bluuebunny/crossref_metadata_2025_split huggingface dataset:
Probabilistic Quantitative Assessment of Coronary Heart Disease Risk From Dietary Exposure to Industrially Produced Trans-Fatty Acids in Partially Hydrogenated Oils
Authors: Park Jin-Young K , Koehler Kathleen M 
Published: July 2019

Abstract
We conducted a probabilistic evaluation of changes in coronary heart disease (CHD) risk and public health burdens from industrially produced trans-fatty acids (IP-TFAs) exposure from the uses of partially hydrogenated oils in food. Our analyses used four quantitative methods based on human studies considering the uncertainty associated with risk parameters for CHD and IP-TFA daily dietary exposure of 0.05% of energy. Method 1 used experimental controlled feeding trial data for changes in low-density lipoprotein cholesterol; Method 2 used changes in both low-density lipoprotein cholesterol and high-density lipoprotein cholesterol; Method 3 used changes in a combination of three emerging CHD risk factor biomarkers; and method 4 used prospective observational studies of CHD cases associated with long-term dietary exposure of trans-fatty acids. We estimated mean percent changes in CHD risk and annual CHD cases in U.S. adults, with lower and upper 95% uncertainty intervals. Our results show that consuming 0.05% of energy from IP-TFA, instead of cis-monounsaturated fatty acids, can cause annual mean increases in CHD cases of 814 (510–1151, method 1), 1502 (990–2043, method 2), or 6877 (3611–10 694, method 4) in U.S. adults. Results for method 3 were intermediate between those for methods 2 and 4. Sensitivity analyses using alternate risk parameters or an alternate exposure scenario resulted in minor changes in public health burden estimates. The results demonstrate that IP-TFA exposure as low as 0.05% of energy from partially hydrogenated oil uses in food can cause substantial public health burdens in the United States from increased CHD risk.
Comparison of Effectiveness of Etoricoxib and Diclofenac on Pain and Perioperative Sequelae After Surgical Avulsion of Mandibular Third Molars
Authors: Isola Gaetano , Matarese Giovanni , Alibrandi Angela , Dalessandri Domenico , Migliorati Marco , Pedullà Eugenio , Rapisarda Ernesto 
Published: July 2019

Objective:
The objective of this analysis was to compare the efficacy of etoricoxib and diclofenac in the management of perioperative sequelae following impacted mandibular third molar surgery.

Materials and Methods:
Ninety-seven patients who needed surgical avulsion of an impacted mandibular third molar were chosen for the study. All patients were randomly allocated to receive one of the following treatments, twice a day for 5 days after surgery: placebo (n=33), diclofenac (n=32), or etoricoxib (n=32). The primary outcome evaluated was postoperative pain, recorded by each patient and evaluated using the Visual Analogue Scale score. The secondary outcomes chosen were, compared with preoperative ones, changes in postoperative swelling and maximum mouth opening.

Results:
Compared with placebo, treatment with etoricoxib and diclofenac demonstrated an enhancement in the primary outcome. Furthermore, when compared with the other groups, patients who had undergone etoricoxib presented a significant median reduction in postoperative pain at 2 hours (P<0.001), 12 hours (P=0.025), and at 48 hours (P=0.018) after surgery. Moreover, the linear regression analysis showed that diclofenac and etoricoxib determined a significant influence on Visual Analogue Scale at 2, 6, 12, 24, 48 hours and at 10 days after surgery. There were no differences in swelling and maximum mouth opening values between groups.

Discussion:
This study demonstrated that both treatments were effective. However, treatment with etoricoxib showed a greater reduction in the incidence and severity of postoperative pain following third molar surgery compared with diclofenac and placebo.
Are Continuous Femoral Nerve Catheters Beneficial for Pain Management After Operative Fixation of Tibial Plateau Fractures? A Randomized Controlled Trial
Authors: Cooke Margaret E. , Welch Tyler , Gusakov Oleg , Tornetta Paul 
Published: July 2019

Objective:
To determine whether a continuous femoral nerve block after open reduction internal fixation of tibial plateau fractures would diminish Visual Analog Scale (VAS) scores and/or systemic narcotic intake.

Design:
Randomized controlled trial.

Setting:
Level 1 academic trauma center.

Patients:
Forty-two consecutive patients with operatively treated tibial plateau fractures.

