bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is It Time to Stop Using Single-dose Oral Metronidazole for the Treatment of Trichomoniasis in Women?
Authors: Muzny Christina A. , Richter Saralyn , Kissinger Patricia 
Published: December 2018

Abstract
The 2015 Centers for Disease Control Sexually Transmitted Disease treatment guidelines currently recommend a single 2-g dose of oral metronidazole as the preferred regimen for treatment of trichomoniasis in human immunodeficiency virus (HIV)-negative women. Mounting recent evidence has shown that the 7-day oral metronidazole dosing regimen is more efficacious than the single 2-g dose. This commentary reviews the implications associated with these new data and discusses issues surrounding it that should be considered moving forward.
Miscarriage Treatment–Related Morbidities and Adverse Events in Hospitals, Ambulatory Surgery Centers, and Office-Based Settings
Authors: Roberts Sarah C. M. , Beam Nancy , Liu Guodong , Upadhyay Ushma D. , Leslie Douglas L. , Ba Djibril , Kerns Jennifer L. 
Published: December 2018

Objective
The aim of the study was to examine whether miscarriage treatment–related morbidities and adverse events vary across facility types.

Methods
A retrospective cohort study compared miscarriage treatment–related morbidities and adverse events across hospitals, ambulatory surgery centers (ASCs), and office-based settings. Data on women who had miscarriage treatment between 2011 and 2014 and were continuously enrolled in their insurance plan for at least 1 year before and at least 6 weeks after treatment were obtained from a large national private insurance claims database. The main outcome was miscarriage treatment–related morbidities and adverse events occurring within 6 weeks of miscarriage treatment. Secondary outcomes were major events and infections.

Results
A total of 97,374 miscarriage treatments met inclusion criteria. Most (75%) were provided in hospitals, 10% ASCs, and 15% office-based settings. A total of 9.3% had miscarriage treatment–related events, 1.0% major events, and 1.5% infections. In adjusted analyses, there were fewer events in ASCs (6.5%) than office-based settings (9.4%) and hospitals (9.6%), but no significant difference between office-based settings and hospitals. There were no significant differences in major events between ASCs (0.7%) and office-based settings (0.8%), but more in hospitals (1.1%) than ASCs and office-based settings. There were fewer infections in ASCs (0.9%) than office-based settings (1.2%) and more in hospitals (1.6%) than ASCs and office-based settings. In analyses stratified by miscarriage treatment type, the difference between ASCs and office-based settings was no longer significant for miscarriages treated with procedures.

Conclusions
Although there seem to be slightly more events in hospitals than ASCs or office-based settings, findings do not support limiting miscarriage treatment to particular settings.
Managing Acinetobacter baumannii infections
Authors: Garnacho-Montero José , Timsit Jean-François 
Published: December 2018

Purpose of review
We reviewed recent data about epidemiology of Acinetobacter baumannii, resistance mechanisms, and therapeutic options for severe infections caused by multidrug-resistant strains.

Recent findings

A. baumannii is a major cause of nosocomial infections affecting mainly to debilitating patients in the ICU, although the spread to regular wards and to long-term care facilities is increasing. It is characterized by its great persistence in the environment and to have an extraordinary capability to develop resistance to all antimicrobials.
Carbapenems may not be considered the treatment of choice in areas with high rates of carbapenem-resistant A. baumannii. Nowadays, polymyxins are the antimicrobials with the greatest level of in-vitro activity against A. baumannii. Colistin is the most widely used in clinical practice although polymyxin B seems to be associated with less renal toxicity. Colistin is administered intravenously as its inactive prodrug colistimethate. A loading dose of 9 million IU and subsequently high, extended-interval maintenance doses (4.5 million IU/12 h) are recommended. Combination therapy instead of monotherapy increases the rates of microbiological eradication although no clinical study has demonstrated a reduction in clinical outcomes (mortality or length of stay).

Summary
The optimal treatment for multidrug-resistant A. baumannii nosocomial infections has not been established. There are no compelling data to recommend combination therapy for severe A. baumannii infections.
Rheumatoid Arthritis and Mortality in End Stage Renal Disease
Authors: Paudyal Sunita , Waller Jennifer L. , Oliver Alyce , Le Brian , Zleik Nour , Nahman N. Stanley , Carbone Laura 
Published: December 2018

Objective
To determine whether rheumatoid arthritis (RA) is a risk factor for cardiovascular disease (CVD) events, all-cause mortality and cardiovascular mortality in End Stage Renal Disease (ESRD).

