bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nutrient Deficiency-Related Dermatoses after Bariatric Surgery
Authors: Chu Andy S. , Mataga Megan A. , Krueger Loren , Barr Priscilla A. 
Published: October 2019

ABSTRACT
Obesity is a global epidemic that increases the risk of weight-related comorbidities in modern society. It is complex, multifactorial, and largely preventable. Noninvasive treatments for obesity include diet, exercise, and medication. However, bariatric surgeries are becoming popular procedures for those who do not achieve success with noninvasive weight management treatment. Bariatric surgeries often result in dietary restriction and/or malabsorption, which lead to drastic weight loss. Individuals who had bariatric surgeries need lifelong follow-up and monitoring to ensure adequate intake of nutrients. Nutrient deficiencies can ensue when long-term vitamin and mineral supplementation is not followed. Severe nutrient deficiencies may lead to dermatoses that can be corrected by nutrient repletion and careful monitoring. A case report of nutrient deficiency-related dermatoses is followed by a review of obesity and its treatments with a focus on bariatric surgeries.

GENERAL PURPOSE
To provide information on obesity, bariatric surgery, and the nutrient deficiency-related dermatoses that may result from these surgeries.

TARGET AUDIENCE
This continuing education activity is intended for physicians, physician assistants, NPs, and nurses with an interest in skin and wound care.

LEARNING OBJECTIVES/OUTCOMES
After participating in this educational activity, the participant should be better able to:
1. Examine issues related to obesity and bariatric surgery.
2. Identify the sources and role of specific nutrients.
3. Recognize the clinical signs and symptoms of nutrient deficiency following bariatric surgery.
Attitudes and Approaches Towards Repeat Valve Surgery in Recurrent Injection Drug Use-associated Infective Endocarditis: A Qualitative Study
Authors: Hayden Margaret , Moore Amber 
Published: October 2019

Objective:
The aim of this study was to explore the diversity of attitudes and approaches towards treating patients with recurrent injection drug use-associated infective endocarditis (IDU-IE) with a focus on surgical decision-making.

Methods:
Nineteeen qualitative, semistructured interviews were performed with healthcare providers at a single academic medical center. Purposive sampling was used to recruit participants with the goal of sampling a diversity of providers involved in the care of patients with IDU-IE. An inductive, grounded theory approach was used to analyze data.

Results:
Nineteen healthcare providers (12 physicians, 3 social workers, 2 registered nurses, 2 advanced practice providers) with experience caring for patients with IDU-IE across a variety of disciplines and departments participated in the study. Three themes emerged from the interviews: providers feel underprepared to care for patients with IDU-IE; implicit and explicit bias remain pervasive; and criteria for surgical decision-making are not transparent. When discussing surgical decision-making, participants relied on 2 predominant bioethical concepts: futility and rationing.

Conclusions:
There was a wide divergence of opinions on how to approach repeat valve surgeries, ranging from those who endorsed strict single surgery policies to those who felt patients should be offered as many surgeries as needed. Therefore, there is a need to further develop general principles for the care of recurrent IDU-IE to provide more reliable and equitable care to these patients. This will require input from an interdisciplinary group and should address empirical data, and also the appropriateness of futility and rationing of care questions.
Investigating the Role of Childhood Adiposity in the Development of Adult Type 2 Diabetes in a 64-year Follow-up Cohort
Authors: Nianogo Roch A. , Arah Onyebuchi A. 
Published: October 2019

Background:
The contribution of childhood obesity to adult type 2 diabetes (T2DM), not through adult adiposity, as well as the causal pathways through which childhood obesity increases adult T2DM risk are not well understood. This study investigated the contribution of childhood obesity to incident T2DM including pathways not through adult adiposity, and explored whether race modified this contribution.

Methods:
We used data from the Virtual Los Angeles Cohort, an agent-based longitudinal birth cohort composed of 98,230 simulated individuals born in 2009 and followed until age 65 years. We applied the parametric mediational g-formula to the causal mediation analysis investigating the impact of childhood obesity on the development of adult T2DM.

Results:
The marginal adjusted odds ratio (aOR) for the total effect of childhood obesity on adult T2DM was 1.37 (95% CI = 1.32, 1.46). Nearly all the effect of childhood obesity on adult T2DM was mostly attributable to pathways other than through adult obesity; the aOR for the pure direct effect was 1.36 (95% CI = 1.31, 1.41). In all racial subpopulations, a similar 3% of the total effect of childhood obesity on adult T2DM was attributable to its effect on adult obesity.

