bluuebunny/crossref_metadata_2025_split huggingface dataset:
Migration of Umbilical Venous Catheters
Authors: Plooij-Lusthusz Anneloes M. , van Vreeswijk Nick , van Stuijvenberg Margriet , Bos Arend F. , Kooi Elisabeth M. W. 
Published: January 2019

Objective Migration of umbilical venous catheters (UVCs) after initial correct position has been described. The aim of this study was to assess the incidence of malposition of the tip of the UVCs at 24 to 36 hours postinsertion.
Study Design Retrospective analysis of all neonates who had UVC placement in a 14-month period. The primary outcome was the rate of UVCs incorrectly positioned 24 to 36 hours after initial correct placement, defined as the UVC tip below or more than 5 mm above the level of the right diaphragm on a thoracoabdominal X-ray.
Results We included 86 neonates with a median (range) birth weight of 1,617 (535–5,000) grams, and gestational age of 31 (24–42) weeks. Of the 80 UVCs that were further analyzed, only in 38 (48%) of 80 patients, the tip of the UVC still had a correct position 24 to 36 hours after initial placement. In 22 (28%) of 80 patients, the UVCs had a position that was too high and in 20 (25%) that was too low.
Conclusion More than half of UVCs migrated at 24 to 36 hours postinsertion to positions known to have higher complication rates. We, therefore, recommend follow-up evaluation at 24 to 36 hours postinsertion, to prevent complications from malposition.
Highly Elevated Quantitative D-Dimer Assay Values Increase the Likelihood of Venous Thromboembolism
Authors: Francis Samuel , Limkakeng Alexander , Zheng Hui , Hollander Judd , Fermann Gregory , Parry Blair , Lovecchio Frank , Werner Nikos , Schellong Sebastian , Kabrhel Christopher 
Published: January 2019

Objectives In patients with suspected venous thromboembolism (VTE), the D-dimer assay is commonly utilized as part of the workup. The assay is primarily used to determine whether to proceed with radiographic imaging. We compared D-dimer levels in patients suspected of having VTE. We hypothesized that higher D-dimer values predict a higher likelihood of subsequent VTE diagnosis.
Methods We conducted a secondary analysis of a multinational, prospective observational study of low- to intermediate-risk adult patients presenting to the emergency department with suspicion of VTE. Demographic and clinical data were collected in a structured manner. Advanced imaging including ultrasound, computed tomography (CT) pulmonary angiography, and ventilation/perfusion scanning was obtained at the discretion of the treating physicians. Imaging was evaluated by board-certified radiologists in real time. D-dimer values' bins were evaluated using a logistic regression model.
Results We evaluated 1,752 patients for suspected deep vein thrombosis (DVT), with 191 (10.4%) DVT positive. We evaluated 1,834 patients for suspected pulmonary embolism (PE), with 108 (5.9%) PE positive. Higher D-dimer values in both groups were associated with higher likelihood of subsequent VTE diagnosis, with D-dimer values > 3,999 ng/mL in both groups having the highest incidence of VTE. More than 50% of those patients were VTE positive.
Conclusions Increasing D-dimer values predict increased likelihood of being found VTE positive in this patient population. Among those in the highest D-dimer category, > 3,999 ng/mL, over half of patients were VTE positive. Further research could determine additional nuance in D-dimer as a tool to work up suspected VTE.
Persistence of Neonatal Brachial Plexus Palsy among Nulliparous Versus Parous Women
Authors: McLaren Rodney , Chang Kate , Ankumah Nana-Ama , Yang Lynda , Chauhan Suneet 
Published: January 2019