Methods
Cohort study of adult patients with ESRD in the United States Renal Data System (USRDS) with RA and a 5% random sample of those without RA. CVD events, all-cause mortality and cardiovascular mortality were determined in those with RA compared to those without RA using Cox Proportional Hazards modeling.

Results
2,824 subjects, 407 with RA and 2,417 without RA, were included in the analyses. The duration of the study was up to 5 years, depending on mortality and initiation of dialysis. There were no significant differences in CVD events by RA status (n = 311 [76.4% RA] vs. n = 1936 [80.1% without RA], p = 0.09). Subjects with RA had a significantly shorter mean time in months from start of dialysis to an incident CVD event (20.1 ± 12.2 vs. 21.2 ± 14.1, p < 0.01) than those without RA. In multivariable adjusted models, RA was not associated with an increased risk for all-cause mortality (aHR = 1.09, 95%CI 0.94–1.27) or cardiovascular mortality (aHR = 0.95, 95% CI 0.74–1.22) within 5 years. Risk factors for all-cause mortality and cardiovascular mortality in RA included older age and a higher Charlson comorbidity index (CCI).

Conclusions
Clinicians should be aware that persons with RA who develop ESRD incur cardiac events sooner than the general population. However, RA is not an independent risk factor for all-cause or cardiovascular mortality in ESRD.
Evaluation of Oxalate Osteopathy Secondary to Hyperoxaluria With 18F-FDG PET/CT and 99mTc-HMDP Bone Scan
Authors: Somme François , Blondet Cyrille , Matuszak Julien , Heimburger Céline 
Published: December 2018

Abstract
We report a case of a 69-year-old woman with primary hyperoxaluria type I, who developed a severe hypercalcemia despite controlled secondary hyperparathyroidism. Bone scintigraphy showed diffuse increased uptake in axial and peripheral skeleton. 18F-FDG PET/CT showed countless striking hypermetabolic foci, interesting 2 types of lesions (joint calcifications and periosteal resorptions). Bone biopsy demonstrated inflammatory changes around many calcium oxalate crystals; hypercalcemia was then related to oxalate osteopathy. Immunotherapy with denosumab was thus initiated. Eighteen months later, a second PET/CT showed decreased 18F-FDG uptake, reflecting treatment efficacy on inflammatory reaction secondary to calcium oxalosis skeletal deposits.
68Ga-DOTA-TOC PET/CT of von Hippel–Lindau Disease
Authors: Liberini Virginia , Nicolotti Daniele Giovanni , Maccario Mauro , Finessi Monica , Deandreis Désirée 
Published: December 2018

Abstract
We present a rare case of a 42-year-old man with a long history of von Hippel–Lindau disease that was scanned with 68Ga-DOTA-TOC PET/CT for suspicion of disease relapse. 68Ga-DOTA-TOC imaging demonstrated increased DOTA-TOC uptake in pancreas tail and intramedullary and extramedullary spinal hemangioblastomas, only some of which have already been highlighted at MRI examination. This case illustrates the significant role the 68Ga-labeled somatostatin receptor analogs PET/CT in the management of the von Hippel–Lindau disease.
Hybrid 11C-MET PET/MRI Combined With “Machine Learning” in Glioma Diagnosis According to the Revised Glioma WHO Classification 2016
Authors: Kebir Sied , Weber Manuel , Lazaridis Lazaros , Deuschl Cornelius , Schmidt Teresa , Mönninghoff Christoph , Keyvani Kathy , Umutlu Lale , Pierscianek Daniela , Forsting Michael , Sure Ulrich , Stuschke Martin , Kleinschnitz Christoph , Scheffler Björn , Colletti Patrick M. , Rubello Domenico , Rischpler Christoph , Glas Martin 
Published: December 2018

Purpose
With the advent of the revised WHO classification from 2016, molecular features, including isocitrate dehydrogenase (IDH) mutation have become important in glioma subtyping. This pilot trial analyzed the potential for 11C-methionine (MET) PET/MRI in classifying glioma according to the revised WHO classification using a machine learning model.