Conclusions:
Childhood obesity remains a risk factor for adult T2DM separate from its effects on adult obesity. This study emphasizes the potential benefits of early interventions and illustrates that agent-based simulation models could serve as virtual laboratories for exploring mechanisms in obesity research.
Hexokinase II Upregulation Contributes to Asiaticoside-Induced Protection of H9c2 Cardioblasts During Oxygen–Glucose Deprivation/Reoxygenation
Authors: Zhang Jing , Yao Mingyan , Jia Xinwei , Xie Junmin , Wang Yanfei 
Published: October 2019

Abstract:
Asiaticoside (AS), one of the main functional components of Centella asiatica, has been reported to protect neurons from ischemia-hypoxia–induced injury. However, the role of AS in myocardial oxygen–glucose deprivation/reoxygenation (OGD/R) injury has not been investigated. The aim of this study was to investigate the role of AS in OGD/R-treated H9c2 cardiomyocytes and the underlying mechanism involved. Cell viability was detected using MTT assay. Cell apoptosis was measured using flow cytometry. The oxidative stress was assessed by detecting the malonaldehyde (MDA) content and activities of superoxide dismutase, glutathione peroxidase, and catalase (CAT). The glucose consumption and lactate production were determined to reflect glycolysis rate. The expression levels of hexokinase II (HK2) were detected using reverse transcription quantitative polymerase chain reaction and Western blot. H9c2 cells were transfected with small interfering RNA targeting HK2 (si-HK2) to knockdown HK2. Results showed that AS improved cell viability and inhibited apoptosis in OGD/R-injured H9c2 cells. AS pretreatment prevented OGD/R-induced oxidative stress, as evidenced by the decreased MDA content, and increased activities of superoxide dismutase, glutathione peroxidase, and CAT. The decreased glucose consumption and lactate production in OGD/R-injured H9c2 cells were reversed after AS treatment. Mechanically, AS induced the expression of HK2 in OGD/R-injured H9c2 cells. Knockdown of HK2 abolished the protective effects of AS on OGD/R-injured H9c2 cells. In conclusion, the protective effects of AS on cardiomyocytes from OGD/R-induced injury were mediated at least partly by upregulating HK2.
Systematic Review on the Content of Outcome Measurement Instruments on Scar Quality
Authors: Carrière Michelle E. , Kwa Kelly A. A. , de Haas Louise E. M. , Pijpe Anouk , Tyack Zephanie , Ket Johannes C. F. , van Zuijlen Paul P. M. , de Vet Henrica C. W. , Mokkink Lidwine B. 
Published: October 2019

Background:
Measurements of scar quality are essential to evaluate the effectiveness of scar treatments and to monitor scars. A large number of scar scales and measurement devices have been developed, which makes instrument selection challenging. The aim of this study was to provide an overview of the content (ie, included items) of all outcome measurement instruments that measure scar quality in different types of scars (burn, surgical, keloid, and necrotizing fasciitis), and the frequency at which the instruments and included items are used.

Methods:
A systematic search was performed in PubMed and Embase.com up to October 31, 2018. All original studies reporting on instruments that measured at least 1 characteristic of scar quality were included and the instrument’s content was extracted.

Results:
We included 440 studies for data extraction. Included instruments (N = 909) were clinician-reported scales (41%), measurement devices (30%), patient-reported scales (26%), and combined clinician- and patient-reported scales (3%). The Observer scale of the Patient and Observer Scar Assessment Scale, the Cutometer, the Patient Scale of the Patient and Observer Scar Assessment Scale, and the modified Vancouver Scar Scale were the most often used instrument in each of these categories, respectively. The most frequent assessed items were thickness, vascularity, pigmentation, pliability, pain, and itch.

