bluuebunny/crossref_metadata_2025_split huggingface dataset:
Screening Procedure for Hemihypertrophy: Preliminary Results of International Multicenter Prospective Study
Authors: Vaiman Michael , Shilco Phillip , Roitblat Yulia , Padilla-Raygoza Nicolas , Leit Aidan , Kavin Aaron , Schonberger Edan , Nehuliaieva Liliia , Buchris Noa , Shterenshis Michael 
Published: March 2019

Introduction: Isolated or congenital hemihypertrophy is a rare disorder characterized by asymmetric overgrowth of one side of the body. This article describes the protocol and preliminary results of a lateral body asymmetry (hemihypertrophy) screening procedure performed in healthy adolescents in a multicenter study. The reported incidence of hemihypertrophy varies between different publications and standardized protocols are needed to improve research in this area.Methods: Our screening program is taking place in Australia, Israel, Mexico, Ukraine and USA. Procedure includes two steps: (1) “three measurements – three questions” screening, or assessment of face, palms, and shins; (2) in-depth assessment of selected cases in order to exclude localized, lesional, and syndrome-related cases as well as body asymmetry within normative range and to select suspected cases of isolated hemihypertrophy. This step includes measurements of various anatomical regions and a detailed questionnaire.Results: At this stage, the screening procedure is completed and the selected participants are advised to refer to medical institutions for further clinical and genetic follow up to exclude possible tumors and other accompanying disorders.Conclusion: We present an easy-to-use selection tool to identify children with suspected IH, which results in the selection of the risk group that may benefit from referral to a pediatrician and a clinical geneticist.
CATEGORIZACION DE PATOLOGIA DE MAMA SEGÚN SISTEMA BIRADS
Authors: González Georgina , Alvarenga Mirna , Funes Eliza , Guillen Lizandro , González Manuel 
Published: March 2019

El sistema de datos y reporte de imagen de mama (BIRADS) es una herramienta que establece una estandarización en los informes mamográficos, para reducir la confusión en la interpretación del diagnóstico en la patología mamaria. Objetivo: Categorizar la patología mamaria detectada por el sistema BIRADS. Pacientes y Métodos: Estudio descriptivo y prospectivo, realizado a 1537 pacientes que acudieron a Mediscan para estudio de mamografía de tamizaje (mamografía de control/ anual) en el período comprendido entre enero 2014 a marzo 2015. Resultados: 560(36.2%) de los pacientes tenian edades entre 40 y 49 años, 1098(71.4%) de los pacientes presentaron factores de riesgo para cáncer de mama y los que más prevalecieron fueron biopsia previa de mama, carga genética para cáncer de mama y secreción por el pezón. El 2% fueron clasificados como BIRADS IV y V con el estudio de biopsia complementario solicitado, 10 pacientes fueron diagnosticados con Carcinoma Ductal Infiltrante. Conclusión: La relación entre los resultados mamográficos con el sistema BIRADS nos facilita el manejo de los mismos bajo recomendaciones precisas que mejoran la detección del cáncer de mama. Recomendación: Sensibilizar a las pacientes que la detección precoz es la mejor herramienta para el diagnóstico temprano.
Palabras clave
Determinación, Enfermedades Genéticas Congénitas, Neoplasias de la mama, Neoplasias
FACTORES DESENCADENANTES DE LAS COMPLICACIONES EN PACIENTES CON APENDICITIS AGUDA
Authors: Delcid Morazán Allan Fernando , Barahona Andrade Aristides , Barcan Batchvaroff Moran E. 
Published: March 2019