Objective Our objective was to compare persistence of neonatal brachial plexus palsy (NBPP) at 1 and 2 years in children of nulliparous versus parous women.
Study Design We conducted a retrospective cohort study of children diagnosed with NBPP followed at the University of Michigan, Interdisciplinary Brachial Plexus Program (UM-BPP). Self-reported demographics, delivery history, including birth weight (BW) < versus ≥ 9 lbs, and presence of shoulder dystocia (SD) were recorded. Student's t-test and Chi-square test with odds ratio (OR) with 95% confidence intervals (CI) were calculated for comparisons of maternal, neonatal, and peripartum characteristics.
Results Of 337 children with NBPP, 43% (146) were of nulliparas and 57% (191) of multiparas. At 1 year, children with persistent NBPP were similar in both groups (87% vs. 88%, aOR 1.357, 95% CI: 0.297–6.208). Persistent NBPP was not significantly different among nulliparous and multiparous women at 2 years (97% vs. 92% respectively, aOR 0.079, 95% CI: 0.006–1.050).
Conclusion In one of the largest cohorts of NBPP, maternal parity did not influence the likelihood of NBPP persistence at 1 and 2 years.
Serotonerge Modulation der Schmerzwahrnehmung
Authors: Meier T. , Abler B. 
Published: January 2019

ZusammenfassungGegenstand und Ziel: Chronische Schmerzen sind ein häufiges Krankheitssymptom und führen zu erheblichen Einschränkungen der Alltagsfunktionalität. Für erfolgreiche therapeutische Ansätze erscheint ein profundes Verständnis insbesondere der pathophysiologischen Mechanismen im zentralen Nerven-system wertvoll. Neben dem seit langem im Zentrum der Forschung stehenden Opioidsystem rückt zunehmend das monoaminerge System in den Vordergrund. Material und Methoden: Diese Übersichtsarbeit fasst ausgewählte Forschungsergebnisse zur Rolle des serotonergen Systems in der zentralen Schmerzmodulation zusammen. Ergebnisse: Eine Reihe von Tierversuchen zeigt sowohl antinozizeptive wie auch pronozizeptive Wirkungen von Serotonin auf Rückenmarksebene. Untersuchungen an gesunden Probanden zeigen weiterhin Hinweise auf erhöhte Schmerzempfindlichkeit unter verminderter zentraler Serotoninverfügbarkeit bei akutem Schmerz. Untersuchungen an chronischen Schmerzpatienten mit Fibromyalgie zeigen reduzierte Abbauprodukte des Serotoninstoffwechsels im Liquor, erhöhte Antikörper gegen Serotonin und Serotoninrezeptoren sowie inkonsistente Ergebnisse bezüglich genetischer Prädisposition. Im klinischen Einsatz erwiesen sich rein serotonerge Substanzen als we-niger wirksam in der Behandlung chronischer Schmerzen als Pharmaka mit zusätzlich noradrenerger Komponente. Schlussfolgerung: Eine breite Basis an grundlagenwissenschaft-lichen Befunden weist auf einen bedeutsamen Einfluss serotonerger Transmission auf die Schmerzwahrnehmung hin. Klinische Relevanz: Der Einsatz von rein serotonerg wirksamen Pharmaka, wie den Serotoninwiederaufnahmehemmern, kann nur bei Komorbidität chronischer Schmerzen mit Depression empfohlen werden.
Bewegungs- und Sportberatung bei Kindern und Jugendlichen mit rheumatischen Erkrankungen
Authors: Hartmann M. , Schrödl S. , König M. , Georgi M. , Schwirtz A. , Haas J.-P. , Merker J. 
Published: January 2019

ZusammenfassungChronische Erkrankungen im Kindesalter, wie die juvenile idiopathische Arthritis aus dem rheumatischen Formenkreis, können akut, aber auch im Langzeitverlauf zu körperlicher Inaktivität führen. Die Patienten entwickeln funktionelle Einschränkungen bei Alltagsbewegungen und nehmen zeitweise gar nicht oder nur eingeschränkt an Sportangeboten teil. Daraus resultieren Defizite der konditionellen und koordinativen Fähigkeiten. Für eine kindgerechte und psychosoziale Entwicklung, aber auch aus Sicht der Primär- und Sekundärprävention spielt eine regelmäßige körperliche Aktivität für chronisch kranke Kinder eine entscheidende Rolle. Studien zum therapeutischen Einsatz von sportlichem Training zeigen dessen Unbedenklichkeit und Nutzen bei richtiger Durchführung. Daher sollten Kinder mit rheumatischen Erkrankungen nach individueller Beurteilung der Defizite und der Erkrankungsaktivität zum Sport ermutigt werden. In diesem Beitrag werden existierende Bewegungskonzepte für chronisch erkrankte Heranwachsende und ein neues Konzept zur individuellen Bewegungs- und Sportberatung für rheumaerkrankte Kinder und Jugendliche vorgestellt.
Hypermagnesiämie des ionisierten Magnesiums bei 199 Hunden
Authors: Güssow Arne , Schulz Nicole , Bauer Natali , Moritz Andreas 
Published: January 2019

