bluuebunny/crossref_metadata_2025_split huggingface dataset:
Biomechanical Analysis of Ligatures and Technique for Managing Drainage Tubes in Pediatric Glaucoma
Authors: Adams Carolina , Kane Steven , Brooks Steven E. 
Published: July 2019

Purpose:
Absorbable ligatures are often used with glaucoma drainage tubes to avoid early postoperative hypotony. We sought to measure the force required to ligate a drainage tube, and develop a modified technique to promote earlier release in pediatric patients, where plate encapsulation occurs more quickly than adults.

Methods:
A precision digital force gauge was used to measure the tensile strength of several common ophthalmic sutures, and the necessary tensile force required to achieve tube ligation. A novel technique for tube ligation was devised to allow sutures as small as 10-0 to be effectively used.

Results:
The mean tensile strengths of unknotted sutures varied from 55.50±8.50 g for 10-0 vicryl to 477±69 g for 6-0 chromic gut. The mean tensile force required to ligate a Baerveldt or Ahmed tube was 35.9±0.9 g. However, 9-0 or 10-0 vicryl could not be reliably used for ligation, because of breakage, unless a modified technique was used, wherein the tube was first stretched to reduce its thickness and diameter.

Discussion:
Frictional forces inherent to knot tying make it unfeasible to reliably use 9-0 or 10-0 vicryl to ligate a drainage tube, despite the unknotted threads possessing apparently sufficient tensile strength. Our modified ligation technique overcomes this issue, allowing a wider range of suture choices, and the potential for achieving more rapid release in pediatric cases.
Pharmacokinetics of Single Doses of Methadone and Buprenorphine in Blood and Oral Fluid in Healthy Volunteers and Correlation With Effects on Psychomotor and Cognitive Functions
Authors: Strand Maren Cecilie , Ramaekers Johannes G. , Gjerde Hallvard , Mørland Jørg , Vindenes Vigdis 
Published: July 2019

AbstractPurposeWe aimed to study the pharmacokinetics of methadone and buprenorphine in blood and oral fluid after single-dose administration and investigate correlations between concentrations in blood and neurocognitive functions.MethodsA 5-way, double-blind, randomized, placebo-controlled, double-dummy, crossover study was performed to study the pharmacokinetics and neurocognitive effects of methadone (5 and 10 mg per oral) and buprenorphine (0.2 and 0.4 mg sublingual) in 22 healthy volunteers. Blood and oral fluid were collected throughout the test days, and drug concentrations in both matrices were analyzed using ultrahigh-performance liquid chromatography–tandem mass spectrometry. On-road driving testing, neurocognitive computerized tests, and subjective questionnaires were performed.ResultsLarge individual variations in concentrations of methadone and buprenorphine in blood and oral fluid, and accordingly oral fluid/blood drug concentration ratios, were observed. The mean ratio 6.5 hours after drug administration was 2.0 (range, 0.49–7.39) for methadone after both doses. Buprenorphine was not detected above the limit of quantification in blood after 6.5 hours. No significant correlation between methadone concentration in blood and effect was found. Significant correlations were found between buprenorphine concentration in blood and standard deviation of lateral position in the driving test and some measures of reaction time, divided attention, balance, alertness, contentedness. and sleepiness.ConclusionsConcentrations of methadone and buprenorphine in blood and oral fluid showed large interindividual variations. No concentration-effect correlations were found for methadone, whereas low to moderate correlations were observed between buprenorphine concentration and driving, psychomotor function, and subjective rating of sleep and alertness.
Effect of Previous Nitroimidazole Treatment on Helicobacter pylori Eradication Success
Authors: Boltin Doron , Levi Zohar , Gingold-Belfer Rachel , Gabay Hagit , Shochat Tzippy , Schmilovitz-Weiss Hemda , Dotan Iris , Birkenfeld Shlomo 
Published: July 2019

Goals:
The goal of this study was to examine the impact of prior treatment with a nitroimidazole antibiotic on the success of Helicobacter pylori treatment.

Background:
Prior nitroimidazole exposure may increase the likelihood of nitroimidazole-resistant H. pylori. Current H. pylori treatment guidelines recommend that, in the absence of susceptibility testing, patients with prior nitroimidazole exposure should not be treated with a nitroimidazole antibiotic. Data to support this recommendation are lacking.

