bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of the Type of Fixation of Akin Osteotomy
Authors: Liszka Henryk , Gądek Artur 
Published: December 2018

Background: The objective of the study was to assess the influence of the type of fixation of the Akin osteotomy when used during hallux valgus surgery. Methods: Between 2013 and 2016, we performed 138 Akin osteotomy procedures employing a staple (group A, 43 patients), screw (group B, 47 patients), and single or double transosseous suture stabilization (group C, 48 patients). We assessed the pre- and postoperative interphalangeal angle (IPA), hallux valgus angle (HVA), and intermetatarsal angle (IMA) on dorsoplantar and lateral foot weightbearing x-rays and used the American Orthopaedic Foot & Ankle Society (AOFAS) hallux-metatarsophalangeal-interphalangeal scale for preoperative and 12-month postoperative follow-up clinical assessment. All the complications and costs of implant usage were recorded. Results: In all the groups, the average HVA (A: from 33.4 to 13.1 degrees; B: from 32.8 to 14.1 degrees; C: from 31.9 to 12.9 degrees), IMA (A: from 14.4 to 7.2 degrees; B: from 13.9 to 6.9 degrees; C: from 14.5 to 7.1 degrees), and IPA (A: from 12.1 to 5.6 degrees; B: from 11.7 to 6.0 degrees; C: from 12.5 to 5.9 degrees) decreased. The average AOFAS score improved in groups A (from 45 to 91 points), B (from 42 to 90 points), and C (from 42 to 91 points). We observed 1 recurrence after the single-tunnel suture fixation, 1 prominent screw, and 1 staple soft tissue irritation. We did not find a delayed union or nonunion. Conclusion: The suture fixation of the Akin osteotomy provides results comparable to other forms of stabilization. The procedure is cost saving and helps to avoid hardware-related complications. Despite the type of bunion surgery used, fixation of the Akin osteotomy with suture was as good as more expensive and potentially more complicated fixation methods. Level of Evidence: Level III, retrospective comparative study.
Analysis of revascularisation in ischaemic stroke with EmboTrap (ARISE I study) and meta-analysis of thrombectomy
Authors: Mattle Heinrich P , Scarrott Carl , Claffey Mairsil , Thornton John , Macho Juan , Riedel Christian , Söderman Michael , Bonafé Alain , Piotin Michel , Newell John , Andersson Tommy ,   for the ARISE I Study Group
Published: December 2018

Background and purpose The goal of the analysis of revascularisation in ischaemic stroke with EmboTrap study (ARISE I) was to demonstrate the effectiveness of EmboTrap. Methods ARISE I was an open label, single arm, multicentre, prospective study for the treatment of acute stroke due to large vessel occlusion. The primary outcome was revascularisation of the target vessel as measured by the modified thrombolysis in cerebrovascular infarction (mTICI) score of at least 2b following thrombectomy with EmboTrap. For comparison of the ARISE I results a meta-analysis of eight randomised controlled trials was performed. Results ARISE I enrolled 40 patients. Their baseline characteristics that are predictors of stroke outcome and procedure timings in ARISE I were similar to those reported in recent randomised controlled trials. The primary outcome, good revascularisation rates (mTICI 2b/3 scores) after three or fewer passes with EmboTrap were 75% (95% confidence interval (CI) 62–88%), which is the same as 74% found in randomised controlled trials (difference of 0.8%, P = 0.95). After additional EmboTrap passes or the use of another device mTICI 2b/3 scores rose to 85% (95% CI 74–96%), which was also similar to the randomised controlled trials (difference 11%, P = 0.38). The high revascularisation rates in ARISE I converted into 64% good clinical outcomes (modified Rankin scale ≤2) compared to 50% in randomised controlled trials (difference 14%; 95% CI –13.7–41.7%; P = 0.32). Conclusions ARISE I demonstrates that thrombectomy using the EmboTrap stent retriever yields similar results to devices that were used in recent randomised controlled trials for the treatment of stroke due to large vessel occlusions. ClinicalTrials.gov identifier NCT02190552
Use of intravenous alprostadil in patients with severe critical ischemia of the lower limbs
Authors: Machado-Alba Jorge Enrique , Machado-Duque Manuel E 
Published: December 2018