Intervention:
Continuous femoral nerve catheter for postoperative pain management was performed in the experimental group.

Main Outcome Measures:
Both the VAS scores for pain and narcotic intake were assessed at 4, 8, 12, 24, 36, 48, and 72 hours postoperatively.

Results:
Forty-two patients were enrolled in this study. There were 21 women and 21 men 21-70 years of age (avg 49) with operatively treated tibial plateau fractures. Twenty-one patients were randomized to receive a femoral nerve block with 5 crossovers for technical reasons. Accordingly, we analyzed 16 patients with femoral nerve blocks and 26 with standard care. There were no significant differences between the study groups regarding age, sex, or fracture type. There was no significant difference in VAS scores between the control and experimental group at any time point. The total systemic morphine equivalent for the femoral nerve block group and the control group was 375 and 397 respectively (P = 0.76). Across groups, patients with bicondylar fractures tended to have higher VAS than those with unicondylar fractures and to use more narcotics, although neither was statistically significant.

Conclusion:
Femoral nerve blocks for postoperative pain management in tibial plateau fractures did not demonstrate an improvement in pain relief or narcotic use.

Level of Evidence:
Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
Effect of Distal Ulna Osteochondroma Excision and Distal Ulnar Tether Release on Forearm Deformity in Preadolescent Patients With Multiple Hereditary Exostosis
Authors: Belyea Christopher , Pulos Nicholas , Ezaki Marybeth , Wall Lindley , Mills Janith , Beckwith Terri , Oishi Scott N. 
Published: July 2019

Background:
Multiple hereditary exostosis is a benign condition that can lead to significant forearm deformity secondary to physeal disturbances. As the child grows, the deformity can worsen as relative shortening of the ulna causes tethering, which may lead to increased radial articular angle, carpal slippage, and radial bowing, over time this tethering can also result in radial head subluxation or frank dislocation. Worsening of forearm deformities often require corrective reconstructive osteotomies to improve anatomic alignment and function. The purpose of this study is to evaluate the effectiveness of osteochondroma excision and distal ulnar tether release on clinical function, radiographic anatomic forearm alignment, and need for future corrective osteotomies.

Methods:
The authors reviewed a retrospective cohort of preadolescent patients who underwent distal ulna osteochondroma resection and ulnar tethering release (triangular fibrocartilage complex). Patients were invited back and prospectively evaluated for postoperative range of motion, pain scores, self-reported and parent-reported Disabilities of the Arm, Shoulder, and Hand (DASH) and Pediatric Outcomes Data Collection Instrument (PODCI) scores. In addition, preoperative and final postsurgical follow-up forearm x-rays were reviewed.

Results:
A total of 6 patients and 7 forearms were included in our study with an average age of 7.9 years at time of surgery. The average final follow-up was 7.4 years. With respect to range of motion, only passive radial deviation demonstrated improvement −20 to 14 degrees (P=0.01). Although there was not statistically significant change in radial articular angle, this study did find an improvement in carpal slip 75.7% to 53.8% (P=0.03). At final follow-up DASH score was 5.71 (σ=5.35), PODCI Global Function score was 95.2 (σ=5.81), and PODCI-Happiness score 98 (σ=2.74). Visual analogue scale appearance and visual analogue scale pain assessment were 1.67 (σ=1.21) and 1.00 (σ=1.26), respectively, at final follow-up. No patient in the cohort developed a radial head dislocation. Only one of 7 forearms required a corrective osteotomy within the study’s follow-up time period.

Conclusions:
Surgical excision of forearm osteochondromas with ulnar tether release in the preadolescent patients improves carpal slip, may help to prevent subsequent surgical reconstruction and provides satisfactory clinical results at an average 7-year follow-up.

Level of Evidence:
Level III—therapeutic study.
Postoperative Blood Salvage and Autotransfusion for Adult Spinal Deformity
Authors: Nemani Venu M. , Kim Han Jo , Mina Curtis A. , Sheha Evan D. , Ross Thomas , Boachie-Adjei Oheneba 
Published: July 2019

Study Design.
Randomized controlled trial.

Objective.
The aim of this study was to determine whether postoperative blood salvage and autotransfusion versus traditional closed suction drainage reduces the rate of homologous blood transfusions in patients undergoing surgery for adult spinal deformity.