Conclusion:
The results of this study lay the foundation for our future research, which includes an international Delphi study among many scar experts, and an international focus group study among scar patients, aiming to elucidate how scar quality must be defined and measured from both professional and patient perspectives.
Successful Balanced Gait after Reconstruction of the Weight-bearing Mid Plantar Region Using a Free Contralateral Medial Plantar Flap
Authors: Karakawa Ryo , Yoshimatsu Hidehiko , Miyashita Hiroki , Kuramoto Yukiko , Shibata Tomoyoshi , Yano Tomoyuki 
Published: October 2019

Summary:
Although soft tissue sarcoma, especially in the sole of the foot, is a rare disease, weight-bearing region reconstruction considering postoperative gait is needed. For functionally satisfactory sole reconstruction, it is important to cover the weight-bearing region with a nonbulky but durable skin paddle that can withstand a significant amount of shear pressure. We herein present a case in which a free contralateral medial plantar flap was used for reconstruction of the weight-bearing mid plantar region for a 41-year-old man who suffered from mid-foot sarcoma. Gait analysis was performed 6 months after the operation with the lower limb loading gauge sheet, and the result indicated that postoperative balanced gait was obtained. The free medial plantar flap transfer after sole sarcoma resection has several advantages. First, the characteristic of this flap with solid anchoring to deep tissue to resist shearing makes it possible to lower the chances of postoperative ulceration. Second, the medial plantar flap has optimal thickness and good color and texture match for sole reconstruction. Third, a sensate flap can be achieved if the medial plantar nerve is included. Although further clinical investigations such as long-term follow-up will be required to confirm its efficacy, this method would be one option for treating sole sarcoma.
Evaluation of the Intraoperative Blood Flow of Pedicled Perforator Flaps Using Indocyanine Green-fluorescence Angiography
Authors: Jakubietz Rafael G. , Schmidt Karsten , Bernuth Silvia , Meffert Rainer H. , Jakubietz Michael G. 
Published: October 2019

Background:
Although indocyanine-green fluorescence angiography (ICG-FA) has been established as a useful tool to assess perfusion in free tissue transfer, only few studies have applied this modality to pedicled perforator flaps. As both volume and reach of pedicled perforator flaps are limited and tip necrosis often equals complete flap failure, ICG-FA may help to detect hypoperfusion in pedicled flaps.

Methods:
In 5 patients, soft tissue reconstruction was achieved with pedicled perforator flaps. ICG-FA was utilized intraoperatively to visualize flap perfusion.

Results:
Three pedicled anterolateral thigh flap flaps and 2 propeller flaps were transferred. ICG-FA detected hypoperfusion in 2 flaps. No flap loss occurred; in 2 cases, prolonged wound healing was encountered.

Conclusions:
ICG-FA confirmed clinical findings and reliably detected tissue areas with hypoperfusion. A clear cut-off point between nonvital tissue and such that stabilized in the following clinical course could not be found. ICG-FA is a promising technology which could also be used in pedicled perforator flaps.
Association of Traumatic Brain Injury With Vestibular Dysfunction and Dizziness in Post-9/11 Veterans
Authors: Swan Alicia A. , Nelson Jeremy T. , Pogoda Terri K. , Akin Faith W. , Riska Kristal M. , Hall Courtney D. , Amuan Megan E. , Yaffe Kristine , Pugh Mary Jo 
Published: October 2019

Objective:
To describe the prevalence and impact of vestibular dysfunction and nonspecific dizziness diagnoses and explore their associations with traumatic brain injury (TBI) severity, mechanism, and postconcussive comorbidities among post-9/11 veterans.

Setting:
Administrative medical record data from the US Departments of Defense and Veterans Affairs (VA).

Participants:
Post-9/11 veterans with at least 3 years of VA care.

Design:
Cross-sectional, retrospective, observational study.

Main Measures:

International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes for TBI, vestibular dysfunction, dizziness, and other commonly associated postconcussive conditions; Neurobehavioral Symptom Inventory.

Results:
Of the 570 248 post-9/11 veterans in this sample, 0.45% had a diagnosis of vestibular dysfunction and 2.57% had nonspecific dizziness. Those with either condition were more likely to have evidence of TBI (57.11% vs 28.51%) and reported more disruption from neurobehavioral symptoms. Blast and nonblast injuries were associated with greater symptom disruption, particularly in combination.

Conclusions:
There was a consistent, significant association between TBI and vestibular dysfunction or nonspecific dizziness, after controlling for sociodemographic factors, injury mechanism, and comorbid conditions. Given that most deployed post-9/11 veterans report blast and/or nonblast injuries, the need for prompt identification and management of these conditions and symptoms is clear.
Conjunctival Trichodiscoma of the Lower Eyelid
Authors: Kasturi Nirupama , Chavhan Pratima , Ramakant Ghag Gaurav , Devaraj Athira , Babu K. Ramesh , N.G. Rajesh 
Published: October 2019