Study:
We searched the Clalit Health Services database to identify subjects 25 to 60 years old who underwent a first-ever 13C-urea breath test between 2010 and 2015. Patients who underwent a previous H. pylori stool antigen test or gastroscopy were excluded. Pharmacy dispensation data were retrieved.

Results:
A total of 1386 subjects (34.8% male individuals, age 40.7±10.7 y) received a nitroimidazole-containing regimen including 282 (20.4%) with prior nitroimidazole exposure. Successful eradication was achieved in 58.9% and 73.8% of subjects with and without prior nitroimidazole exposure, respectively (odds ratio, 0.51; 95% confidence interval, 0.39-0.67; P<0.0001). Nitroimidazole exposure adversely impacted the success of triple therapy with nitroimidazole, proton pump inhibitor, and amoxicillin or clarithromycin (39.4% vs. 63.4% and 54.4% vs. 73.6%, P<0.01, respectively), but not quadruple therapy. Following multivariate analysis, nitroimidazole exposure was significantly associated with eradication failure (odds ratio, 1.89; 95% confidence interval, 1.43-2.50; P<0.0001). A greater time elapsed from nitroimidazole exposure, and a lower cumulative nitroimidazole dose were observed in subjects with successful eradication (P<0.0001 for both).

Conclusion:
Nitroimidazole exposure may adversely impact the success of nitroimidazole-based triple therapy, but not quadruple therapy. Clinicians should conduct a thorough patient drug history before administering empiric treatment for H. pylori infection.
Association between tongue coating thickness and ultraviolet fluorescence in patients with functional dyspepsia
Authors: Kim Jihye , Kim Jiwon , Yeo Inkwon , Kim Juyeon , Kim Jinsung , Nam Dong-Hyun 
Published: July 2019

Abstract
The aim of this study was to examine the correlation between the tongue coating thickness (TCT) and ultraviolet (UV) fluorescence and propose a new method for the estimation of TCT using a computerized tongue image acquisition system (CTIS).
In this prospective and observational single-center study, we acquired tongue images under visible light and near-UV light for 60 patients with functional dyspepsia. Tongue images were acquired twice within a 30-minute interval to assess the reliability of CTIS. Then, the tongue coating was scraped and weighed to derive the wet weight of the tongue coating (WWTC). The percentage of the tongue coating area was calculated from the tongue images acquired under visible light. Mean color values (mCVs) for the UV fluorescence of the dorsal surface of the tongue were also computed.
The reliabilities of the derived mCVs and percentage of the tongue coating area were acceptable (intraclass correlation coefficients, 0.907–0.947). The mCVs were more strongly correlated with WWTC than with the area, with mCV of modified lightness showing the strongest association (r = 0.785, P < .01). Finally, we suggested an estimation model for TCT based on the results.
The results of this study suggest that both UV fluorescence of the dorsal tongue and the distribution area of tongue coating are useful parameters for the quantitative assessment of tongue coating. We believe that these findings will contribute to the development of a clinically useful CTIS.
A network meta-analysis protocol of adjuvant chemotherapy for unresectable patients with advanced gastric cancer
Authors: Li Long , Guo Ling-yun , Mao Jie 
Published: July 2019

Abstract

Background:
The treatment methods about surgery, chemotherapy, and radiation therapy were recommended for gastric cancer (GC) patients by National Comprehensive Cancer Network (NCCN) guidelines. However, for the advanced gastric cancer patients or with metastatic lesions who have lost their chance of surgery, the current adjuvant chemotherapy treatments are still controversial. Therefore, this network meta-analysis is mainly to assess the relative efficacy of different adjuvant chemotherapy regimens for advanced gastric cancer (AGC).

Methods:
In order to compare the relative efficacy among different adjuvant chemotherapy regimens for AGC patients, randomized controlled trials (RCTs) and non-RCTs were systematic searched in PubMed, Web of Science, Clinical Trials, Cochrane Library and Embase database. R-3.4.1 software will be used for data analysis. The risk of bias in RCTs and non-RCTs will be evaluated through the risk of bias tool from the Cochrane Handbook version 5.1.0 and non-randomized studies of interventions (ROBINS-I), respectively.

Results and conclusion:
The results of this network meta-analysis will evaluate the relative effectiveness and rank the interventions among all chemotherapy methods for unresectable AGC patients, and provide more evidence-based guidance in clinical practice.