Antecedentes: La apendicitis aguda es la urgencia quirúrgica más frecuente en las emergencias y lleva a serias complicaciones. Su incidencia anual es de 1,33 por 1000 hombres y 0,09 por 1000 mujeres. El diagnóstico temprano, profilaxis antibiótica y terapia postoperatoria correcta, evitan complicaciones. Objetivo: Demostrar los principales factores desencadenantes de las complicaciones en los pacientes con Apendicitis Aguda en el Hospital General del Sur de Junio de 2015 a Febrero de 2016. Pacientes y métodos: Estudio no experimental, transversal, analítico, con universo de 568 pacientes operados por apendicitis aguda, muestra de 300 pacientes, constituida por 179 casos y 121 controles. Se determino un intervalo de confianza de 3.88, con nivel de confianza de 95%, el valor de precisión 0.6, dando como resultado una muestra de 237 la cual se cambio a 300 por tener más disponibilidad de los expedientes y realizar un estudio más preciso. Resultados: 179 (59%) de los pacientes eran hombres, 128 (70.1%) tenían entre 1-29 años, el diagnóstico se realizó con: hipersensibilidad en cuadrante inferior derecho del abdomen (98%), neutrofilia mayor a 70% (93%). No se le aplico profilaxis antibiótica a 204 pacientes (68%), hubieron apéndicitis complicadas en 59.7% y no complicadas en 40.3%, infección de la herida quirúrgica en un 10%, y la relación entre uso de profilaxis e infección de herida quirúrgica dio un OR 0.37 Conclusiones: la dificultad en los accesos de salud, la demora en el manejo y tratamiento de los pacientes y la falta de profilaxis antibiótica se vieron como factores desen- cadenantes. El más importante de estos fue la profilaxis antibiótica ya que su OR de 0.37 nos da un porcentaje de beneficiencia de 63% para prevenir infección de sitio quirúrgico.

Palabras clave
Apendicitis, Apéndice, Abdomen agudo, Profilaxis antibiótica
MENDICIDAD, ABANDONO Y TRABAJO INFANTIL EN LA COMUNIDAD GARÍFUNA DE TRAVESÍA, PUERTO CORTES
Authors: Miranda Baquedano Vilma Mercedes , Flores Girón Lesby Melissa , Euceda Garza Erick Alejandro 
Published: March 2019

La mendicidad, abandono y trabajo infantil son una realidad social en la que se ven involucrados muchos niños y niñas, siendo estos una población vulnerable ante los factores que potencian esta situación Objetivo: Conocer la prevalencia de mendicidad, abandono y trabajo infantil en la comunidad Garífuna de Puerto Cortés, I semestre 2016. Pacientes y Métodos: Estudio cuantitativo, descriptivo/exploratorio, transversal. Población 450 familias, muestra 149 familias, alea- torio simple. Instrumento tipo cuestionario. Resultados: 47% de las personas han observado niños mendigando, 86.58% si sabe que es abandono, 87.2% no conoce instituciones que ayuden a los niños abando- nados, en 42.28% de los hogares habitan niños abandonados por algún familiar, 50.79% indicaron ser la abuela de los niños. 26.17% de los hogares los menores realizan actividades para generar ingresos económicos, 13.51% realizan ventas ambulantes y el 4.73% construcción. Conclusión: Los resultados de la investigación muestran que si hay abandono, tanto físico como emocional en los niños de la comunidad Garífuna, al igual que la mendicidad, aunque no se observan niños pidiendo a simple vista estos si rodean la comunidad o realizan esta actividad duran- te las fechas donde hay más turistas, el trabajo infantil no se ve muy marcado en la población encuestada, sin embargo los niños si realizan actividades económicas para generar ingresos en su hogar, como la venta de pan de coco, tabletas, algunos en construcción, la mayoría de estos niños trabajan también estudian.