Zusammenfassung
Ziel: Ermittlung von Häufigkeit und Ätiologie einer erhöhten Konzentration des ionisierten Magnesiums (iMg) beim Hund und Evaluierung deren Relevanz als prognostischer Faktor. Material und Methoden: Von April 2009 bis Dezember 2013 wurden bei 9950 Hunden Serum-elektrolyte mittels ionenselektiver Elektrode gemessen. Einschlusskriterium für die retrospektive Studie war eine Hypermagnesiämie (iMg ≥ 0,68 mmol/l), wobei zudem Gesamtmagnesium (tMg), Kalium, ionisiertes Kalzium und Urinabsatz evaluiert wurden. Bei wiederholten Messungen fand nur die erstmalig bestimmte erhöhte iMg-Konzentration eines Tieres Berücksichtigung. Nach der Ätiologie erfolgte die Zuordnung in die Diagnosegruppen Azotämie, iatrogen/medikamentenassoziiert, endokrinologische Störungen, Gewebeuntergang, unbekannte Ätiologie für Hypermagnesiämie. Ausgewertet wurden Überlebensrate und iMg-Konzentration in den Diagnosegruppen sowie die Korrelation von iMg und tMg. Ergebnisse: Die Prävalenz einer Hypermagnesiämie betrug 2,0 % (199/9950). Häufigste Ursache war eine Azotämie (80/199; 40 %), gefolgt von iatrogener Verabreichung (37/199; 19 %), Gewebeuntergang (21/199; 11 %) und endokrinologischen Störungen (12/199; 6 %). Bei 49/199 Hunden (25 %) war die Ätiologie unbekannt. Eine Hyperkalzämie zeigten 24/199 Hunde (12 %), eine Hypokalzämie 58/199 (29 %). Eine Nierenerkrankung hatten 64 % der Hunde (51/80) mit Azotämie, wovon 53 % (27/51) eine Hyperkaliämie aufwiesen. Zudem bestand bei 37 % (19/51) der Tiere mit Nierenerkrankung eine Anurie/Oligurie, davon hatten 59 % (11/19) eine Hyperkaliämie. Insgesamt verstarben 83/199 (42 %) Hunde, wovon 48/83 (58 %) der Gruppe Azotämie angehörten. Die iMg-Konzentration differierte zwischen den Gruppen nicht (p = 0,15). Die Korrelation von iMg und tMg war mit rs = 0,28 unzureichend. Schlussfolgerung: Eine erhöhte iMg-Konzentration ist selten und weist auf schwer wiegende Erkrankungen hin. Insbesondere bei einer Azotämie kann sie mit erhöhter Mortalität assoziiert sein. Die tMg-Konzentration lässt keine Rückschüsse auf die iMg-Konzentration zu.
Tear film examinations and eyelid histology of pugs
Authors: Krecny Marion , Witter Kirsti , Tichy Alexander , Nell Barbara 
Published: January 2019

