bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reverse Abdominoplasty Advancement Flap: An Innovative Option in Breast Reconstruction in Post-Massive Weight Loss Patients
Authors: Asiry Abdulaziz , Garrido Ignacio , Chaput Benoit , Chantalat Elodie , Vaysse Charlotte 
Published: May 2019

Summary:
With the increase in obesity in the world, we observe more and more bariatric surgeries. Simultaneously, the incidence of breast cancer increases. The reverse abdominoplasty has been essentially described to lift the upper part of the abdomen for the individual who has loose excess skin in the supraumbilical region. The application of reverse abdominoplasty flap has been extended beyond aesthetic procedures to breast reconstructive interventions. We present an innovative option of postbreast cancer reconstruction by reverse abdominoplasty advanced flap following massive weight loss.
Cognitive self-regulation influences pain-related physiology
Authors: Matthewson Gordon M. , Woo Choong-Wan , Reddan Marianne C. , Wager Tor D. 
Published: May 2019

Abstract
Cognitive self-regulation can shape pain experience, but its effects on autonomic responses to painful events are unclear. In this study, participants (N = 41) deployed a cognitive strategy based on reappraisal and imagination to regulate pain up or down on different trials while skin conductance responses (SCRs) and electrocardiogram activity were recorded. Using a machine learning approach, we first developed stimulus-locked SCR and electrocardiogram physiological markers predictive of pain ratings. The physiological markers demonstrated high sensitivity and moderate specificity in predicting pain across 2 data sets, including an independent test data set (N = 84). When we tested the markers on the cognitive self-regulation data, we found that cognitive self-regulation had significant impacts on both pain ratings and pain-related physiology in accordance with regulatory goals. These findings suggest that self-regulation can impact autonomic nervous system responses to painful stimuli and provide pain-related autonomic profiles for future studies.
Nerve growth factor antibody for the treatment of osteoarthritis pain and chronic low-back pain: mechanism of action in the context of efficacy and safety
Authors: Schmelz Martin , Mantyh Patrick , Malfait Anne-Marie , Farrar John , Yaksh Tony , Tive Leslie , Viktrup Lars 
Published: May 2019

AbstractChronic pain continues to be a significant global burden despite the availability of a variety of nonpharmacologic and pharmacologic treatment options. Thus, there is a need for new analgesics with novel mechanisms of action. In this regard, antibodies directed against nerve growth factor (NGF-Abs) are a new class of agents in development for the treatment of chronic pain conditions such as osteoarthritis and chronic low-back pain. This comprehensive narrative review summarizes evidence supporting pronociceptive functions for NGF that include contributing to peripheral and central sensitization through tropomyosin receptor kinase A activation and stimulation of local neuronal sprouting. The potential role of NGF in osteoarthritis and chronic low-back pain signaling is also examined to provide a mechanistic basis for the observed efficacy of NGF-Abs in clinical trials of these particular pain states. Finally, the safety profile of NGF-Abs in terms of common adverse events, joint safety, and nerve structure/function is discussed.
Effects of an Education Intervention on Nursing Students' Knowledge and Attitudes Regarding Skin Self-Examination and Skin Cancer Risks
Authors: ERKİN Özüm , AYGÜN Özcan 
Published: May 2019

ABSTRACT

Background
The incidence of skin cancers is increasing in Turkey as well as worldwide. Nurses have a potentially influential role to play in educating the public about skin cancer prevention.

Purpose
The purpose of this study was to teach nursing students the risks of skin cancer and the steps involved in conducting related skin self-examinations to encourage positive attitudes toward skin cancer protection and early detection.

Methods
This research used a quasi-experimental, single-group, pretest–posttest design. The study population was composed of all the nursing students who were currently enrolled in a university in Muğla, a city in southern Turkey (n = 900). The study analysis included the 332 nursing students who had completed both the pretest and posttest assessments. An intervention to raise awareness about skin cancer risks and skin self-examination was carried out using educational materials that included posters/pictures, brochures, a PowerPoint slideshow, and a video. The posttest assessment was done 6 weeks after the pretest.

Results
The participants were 18–23 years old, and 67.5% were female. Furthermore, 3.6% had undergone a routine (external) screening for skin cancer, and 14.5% believed that they were at risk for skin cancer. The mean score for knowledge of skin cancer risks for those participants who had completed the program was 5.75 ± 1.20 in the pretest and 6.84 ± 1.17 in the posttest (minimum: 0, maximum: 8). The mean posttest score was higher than the pretest score in this group, F(1, 329) = 6.49, p = .011, and a significant difference was found between the mean pretest and posttest score for knowledge of the ABCDE rule (p < .05).