Objectives To determine the indications for the use, potential benefits, and adverse reactions of alprostadil in a group of Colombian patients. Methods A retrospective cross-sectional study was conducted in patients diagnosed with critical limb ischemia who received alprostadil in five hospitals in Colombia between September 2011 and July 2017. We reviewed the clinical records of each patient to obtain the sociodemographic and pharmacological variables, clinical stages, complications, comorbidities, reported effectiveness and adverse reactions. Results Sixty-one patients treated with alprostadil were evaluated; 50.8% of patients were men, and the average age of 72.5 ± 10.7 years. A total of 86.9% of patients were hypertensive, and 65.6% were diabetic. A total of 77.0% presented ulceration, and this condition was considered as a diabetic foot in 57.4% of patients. A total of 81.9% of patients were classified as Fontaine stage 4; 60.7% received therapy as initially indicated, with an average of 19 days of alprostadil use. Regarding the therapy results, 58.0% of the patients with ulcers or trophic lesions showed improvement, 86.2% showed improvement of pain, and the limb was saved in 72.1% of patients. Conclusions Critical limb ischemia was presented by patients with advanced age and high cardiovascular risk who were treated during severe and advanced stages where therapeutic options are limited. Treatment with alprostadil achieved satisfactory results with improvement in ulcers, pain, and limb salvage rates in this series of patients.
Clearance and persistence of the human papillomavirus infection among Cameroonian women
Authors: Akaaboune Mohamed , Kenfack Bruno , Viviano Manuela , Temogne Liliane , Catarino Rosa , Tincho Eveline , Mbobda Joel , Tran Phuong Lien , Camail Roxane , Vassilakos Pierre , Petignat Patrick 
Published: December 2018

Objective: Persistent infection with human papillomavirus is the prerequisite for the development of cervical precancerous and cancerous lesions. The aim of this study was to determine the time-to-viral clearance in a population of human papillomavirus–infected Cameroonian women and to examine the possible predictors of viral persistence. Methods: We conducted a prospective cohort study based on a population of human papillomavirus–positive women having previously been recruited in a self-human papillomavirus-based cervical cancer screening campaign, who were invited for a control visit at 6 and 12 months. We determined human papillomavirus clearance using self-sampling (Self-HPV) and physician-sampling (Dr-HPV), which were analyzed with a point-of-care assay (GeneXpert® IV; Cepheid, Sunnyvale, CA, USA). Logistic regression was performed to assess the relationship between sociodemographic and clinical characteristics with HPV clearance according to the two sampling techniques. Results: A total of 187 participants were included in the study. At the 12 months follow-up, 79.5% (n = 104) and 65.3% (n = 86) had cleared their human papillomavirus infection according to Dr-HPV and self-HPV, respectively (p = 0.001). Only parity (>5 children) was statistically associated with viral persistence (p = 0.033). According to Dr-HPV, clearance of women treated with thermoablation at 12 months was of 84.1% versus 70.2% for non-treated women (p = 0.075). Conclusion: The human papillomavirus clearing rates found in our study are close to those found in other studies worldwide. Parity was significantly associated with human papillomavirus persistence. Larger, prospective studies are needed to confirm our results.
Systematic literature review of risk factors for cervical cancer in the Chinese population
Authors: Li Xiao , Hu Shang Ying , He Yunkun , Hernandez Donoso Leyla , Qu Kelly Qiao , Van Kriekinge Georges , Zhao Fang Hui 
Published: December 2018

Objectives: Human papillomavirus is the necessary cause of cervical cancer, in particular the human papillomavirus-16/18 strains, which have been detected in ~70% of all cervical cancer cases worldwide. This study aims to assess whether other cofactors, which might be specific for the Chinese population, are involved in the development of cervical cancer. These findings may support the future direction of cervical cancer prevention. Study Design: Systematic literature review. Methods: The following databases were searched: MEDLINE, MEDLINE-IN-PROCESS, EMBASE, China National Knowledge Infrastructure, Wanfang Data and Chongqing VIP Information. The target population were adolescents or adults from mainland China. All observational studies irrespective of intervention or comparator reporting risk factors for cervical cancer were included. The Newcastle-Ottawa Scale was used to assess study quality. The impact of each outcome was reported in numerical terms. Results: A total of 2,676 articles were screened. A total of 21 articles met the inclusion criteria. All studies were case-controlled designs mostly conducted in hospitals of South-Eastern China. A total of 18 studies reported lifestyle behaviours as significant influencing factors in the development of cervical cancer. Sexual behaviour, gestational factors, screening history, disease history and socio-demographics status were reported as significant risk factors for cervical cancer development. Conclusion: This review provides an up-to-date insight of current cervical cancer risk factors in China. Due to the heterogeneity of the results, further evaluation is recommended to determine the association of these risk factors to the overall risk of cervical cancer.
Hemorrhagic Infarction of Cerebellum and Brainstem Due to Cervical Epidural Steroid Injection – Case Report and Review of the Literature
Authors: Bao Connie , Bao Shiping 
Published: December 2018