Summary
Objectives: To determine if qualitative tear film and histological changes of the eyelid margins in pugs compared to other brachycephalic dogs could be potential contributing factors to the high prevalence of corneal diseases in this breed. Methods: Ophthalmic examin ation (including tear film break-up time [TFBUT] and meibometry) was undertaken on three groups (pugs with and without ophthalmologic abnormalities as well as on other brachycephalic breeds with history of ophthalmologic abnormalities). Histology of eyelid tissue obtained during medial canthoplasty was performed, using hematoxylin-eosin and oil-red-O-staining. Results: Seventy-eight pugs and 11 brachycephalic dogs were included. Mean ages were 3.54 and 5.5 years respectively. STT 1 values below 15 mm/min were found in 12 of 150 eyes of pugs and in three of 18 eyes of other brachycephalic dogs. Tear film break-up time values below 20 seconds were determined in 118 of 126 eyes of pugs, and in eight of 18 eyes of other brachycephalic dogs. Meibometry values over 100 MU were only identified in 20 of 147 eyes of pugs and 12 of 20 eyes in other brachycephalic dogs. Eyelid tissue of 21 pugs and 11 brachycephalic dogs was obtained. All pugs had a higher number of inflammatory cells in eyelid tissue than other brachycephalic breeds. Conclusions: Young pugs are often presented with STT 1 values within the reference range and low TFBUT and meibometry values. As other brachycephalic breeds are often presented with STT 1 values within reference ranges as well as low TFBUT values, the only marked difference between pugs and other brachycephalic breeds are low meibometry values and the higher number of inflammatory cells in the medial canthal lid margins.
Orbital paraganglioma in a dog
Authors: Taeymans Olivier , Monti Paola , Scurrell Emma , Eddicks Lina , Matiasek Kaspar , Busse Claudia , Fischer Maria-Christine 
Published: January 2019

SummaryA 10-year-old Rottweiler presented with right-sided moderately painful exophthalmia, blindness, absence of dazzle and pupillary light reflexes, a swollen optic nerve head and ventrolateral indentation of the globe. On magnetic resonance imaging, a 3 x 2 x 2 cm mass with a fluid filled center and contrast-enhancing periphery was noted posteriolateral of the globe. Orbital ultrasound was used for a guided fine needle aspirate of the mass. Cytology revealed moderate numbers of polygonal cells with lightly basophilic cytoplasm. Several cells showed nuclear pseudoinclusions. Histopathology following exenteration of the orbit revealed an infiltrative, extradural neoplasm surrounding the optic nerve. Cells were arranged in packets. Neoplastic cells were immunopositive for neuron specific enolase, synaptophysin and chromogranin A and immunonegative for cytokeratin. Findings were consistent with an extra-adrenal paraganglioma (neuroendocrine tumour). Although complete excision could not be confirmed on histopathology, the owners reported no apparent tumour recurrence 25 months after surgery. In conclusion a paraganglioma should be considered as a differential diagnosis of an orbital mass.
Einsatz mesenchymaler Stammzellen beim Hund
Authors: Kilchling Tim , Meyer-Lindenberg Andrea 
Published: January 2019

ZusammenfassungMesenchymale Stammzellen (MSC) sind multipotente Zellen, die sich in verschiedene Zelltypen des Körpers differenzieren können, z. B. in osteogene, chondrogene, adipogene und myogene Richtungen. Die klinische Anwendung von Stammzellen stellt in der Humanmedizin ein seit Jahrzehnten etabliertes Verfahren dar. Auch in der Veterinärmedizin werden insbesondere beim Pferd schon seit längerem Therapien mit MSC durchgeführt. Seit ca. 15 Jahren findet dieses Verfahren auch beim Hund immer häufiger klinische Anwendung. Haupteinsatzgebiet sind hier Erkrankungen des Bewegungsapparats, vor allem Lahmheiten infolge osteoarthrotischer Veränderungen der großen Gelenke. Die Isolierung der MSC erfolgt in der Veterinärmedizin überwiegend aus dem Knochenmark oder dem Fettgewebe. Diese Arbeit gibt einen Überblick über Entnahmelokalisation, Gewinnung, Charakterisierung und Anwendungsmöglichkeiten von MSC in der Veterinärmedizin, insbesondere beim Hund. Dargestellt werden dabei die in der zugängli-chen Literatur beschriebenen Studien zur Therapie bei orthopädischen Erkrankungen des Hundes.
Clinical Context-Specific Staphylococcus aureus Susceptibilities May Differ Substantially and Be Obscured by Aggregate Antibiograms
Authors: Islam Shamim , Shah Neel , Biary Nora 
Published: January 2019