Conclusions
Educating nursing students about skin self-examination increased their level of knowledge about both skin cancer risks and the ABCDE rule. We believe that this and similar educational programs are an effective way to increase the knowledge and awareness of nurses regarding skin cancer and to improve their attitudes toward performing skin self-examination.
Combined navigated drilling and arthroscopy facilitate minimally invasive surgical treatment of ulnar–radial joint dislocation caused by epiphyseal premature closure
Authors: Yu Tong , Yuan Bao-Ming , Jiang Yi-Kun , Li Qi-Wei , Wang Qian , Kang Li-Heng , Zhang Xi-Wen , Wu Dan-Kai , Zhao Jian-Wu 
Published: May 2019

Abstract

Rationale:
In this paper, the efficacy and safety of using navigated drilling and arthroscopy (NDA) to assist surgery for ulnar–radial joint dislocation caused by epiphyseal premature closure (EPC) are described. Deformity correction surgery was mentioned in the literature, but there were numerous complications, for example, poor correction, infection, neurovascular injury, osteofascial compartment syndrome, failure of internal fixation, and nonunion after osteotomy. In order to minimize surgical complications, we utilized navigated drilling to finish accuracy bone bridge resection and applied arthroscopy to assess wrist lesions.

Patient concerns:
An 11-year-old male patient showed swelling and pain of the left wrist.

Diagnoses:
The patient was diagnosed with a postoperative of Kirschner wire internal fixation for epiphyseal injury, left lower ulnar–radial joint dislocation, left wrist deformity, and EPC.

Interventions:
A NDA was used to assist the bone bridge resection in this patient.

Outcomes:
Pain was relieved clearly in the patient. Dorsiflexion increased from 60.8° to 85.3°, palmar flexion increased from 45.3° to 65.8°, supination increased from 41.3° to 69.5°, and pronation increased from 31.6° to 62.9°. The preoperative disabilities of the arm, shoulder, and hand (DASH) score was 86.1, which was increased to 16.4 postoperatively. Surgery designing lasted for 2 minutes, bone bridge resection lasted for 56 minutes, and fluoroscopic time was 2.4 minutes. Complications, for example, neurological injury, vascular injury, infection and deformity aggressive, were not found during the 5-month follow up.

Lessons:
The outcome of the present study suggests that the NDA maximizes the bone bridge resection accuracy in EPC treatment, which is made efficient by reducing surgical trauma and avoiding neurovascular injury. An experience was gained that in the process of bone bridge removal, the bit of navigated drill should be continuously washed with normal saline to cool down, so as to avoid damage of nerve caused by heat conduction.
Natural history and therapeutic strategies of post-pancreatoduodenectomy abdominal fluid collections
Authors: Zhao Ning , Cui Jing , Yang Zhiyong , Xiong Jiongxin , Wu Heshui , Wang Chunyou , Peng Tao 
Published: May 2019

Abstract

Trial Design:
The aim of this study was to identify independent risk factors for post-pancreatoduodenectomy (post-PD) abdominal fluid collections (AFCs) and evaluate our management protocol on it.

Methods:
A retrospective analysis of consecutive 2064 cases who underwent PD over the past decade in 1 single center was conducted. The patients were divided into AFCs and non-AFCs group. Univariable and multivariate logistic regression analysis was performed to identify independent risk factors of AFCs. The AFCs group was compared with the non-AFCs group with respect to the incidence of postoperative outcomes. The characteristics of AFCs were further analyzed in terms of clinical manifestations.

Results:
Two thousand sixty-four cases with pancreaticoduodenectomy were recruited and 15% of them were found AFCs. Diameter of main pancreatic duct ≤3 mm was found to be an independent predictor of AFCs (P < .001), along with soft pancreatic texture (P = .002), mesenterico-portal vein resection (P < .001), and estimated intraoperative blood loss >800 mL (P < .001). The incidence of mild complications was significantly higher in AFCs group than in non-AFCs group (34% vs 20%, P < .001), whereas no significant differences were noted in the rate of severe complications between these 2 groups (15% vs 15%, P = .939).