Palabras clave
Pobreza, Niño abandonado, Trabajo infantil, Grupo étnico, Niños
REIMPLANTACIÓN TARDÍA DE DIENTES AVULSIONADOS. REPORTE DE CASOS
Authors: Hernández Serrano Emny Carolina , Vijil Leclair Ana María 
Published: March 2019

La avulsión es considerada, dentro de los traumatismos dentoalveolar, como la exarticulación o desplazamiento completo del diente fuera de su alveolo. Este tipo de trauma tiene alta incidencia en niños y adolescentes. Es considerada como una verdadera emergencia en la cual la reimplantación inmediata es lo ideal, para un pronóstico favorable, aunque esto no siempre puede ser posible. Las complicaciones, como la reabsorción inflamatoria o reabsorción reemplazante son muchas veces inevitables, la reimplantación dental aun siendo tardía es una buena alternativa para ayudar a la conservación del espacio en el alveolo durante la maduración ósea, considerando también la estética, la función y el aspecto psicológico del paciente. El resultado final depende de diferentes factores, siendo de mayor importancia la reacción del cuerpo ante la colocación del diente en su lugar. El presente es el reporte de dos casos clínicos sobre avulsión dentaria con un tiempo extrao- ral mayor de 12 horas, en pacientes de 1 año 6 meses y otro de 3 años, que acudieron a la clínica de endodoncia en el Hospital Leonardo Martínez Valenzuela (HLMV) de la carrera de Odontología de la Universidad Nacional Autónoma de Honduras en el Valle de Sula (UNAH-VS). El paciente del primer caso se encuentra aún asintomático después de tres años de observación y el segundo presenta una reabsorción reemplazante.
Palabras clave
Avulsión dental, Resorción Radicular, Reimplantación
EVALUACIÓN DE LA INGESTA DIETÉTICA EN ESTUDIANTES DE CUARTO AÑO DE MEDICINA
Authors: González Pineda José Obdulio , Mejía Rodríguez Saúl Alejandro , Corea Cruz Claudia Raquel , Sánchez Mendoza Joselyn Gabriela , Majano Hernández Wilmer Roberto , Carranza Linares Ricardo Jafet , Elvir Gale Patricia Monserrath 
Published: March 2019

La malnutrición, ya sea por déficit o exceso de nutrientes, constituye un problema creciente a nivel mundial, siendo los jóvenes universitarios uno de los grupos más vulnerables. Objetivo: Evaluar la ingesta dietética de los estudiantes de Farmacología II y/o Fisiopatología II de medicina de la Universidad Nacional Autónoma de Honduras en el Valle de Sula (UNAH-VS) en mayo del 2017. Pacientes y métodos: Se realizó un estudio cuantitativo, descriptivo, transversal, en el mes de mayo del 2017, en estudiantes del cuarto año de medicina. Mediante muestreo probabilístico aleatorio estratificado se obtuvo una muestra de 65 estudiantes. La información fue recolectada mediante dos encuestas de recordatorio de 24 horas reali- zadas en dos días diferentes. Dicha información fue procesada mediante el software NutrINCAP y Microsoft Excel. Resultados: Se encontró que los participantes tenían una ingesta energética media de 3892.88 kcal/día y de 2245.16 kcal/día y una ingesta de proteínas de 136.06 y 82.79 gramos al día para hombres y mujeres, respectivamente. La ingesta media de colesterol en hombres fue de 490.04 mg/día, mientras que en las mujeres fue de 268.31 mg/día. En promedio, el consumo de calcio que se encontró para ambos sexos fue 640.56 mg/día y 946.59 mg/día, mientras que de hierro fue 27.32 mg y 38.63 mg/día, para mujeres y hombres, respectivamente. Conclusiones: Los hombres evaluados presentaron una dieta hipercalórica, con exceso de colesterol y déficit de calcio y hierro. Por su parte, las mujeres mantienen una dieta hipocalórica, hiperproteica y con déficit de calcio y hierro.