Radiculopathy is a painful condition usually due to a compressed nerve in the spine. It is reported that cervical radiculopathy has an annual incidence of 83.2 cases per 100 000 people. Cervical epidural steroid injection is one of the main treatments, but it can result in serious adverse events, including loss of vision, stroke, paralysis, and death. A 69-year-old female died after receiving the second of three planned C5/C6 epidural steroid injections. The autopsy revealed extensive hemorrhage and necrosis of the entire right side of the cerebellum and nearby brainstem, and extensive petechial hemorrhage of the left side of the cerebellum. This report discusses the importance of a complete autopsy in the case of death due to cervical epidural steroid injection and reporting the case either to peer review literature or to the Food and Drug Administration Adverse Event Reporting System (F AERS) database.
Use of Fat-Suppressed T2-Weighted MRI Images to Reduce the Magic Angle Effect in Peroneal Tendons
Authors: Ieong Edmund , Rafferty Michael , Khanna Monica , Walker Miny , Rosenfeld Peter 
Published: December 2018

Introduction. Peroneal tendon disorders pose a diagnostic conundrum to the clinician. Magnetic resonance imaging (MRI) is widely used to assess tendon pathology. A recognized artifact of MRI, the magic angle effect (MAE), can lead to spurious results and inappropriate management. The aim of this study is to assess whether T2 fat-suppressed sequences (T2FSs) reduce the frequency of MAE compared with proton density fat-suppressed (PDFS) images. Methods. MRI scans of 18 patients were prospectively assessed for MAE. The peroneal tendons were assessed at 5 defined levels on PDFS and T2FS images. The frequency of MAE in the peroneal tendons were compared between the 2 scan sequences. Results. In the peroneus brevis tendon, 17/72 levels, on PDFS scans, showed MAE compared with 2/72 levels on the T2FS scans, demonstrating a reduction in the MAE by 85% (P = .0003). In the peroneus longus tendon 14/72 levels, on PDFS scans, demonstrated MAE compared with 4/72 on T2FSs, demonstrating a reduction of 71% (P = .02). Conclusion. The inclusion of T2-weighted sequences is useful in MRI scanning for peroneal tendons to mitigate the MAE artifact, avoid potential misdiagnosis, and guide subsequent management of peroneal tendon disorders. Levels of Evidence: Level IV: Case series
Prevalence and predictors of lower urinary tract symptoms in Pakistani men: A cross-sectional study
Authors: Salman M , Khan JH , Khan AH , Sulaiman SAS , Aslam Z , Asif N , Mustafa ZU , Hassan M , Saleem Z , Iqbal M 
Published: December 2018

Objective: The purpose of this study was to investigate the prevalence and severity of the condition of lower urinary tract symptoms in Pakistani men, determine its predictors and assess its impact on the quality of life. Methods: A cross-sectional, population-based study was conducted among men aged 30 years and over in three districts of Punjab province, Pakistan. The modified Urdu version of the International Prostate Symptom Score was used to assess the prevalence and severity of lower urinary tract symptoms. Individuals with total symptom score ⩾8 were considered as having lower urinary tract symptoms. The data were analysed using SPSS version 22. The chi-square test and Mann-Whitney U test were used to assess the difference among categorical and continuous variables, respectively. Moreover, binary logistic regressions were performed to determine the predictors of lower urinary tract symptoms. Results: The overall prevalence of lower urinary tract symptoms in our sample was 33.7%. The frequency of individuals having mild, moderate and severe lower urinary tract symptoms was 66.3, 30.3 and 3.4%, respectively. Storage symptoms were more common than voiding symptoms (35.6% vs 28.2%, respectively). Increasing age (one-decade interval age stratum), higher education levels, working status (currently not working), smoking, hypertension, diabetes and renal impairment were positive predictors of lower urinary tract symptoms. Moreover, the condition of lower urinary tract symptoms was associated with a significant reduction in an individual’s quality of life. Conclusion: Around one-third of adult Pakistani men suffer from clinically relevant urinary symptoms, with lower urinary tract symptoms sufferers having poor quality of life as compared to non-sufferers. We recommend that the aging population should be made aware of conventional measures to mitigate mild urinary symptoms affecting their routine activities. Level of evidence: 2c
Usefulness of Shoulder36 in rotator cuff tears: Comparison with Simple Shoulder Test
Authors: Kawakami Junichi , Gotoh Masafumi , Matsuura Koumei , Shin Kunichika , Fujito Ikuhisa , Tanaka Aya , Matsunaga Saho , Imai Takaki , Nagamatsu Takashi , Karasuyama Masaki , Ohota Toshiaki , Madokoro Kazuya , Shiba Naoto 
Published: December 2018