Summary of Background Data.
The use of intraoperative blood salvage has become commonplace in spine surgery; however, the collection and reinfusion of blood drained from the wound postoperatively have not been employed routinely because of increased cost and questionable benefit.

Methods.
Adult patients undergoing long posterior fusions were randomized to either a blood salvage and reinfusion system (OrthoPat – Group 1) or a standard subfascial closed suction drain (Group 2). Blood collected in Group 1 was reinfused according to the manufacturer's protocol. Reinfusion drains were converted to standard closed suction drains when output was <50 mL during 4 hours, and drains were removed when output was minimal. Patients received autologous or homologous blood transfusions when hemoglobin (Hg) <8 g/dL or they had symptomatic anemia.

Results.
Thirty-four patients were randomized into Group 1 and 36 patients into Group 2. There were no differences in preoperative or intraoperative parameters. Patients in Group 1 had higher hemoglobin levels on postoperative day (POD) 2 and POD 3 compared to those in Group 2. However, there was no significant difference in the percentage of patients requiring homologous blood transfusion between the two groups (41% Group 1 vs. 60% Group 2, P = 0.17). Similarly a subgroup analysis in patients with estimated blood loss >2000 mL also showed no difference in homologous blood transfusion rates (67% Group 1 vs. 76% Group 2, P = 0.58). There were no differences in the rate or type of postoperative complications.

Conclusion.
Postoperative blood salvage and reinfusion result in a higher hemoglobin level in the early postoperative period, but does not significantly reduce the need for homologous blood transfusion.

Level of Evidence: 1
Impact of Thoracic Cage Dimension and Geometry on Cardiopulmonary Function in Patients With Congenital Scoliosis
Authors: Lin Youxi , Tan Haining , Rong Tianhua , Chen Chong , Shen Jianxiong , Liu Shufen , Yuan Wangshu , Cong Hui , Chen Lixia , Luo Jinmei , Kwan Kenny Yat Hong 
Published: July 2019

Study Design.
A prospective study of cardiopulmonary function in patients with congenital scoliosis (CS).

Objective.
To investigate the relationship of thoracic cage deformity and exercise tolerance in CS patients.

Summary of Background Data.
Congenital thoracic scoliosis and chest deformity lead to restrictive pulmonary dysfunction and in some severe cases cause cardiopulmonary failure. However, it is still unknown the relationship between thoracic deformity and exercise performance.

Methods.
Patients with congenital thoracic spinal deformity were included and had radiological assessment of thoracic cage, pulmonary function testing, and cardiopulmonary exercise testing. Thoracic dimension including height, width, and depth were measured and geometry parameters were calculated. Two-tailed Pearson and Spearman correlation test and linear regression analysis were performed to investigate correlation of radiographic parameters, pulmonary function, and physical capacity.

Results.
Sixty patients (41 females and 19 males) were included, with an average age of 18.9 years. Patients with smaller thoracic height (P < 0.001) and width (P < 0.01) and larger depth (P < 0.05) had significantly worse static pulmonary function. In exercise testing, these patients showed significant tendency of ventilation insufficiency, including lower minute ventilation (P < 0.05), faster breathing frequency (P < 0.05), and smaller tidal volume (P < 0.01). Thoracic depth was negatively correlated to exercise capacity, reflected by work rate (P < 0.001), peak oxygen intake (P < 0.001), and heart rate (P = 0.043). Patients with abnormal thoracic geometry, especially a lower ratio of height to depth and a lower ratio of width to depth, have significantly worse static pulmonary function and exercise capacity (all P < 0.05).

Conclusion.
Decreasing thoracic height and width results in restrictive pulmonary dysfunction. Distortion and asymmetry of the thoracic cage are associated with abnormal breathing pattern and reduction of exercise capacity.