Trichodiscomas are benign tumors of the skin which develop around a hair follicle. They usually present on the face, neck, or trunk region. The authors report a rare case of a 63-year-old man who presented with a tumor on the left lower eyelid that was histologically proven to be a trichodiscoma of conjunctival origin.
Trichodiscomas are benign tumors of the skin appendage which develop around a hair follicle. Although conjunctival hair follicles are rudimentary and do not give rise to hair, rarely a benign proliferation of these cells can result in trichodiscoma of the conjunctiva.
Emergency bedside ultrasound: benefits as well as caution – part 1. General
Authors: Wong Adrian , Vieillard-Baron Antoine , Malbrain Manu L.N.G. 
Published: October 2019

Purpose of review
The use of bedside or point-of-care ultrasound (POCUS) in medical emergencies is rapidly becoming more established as an effective acute diagnostic tool. The purpose of this review is to provide an overview of the various techniques currently used that are readily available, as well as several in development. Possible caveats are also addressed.

Recent findings
Despite its widespread use, definitive studies demonstrating improved patient outcomes are limited. The list of indications for POCUS nonetheless is increasing as practitioners acknowledge clinical benefits, and technological advancement improves diagnostic accuracy and efficiency of use.

Summary
We believe that a core level of POCUS should be achievable by practicing clinicians. Ultimately, the integration of POCUS findings into a patient management strategy must be holistic, and hence requires prudent consideration of the clinical scenario.
The outcome of the HCC patients underwent ALPPS
Authors: Peng Chihan , Li Chuan , Liu Chang , Wen Tianfu , Yang Jiayin , Li Bo , Yan Lvnan 
Published: October 2019

Abstract
The complete resection offers the best long-term survival for advanced hepatocellular carcinoma patients. ALPPS as a choice of resection, how is its outcome compared to one-stage resection, liver transplantation and TACE? This retrospective study included 20 ALPPS patients. To minimize the effect of confounding influences of measured covariates, PSM was performed. The overall survival (OS), morbidity, mortality and the increasing rate, KGR were analyzed. The OS in ALPPS group is 27.4 (±3.8 months) moths and the TACE group is 13.5(±1.2 months) (P < .001), LT group is 41.3 (±3.2 months) (P = .048), Resection group is 31.8 (±2.6 months) (P = .368). And the medium increasing volume is 209.5 cm3 (±61.5 cm3) with the increasing ratio 52.4% (+26.9%). The ALPPS is a feasible treatment for HCC patients and it provides a better long-term survival than TACE and it is similar to Resection, less than LT.
Evaluation of the effectiveness of infrared light-emitting diode photobiomodulation in children with sleep bruxism
Authors: Kobayashi Fernanda Yukie , Castelo Paula Midori , Gonçalves Marcela Leticia Leal , Motta Lara Janisky , Mota Ana Carolina da Costa , Altavista Olga Maria , Pinto Marcelo Mendes , Salgueiro Monica Canuto , Ferreira Kristianne Porta Santos , Bussadori Sandra Kalil 
Published: October 2019

Abstract

Background:
Sleep bruxism is a masticatory muscle activity characterized as rhythmic (phasic) or nonrhythmic (tonic). In children and adolescents, etiological factors, such as breathing pattern and sleep quality, have recently been addressed in studies investigating sleep bruxism. New therapies for adults, such as botulinum toxin, have been investigated, but such techniques are not applicable for individuals in the growth and development phase.

Methods:
The participants will be 76 children, which will be randomly allocated to a control group, that is group 1, absence of bruxism; group 2, children with bruxism treated with infrared light-emitting diode (LED); and group 3, bruxism treated with occlusal splint. All participants will be submitted to a clinical evaluation to evaluate muscle activity and salivary biomarkers, before and after treatments. Muscle activity will be verified by electromyography of muscles mastication, masseter and temporal, and salivary biomarkers observed will be cortisol and dopamine levels.

Discussion:
Photobiomodulation therapy has piqued the interest of researchers, as this noninvasive method has demonstrated positive results in problems related to muscle tissues. This document describes the protocol for a proposed study to evaluate morphological and psychosocial aspects in children and adolescents with awake bruxism and their responses to photobiomodulation therapy with infrared LED.