Palabras clave
Evaluación nutricional, Estudiantes de medicina, Ingestión de energía
CARACTERIZACIÓN GENERAL DE ZIKA
Authors: Díaz Mercadal Karla Patricia , Flores Zelaya Rut Elizabeth , Fajardo Dubón German Edgardo 
Published: March 2019

El Zika es un arbovirosis que causa enfermedad febril caracterizada por fiebre, rash, artralgias y conjuntivitis no purulenta. En 2015 se registraron casos autóctonos en Brasil, en menos de un año el Zika se extendió a más de 30 países y territorios de América Central, América del Sur, el Caribe y México, entre estos Honduras. Se ha relacionado con aumento de los casos de Guillain Barré y microcefalia en zonas donde produce epidemia. En Honduras, entre la semana epidemiológica 1 del 2016 a la 33 del 2017, hubo un total acumulado de 681 mujeres embarazadas con sospecha de Zika identificadas en el país, 125 de las cuales han sido confirmadas en laboratorio por reacción en cadena de polimerasa. Se realizó una revisión bibliográfica de 30 artículos tomando como referencia: artículos de revistas, normas y recomendaciones menores de 5 años de haber sido publicados o aquellos con importancia histórica, con el fin de brindar información útil al lector acerca del tema. Zika es una enfermedad que puede generar un impacto negativo en la salud de la niñez, dejando secuelas a largo plazo.
Palabras clave
Virus Zika, Arbovirosis, Microcefalia
O agir em psicossociologia do trabalho
Authors: Lhuilier Dominique 
Published: March 2019

Neste artigo, buscaremos esclarecer os sentidos dados aos termos agir, ação, atividade, ato, práxis, conceitos próximos, mas não sinônimos. Para isso, vamos propor uma discussão através da conceitualização da atividade, em psicossociologia do trabalho, centrando-nos em duas questões essenciais: a que serve a atividade? Quais as relações entre atividade e trabalho? A atividade está no fundamento da construção do sujeito e das unidades sociais. Com efeito, as atividades humanas são, a um só tempo, produção de si e do mundo. Além disso, salientamos aqui a unidade dialética das atividades humanas. Isso nos leva a questionar, de um lado, a dicotomia entre o fazer e o agir, a poiesis e a praxis; de outro lado, a clivagem entre trabalho e não-trabalho, vida profissional e extra-profissional. Em seguida, apresentaremos sucintamente uma pesquisa-ação relativa ao que significa, do ponto de vista da atividade, o fato de se viver e trabalhar com uma doença crônica, no mundo contemporâneo mundo do trabalho - mas não só nele.
Survey of the Current Use of Dexmedetomidine and Management of Withdrawal Symptoms in Critically Ill Children
Authors: Thompson R. Zachary , Gardner Brian M. , Autry Elizabeth B. , Day Scottie B. , Krishna Ashwin S. 
Published: March 2019

OBJECTIVES Dexmedetomidine use for sedation in the pediatric intensive care units (PICUs) has increased since its initial US Food and Drug Administration (FDA) approval in adults. However, there is limited evidence to direct providers regarding current usage, dosing, and monitoring for withdrawal symptoms in pediatric patients. This study sought to determine the utilization of dexmedetomidine and management of dexmedetomidine withdrawal symptoms among PICU physicians.
METHODS A questionnaire survey was distributed to all members of the American Academy of Pediatrics Section on Critical Care. It assessed the practice site demographics, indication, dosing, and duration of dexmedetomidine infusion, unit protocol, and strategies for management of dexmedetomidine withdrawal.
RESULTS A total of 147 surveys (21.1%) were returned and analyzed. The reported uses for dexmedetomidine were as a primary sedative (59.9%), adjunctive agent for sedation (82.3%), and adjunctive agent to assist weaning sedation (62.6%) or from mechanical ventilation (70.1%). One hundred twenty-nine respondents (87.8%) had concerns over dexmedetomidine withdrawal, with 59 respondents becoming concerned after 120 hours of infusion (45.7%). Most respondents reported managing dexmedetomidine withdrawal symptoms via a regimented wean and initiation of clonidine (81%). Units with &gt;1000 admissions per year were more likely to have a protocol related to dexmedetomidine use (p = 0.021). Units with &gt;1000 admissions per year reported using clonidine for withdrawal at a higher rate, whereas units with ≤1000 admissions per year used a systematic wean of dexmedetomidine (p = 0.014).
CONCLUSIONS Dexmedetomidine use in the PICU is varied among pediatric intensive care physicians. Intensivists have withdrawal concerns after dexmedetomidine discontinuation, and the primary management of this withdrawal phenomenon is the initiation of clonidine with a regimented dexmedetomidine wean.
Uncomplicated Urinary Tract Infection in Ambulatory Primary Care Pediatrics: Are We Using Antibiotics Appropriately?
Authors: AL-Sayyed Ban , Le Jeremy , Al-Tabbaa Mohammad Mousbah , Barnacle Brian , Ren Jinma , Tapping Richard , Aiyer Meenakshy 
Published: March 2019