Conclusion:
Enhanced drainage is recommended as an effective measure to decrease the incidence of severe complications caused by post-PD AFCs.
Comparison of dexamethasone intravitreal implant with intravitreal anti-VEGF injections for the treatment of macular edema secondary to branch retinal vein occlusion
Authors: Ji Kaibao , Zhang Qinglin , Tian Man , Xing Yiqiao 
Published: May 2019

Abstract

Background:
This meta-analysis compared the efficacy and safety of dexamethasone intravitreal implant (DEX) and anti-vascular endothelial growth factor (anti-VEGF) in the treatment of macular edema (ME) secondary to branch retinal vein occlusion (BRVO).

Methods:
The PubMed, Embase, Cochrane Library, and Web of Science databases were comprehensively searched for published studies comparing DEX with anti-VEGF for the treatment of ME caused by BRVO. Outcomes of the selected studies included best-corrected visual acuity (BCVA), central macular thickness (CMT), and adverse events. Review Manager (RevMan) 5.3 was used to analyze the data.

Results:
Six trials comparing the efficacy and safety of DEX with anti-VEGF were included in this meta-analysis. At 1 month, DEX achieved a mean BCVA superior to that achieved by anti-VEGF (MD = −0.11, P < .0001), in addition to a superior mean BCVA change (MD = −0.35, P < .00001). At 3 months, the mean BCVA showed a significant difference (MD = −0.06, P = .03) between DEX and anti-VEGF treatment, while the mean BCVA change was similar to that with anti-VEGF treatment (MD = −0.06, P = .11). However, neither mean BCVA nor mean BCVA change showed a significant difference between DEX and anti-VEGF treatment at 6 months (MD = 0.08, P = .06; MD = 0.06, P = .43, respectively). Mean CMT and mean CMT change were significantly lower in the DEX group than in the anti-VEGF group at 1 month (MD = −53.63 μm, P < .00001; MD = −60.1 μm, P = .005, respectively). However, at 3 months, mean CMT and mean CMT change were similar between DEX and anti-VEGF treatment (MD = 17.4 μ, P = .74; MD = 18.01 μm, P = .72, respectively). Although mean CMT in the anti-VEGF group was not significantly lower than that in the DEX group at 6 months (MD = 55.53, P = .07), the mean CMT change from baseline achieved by the anti-VEGF treatment was significantly superior to that obtained with DEX (MD = 75.53, P = .0002). Concerning adverse events, no statistically significant differences were observed in the incidence of cataract (OR = 4.25, P = .07), but the use of DEX led to a higher risk of intraocular pressure elevation compared with anti-VEGF treatment (OR = 12.04, P = .006).

Conclusions:
Our results show that visual acuity recovery and CMT were better in the DEX group than in the anti-VEGF group after 1 and 3 months, although the difference in CMT at 3 months was not significant. However, there were no significant differences in terms of visual acuity and CMT between the two groups after 6 months of follow-up. Therefore, DEX may be recommended as the first treatment option in ME associated with BRVO.
A novel mutation in SPTA1 identified by whole exome sequencing in a Chinese family for hereditary elliptocytosis presenting with hyperbilirubinemia
Authors: Xi Yaming , Wang Lina , Zhang Pengpeng , Jia Mingfeng , Li Zijian 
Published: May 2019

Abstract

Rationale:
Hereditary elliptocytosis is an inherited disorder characterized by the elliptical red blood cells (RBCs) on the peripheral blood smear and related hemolysis, mainly results from a heterozygous mutation in the genes that encode protein 4.1, α-spectrin, β-spectrin. Mutations of SPTA1 are the most common.

Patient concerns:
A 21-year-old female presented with left epigastric pain and jaundice with numerous elliptical RBCs on blood film. The family history review discovered jaundice in her sibling.

Diagnosis:
A novel heterozygous mutation of SPTA1 was detected in the proband, her brother and father, c.7220_7221del:p.Tyr2407∗ in exon 52. Bioinformatics analysis indicated that this mutation was likely pathogenic and results in early termination of transcription and production of defective protein.

Interventions:
The proband underwent splenectomy and cholecystectomy due to symptomatic splenomegaly and gallstone.

Outcomes:
After surgery, the bilirubin levels decreased to normal (i.e., total bilirubin 16.4 μmol/L; indirect bilirubin 12.3 μmol/L), and the pain and uncomfortableness in the upper abdomen relieved completely.

Lessons:
We suggest that simultaneous whole exome sequencing of causative genes of all family members is a useful strategy to identify pathogenetic mutations for hereditary RBC membrane disorders, mainly in cases with an ambiguous phenotype.
The effect of early Helicobacter pylori eradication on the healing of ESD-induced artificial ulcers
Authors: Song Wen chong , Wang Xiao feng , Lv Wei wei , Xu Xiao yan , Tian De min 
Published: May 2019

Abstract

Background:
The role of Helicobacter pylori eradication is still not clear in endoscopic submucosal dissection (ESD)-induced artificial ulcer. This study investigates the therapeutic effects of H. pylori eradication on ESD-induced artificial ulcers.