Level of Evidence: 3
Prechemotherapy Hemoglobin Levels as a Predictive Factor of Ovarian Cancer Survival
Authors: Pergialiotis Vasilios , Daskalakis Georgios , Thomakos Nikolaos , Bellos Ioannis , Haidopoulos Dimitrios , Loutradis Dimitrios , Rodolakis Alexandros 
Published: July 2019

Objectives:The impact of anemia on cancer survival has been previously mentioned in various oncological fields. To date, however, it remains unknown whether prechemotherapy hemoglobin (Hgb) levels are predictive of ovarian cancer survival (OC). The purpose of the present systematic review is to accumulate evidence in this field.Materials and Methods:We used the Medline, Scopus, Clinicaltrials.gov, EMBASE, Cochrane Central Register of Controlled Trials CENTRAL, and Google Scholar databases in our primary search. The date of our last search was set for July 30, 2018. Statistical meta-analysis was performed with the RevMan 5.3 software.Results:Overall, 11 articles were included that recruited 1816 women with OC. Five articles that involved 856 OC patients were included in the meta-analysis. Compared with patients with anemia, patients with Hgb levels >12 g/dL had increased odds of overall survival (odds ratio, 1.72; 95% confidence interval: 1.41, 2.10). Similarly, the progression-free survival of patients was significantly affected, although the available data could not be accumulated in a meta-analysis because of the heterogeneity in outcome reporting measures.Conclusions:Current evidence suggests that prechemotherapy Hgb levels below the threshold of 12 g/dL can potentially predict worse overall survival of OC patients. Future research is required in the field to elucidate whether several independent variables such as the stage and histology of disease and rates of optimal debulking affect the clinical significance of this association.
Multiple Scrotal Cysts Composed of Combined Syringomas and Epidermal Inclusion Cysts: A Previously Unreported Association
Authors: Diep My , Cassarino David S. 
Published: July 2019

Abstract:
Epidermal inclusion cyst (EIC) and syringoma are both benign lesions that are primarily asymptomatic and occur at various places on the body. Although both EIC and syringoma are common, their joint appearance has not been previously reported. These benign proliferations target different populations, and with differing clinical presentations. Syringomas tend to develop in young females as smaller multiple lesions, while EICs often present in older males as single or multiple variants that are typically larger in size. They also possess distinctive histopathological appearances that can used for their diagnosis. Furthermore, despite both having unclear etiologies, the involvement of the eccrine duct has been a proposed mechanism in the development of both lesions. Thus, further investigation of eccrine ducts in the pathology of these lesions can be the basis for assessing the association between EICs and syringomas. We report a unique case of a 16-year-old boy who presented to the clinic with multiple cysts (at least 20) on the scrotum, most of which consisted of both EIC and syringoma histologically. We are not aware of any previous reports of patients with multiple combined syringomas and EICs, and their potential association should be further explored.
Kaposi Sarcoma in Association With an Extracavitary Primary Effusion Lymphoma Showing Unusual Intravascular Involvement: Report of a Case Harboring a FAM175A Germline Mutation
Authors: Kastnerova Liubov , Belousova Irena E. , Michal Michael , Ptakova Nikola , Michal Michal , Kazakov Dmitry V. 
Published: July 2019

Abstract:
Primary effusion lymphoma (PEL) is a rare form of aggressive B-cell lymphoma characterized by a malignant serous effusion involving body cavities. It usually associated with human herpes virus–8 (HHV-8) and coexpression of Epstein–Barr virus and mostly affects patients with HIV. We report a rare case of cutaneous PEL with an unusual intravascular presentation, combined with Kaposi sarcoma involving the skin, lung, and gastrointestinal tract. The molecular genetic analysis of the sarcoma and lymphoma components, using next-generation sequencing was performed. The patient was a 67-year-old man who presented with multiple cutaneous tumors and mass in the left lung. He died 17 hours after the admission to the hospital. At autopsy, in addition to the cutaneous lesions, tumors in the left lung and gastrointestinal mucosa were detected, and no effusions in the body cavities were seen. The biopsy from the cutaneous lesions, pulmonary, and intestinal tumors revealed histological and immunohistochemical features of Kaposi sarcoma. In addition, the skin biopsy specimens contained a diffuse infiltrate composed of large pleomorphic cells, with focal intravascular growth that were negative for pan B-cell markers, weakly positive for CD38 and CD138 but expressed CD3, HHV-8, and Epstein–Barr virus. Molecular genetic studies in this specimen revealed monoclonal rearrangements of the IgH gene. The diagnosis of PEL, solid variant, was made. Next-generation sequencing analysis of the tumorous and normal tissue detected a pathogenic germline mutation of the FAM175A gene and somatic mutations in BRCA2 and RAD51B (in both sarcoma and lymphoma specimens), and INPP4B and RICTOR (in lymphoma specimen only).
Spitz Tumors With ROS1 Fusions: A Clinicopathological Study of 6 Cases, Including FISH for Chromosomal Copy Number Alterations and Mutation Analysis Using Next-Generation Sequencing
Authors: Donati Michele , Kastnerova Liubov , Martinek Petr , Grossmann Petr , Sticová Eva , Hadravský Ladislav , Torday Tomas , Kyclova Jitka , Michal Michal , Kazakov Dmitry V. 
Published: July 2019