Protocol registration number:
CRD42018111835.
Dissociation between the growing opioid demands and drug policy directions among the U.S. older adults with degenerative joint diseases
Authors: Kim Pearl , Yamashita Takashi , Shen Jay J. , Park Seong-Min , Chun Sung-Youn , Kim Sun Jung , Hwang Jinwook , Lee Se Won , Dounis Georgia , Kang Hee-Taik , Lee Yong-Jae , Han Dong-Hun , Kim Ji Eun , Yeom Hyeyoung , Byun David , Bahta Tsigab , Yoo Ji Won 
Published: July 2019

Abstract
We aim to examine temporal trends of orthopedic operations and opioid-related hospital stays among seniors in the nation and states of Oregon and Washington where marijuana legalization was accepted earlier than any others.
As aging society advances in the United States (U.S.), orthopedic operations and opioid-related hospital stays among seniors increase in the nation.
A serial cross-sectional cohort study using the healthcare cost and utilization project fast stats from 2006 through 2015 measured annual rate per 100,000 populations of orthopedic operations by age groups (45–64 vs 65 and older) as well as annual rate per 100,000 populations of opioid-related hospital stays among 65 and older in the nation, Oregon and Washington states from 2008 through 2017. Orthopedic operations (knee arthroplasty, total or partial hip replacement, spinal fusion or laminectomy) and opioid-related hospital stays were measured. The compound annual growth rate (CAGR) was used to quantify temporal trends of orthopedic operations by age groups as well as opioid-related hospital stays and was tested by Rao–Scott correction of χ
2 for categorical variables.
The CAGR (4.06%) of orthopedic operations among age 65 and older increased (P < .001) unlike the unchanged rate among age 45 to 64. The CAGRs of opioid-related hospital stays among age 65 and older were upward trends among seniors in general (6.79%) and in Oregon (10.32%) and Washington (15.48%) in particular (all P < .001).
Orthopedic operations and opioid-related hospital stays among seniors increased over time in the U.S. Marijuana legalization might have played a role of gateway drug to opioid among seniors.
Lupus intestinal pseudo-obstruction and hydronephrosis
Authors: Adler Brittany L. , Timlin Homa , Birnbaum Julius 
Published: July 2019

Abstract

Introduction:
Intestinal pseudo-obstruction (IPO) is a rare and life-threatening complication of lupus.

Patient Concerns:
A patient with long-standing lupus developed recurrent abdominal pain and distension as well as nausea and emesis.

Diagnosis:
Imaging showed dilated small bowel loops with air-fluid levels and bowel wall thickening. She also had bilateral hydronephrosis.

Interventions
: She was given high-doses of intravenous steroids and cyclophosphamide.

Outcomes:
Her symptoms resolved within a week of starting immunosuppression. She was eventually transitioned to mycophenolate mofetil. She remained in remission and immunosuppression was successfully stopped after 1 year.

Conclusions:
Intestinal pseudo-obstruction is a rare complication of lupus that is often seen in association with ureterohydronephrosis and interstitial cystitis. This clinical syndrome is thought to be because of smooth muscle dysmotility of the gastrointestinal and genitourinary tracts, although the exact mechanism of dysmotility remains unknown. This condition is often responsive to immunosuppression if recognized and treated promptly.
Exertional rhabdomyolysis in a 21-year-old healthy man resulting from lower extremity training
Authors: Peng Fenfen , Lin Xuexin , Sun Ling Zhi , Zhou Weidong , Chen Yihua , Li Peilin , Chen Ting , Wu Jiayu , Xu Zhaozhong , Long Haibo 
Published: July 2019

Abstract

Rationale:
The incidence exercise-induced rhabdomyolysis is increasing in the healthy general population. Rhabdomyolysis can lead to the life-threatening systemic complications of acute kidney injury (AKI), compartment syndrome, and disseminated intravascular coagulopathy.

Patient concerns:
A 21-year-old man had bilateral lower limb pain and soreness, dark brown urine after lower exremity training. Laboratory results showed that creatinine kinase (CK) and myoglobin (Mb) increased to 140,500 IU/L and 8632 μg/L respectively, with elevated liver enzymes, Scr, and proteinuria.

Diagnoses:
Exercise-induced rhabdomyolysis with AKI.

Interventions:
The patient was hospitalized and treated with vigorous hydration and sodium bicarbonate for 6 days.

Outcomes:
After 6 days of treatment, the patient had a significant decrease in the CK and Mb levels. His renal function returned to normal. His laboratory tests had completely normalized during 2-week follow-up.