Methods
Patients with newly diagnosed WHO grade II–IV glioma underwent preoperative MET-PET/MRI imaging. Patients were retrospectively divided into four groups: IDH wild-type glioblastoma (GBM), IDH wild-type grade II/III glioma (GII/III-IDHwt), IDH mutant grade II/III glioma with codeletion of 1p19q (GII/III-IDHmut1p19qcod) or without 1p19q-codeletion (GII/III-IDHmut1p19qnc). Within each group, the maximum tumor-to-brain-ratio (TBRmax) of MET-uptake was calculated. To gain generalizable implications from our data, we made use of a machine learning algorithm based on a development and validation subcohort. A support vector machine model was fit to the development subcohort and evaluated on the validation subcohort. Receiver operating characteristic (ROC) analysis served as metric to assess model performance.

Results
Of a total of 259 patients, 39 patients met the inclusion criteria. TBRmax was highest in the GBM cohort (TBRmax 3.83 ± 1.30) and significantly higher (P = 0.004) compared to GII/III-IDHmut1p19qnc group, where TBRmax was lowest (TBRmax 2.05 ± 0.94). ROC analysis showed poor AUC for glioma subtyping (AUC 0.62) and high AUC of 0.79 for predicting IDH status. In the GII/III-IDHmut1p19qcod group, TBR values were slightly higher than in the IDHmut1p19qnc group.

Conclusions
MET-PET/MRI imaging in pre-operatively classifying glioma entities appears useful for the assessment of IDH status. However, a larger trial is needed prior to translation into the clinical routine.
Rationale for Study of the Deep Subfascial Lymphatic Vessels During Lymphoscintigraphy for the Diagnosis of Peripheral Lymphedema
Authors: Campisi Corrado Cesare , Ryan Melissa , Villa Giuseppe , Di Summa Pietro , Cherubino Mario , Boccardo Francesco , Campisi Corradino 
Published: December 2018

PurposeThe current study aimed to determine the utility of including the study of deep subfascial lymphatic vessels in a 2-compartment lymphoscintigraphy for the diagnosis of lymphedema in patients with limb swelling. Lymphoscintigraphy is a valuable imaging tool for the timely diagnosis of peripheral lymphedema. However, there is a lack of standardization in its application, especially regarding which type of lymphatic vessels to examine (superficial, deep, or both).MethodsTwo hundred fifty-eight patients with lymphedema underwent segmental lymphoscintigraphy. The transport index (TI) was calculated to categorize the flow of the superficial and deep vessels as normal (<10) or pathological (≥10). The scores from 248 patients (48 unilateral arm, 86 unilateral leg, 114 bilateral leg) were tested with a 3-way analysis of variance to examine the relationship between affected limb, deep or superficial pathways, and primary or secondary lymphedema. The relationship between clinical presentation and TI was also investigated.ResultsIn general, primary and secondary lymphedema patients had similar patterns of lymphoscintigraphic lymphatic abnormalities. Patients with unilateral clinical presentation can have bilateral TI abnormalities. The vast majority of patients (88%–98%) had either the deep subfascial vessels alone, or both the superficial and deep vessels, with a pathological TI.ConclusionsA 2-compartment lymphoscintigraphy is able to accurately detect lymphatic flow abnormalities in patients with limb swelling. Given that the vast majority of patients had deep lymphatic vessels abnormalities, inclusion of these vessels in the lymphoscintigraphic diagnostic protocol is recommended.
Skeletal Superscan on 18F-FDG PET/CT in a Patient With Multiple Myeloma
Authors: Fu Zhanli , Chen Xueqi , Yang Xing , Li Qian 
Published: December 2018

Abstract
An 18F-FDG PET/CT was performed on a 47-year-old man diagnosed as multiple myeloma with diffuse bone marrow infiltration on pathology. PET/CT findings presented as a pattern of skeletal “superscan,” including diffuse and prominent hypermetabolism throughout the axial and proximal appendicular skeleton, which all alleviated after 5 cycles of chemotherapy.
18F-Choline PET/CT in Leptomeningeal Breast Cancer Metastases
Authors: Cuppari Lea , Reccia Pasquale , Burei Marta , Cervino Anna Rita , Evangelista Laura 
Published: December 2018

Abstract
We describe a case of 47-year-old woman affected by human epidermal growth factor receptor-2–positive breast cancer with a diffuse leptomeningeal carcinomatosis. An intense uptake of 18F-choline was reported at fused PET/MRI images in the brain, compatible with a diffuse leptomeningeal disease. This case highlights that 18F-choline PET would be used for the identification of leptomeningeal involvement in patients affected by breast cancer, as a support of MRI images.
A Mixed Variant of Castleman Disease Detected by Somatostatin Receptor Scintigraphy with 99mTc-HYNIC-TOC and 18F-FDG PET/CT
Authors: Pan Qingqing , Zhang Xin , Luo Yaping , Ma Yanru , Li Fang 
Published: December 2018