Clinical trials:

https://clinicaltrials.gov/ct2/show/NCT03710174
Predictive role of monocyte-to-lymphocyte ratio in patients with Klebsiella pneumonia infection
Authors: Wang Jia-lu , Lu Xiao-ye , Xu Xin-hui , Zhang Ke-ji , Gong Hao , Lv Dan , Ni Zhu-ang , Zhu Chang-qing 
Published: October 2019

Abstract
The aim of the study is to explore whether monocyte–to-lymphocyte ratio (MLR) provides predictive value of the severity in patients with Klebsiella pneumonia infection (KPI).
Patients in a tertiary medical center with Klebsiella pneumonia infection from 2014 to 2017 were recruited in this study. Patients with Klebsiella pneumonia infection were stratified into two groups based on the National Early Warning Score (NEWS). MLR was calculated by dividing monocytes count by lymphocytes count obtained from routine blood examination. The area under the curve (AUC) values was determined using the receiver-operating characteristic (ROC) curve. The correlation between the variables was tested with Pearson or Spearman correlation analysis. Ordinal logistic regression analysis was used to assess the relationship between MLR and the severity of Klebsiella pneumonia infection.
One hundred fifty-two patients were finally enrolled for analysis. Among those, 43 (28.29%) cases had severe KPI. MLR was found to be an independent risk factor of the serious Klebsiella pneumonia infection (OR: 23.74, 95% CI: 5.41–104.11, P < .001). Besides, MLR was positively correlated with NEWS score (r = 0.57, P < .001). In the receiver-operating characteristic (ROC) curve analysis, MLR, with an optimal cut-off value of 0.665, predicted the severe coronary lesion with a sensitivity of 79.4% and specificity of 84.4%.
MLR was an independent predictor of the severe Klebsiella pneumonia infection. Compared with neutrophil-to-lymphocyte ratio (NLR), MLR has a better performance to evaluate the severity of Klebsiella pneumonia infection.
Efficacy and safety of electroacupuncture on metabolic syndrome due to olanzapine and risperidone
Authors: Ning Yanzhe , Jia Hongxiao , Chen Pei , Zhu Hong , Yin Dongqing 
Published: October 2019

Abstract

Introduction:
With the second-generation antipsychotics (SGAs) widely applied to treat patients with schizophrenia, adverse effects, especially the metabolic syndrome (MetS), were paid more attention following by the efficacy of SGAs. Several studies have suggested that acupuncture could be an effective and safe intervention for MetS. Here, we present a study protocol to investigate the effect of electroacupuncture on MetS due to olanzapine and risperidone.

Methods:
This study is a prospective, randomized, single-centered, patient-assessor-blinded, parallel-controlled clinical pilot trial. In all, 36 patients will be randomized to an experimental group or control group by a 1:1 ratio. All patients will receive lifestyle interventions. The experimental group will receive electroacupuncture treatment. The control group will receive sham electroacupuncture treatment. The primary outcomes are body mass index (BMI) and waist circumference (WC). The secondary outcome measures include blood pressure (BP), fasting blood glucose (FBG), triglycerides (TG), total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL), leptin, and adiponectin. We will assess at baseline, 8 weeks after intervention and at the end of 3 months’ follow-up.

Discussion:
The results of this trial are expected to provide data on the efficacy and safety of electroacupuncture on MetS due to olanzapine and risperidone, and potential biochemical mechanism.
Uterus-like mass in the right broad ligament
Authors: Liu Lei , Yang Hui , Zhang Shu-Peng 
Published: October 2019

Abstract

Rationale:
Uterus-like masses (ULMs) are rare benign lesions that resemble the uterus.

Patient concerns:
Here, we describe the case of a woman with a ULM in the right broad ligament. A 51-year-old woman with a 2-month history of irregular vaginal bleeding was found to have a mass in the right broad ligament. Imaging studies revealed a solid-cystic lesion, suggestive of an endometrial cyst with malignant transformation.

Interventions:
She underwent prompt surgery for the removal of the mass. Intraoperatively, the uterus and ovaries appeared normal, and an 8-cm-long mass was observed in the right broad ligament without any connection to the uterus or ovaries. The mass was successfully excised.

Diagnoses:
Postoperative histopathological examination showed that the cystic mass was filled with a blackish-brownish fluid and that it had thick walls resembling the uterine myometrium. The cyst center was lined by endometrial glands that were positive for cytokeratin as well as estrogen and progesterone receptors, and by stromal cells that were positive for CD10.

Outcomes:
The patient recovered well and has had no further symptoms during 2 years of follow-up.

Lessons:
We have reported a case of ULM in the right broad ligament in a Chinese woman. Although ULMs are rare, they should be considered in the differential diagnosis for pelvic masses.