Methods:
Eighty-four patients with ESD-induced artificial ulcers were enrolled. H. pylori eradication success subgroup (Group A1) and H. pylori eradication failure subgroups (Group A2) received standard triple therapy orally for 7 days, followed by esomeprazole 20 mg bis in die (bid) orally for the remainder of the treatment period (4 weeks in total). The H. pylori positive (Group B1) and H. pylori negative subgroups (Group B2) received esomeprazole 20 mg bid orally for 4 weeks. Ulcer healing was evaluated by gastroscopy, and H. pylori was identified by a C13 breath test or an Hp-RUT 2 and 6 months after treatment.

Results:
Successful eradication of H. pylori can promote healing of ESD-induced artificial ulcers. The ESD-induced artificial ulcer healing rate in Group A1 was statistically higher than that in Groups A2, B1, and B2.

Conclusion:
Our results indicated that early H. pylori eradication therapy can promote ESD-induced artificial ulcer healing in H. pylori positive patients with ESD-induced artificial ulcers.
A spontaneous protruded angle-supported anterior chamber intraocular lens
Authors: Lin Hsin-Le , Tseng Gow-Lieng 
Published: May 2019

Abstract

Rationale:
Anterior chamber intraocular lens (ACIOL) remains a surgical option for visual rehabilitation during complicated cataract surgeries with minimal or no capsular support. ACIOL causing scleral perforation is rare, and the involved causes remain debatable.

Patient concerns:
Here, we present the case of a 62-year-old female with spontaneous protrusion of an angle-supported ACIOL haptic tip through an extracapsular cataract extraction (ECCE) wound, who presented with progressive right-eye ptosis and right-side headache.

Diagnosis:
The slit lamp examination showed a vertically aligned angle-supported Kelman Multiflex ACIOL in the anterior chamber. The ACIOL had deviated upward, with upper haptic protruding from the previous ECCE scleral tunnel wound. Fundus examination and optical coherence tomography (OCT) revealed cystoid macular edema (CME) with mild epiretinal membrane (ERM).

Interventions:
The patient was treated with ACIOL extraction, pars plana vitrectomy, ERM peeling, and scleral-fixated posterior chamber IOL implantation.

Outcomes:
Three months after surgery, the best-corrected visual acuity in the right eye improved to 20/80 and the right-side headache and hyperemia of the conjunctiva had significantly subsided. Repeated OCT revealed improved CME.

Lessons:
Poor construction of the scleral tunnel incision may cause wound dehiscence. The vertically aligned ACIOL haptic tip resting at the angle may exert stress toward the dehiscent wound, exacerbating tissue erosion and causing scleral perforation with haptic tip exposure.
Gluteal, abdominal, and thoracic multiple impalement injuries
Authors: Ugoletti Lara , Zizzo Maurizio , Castro Ruiz Carolina , Pavesi Erica , Biolchini Federico , Annessi Valerio 
Published: May 2019

Abstract

Rationale:
Historically, traumatic injuries include penetrating and blunt lesions. Impalement injury represents one of the rarest and potentially dramatic forms of penetrating trauma. If patient reaches hospital alive and is hemodynamically stable, there is a good chance that patient overcomes the traumatic event. However, non-removal of foreign body represents the cornerstone in initial treatment of this type of patients.

Patient concerns:
A stable 55-year-old woman was admitted to the Emergency Department after falling out of a tree onto a wooden fence. One fence pole transfixed left gluteus, left abdominal wall, left abdominal cavity, and left thoracic wall by transdiaphragmatic way.

Diagnosis:
Due to patient stability, a chest-abdomen CT scan with contrast medium was performed. It showed multiple parietal and visceral traumatic penetrating injuries from a foreign object.

Interventions:
After primary and secondary advanced trauma life support (ATLS) assessment, patient underwent successful surgery.

Outcomes:
Patient was discharged on 9th postoperative day in good general clinical condition.