Abstract
A 50-year-old woman was found with a hypervascular abdominal mass in the right lower quadrant in contrast-enhanced CT. Somatostatin receptor scintigraphy with 99mTc-HYNIC-TOC showed positivity of the abdominal mass and detected additional lesion with moderate increased radioactivity in the right axilla. In 18F-FDG PET/CT, both of the lesions were FDG-avid. A hypermetabolic node in the right supraclavicular fossa was also noted. The histopathological examination of the abdominal mass after surgical resection revealed Castleman disease, a mixed hyaline vascular and plasma cell variant. The right axillary and supraclavicular lesions were considered involvement of Castleman disease.
Gallbladder Metastasis From Conjunctival Melanoma
Authors: Cassou-Mounat Thibaut , Luporsi Marie , Huchet Virginie , Jehanno Nina 
Published: December 2018

Abstract
Malignant conjunctival melanoma is a rare tumor. A 46-year-old woman with a history of locally recurrent left conjunctival melanoma was followed by 18F-FDG PET/CT. Four years after the local recurrence treated by orbital exenteration, the follow-up PET/CT scan showed an incidental intense FDG uptake mass infiltrating the gallbladder associated with a low uptake of an infracentimetric pulmonary nodule. The patient was completely asymptomatic with no sign of local recurrence. Laparoscopic cholecystectomy was performed, and histopathologic findings were consistent with gallbladder metastasis of melanoma. After almost 2 years of immunotherapy, the patient is still in complete response.
Ultrasound Imaging of the Brachial Plexus and Nerves About the Neck
Authors: Nwawka O. Kenechi 
Published: December 2018

Abstract
This review describes techniques for sonographic evaluation of the brachial plexus and multiple regional nerve branches in the neck, essential for successful implementation of neurosonology in the neck. High-frequency ultrasound transducers have the ability to produce superior, high-resolution images, allowing for superb depiction of nerve fascicular anatomy. Sonographic appearances of normal nerve anatomy and nerve-specific pathology are reviewed. Benefits and limitations of ultrasound nerve imaging compared with magnetic resonance imaging are discussed.
Can Presurgical Ultrasound Predict Survival in Women With Ovarian Masses?
Authors: Mubarak Ahmad Iyad , Morani Ajaykumar C. , Samuel Jessica , Sun Jia , Wei Wei , Bhosale Priya R. 
Published: December 2018

Purpose
This study aimed to determine the ability of ultrasound to predict survival and detect more aggressive tumors in women with ovarian masses.

Materials and methods
Institutional review board approval was obtained. A total of 167 patients who presented with adnexal mass/masses were included. These were documented as benign or malignant on ultrasound. Age, date of diagnosis and date of death, type of tumor, and tumor marker cancer antigen 125 (CA-125) values were recorded. A CA-125 value of less than 35 U/mL was considered normal. All cases underwent surgery. Pathologic findings were considered as reference standard. The 2 × 2 cross-tabulations were used to correlate dichotomized CA-125, US diagnosis (benign vs malignant), and pathologic status. Difference of distributions was tested using the Wilcoxon rank sum test, and their association was tested using the Fisher exact test. All tests were 2-sided, and P values of 0.05 or less were considered statistically significant. Kaplan-Meir curves were generated to estimate survival.

Results
There was a statistically significant difference in patients with benign versus malignant tumors based on pathology (P < 0.0001) and ultrasound (P < 0.0003). Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of ultrasound were 55%, 86%, 90% and 46%, and 81%. Patients diagnosed as having malignant tumors based on ultrasound had statistically significant worse overall survival. Probability of survival based on pathologic diagnosis of malignancy was statistically significant at P < 0.0003; based on ultrasound, P < 0.0001; and based on CA-125, P < 0.041.