Abstract:
Spitz tumors represent a heterogeneous group of melanocytic neoplasms with a spectrum of biological behavior ranging from benign (Spitz nevus) to malignant (spitzoid melanoma). Prediction of the behavior of these lesions based on their histological presentation is not always possible. Recently, mutually exclusive activating kinase fusions, involving ALK, NTRK1, NTRK3, RET, MET, ROS1, and BRAF, have been found in a subset of spitzoid lesions. Some of these genetic alterations were associated with specific morphological features. Here, we report the histological presentation of 6 Spitz tumors with ROS1 fusion. The age of the patients ranged from 6 to 34 years, with strong female prevalence (5:1). All neoplasms were compound melanocytic proliferations with a predominant dermal growth but a conspicuous junctional component displaying atypical microscopic features qualifying them as atypical Spitz tumor. FIP1L1 and CAPRIN1 were identified as 2 novel 5′-fusion partners of ROS1 along with the known PWWP2A–ROS1 fusion. FISH for copy number changes of 9p21, 6p25, and 11q13 was negative in all but 1 neoplasm harboring isolated gain of 8q24. TERT-promoter hotspot mutation analysis was negative in all tumors. All patients are disease-free after a mean follow-up period of 30 months. It is concluded that ROS1-fused spitzoid neoplasms seem to have no distinctive histopathological features although consistent findings were spindled melanocytes arranged in confluent whorling nests, prominent transepidermal elimination of melanocytic nests, and myxoid/mucinous changes.
G-Protein–Coupled Estrogen Receptor Agonist G1 Improves Diastolic Function and Attenuates Cardiac Renin–Angiotensin System Activation in Estrogen-Deficient Hypertensive Rats
Authors: da Silva Jaqueline S. , Sun Xuming , Ahmad Sarfaraz , Wang Hao , Sudo Roberto T. , Varagic Jasmina , Ferrario Carlos M. , Zapata-Sudo Gisele , Groban Leanne 
Published: July 2019

Abstract:
This study was aimed to clarify differences in how specific agonists of the 3 estrogen receptors (ERs) influence diastolic function and the renin–angiotensin system (RAS) after ovariectomy (OVX) in 24 female spontaneously hypertensive rat (SHR) undergoing bilateral OVX at 12 weeks of age. Eight weeks after surgery, rats were randomized (n = 6/group) to receive equipotent, daily treatments of one of the ER agonists (ERα agonist, propyl pyrazole trisphenol 94 μg/kg; ERβ agonist, diarylpropionitrile 58 μg/kg; G-protein–coupled estrogen receptor [GPER] agonist, G1 100 μg/kg), or vehicle (peanut oil). After 4 weeks of treatment, left ventricular function/structure and systemic/intracardiac pressure measurements were obtained by echocardiography and a fluid-filled catheter attached to a pressure transducer, respectively. Selective ER agonist treatment with G1 or propyl pyrazole trisphenol led to improvements in diastolic function after estrogen loss when compared with vehicle-treated OVX rats. Although mean arterial blood pressure was not overtly different among groups, chronic G1, but not the other ER ligands, enhanced the in vitro vasorelaxant responsiveness to acetylcholine in aortic rings. These favorable effects of G1 were further linked to reductions in cardiac angiotensin-converting enzyme activity, AT1R protein expression, and Ang II immunoreactivity. Activation of ERβ had no effect on cardiac function and did not alter components of the canonical cardiac RAS in comparison with vehicle-treated OVX SHR. These data imply that of the 3 ERs, GPER has a unique role in preserving diastolic function and favorably modulating the cardiac RAS independent of arterial pressure. Specifically, if GPER is pharmacologically activated, it could provide a therapeutic opportunity to limit the development and/or progression of diastolic dysfunction in hypertensive women after estrogen loss.