Background: In patients with rotator cuff tears, Shoulder36 (Sh36) was compared to the Simple Shoulder Test (SST) to determine a broader use of Sh36 worldwide. Methods: Sh36, SST, “Constant score,” and the Japanese Orthopaedic Association score (JOA) were used to evaluate 230 patients (male, 116; female, 114) during the first visit, analyzed by staff blinded to the study. Pearson’s correlation coefficient was used for the statistical analysis. Results: The correlation coefficient between the Constant score and each domain in Sh36 was as follows: r = 0.68 (vs. pain, p < 0.01); r = 0.69 (vs. range of motion, p < 0.01); r = 0.74 (vs. muscle strength, p < 0.01); r = 0.62 (vs. general health, p < 0.01); r = 0.66 (vs. ability of daily living, p < 0.01); and r = 0.65 (vs. ability for sports, p < 0.01). The correlation coefficient between the JOA and each domain in Sh36 was as follows: r = 0.76 (vs. pain, p < 0.01); r = 0.73 (vs. range of motion, p < 0.01); r = 0.78 (vs. muscle strength, p < 0.01); r = 0.68 (vs. general health, p < 0.01); r = 0.71 (vs. ability of daily living, p < 0.01); and r = 0.70 (vs. ability for sports, p < 0.01). The correlation coefficient between the SST and each domain in Sh36 was as follows: r = 0.73 (vs. pain, p < 0.01); r = 0.70 (vs. range of motion, p < 0.01); r = 0.75 (vs. muscle strength, p < 0.01); r = 0.67 (vs. general health, p < 0.01); r = 0.69 (vs. ability of daily living, p < 0.01); and r = 0.64 (vs. ability for sports, p < 0.01). Conclusion: A strong association exists between the SST and each domain in the Sh36, in patients with rotator cuff tears ( r = 0.64–0.73), suggesting the usefulness of Sh36 for patient-based scoring.
A Systematic Review of Etiological Risk Factors Associated With Early Mortality Among National Football League Players
Authors: Owora Arthur H. , Kmush Brittany L. , Walia Bhavneet , Sanders Shane 
Published: December 2018

Background: Multiple risks predispose professional football players to adverse health outcomes and, in extreme cases, early death; however, our understanding of etiological risk factors related to early mortality is limited. Purpose: To identify etiological risk factors associated with all-cause and cause-specific mortality among National Football League (NFL) players. Study Design: Systematic review; Level of evidence, 3. Methods: Articles examining all-cause and cause-specific mortality risk factors among previous NFL players were identified by systematically searching: PubMed, PsycINFO, Web of Science, and Google Scholar from 1990 to 2017. Study eligibility and quality were evaluated using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Results: A total of 801 nonduplicated studies were identified through our search strategy. Of these, 9 studies examining 11 different risk factors were included in the systematic review. Overall, the risk of all-cause and cause-specific mortality was lower among NFL players than among the general male population in the United States. Nonwhite athletes, those in power positions, and those with a high playing-time body mass index (≥30 kg/m2) were associated with elevated all-cause and cardiovascular mortality risks. Conclusion: Methodological issues associated with the examined all-cause and cause-specific mortality risk factors preclude a definitive conclusion of etiological protective or risk effects. Comparison groups less prone to selection bias (“healthy worker effect”) and a life-course approach to the evaluation of suspected risk factors are warranted to identify etiological factors associated with early mortality among NFL players.
Demographics and Epidemiology of Osteochondritis Dissecans of the Elbow Among Children and Adolescents
Authors: Kessler Jeffrey I. , Jacobs John C. , Cannamela Peter C. , Weiss Jennifer M. , Shea Kevin G. 
Published: December 2018

