmol·L−1 ammonium phosphate = 25:25:50, V/V/V, pH adjusted to 7.2 using phosphoric acid) and a second-dimensional mobile phase (acetonitrile:10 mmol·L−1 ammonium phosphate = 28:72, vol/vol, pH adjusted to 3.7 using phosphoric acid). The ultraviolet detection wavelength was set at 340 nm. The temperature of the detector cell was 40°C, and the injection volume was 500 μL.

Results:
The range of calibration curve was 15.27–1491.48 ng/mL. The accuracy and imprecision were within ±2.23% and less than 10.22%, respectively (intraday and interday). The range of recovery was 97.45%–108.92%. The intraday and interday relative SDs (reproducibility) of high-performance liquid chromatography retention times were less than 0.18% and 0.46%, respectively. In the clinical assessment, the dose range of apatinib mesylate for patients with gastric cancer was 250–500 mg every day (2–60 days), resulting in trough plasma concentrations between 272.7 and 727.8 ng/mL.

Conclusions:
A simple, convenient, accurate, and robust 2-dimensional liquid chromatography method was developed and verified, which successfully determined the plasma concentrations of apatinib in patients with gastric cancer.
Nonmicrosurgical Grafting for Facial Nerve Branches with Permanent Sensational Functional Outcome
Authors: Ali Yasser Helmy , Al Sheikh Abd El-Fattah 
Published: May 2019

Summary:
A 49-year-old man underwent intraoperatively modified procedure from superficial to radical parotidectomy with excision of the facial nerve 4 branches, temporal, zygomatic, buccal, and mandibular. We have dissected and harvested the branches of the great auricular nerve to repair the defects of the temporal, zygomatic, buccal, and mandibular nerves without microsurgery aid. The aims of the repair were just to mark the nerve endings, to try autologous grafting, and to avoid neuroma(s) formation, although neuroma(s) formations from motor nerves are rare. We did an immediate temporary nonmicrosurgical nerve grafting, and we have sutured each nerve anastomosis by 2–3 stitches of Prolene 6–0. We have observed facial nerve branches’ recovery on the second month, even with radiation therapy, and then gradually more improvements on the third month and then on the sixth month of the follow-up. Finally, the procedure results in permanent sensational functional outcome after 1 year. Because we did not plan a microsurgical repair, this case report does not support any intended nonmicrosurgical procedures for facial nerve repair, but it raises questions for laboratory and animal investigations about the size of Prolene we have used, grip repair taking the epineurium and fascicle in mass closure, and the positive fast functional results. In surgical environments where microscope or microinstruments are lacking, one can still perform primary nerve grafting.
Myasthenia gravis presentation and treatment variations: A case study approach
Authors: Deters Darlene , Patel Darpan I. 
Published: May 2019

ABSTRACT
Myasthenia gravis (MG) is an autoimmune neuromuscular disorder that can affect the ocular, bulbar, neck, proximal limb, and respiratory muscles. This case study presents two similar individuals diagnosed with MG that presented with varying symptomatology and also with a different response to therapy. These two patients represent a unique patient group that represents only 10% of patients diagnosed with MG.
Psychological affection in rheumatoid arthritis patients in relation to disease activity
Authors: Hassan Amal Ali , Nasr Mona Hamdy , Mohamed Ahmed Lotfi , Kamal Ahmed Mohmed , Elmoghazy Alyaa Diaa 
Published: May 2019

Abstract
Rheumatoid arthritis (RA) is a common, systemic autoimmune disease characterized by persistent symmetric polyarthritis (synovitis). Anxiety and depression are common among patients with RA, compared to the general population and have been associated with increased pain, fatigue, physical disability and health care costs, and an overall reduced health-related quality of life. The aim of the present study was to assess the relation between psychological factors (anxiety and depression) and disease activity (and severity) parameters in RA patients.
This national, single-center, cross-sectional study recruited over 6 months 25 patients with RA diagnosed according to the 2010 American College of Rheumatology/European League Against Rheumatism classification criteria, and 25 healthy control individuals. All participants were subjected to the clinical and laboratory evaluation of disease activity and psychological assessment according to the International Classification of Mental and Behavioral Disorders tenth revision. Significance and regression analyses were performed to determine disease activity and severity predictors.
80% of RA patients had depression and 52% anxiety symptoms, while only 8% of healthy controls reported mild depression (P < .001). Data also found highly significant correlation between depressive symptoms and RA disease activity (P < .05).
Psychiatric manifestations are common in RA and they strongly correlate with severity of the disease.
Effects of systemic and neuraxial morphine on the immune system
Authors: Chen Shih-Hong , Chen Shiou-Sheng , Wang Yi-Ping , Chen Li-Kuei 
Published: May 2019