Lessons:
Exercise-induced rhabdomyolysis can cause serious complications such as AKI. Delayed diagnosis can be critical, so timely manner should be taken to achieve a favorable prognosis.
A primary splenic angiosarcoma hepatic metastasis after splenectomy and its genomic alteration profile
Authors: Cao Linping , Hong Jiawei , Wang Yacong , Yu Jun , Ma Ruobing , Li Jia , Wu Jian , Zheng Shusen 
Published: July 2019

Abstract

Rationale:
Primary splenic angiosarcoma (PSA) is a rare mesenchymal malignancy of the splenic vascular origin often with a dismal prognosis. Genomic profile may provide evidence for the solution of therapy.

Patient concerns:
We reported a case of a 51-year-old woman with splenectomy 4 years ago and the postoperative histopathology diagnosis revealed “splenic hemangioma” with spontaneous rupture. Two years after the operation, the patient's rechecked abdominal computed tomography (CT) showed multiple hepatic occupations.

Diagnoses:
Pathological test suggested PSA hepatic metastasis.

Interventions:
The patient was treated with trans-catheter arterial chemoembolization (TACE) and a pathological diagnosis of PSA was highly suspected in the hepatic biopsy. Four somatic alterations, phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA), Fos proto-oncogene, AP-1 transcription factor subunit (FOS), MCL1 apoptosis regulator (MCL1), and phosphoinositide-3-kinase regulatory subunit 1 (PIK3R1) were detected in the tumor tissue using a Next generation sequencing (NGS) technology. The results prompted that the patient may get clinical benefit from using some agents for targeted therapy, Everolimus, Temsirolimus, or Copanlisib.

Outcomes:
The patient refused targeted therapy. As a result, the patient passed away within 51 months after splenectomy.

Lessons:
PSA is an aggressive disease that often presented with a high propensity for metastasis and rupture hemorrhage. Some of these mutations were first discovered in PSA and these findings added new contents to the genomic mutation profile of PSA.
Effectiveness of mesalazine to treat irritable bowel syndrome
Authors: Zhang Fen-Ming , Li Sha , Ding Liang , Xiang Sai-Heng , Zhu Hua-Tuo , Yu Jing-Hua , Xu Guo-Qiang 
Published: July 2019

Abstract

Aim:
Accumulating evidence has explored the effect of mesalazine on irritable bowel syndrome (IBS). However, these studies remain inconsistent. Thus, a meta-analysis was conducted to estimate the role of mesalazine on IBS.

Methods:
PubMed, Medline, Embase, Web of Science, and the Cochrane Library Database were searched for all relevant randomized, controlled, blinded trials on mesalazine in patients with IBS between January 1980 and October 2018. All statistical analyses were performed using Revman 5.3 software. A fixed-effects model was adopted, 95% confidence intervals for SMD was calculated. Heterogeneity was evaluated by χ2 test and I
2 statistic.

Results:
Five studies involving 387 participants were finally included in this meta-analysis. The results showed that the SMD for clinical efficacy on abdominal pain in IBS patients treated with mesalazine in comparison to placebo was 0.19 (95% CI = −0.01 to 0.39, P = .06), which was statistically non-significant but clinically important. For beneficial effect of abdominal bloating, the SMD was 0.05 (95% CI = −0.20 to 0.30, P = .70), which was statistically non-significant. In regard to clinical efficacy on defecation frequency per day, the results revealed that the SMD was 0.29 (95% CI = −0.14 to 0.73, P = .18), which was statistically non-significant but clinically important. As for beneficial effect of general well-being, we found that the SMD was 0.41 (95% CI = −0.75 to 1.58, P = .49), which was statistically non-significant. With respect to stool consistency, the SMD was 0.01 (95% CI = −0.31 to 0.33, P = .96), which was statistically non-significant. For the effect of defecation urgency severity in IBS patients treated with mesalazine in comparison to placebo, we detected a surprising result with an SMD of 0.54 (95% CI = 0.05–1.04, P = .03), which was statistically significant. There was no significant difference between mesalazine group and placebo group on total mucosal immune cell counts of the patients with IBS with an SMD of −1.64 (95% CI = −6.17 to 2.89, P = .48) and there was also no significant difference in adverse reactions between two groups with an SMD of 1.05 (95% CI = 0.76–1.46 P = .77).