Background: Osteochondritis dissecans (OCD) of the elbow is a disorder of subchondral bone and articular cartilage, of which the incidence among children is not clearly known. Purpose: To assess the demographics and epidemiology of OCD of the elbow among children. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A retrospective chart review of an integrated health system for the years 2007 through 2011 was performed for patients with elbow OCD aged 2 to 19 years. Lesion location, laterality, and all patient demographics were recorded. OCD incidence was determined for the group as a whole as well as by sex and age group (2-5, 6-11, 12-19 years). Patient differences based on age, sex, and ethnicity were analyzed, and multivariable logistic regression models were used to assess the risk of elbow OCD by group. Results: A total of 37 patients with 40 OCD lesions fit the inclusion criteria. No lesion was found among 2- to 5-year-olds. A majority of lesions (n = 39, 97.5%) were in the capitellum, and 1 (2.5%) was in the trochlea. Twenty-five patients (67.6%) had right-sided lesions; 9 (24.3%), left-sided; and 3 (8.1%), bilateral. The incidence of elbow OCD for patients aged 6 to 19 years was 2.2 per 100,000 overall and 3.8 and 0.6 per 100,000 for males and females, respectively. The majority of OCD cases were seen in those aged 12 to 19 years, with an incidence of 3.4 per 100,000 versus 0.38 among 6- to 11-year-olds. Multivariable logistic regression analysis revealed a 21.7-times increased odds ratio of elbow OCD among patients aged 12 to 19 years versus 6 to 11 years, and males had a 6.8-times greater odds ratio of elbow OCD than females ( P < .0001 for both). Based on race and ethnicity, non-Hispanic whites had the highest incidence of elbow OCD as compared with all other ethnic groups. Conclusion: In this population-based cohort study of pediatric elbow OCD, males had almost 7 times the risk of elbow OCD as compared with females, and 12- to 19-year-olds had nearly 22 times the risk of elbow OCD versus 6- to 11-year-olds. In keeping with many prior studies, the majority of patients had right-sided lesions.
Phase 1b trial of an ibrutinib-based combination therapy in recurrent/refractory CNS lymphoma
Authors: Grommes Christian , Tang Sarah S. , Wolfe Julia , Kaley Thomas J. , Daras Mariza , Pentsova Elena I. , Piotrowski Anna F. , Stone Jacqueline , Lin Andrew , Nolan Craig P. , Manne Malbora , Codega Paolo , Campos Carl , Viale Agnes , Thomas Alissa A. , Berger Michael F. , Hatzoglou Vaios , Reiner Anne S. , Panageas Katherine S. , DeAngelis Lisa M. , Mellinghoff Ingo K. 
Published: December 2018

Abstract
Ibrutinib is a first-in-class inhibitor of Bruton tyrosine kinase (BTK) and has shown single-agent activity in recurrent/refractory central nervous system (CNS) lymphoma. Clinical responses are often transient or incomplete, suggesting a need for a combination therapy approach. We conducted a phase 1b clinical trial to explore the sequential combination of ibrutinib (560 or 840 mg daily dosing) with high-dose methotrexate (HD-MTX) and rituximab in patients with CNS lymphoma (CNSL). HD-MTX was given at 3.5 g/m2 every 2 weeks for a total of 8 doses (4 cycles; 1 cycle = 28 days). Ibrutinib was held on days of HD-MTX infusion and resumed 5 days after HD-MTX infusion or after HD-MTX clearance. Single-agent daily ibrutinib was administered continuously after completion of induction therapy until disease progression, intolerable toxicity, or death. We also explored next-generation sequencing of circulating tumor DNA (ctDNA) in cerebrospinal fluid (CSF) before and during treatment. The combination of ibrutinib, HD-MTX, and rituximab was tolerated with an acceptable safety profile (no grade 5 events, 3 grade 4 events). No dose-limiting toxicity was observed. Eleven of 15 patients proceeded to maintenance ibrutinib after completing 4 cycles of the ibrutinib/HD-MTX/rituximab combination. Clinical responses occurred in 12 of 15 patients (80%). Sustained tumor responses were associated with clearance of ctDNA from the CSF. This trial was registered at www.clinicaltrials.gov as #NCT02315326.