Abstract
In the study, we tried to evaluate the effects of morphine injected through the systemic or neuraxial route on immune cell function and cytokine production in healthy women.
In total, 29 paired samples of fresh peripheral blood were collected from healthy women who had been administered morphine for anesthetic analgesia through intravenous (IV), epidural, or spinal route postpartum. Their isolated peripheral blood mononuclear cells were mitogen-activated and stained with fluorochrome-conjugated anti-CD4, anti-CD8, anti-interleukin (IL)-2, and anti-interferon (IFN)-γ antibodies for flow cytometry, and the plasma levels of cytokines, including IL-6, IFN-α2, IL-10, IL-8, GM-CSF, and monocyte chemoattractant protein (MCP)-1, were measured through enzyme-linked immunosorbent assay.
The results demonstrated that regardless of the administration route, morphine delivery slightly reduced IL-2 expression in CD4+ cells after activation, and the same effect was not noted for CD8+ cells. Intravenous or epidural morphine tended to reduce IFN-γ expression in CD8+ cells. Spinal and IV morphine substantially increased IL-6 production, whereas epidural morphine hindered IL-10 and GM-CSF production. IV morphine injection reduced MCP-1 production in plasma. Compared with spinal morphine, IV or epidural morphine may more effectively inhibit the expression of various cytokines and thus affect immune response.
All 3 routes of morphine injection tended to decrease IL-2 production by CD4+ cells, whereas IV or epidural morphine injection showed lower IFN-γ production by CD8+ cells. However, additional large-scale studies with longer follow-up durations are warranted.
Serum ROCK1 mRNA is of great diagnostic value for glioma patients
Authors: Liu Yunyang , Zhang Jianjun , Wang Dong , Yang Xinyu 
Published: May 2019

Abstract
The study aimed to measure the presence of rho-associated protein kinase 1 (ROCK1) mRNA in serum samples collected from glioma and investigate its diagnostic significance in glioma.
The presence of ROCK1 mRNA was examined by quantitative real-time polymerase chain reaction (qRT-PCR). The relationship between ROCK1 mRNA and clinical characteristics was analyzed via Chi-square test. The criteria of diagnosis evaluation, including sensitivity, specificity, optimal cutoff point, and area under the curve (AUC) were determined through the receiver operating characteristic (ROC) curve analysis.

ROCK1 mRNA was significantly increased in serum samples collected from glioma patients compared to the controls (P <.05). Besides, high ROCK1 mRNA expression was tightly related with Karnofsky Performance Status (KPS) score (P = .024) and World Health Organization (WHO) grade (P = .029). However, there was no association between ROCK1 expression and gender, neurological disorders, family history and cigarette smoking (all, P >.05). In addition, the optimal cutoff point was 3.025, with the sensitivity and specificity of 88.89% and 79.25%, respectively. The AUC was 0.881, indicating that ROCK1 was a diagnostic biomarker for glioma patients (P <.0001, 95% CI = 0.829–0.933).
Serum ROCK1 mRNA is significantly up-regulated in glioma cases compared to healthy controls. ROCK1 may be a potential diagnostic biomarker in glioma.
Timely diagnosis and treatment of neonatal alloimmune thrombocytopenia caused by anti HPA-3a antibody
Authors: Yang Qiankun , Lv Xianping , Kong Yongkui , Liu Xin , Shao Ming , Zhao Yanteng , Xia Namei , Wang Shuya , Li Huidong 
Published: May 2019

Abstract

Rationale:
Neonatal alloimmune thrombocytopenia (NAIT) caused by anti HPA-3a antibody is rare, and the clinical features of the syndrome are not specific.

Patient concerns:
A male infant was noted to be irritable and physical examination revealed the presence of petechiae and bruising on the right arm and thigh after born.

Diagnoses:
Platelet antibodies were investigated using the monoclonal antibody-specific immobilization of platelet antigens (MAIPA) assay, platelet genotyping (HPA 1–17) was performed by polymerase chain reaction technique with sequence-specific primers (PCR-SSP). The HPA genotype of the newborn was HPA-3a/b, while that of his mother and his father were HPA-3b/b and HPA-3a/a, respectively. The sera of newborn contained antibody against the platelet of newborn's father. The HPA antibody of the newborn was identified as anti HPA-3a. The newborn was confirmed as a patient of NAIT caused by anti HPA-3a antibody.

Interventions:
A single dose of intravenous immunoglobulin (IVIG) 1 g/kg was administered from day 3 to day 7.

Outcomes:
At follow-up 3 months after discharge from the hospital, the baby was developing normally and had a normal platelet count (361 × 109/L).

Lessons:
NAIT caused by anti HPA-3a antibody is rare, and we believe this study can provide insights for diagnosing prospective cases. Prognosis of NAIT caused by HPA3a seems to be favorable if diagnosed and treated in a timely manner.