bluuebunny/crossref_metadata_2025_split huggingface dataset:
Review of Endovenous Thermal Ablation of the Great Saphenous Vein: Endovenous Laser Therapy Versus Radiofrequency Ablation
Authors: Ahadiat Omeed , Higgins Shauna , Ly Alexandre , Nazemi Azadeh , Wysong Ashley 
Published: February 2018

BACKGROUND
Endovenous thermal ablation is a popular treatment for varicose veins of the greater saphenous vein. Two common techniques of thermal ablation are endovenous laser therapy (EVLT) and radiofrequency ablation (RFA).

OBJECTIVE
The authors compare EVLT and RFA in vein therapy.

METHODS
A review was conducted using PubMed. Studies comparing the treatment modalities were gathered and compared on the basis of 5 main standpoints, including: efficacy, side effects, serious complications, recurrence, and quality of life.

RESULTS
It was found that EVLT and RFA are both highly efficacious (>80%). Endovenous laser therapy seems to be slightly more efficacious than RFA in numerous studies but its significance is uncertain. Side effect profiles varied regarding postoperative pain and bruising because both were seen to be significantly less using RFA. Serious complications were found to be rare in both with no significant difference in incidence. Recanalization rate was observed to be higher using RFA with uncertainty in significance among various studies. Quality of life improved after both procedures with no significant difference among the 2.

CONCLUSION
Efficacy and recurrence rate seem to favor EVLT, whereas postoperative pain and bruising favor RFA. Further studies are needed to validate the significance of the differences found.
Pubic Hair Restorative Surgery Using Grafts Harvested by the Nonshaven Follicular Unit Extraction Technique
Authors: Kim NaRae , Park Jae Hyun 
Published: February 2018

BACKGROUND
Pubic atrichosis or hypotrichosis is quite common among Korean women. Although Korean people are increasingly opening up to Western culture, pubic hair transplantation is still pursued for cultural reasons. However, many hesitate to undergo restorative surgery because follicular unit strip surgery would leave a linear donor scar, preventing patients from hiding their surgical history. Thus, follicle harvesting using nonshaven follicular unit extraction (NS-FUE), aside from many other strengths, is very useful when performing pubic restorative surgery. There has been no previous report concerning the effectiveness of NS-FUE for treating pubic atrichosis or hypotrichosis.

OBJECTIVE
To investigate the effectiveness of NS-FUE when performing pubic restorative surgery.

MATERIALS AND METHODS
The 50 patients who were included in the study underwent pubic hair restoration using NS-FUE between March 2014 and June 2016 at Dana Plastic Surgery Clinic (Seoul, Korea), and were followed for at least 10 months afterward. Patients and the surgeon completed a survey about donor and recipient site surgical results using a 5-point Likert scale.

RESULTS
The average satisfaction scores of patients and surgeon were 4.5 and 4.6, respectively.

CONCLUSION
Nonshaven follicular unit extraction is one of the most effective harvesting methods when performing restorative surgery for patients with pubic atrichosis or hypotrichosis.
Evaluation of Multiple Linear Regression–Based Limited Sampling Strategies for Enteric-Coated Mycophenolate Sodium in Adult Kidney Transplant Recipients
Authors: Brooks Emily K. , Tett Susan E. , Isbel Nicole M. , McWhinney Brett , Staatz Christine E. 
Published: February 2018

Background:
Although multiple linear regression–based limited sampling strategies (LSSs) have been published for enteric-coated mycophenolate sodium, none have been evaluated for the prediction of subsequent mycophenolic acid (MPA) exposure. This study aimed to examine the predictive performance of the published LSS for the estimation of future MPA area under the concentration–time curve from 0 to 12 hours (AUC0–12) in renal transplant recipients.

Methods:
Total MPA plasma concentrations were measured in 20 adult renal transplant patients on 2 occasions a week apart. All subjects received concomitant tacrolimus and were approximately 1 month after transplant. Samples were taken at 0, 0.33, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 6, and 8 hours and 0, 0.25, 0.5, 0.75, 1, 1.25, 1.5, 2, 3, 4, 6, 9, and 12 hours after dose on the first and second sampling occasion, respectively. Predicted MPA AUC0–12 was calculated using 19 published LSSs and data from the first or second sampling occasion for each patient and compared with the second occasion full MPA AUC0–12 calculated using the linear trapezoidal rule. Bias (median percentage prediction error) and imprecision (median absolute prediction error) were determined.