Conclusion
Patients who had ultrasound-based prediction of ovarian malignancy had overall worse survival probability (P < 0.0001) compared with CA-125– or pathology-based prediction.
Utilization of Anterolateral Thigh Flap and Transverse Cervical Recipient Vessels for Head and Neck Cancer Patients With Former Neck Dissection and Irradiation
Authors: Lin Kuan-Wen , Huang Tony Chieh-Ting , Cheng Hsu-Tang 
Published: December 2018

PurposeFree flap reconstruction in head and neck cancer patients with prior tumor resection, neck dissection, and irradiation is clinically challenging. The purpose of this study was to investigate the reliability and outcome of using the anterolateral thigh (ALT) flap and transverse cervical recipient vessels for microvascular reconstruction in patients with depleted vessels in the head and neck region caused by previous surgery and irradiation.MethodsBetween January 2015 and December 2017, microsurgical head and neck reconstruction was performed using the ALT flap and transverse cervical artery (TCA) as the recipient vessel in 15 patients who had undergone previous neck dissections and irradiation for cancer treatment. All patients had a “vessel-depleted neck” resulting from severe scarring and radiation fibrosis. Clinical data of each patient were recorded.ResultsAll ipsilateral TCAs were found to be damage free. Subsequently, free ALT flaps were revascularized using the TCAs. One patient developed venous thrombosis, and another patient developed arterial thrombosis. They were both salvaged within 6 hours postoperatively. No flap failure or mortalities were reported within the 30-day postoperative period. Two patients developed orocutaneous fistula and were further managed with wound care. The mean follow-up time was 11.9 ± 6.0 months (range, 5–23 months). Five patients died during the follow-up period from cancer progression.ConclusionsThe use of the free ALT flap and TCA as the recipient vessel provides favorable microsurgical outcomes in patients with depleted recipient vessels in the head and neck region caused by previous neck dissections and radiation therapy.
Influence of Recipient Site on the Function and Survival of Fat Grafts
Authors: Chen Xi , Wu Yaohao , Liu Guangpeng 
Published: December 2018

Background
Autologous fat grafting has become an increasingly common procedure for soft tissue augmentation throughout the body. However, the long-term outcome is always unpredictable because of inconsistent graft survival. Based on the “law of use and disuse,” we speculate that the volume loss of fat grafts will occur when transferred into a site where there is less fat. The purpose of this study is to investigate the cause of high resorption rate from the perspective of fat function after transplantation.

Methods
Adipose aspirates obtained from routine liposuction were injected into the dorsal site of athymic mice, which have no subcutaneous fat layer. The fat grafts were explanted at days 7, 15, and 30 after transplantation. Changes in fat function were evaluated by measuring the adipocyte size and the expression level of adipose differentiation–related protein.

Results
After grafting, adipose tissue was replaced by fibrosis, inflammation, and vacuolar tissues gradually over time. The size of fat cells decreased sharply from day 0 to day 7, increased at day 15, and further declined at day 30. Adipose differentiation–related protein expression experienced a dramatic increase at day 7 and then continuously decreased until day 30.

Conclusions
Assuming that the extrinsic factors influencing fat function and distribution remain stable, capabilities of the redistributed fat to handle free fatty acid and store lipid substance are reduced, leading to substantial tissue atrophy and volume decline after grafting.
Melanocyte Differentiation From Induced Pluripotent Stem Cells Derived From Human Adipose-Derived Stem Cells
Authors: Huang Wen-Shyan , Wei Lin-Gwei , Li Jhen-Kai , Fu Keng-Yen , Huang Tai-Chun , Hsieh Pai-Shan , Huang Nien-Chi , Dai Lien-Guo , Chang Fung-Wei , Loh Shih-Hurng , Chen Yuan-Hao , Yang Bing-Heng , Shiau Chia-Yang , Wu Gwo-Jang , Dai Niann-Tzyy 
Published: December 2018

Abstract
The pigment melanin is produced by melanocytes, is primarily responsible for skin color, and protects it against ultraviolet rays that can cause the destruction of genetic material within the keratinocytes. To elucidate the mechanisms of many diseases associated with melanocytes, such as melanoma and albinism, or burns with uneven pigment distribution, the disease model needs to be established first. In this study, we aimed to construct the melanocyte model from patients in a short period.
Sandai virus vector containing 4 stemness genes (Oct4, Sox2, Klf4, c-Myc) was transfected into human adipose-derived stem cells to produce induced pluripotent stem cells (iPSCs). Immunofluorescence staining was used to confirm the expression of specific proteins for iPSCs, including Tra-1-60, Tra-1-81, Oct-4, Sox-2, and Nango. polymerase chain reaction results also showed that specific genes of iPSCs with the ability to cause the differentiation of cells into the 3 germ layers were expressed. In our in vivo experiments, iPSCs were subcutaneously injected into nude mice to induce teratoma formation for 2 months. The morphology of the 3 germ layers was confirmed by hematoxylin and eosin staining. Furthermore, melanocytes were purified by serial induction medium, and their presence was confirmed by flow cytometry and the expression of different markers for melanocytes.