Lessons:
Impalement injury represents a rare and potentially lethal traumatic event. Unstable patients rarely reach Emergency Department alive. On the contrary, stable patients have a good chance of successful treatment, if they are quickly taken to tertiary Trauma Center. In this case, chest X-ray and Focused Assessment with Sonography for Trauma (FAST) represent useful diagnosing investigations, although CT scan remains gold standard. Conservative treatment is not possible, while thoracoscopy/laparoscopy/laparotomy is/are mandatory.
Acute dystonic reaction induced by a single dose of clebopride
Authors: Seo Young Woo , Ko Seung Hyun , Jang Tae Chang , Kim Gyun Moo 
Published: May 2019

Abstract

Rationale:
Clebopride is known as a dopamine antagonist used for alleviating emetic symptoms with minimal side effects. Herein, we report a case of acute dystonic reaction possibly caused by administration of clebopride in a young male.

Patient concerns:
A 19-year-old with no special medical conditions, visited a local clinic complaining of abdominal discomfort, associated with nausea and vomiting. The patient was prescribed with tiropramide, clebopride, simethicone, and mosapride citrate, only to visit the emergency department for abrupt neck pain followed with dystonic reactions upon oral administration of the drugs. The patient suffered involuntary movements of the neck to the right, while maintaining voluntary motor controls of the neck to the left.

Diagnosis:
Vital signs and neurological exams showed no obscurity and the preliminary blood workup (a complete blood count and measurement of electrolytes, inflammatory marker levels, copper concentration, etc) were all within normal ranges. Additional imagery tests including brain computed tomography (CT), neck contrast-enhanced CT, and magnetic resonance imaging failed to prove any focal lesion pertinent to the condition. Drug screening was done and then clebopride was suspected to be the cause of the dystonic reactions.

Interventions:
Benztropine (1 mg) was administered orally.

Outcomes:
The patient's symptoms improved after 1 hour, and he was observed for 6 more hours for possible recurrences before he was discharged. The patient was referred to an outpatient neurology department for 1 month, during which he had no recurrence or other extrapyramidal symptoms.

Lessons:
Although it is uncommon to experience extrapyramidal symptoms by clebopride, its chemical closeness to metoclopramide may induce such symptoms under certain clinical situations. Therefore, physicians should take in consideration of this effect and dwell in caution upon prescribing the drug.
Low interferon-gamma release in response to phytohemagglutinin predicts the high severity of diseases
Authors: He Xing , Liu Li-Ying , Ji Xiao-Kun , Xian Ya-Bin , Yan Yong-Jun , Xu Hui-Juan , Sha Li , Pu Chun-Li , Zhou Jun-Yan , Yuan Chun-Yan , Yang Mei , Zheng Song-Guo 
Published: May 2019

Abstract
A clinically useful immune biomarker could potentially assist clinicians in their decision making. We stimulated T-cell proliferation to secret interferon gamma (IFN-γ) by phytohemagglutinin, and then measured the production of IFN-γ (mitogen value [M value]). We aimed to determine the relationship between the M value, clinical severity, and outcomes of diseases.
In all, 484 patients admitted to intensive care units were enrolled in this retrospective study. The Acute Physiology and Chronic Health Evaluation II (APACHE II) scores were collected within the first 24 hours. M value, C-reaction protein (CRP), procalcitonin (PCT), erythrocyte sedimentation rate (ESR), and routine blood tests were analyzed and collected during the study.
When APACHE II scores were greater than 15 and M values were less than 6, the hospital mortality rose in a straight line. There was an inverse correlation between APACHE II score and M value (r
s = −0.212, P < .001). There was a positive correlation between M value and lymphocyte numbers (b’ = 0.249, P < .001); however, there was an inverse correlation between M value and WBC (b’ = −0.230, P < .001), and ESR (b’ = −0.100, P = .029). Neurological diseases had the greatest influence on APACHE II scores (b’ = 10.356, P < .001), whereas respiratory diseases had the greatest influence on M value (b’ = 1.933, P < .001). Furthermore, in the respiratory system, severe pneumonia had a greater influence on M value. Taking the APACHE II score as the gold standard, the area under the curve of M was 0.632 (95% confidence interval [CI] 0.575–0.690, P < .001), PCT was 0.647 (95% CI 0.589–0.705, P < .001), CRP was 0.570 (95% CI 0.511–0.629, P = .022), and ESR was 0.553 (95% CI 0.494–0.612, P = .078). Divided by M value = 5, the positive predictive value of the M value is 37.22% (115/309) and negative predictive value is 75.43% (132/175).
The results show that the M values, PCT, and CRP were better than ESR to predict the severity of diseases. The number and proportion of lymphocytes also affected the result of the M value. To a certain extent, the M value may be a clinically useful immune biomarker, which may help clinicians objectively evaluate the severity of diseases, especially in the respiratory system.