AbstractAggregate data in institutional antibiograms may not accurately represent major pathogens' antibiotic susceptibility patterns in important clinical scenarios. In this analysis of Staphylococcus aureus isolates between 2013 and 2016 at the Women and Children's Hospital of Buffalo, methicillin and clindamycin susceptibility rates of S. aureus differed significantly from aggregate data when stratified by wound specimen and osteoarticular infection (OAI) isolates. Clindamycin susceptibility of methicillin-resistant S. aureus (MRSA) in wound specimens was higher than published antibiograms, whereas the proportion of MRSA and total clindamycin susceptibility in OAI was relatively lower, which impacts empiric antibiotic decision-making. With S. aureus antibiotic susceptibility patterns shifting and differences by infection type, as well as geographic location, pediatric facilities are encouraged to perform local reviews and emphasize specimen and clinical-context rather than aggregate antibiograms.
Adverse Outcomes with Maternal Blood Pressure Less than 140/90 in Pregnancy Complicated by Hypertension
Authors: Mitchell Courtney J. , Tita Alan , Anderson Sarah B. , Pasko Daniel N. , Harper Lorie M. 
Published: January 2019

Objective We assessed the risk of small for gestational age and other outcomes in pregnancies complicated by chronic hypertension with blood pressure <140/90 mm Hg.
Study Design Retrospective cohort of singletons with hypertension at a single institution from 2000 to 2014. Mean systolic blood pressure and mean diastolic blood pressure were analyzed as continuous and dichotomous variables (<120/80 and 120–139/80–89 mm Hg). The primary outcome was small for gestational age. Secondary outcomes included birth weight, preeclampsia, preterm birth <35 weeks, and a composite of adverse neonatal outcomes.
Results Small for gestational age was not increased with a mean systolic blood pressure <120 mm Hg compared with a mean systolic blood pressure 120 to 129 mm Hg (adjusted odds ratio [AOR] 1.6; 95% confidence interval [CI] 0.92–2.79). Mean diastolic blood pressure <80 mm Hg was associated with a decrease in the risk preeclampsia (AOR 0.57; 95% CI 0.35–0.94), preterm birth <35 weeks (AOR 0.35; 95% CI 0.20–0.62), and the composite neonatal outcome (AOR 0.42; 95% CI 0.22–0.81).
Conclusion Mean systolic blood pressure <120 mm Hg and mean diastolic blood pressure <80 mm Hg were not associated with increased risk of small for gestational age when compared with higher, normal mean systolic and diastolic blood pressures.
Association of Fast Food and Supermarket Density with Neonatal Outcomes of Pregnancies Affected by Gestational Diabetes
Authors: Battarbee Ashley N. , Yee Lynn M. 
Published: January 2019

Objective To measure the association of fast food density (FFD) and supermarket density (SD) with adverse neonatal outcomes in pregnancies with gestational diabetes mellitus (GDM).
Study Design This was a retrospective cohort study of women with GDM who delivered at a tertiary care center in a large metropolitan area (1/2010–2/2016). ZIP codes were used to link women with surrounding food environment. FFD and SD were calculated as the number of establishments per 100,000 residents for each ZIP code and classified into quartiles. Quartile 1 represented lowest FFD or SD. Four neonatal outcomes were assessed: large for gestational age (LGA) neonate, shoulder dystocia, neonatal hypoglycemia, and neonatal intensive care unit admission > 3 days. Bivariable and multivariable analyses estimated associations of FFD and SD with outcomes.
Results A total of 2,373 women met eligibility criteria. Insurance, race/ethnicity, language, and body mass index differed between quartiles, although GDM type did not. High FFD was associated with lower odds of LGA but not with other outcomes. Low SD and FFD:SD ratios were not associated with any outcomes.
Conclusion Among women with GDM, high FFD was associated with some neonatal outcomes, but low SD and FFD:SD ratio was not. Food environment may not be the only social determinant of neonatal outcomes in pregnancies with GDM.
A De novo Loss-of-Function Mutation in PAFAH1B1 Identified in a Single Case with Agyria–Pachygyria Complex
Authors: Ou Yali , Xiang Bingwu , Yang Liu , Chen Wei , Chen Xiang , Cai Tao 
Published: January 2019