OBJECTIVES Antimicrobial stewardship programs target antimicrobial use within the inpatient care setting. However, most antimicrobials are prescribed at ambulatory sites. We aim to determine the appropriateness of the diagnosis and treatment of uncomplicated urinary tract infection (UTI) in children within the outpatient setting at our institution, and to evaluate the cost of antibiotic treatment in our patient cohort.METHODS This retrospective study was conducted by reviewing electronic records of patients aged 2 to 18 years diagnosed with uncomplicated UTI and treated with antibiotics in the outpatient setting from January 1, 2016, to April 30, 2016. Appropriate diagnosis was defined as confirmed UTI that included: pyuria (&gt;5 white blood cells per high-power field or positive for leukocyte esterase), a positive urine culture (≥50,000 colony units/mL of a single uropathogen for a catheterized sample or ≥100,000 colony units/mL for a clean catch urine sample), and lower urinary tract symptoms. Treatment was considered appropriate if the patient was prescribed first-line antibiotic for the susceptible isolate (trimethoprim sulfamethoxazole, amoxicillinclavulanate, nitrofurantoin, and cephalexin), and if the appropriate dose was used.RESULTS We included 178 patients receiving a diagnosis of uncomplicated UTI and treated with antibiotics. Of these, 70% received an inappropriate diagnosis (n = 125). 58% (n= 72) of improperly diagnosed patients had polymicrobial growth in their urine cultures. Antibiotics prescribed mostly in this group were trimethoprim-sulfamethoxazole (53%, n = 66) and cephalexin (22%, n = 27). Only 30% of all included patients received an appropriate diagnosis (n = 53). Of all appropriate diagnosis patients (n = 53), 26% were treated inappropriately (n = 14) with either wide-spectrum antibiotics (n = 8) or with low calculated dose (n = 6). The estimated cost of antibiotic treatment for the inappropriate diagnosis group (n = 125) was $10,755.87.CONCLUSION Antimicrobial stewardship programs should target the pediatric outpatient setting and antibiograms should be developed. Education of providers about the appropriate diagnosis and treatment of uncomplicated UTI in children is essential for reducing the cost of inappropriate therapy.
Implementation of a Palivizumab Order Panel to Decrease Inappropriate Use
Authors: Rida Nada M. , Tribble Alison , Klein Kristin C. 
Published: March 2019

OBJECTIVE Palivizumab is a monoclonal antibody used to prevent infection from respiratory syncytial virus (RSV) in certain patients who are at high risk for complications. A previous medication use evaluation (MUE) demonstrated 12% of our palivizumab use did not meet criteria for use. Prior to the start of the 2016–2017 RSV season, an order panel was implemented requiring prescribers to select the approved criterion for each patient prescribed palivizumab. In addition, our restriction policy changed to state that palivizumab use outside of preapproved criteria would require authorization from pediatric infectious diseases or the antimicrobial stewardship team. An MUE was conducted during the summer of 2017 to determine whether the order panel had an impact on appropriate prescribing of palivizumab.
METHODS Medication orders for patients who received palivizumab from December 2015 to April 2016 and from December 2016 to April 2017 were reviewed to determine the proportion of patients who did not meet the preapproved restriction criteria. Charts were reviewed to verify indications of palivizumab for each patient during both seasons. A χ2 test was used to compare the proportion of inappropriate orders between the 2 seasons.
RESULTS During the 2015–2016 RSV season, of the 80 palivizumab orders, there were 11 inappropriate administrations (13.8%). During the 2016–2017 RSV season, 70 orders were administered to patients, and 4 doses (5.7%) were inappropriate. The cost of palivizumab increased from year 1 to year 2 (acquisition cost of $2477.44 per 100 mg/mL vial during year 1, $2613.71 per 100 mg/mL vial during year 2). An estimated cost avoidance of $12,807.18 was observed due to the decrease in the number of inappropriate administrations of palivizumab following implementation of the order panel (n = 7). There was an overall reduction in the number of inappropriate orders from year 1 to year 2 (8.1%); however, the reduction was not significant (p = 0.102).
CONCLUSIONS Following the implementation of the order panel plus restriction policy, we observed a decrease in the proportion of inappropriate doses that were administered from the preimplementation period to the postimplementation period, which also resulted in a cost avoidance of approximately $13,000.
La santé mobile en Belgique : le cas de la télésurveillance de la broncho-pneumopathie chronique obstructive
Authors: Slomian Cynthia , Schoenaers Frédéric 
Published: March 2019