Results:
Median percentage prediction error and median absolute prediction error for the prediction of full MPA AUC0–12 were <15% for 4 LSSs, using the data from the same (second) occasion. One equation (1.583C1 + 0.765C2 + 0.369C2.5 + 0.748C3 + 1.518C4 + 2.158C6 + 3.292C8 + 3.6690) showed bias and imprecision <15% for the prediction of future MPA AUC0–12, where the predicted AUC0–12 from the first occasion was compared with the full AUC0–12 from the second. All LSSs with an acceptable predictive performance included concentrations taken at least 6 hours after the dose.

Conclusions:
Only one LSS had an acceptable bias and precision for future estimation. Accurate dosage prediction using a multiple linear regression–based LSS was not possible without concentrations up to at least 8 hours after the dose.
Effect of Extracorporeal Membrane Oxygenation on the New Vancomycin Dosing Regimen in Critically Ill Patients Receiving Continuous Venovenous Hemofiltration
Authors: Yang Chi-Ju , Wu Chia-Wei , Wu Chien-Chih 
Published: February 2018

Background:
The optimal dosing regimen of vancomycin for critically ill patients receiving continuous venovenous hemofiltration (CVVH) remains controversial, not to mention those with concurrent use of extracorporeal membrane oxygenation (ECMO). We aimed to determine if a new dosing regimen can achieve the target vancomycin trough concentration (Ctrough) of 10–20 mcg/mL in patients receiving CVVH with or without ECMO.

Methods:
We conducted a retrospective study by enrolling patients who received vancomycin while undergoing CVVH. The vancomycin dosing regimen was 15–20 mg/kg as the loading dose and 7.5 mg/kg every 12 hours as the maintenance doses. Serum concentration was determined after at least 4 doses of vancomycin were given.

Results:
A total of 38 patients were enrolled, of which 21 were also on ECMO. The ultrafiltration rate of CVVH was 30.6 ± 5.5 mL·kg−1·h−1 with the Ctrough of 14.7 ± 3.5 mcg/mL. Ctrough was within the target range in 82% of patients. All CVVH-only patients achieved the target concentration, whereas only 76.2% of those with concurrent ECMO did (P = 0.031).

Conclusions:
All patients receiving CVVH achieved the target Ctrough with this new dosing regimen, but those with concurrent ECMO did not. Ctrough must be more closely monitored in patients using ECMO simultaneously.
Contraception for midlife women: a review
Authors: Miller Taniqua A. , Allen Rebecca H. , Kaunitz Andrew M. , Cwiak Carrie A. 
Published: February 2018

Abstract
Family planning represents a key component of reproductive health care. Accordingly, the provision of contraception must span the reproductive age spectrum, including perimenopause. The risk of pregnancy is decreased, but not trivial, among women over 40 years of age. Evidence-based guidelines for contraceptive use can assist clinicians in counseling their patients in this population. Intrauterine contraception is one of the most effective methods and is safe to use in midlife women with few exceptions. Progestin-only contraception is another safe option for most midlife women because it is not associated with an increased risk of cardiovascular complications. Combined (estrogen-containing) contraception can be safely used by midlife women who do not have cardiovascular risk factors. Unique noncontraceptive benefits for this population include: improvement in abnormal uterine bleeding, decreased hot flashes, and decreased cancer risk. Finally, guidelines state that contraception can be used by midlife women without medical contraindications until the age of menopause, at which time they may consider transition to systemic hormone therapy.
Effects of abaloparatide on bone mineral density and risk of fracture in postmenopausal women aged 80 years or older with osteoporosis
Authors: McClung Michael R. , Harvey Nicholas C. , Fitzpatrick Lorraine A. , Miller Paul D. , Hattersley Gary , Wang Yamei , Cosman Felicia 
Published: February 2018

Abstract

Objective:
Advanced age is an important risk factor for fracture. The Abaloparatide Comparator Trial In Vertebral Endpoints (ACTIVE) trial showed that subcutaneous abaloparatide increased bone mineral density (BMD) and reduced the risk of vertebral and nonvertebral fractures in postmenopausal women with osteoporosis. This study describes the effects of abaloparatide in the subgroup of women aged 80 or more years in ACTIVE.

Methods:
Post hoc analyses of BMD and fracture incidence in this subgroup of women who received abaloparatide or placebo in the 18-month, phase 3, double-blind, randomized controlled ACTIVE trial.