Conclusion:
Mesalazine is not superior to placebo in relieving clinical symptoms of abdominal pain, abdominal bloating, and general well-being of IBS and has no advantage of reducing defecation frequency per day and immune cell infiltration and improving stool consistency though without adverse reactions of mesalazine compared with placebo. For defecation urgency severity, placebo is even superior to mesalazine for IBS patients. Thus, mesalazine might be a cost burden to patients without providing good effectiveness. In view of the small sample size of the current study and the differences in every experimental designs, this study has high heterogeneity and requires subsequent verification.
Frequency of neuroimaging for pediatric minor brain injury is determined by the primary treating medical department
Authors: Klora Mike , Zeidler Jan , Bassler Stefan , Hirsch Franz Wolfgang , Gosemann Jan-Hendrik , Lacher Martin , Zimmermann Peter 
Published: July 2019

Abstract
To investigate the use of neuroimaging in children and adolescents with minor brain injury in pediatric and non-pediatric departments.
In this observational cohort study data were extracted from a large German statutory health insurance (AOK Plus Dresden ∼3.1 million clients) in a 7-year period (2010–2016). All patients with International Classification of Diseases (ICD) code S06.0 (concussion; minor brain injury; commotio cerebri) aged ≤ 18 years were included. Demographic and clinical data were analyzed by logistic regression analysis for associations with the use of CT and MRI (independent variables: gender, age, length of stay, pediatric vs non-pediatric department, university vs non-university hospital).
A total of 14,805 children with minor brain injuries (mean age 6.0 ± 5.6; 45.5% females) were included. Treatment was provided by different medical departments: Pediatrics (N = 8717; 59%), Pediatric Surgery (N = 3582, 24%), General Surgery (N = 2197, 15%), Orthopedic Trauma Surgery (N = 309, 2.1%). Patients admitted to pediatric departments (Pediatrics and Pediatric Surgery) underwent head CT-imaging significantly less frequently (3.8%) compared to patients treated in non-pediatric departments (18.5%; P < .001; General Surgery: 15.6%; Orthopedic Trauma Surgery: 39.2%). Logistic regression confirmed a significantly higher odds ratio (OR) for the use of cranial CT by the non-pediatric departments (OR: 3.2 [95-%-CI: 2.72–3.76]).
CT was significantly less frequently used in pediatric departments. Educational efforts and quality improvement initiatives on physicians, especially in non-pediatric departments may be an effective approach to decreasing rates of CT after minor traumatic brain injuries.
High BRAFV600E mutation frequency in Chinese patients with papillary thyroid carcinoma increases diagnostic efficacy in cytologically indeterminate thyroid nodules
Authors: Li Xing-Jia , Mao Xiao-dong , Chen Guo-fang , Wang Qi-feng , Chu Xiao-qiu , Hu Xin , Ding Wen-bo , Zeng Zheng , Wang Jian-hua , Xu Shu-hang , Liu Chao 
Published: July 2019

Abstract
To estimate the BRAFV600E mutation frequency in Chinese patients with papillary thyroid carcinoma (PTC), and the diagnostic value of BRAFV600E mutation status in thyroid nodules with indeterminate TBSRTC categories.
A total of 4875 consecutive samples for thyroid ultrasound-guided fine-needle aspiration cytology (FNAC) and BRAFV600E mutation analysis were collected from patients at Jiangsu Province Hospital on Integration of Chinese and Western Medicine. Among all the cases, 314 underwent thyroidectomy. According to TBSRTC categories, FNAC was performed for a preoperative diagnosis. ROC of the subject was constructed to evaluate the diagnostic value of these 2 methods and their combination.
BRAFV600E mutation in FNAC of thyroid nodules occurred in 2796 samples (57.35%). Of 353 nodule samples from 314 patients with thyroid operation, 333 were pathologically diagnosed as PTC. Of these PTC patients, 292 (87.69%) were found to have BRAFV600E mutation in their preoperative FNAC. In 175 cytologically indeterminate thyroid nodules, BRAFV600E mutation identified 88% of PTC. According to ROC data, BRAFV600E mutation testing had an obviously higher sensitivity (87.69%) and specificity (100.00%) than TBSRTC. Combining BRAFV600E mutation testing and TBSRTC achieved the largest AUC (0.954). For 41 PTC with a negative BRAFV600E mutation in preoperative evaluation, the repeated BRAFV600E mutation testing found out 12 samples with BRAFV600E mutation. The true BRAFV600E mutation rate of Chinese PTC patients was 91.29%.
Chinese patients with PTC have a higher frequency of BRAFV600E mutation. The BRAFV600E mutation testing affords a high diagnostic value in thyroid nodules with indeterminate cytology.