Le développement de la santé mobile en Belgique fait partie intégrante du Plan d’action e-Santé 2013-2018. Un projet pilote de télésurveillance de patients atteints de broncho-pneumopathie chronique obstructive (BPCO) s’est déroulé en 2017 sous l’impulsion de l’Institut national d’assurance maladie-invalidité (INAMI). Le dispositif met en lien une tablette et des objets connectés, une équipe hospitalière, des patients, des médecins généralistes et une firme privée. La présence de ce dernier actant au sein du réseau sociotechnique (Akrich, 2006a, 2006b ; Callon, 2006) fait toute l’originalité du projet et crée une double médiation, induite à la fois par le dispositif mobile et par les agents de l’opérateur privé. Grâce à une méthode de récolte de données qualitatives alliant entretiens, observations (participantes ou non) et analyses documentaires, nous montrerons comment les actants dévient du script inscrit dans le dispositif technique, mais aussi dans le protocole médical et le manuel d’utilisateur. La double médiation empêche les patients de devenir de véritables agents diagnostiques (Oudshoorn, 2008) et la méfiance (Marzano, 2010) grandissante au sein du système provoque un effet de surveillance mutuelle qui empêchera, à terme, la normalisation du dispositif (Nicolini, 2010).
Comparative transcriptomics of sympatric species of coral reef fishes (genus: Haemulon)
Authors: Bernal Moisés A. , Dixon Groves B. , Matz Mikhail V. , Rocha Luiz A. 
Published: March 2019

Background
Coral reefs are major hotspots of diversity for marine fishes, yet there is still ongoing debate on the mechanisms that promote divergence in these rich ecosystems. Our understanding of how diversity originates in this environment could be enhanced by investigating the evolutionary dynamics of closely related fishes with overlapping ranges. Here, we focus on grunts of the genus Haemulon, a group of coral reef fishes with 15 species in the Western Atlantic, 11 of which are syntopic.

Methods
Wild fish samples from three sympatric species of the Caribbean: Haemulon flavolineatum, H. carbonarium and H. macrostomum, were collected while SCUBA diving. RNA was extracted from livers, and the transcriptomes were assembled and annotated to investigate positive selection (Pairwise dN/dS) and patterns of gene expression between the three species.

Results
Pairwise dN/dS analyses showed evidence of positive selection for genes associated with immune response, cranial morphology and formation of the anterior–posterior axis. Analyses of gene expression revealed that despite their sympatric distribution, H. macrostomum showed upregulation of oxidation-reduction machinery, while there was evidence for activation of immune response in H. carbonarium.

Discussion
Overall, our analyses suggest closely related grunts show important differences in genes associated with body shape and feeding morphology, a result in-line with previous morphological studies in the group. Further, despite their overlapping distribution they interact with their environment in distinct fashions. This is the largest compendium of genomic information for grunts thus far, representing a valuable resource for future studies in this unique group of coral reef fishes.