Results:
The mean ages of the women ≥80 years were 81.9 and 81.7 years in the placebo (n = 43) and abaloparatide (n = 51) groups, respectively. The increases in BMD from baseline to 18 months with abaloparatide treatment were 3.9% at the total hip (P < 0.001), 3.6% at the femoral neck (P < 0.01), and 12.1% at the lumbar spine (P < 0.001), and were similar to those observed in the overall population. Abaloparatide therapy was associated with numerical, but not statistically significant, reductions in the risk of vertebral and nonvertebral fractures in this subpopulation, compared with placebo. The proportion of participants reporting adverse events was similar between treatment groups and between the older subgroup and the overall population.

Conclusion:
Abaloparatide was effective in increasing BMD in the very elderly subgroup of ACTIVE, with a safety profile similar to that of the overall study population.
Combining Breast Reduction Techniques to Treat Gigantomastia in Ghana
Authors: Scheefer Melody F. , Agbenorku Pius , Hoyte-Williams Paa Ekow , Farhat Boutros , Goodwin Isak A. , Rockwell W. Bradford 
Published: February 2018

Summary:
In this presentation of 2 consecutive cases of symptomatic juvenile breast hypertrophy in Ghana, we review the patient presentation, workup, and discuss outcomes following a combined technique of inferior pedicle stump with free nipple graft reduction mammoplasty. Surgical goals for treatment of gigantomastia were 2-fold: to resect adequate tissue to obtain symptomatic relief with improved quality of life, while avoiding a flat, boxy-appearing breast shape.
Patient Acceptance of Sustained Glaucoma Treatment Strategies
Authors: Varadaraj Varshini , Kahook Malik Y. , Ramulu Pradeep Y. , Pitha Ian F. 
Published: February 2018

Purpose:
To assess patient acceptance of different methods for delivering sustained-release, intraocular pressure (IOP)-lowering medications.

Methods:
Electronic surveys were administered to 150 patients at 2 glaucoma clinics. Participants were questioned on their willingness to accept: (1) drug-eluting contact lenses, (2) ring inserts (3) punctal plugs, and (4) subconjunctival injections as alternatives to IOP-lowering eye drops based on various success levels. Multivariable logistic regression models determined the association between device type and treatment acceptance adjusting for age, sex, study site, cost burden of drops, and previous contact lens use.

Results:
The majority (69%) of participants were 55 to 74 years of age, and white (65%), and half were female. The majority of participants would accept contacts (59%), rings (51%), plugs (57%), and subconjunctival injections (52%) if they obviated glaucoma surgery; fewer would accept these devices if they reduced (23% to 35%) or eliminated (27% to 42%) drops. Most participants would also accept contacts (56%), plugs (55%), and subconjunctival injections (53%) if they were more effective than eye drops, whereas only 47% would accept a ring; fewer would accept any device if it were equally or less effective than drops. Participants were also 36% (95% confidence interval=0.44-0.92; P=0.02) less likely to accept rings and 32% (95% confidence interval=0.47-0.98; P=0.04) less likely to accept subconjunctival injections as compared with contacts.

Conclusion:
Most glaucoma patients considered sustained drug-delivery modalities acceptable alternatives to IOP-lowering eye drops, but only when they were said to obviate surgery or demonstrate greater efficacy than eye drops.
Diurnal Variations of Peripapillary and Macular Vessel Density in Glaucomatous Eyes Using Optical Coherence Tomography Angiography
Authors: Mansouri Kaweh , Rao Harsha L. , Hoskens Kirsten , D’Alessandro Elisa , Flores-Reyes Elsa M. , Mermoud André , Weinreb Robert N. 
Published: February 2018

Purpose:
The purpose of this study was to investigate the diurnal variation in peripapillary and macular vessel density (VD) measurements using optical coherence tomographic angiography (OCT-A) and its correlation to intraocular pressure (IOP) changes in glaucoma patients.

Methods:
Prospective, observational cross-sectional study including 37 patients (74 eyes; age, 63.8±12.9 y) with open-angle glaucoma. OCT-A imaging and IOP measurements were performed at 08:00, 11:00, 14:00, and 16:00 timepoints on a single day. At each timepoint, 2 scan protocols were used to generate 3-dimensional en face OCT angiograms: 4.5×4.5-mm scan centered on the optic nerve head and 6×6-mm scan centered on the fovea. For each scan mode, the “radial peripapillary capillary” segment, composed of the vasculature of the retinal nerve fiber layer and ganglion cell layer, was calculated. Two trained readers reviewed OCT-A image quality. Only scans with signal strength intensity (SSI) higher than 46 and without image artifacts interfering with measurements were included. Variation in VD measurements assessed using analysis of variance (ANOVA) and the association between VD and IOP changes assessed using linear mixed modeling methods.