AbstractTo identify genetic causes in affected infants with abnormalities of brain development, including malformations of cortical development–associated neuropsychological disorders, affected infants were recruited based on their clinical examination and cranial imaging studies. Trio whole-exome sequencing (WES), bioinformatic analysis, and genotype–phenotype correlations were performed for 20 affected subjects to identify candidate mutations, followed by Sanger sequencing for further verification. In the present study, we identified a de novo heterozygous mutation (c.265C > T, p.R89*) of the PAFAH1B1 gene in the affected child with epilepsy, speech impairment, and cerebral palsy. The mutation was predicted to be a null loss-of-function allele, which was not found in ExAC and the Chinse Han Exome Sequences databases. Magnetic resonance imaging of the brain demonstrated bilateral parieto-occipital and temporal lissencephaly as well as frontal partial pachygyria in the affected child. This is the first case with agyria–pachygyria complex due to a nonsense mutation in the Chinese population identified by a trio WES approach.
Thirty-Day Unplanned Readmission after Total Knee Arthroplasty at a Teaching Community Hospital: Rates, Reasons, and Risk Factors
Authors: Workman Kalain K. , Angerett Nathan , Lippe Ronald , Shin Alex , King Scott 
Published: January 2019

AbstractUnplanned readmission after total knee arthroplasty (TKA) has an increasing prevalence in the United States. Readmissions are now a metric for hospital quality of care, yet there are mixed results and variables associated with unplanned readmission. In this changing healthcare, it is critical for community healthcare institutions to identify risk factors for unplanned readmissions following TKA. Retrospective chart review and a hospital administrative database query to report causes, demographics, and medical comorbid risk factors result in 30-day readmission after undergoing primary TKA between 2011 and 2016 at a teaching community hospital. This study identified 7,482 primary TKA procedures of which 210 (2.8%) were unplanned readmissions. Gastrointestinal bleed (9.05%) and periprosthetic infection (8.10%) were the most common causes of readmission. Age 65 and older (odds ratio [OR], 1.64; 95% confidence interval [CI], 1.21–2.21; p = 0.0012), male (OR, 1.37; 95% CI, 1.03–1.83; p = 0.0302), length of stay > 3 days (OR, 2.04; 95% CI, 1.45–2.86; p < 0.0001), and discharge to rehab (OR, 2.21; 95% CI, 1.49–3.26; p ≤ 0.0001) were correlated significantly with risk of 30-day readmission. Chronic airway disease (OR, 2.81; 95% CI, 1.54–5.14; p = 0.0008) and obesity (OR, 1.45; 95% CI, 1.006–2.10; p = 0.0463) were significant risk factors. Higher Charlson comorbidity index was not a predictor of time to readmission within 30 days after TKA.
A Rare Co-occurrence of Intestinal Malrotation and Hirschsprung's Disease in a Neonate with 13q21.31q33.1 Interstitial Deletion Including the EDNRB Gene
Authors: Chatmethakul Trassanee , Phaltas Rozaleen , Minzes Gwen , Martinez Jose , Bhat Ramachandra 
Published: January 2019

AbstractWe report a rare co-occurrence of intestinal malrotation and Hirschsprung's disease (HSCR) in a male neonate with a large 38.8 Mb interstitial deletion of chromosome 13 extending from q21.31 to q33.1 including the EDNRB gene, who presented with craniofacial dysmorphic features and central nervous system malformations. The loss of EDNRB gene in addition to bilateral hearing loss and HSCR suggested an additional diagnosis of Waardenburg–Shah's syndrome. This case highlights the fact that prior knowledge of this rare association in infants with 13q deletion syndrome would enable early diagnosis and prompt interventions to prevent gastrointestinal complications.