Results:
The optic nerve head and peripapillary VD measurements at 14:00 and 16:00 timepoints were greater than the measurements at 08:00 and 11:00 timepoints. The 14:00 and 16:00 VD measurements were statistically significantly greater (P<0.05) than the 08:00 measurements for the whole en face (50.1% and 50.1% vs. 49.4%), inside disc (50.6% and 50.5% vs. 49.6%), and average peripapillary (58.2% and 58.5% vs. 57.5%) VDs. The macular VD measurements at the 14:00 timepoint were greater than the measurements at 08:00 and 11:00 timepoints. Changes in VD were significantly associated with changes in SSI but not IOP.

Conclusions:
Diurnal changes in OCT-A-measured VD in glaucoma patients were small and clinically insignificant. These changes were not associated with IOP changes.
Macular Vessel Density in Glaucomatous Eyes With Focal Lamina Cribrosa Defects
Authors: Ghahari Elham , Bowd Christopher , Zangwill Linda M. , Suh Min Hee , Shoji Takuhei , Hasenstab Kyle A. , Saunders Luke J. , Moghimi Sasan , Hou Huiyuan , Manalastas Patricia I.C. , Penteado Rafaella C. , Weinreb Robert N. 
Published: February 2018

Purpose:
To compare optical coherence tomography angiography (OCTA) measured macular vessel density and spectral domain optical coherence tomography (SDOCT) measured macular ganglion cell complex (GCC) thickness in primary open-angle glaucoma eyes with and without focal lamina cribrosa (LC) defects.

Methods:
In this cross-sectional, case-control study of patients with primary open-angle glaucoma, 46 eyes of 46 patients with LC defects and 54 eyes of 54 patients without observable LC defects were included. OCTA and SDOCT imaging were performed on the same day by the same operator. Perimetry and swept-source OCT testing used to identify LC defects were conducted within 6 months of OCTA and SDOCT testing. Global and local parafoveal vessel density and macular GCC thickness were compared between study groups.

Results:
Glaucoma severity was similar between groups (SAP mean deviation=−5.63 and −4.64 dB for eyes with and without LC defects, respectively; P=0.40). Global and local measured parafoveal vessel density was similar between groups (all P≥0.11). GCC focal loss volume was higher in eyes with LC defects than eyes without LC defects (7.2% and 4.97%, respectively; P=0.03). In addition, GCC focal loss volume was topographically related to defect location in LC defect eyes.

Conclusions:
Although OCTA macular vessel density was not significantly different between eyes with and without LC defects, focal GCC loss in eyes with LC defects was different. This highlights the importance of not relying solely on vessel density measurements for determining macular changes for diagnosing and detecting glaucomatous progression.
Optimizing Vancomycin Monitoring in Pediatric Patients
Authors: Alsultan Abdullah , Abouelkheir Manal , Alqahtani Saeed , Aljabri Ahmad , Somily Ali M. , Alsubaie Sarah , Alrabiaah Abdulkarim , Bukhari Elham , Alzamil Fahad 
Published: February 2018

Background:
Several studies have reported that trough levels may not be optimal for monitoring vancomycin therapy, because of overexposure and nephrotoxicity risks. Therefore, we developed a population pharmacokinetic model to optimize vancomycin dosing and monitoring in pediatrics.

Methods:
Data were retrospectively collected on 76 pediatric patients 1–12 years of age, admitted to general pediatric wards or intensive care units at King Saud University Medical City, Riyadh, Saudi Arabia. The predictability of 3 methods for calculating the area under the curve (AUC) at steady state was assessed for optimum vancomycin therapy monitoring. The 3 methods were simple linear regression, Bayesian approach and the 2-sample pharmacokinetic equation method. We also used Monet Carlo simulations to evaluate the dosing of vancomycin.

Results:
A 1-compartment model adequately described the data. A strong correlation occurred between the observed and predicted AUC from 0 to 24 hours (AUC0–24h) calculated using the Bayesian approach with a trough sample only or pharmacokinetic equations based on 2 measured samples (R
2 = 0.93 and 0.92, respectively). For the simple linear regression method with a trough sample only, the predicted AUC0–24h at steady state with vancomycin trough levels of 10, 15 and 20 µg/mL were 413, 548 and 714 µg·hour/mL, respectively. The target AUC0–24h above 400 was achieved in 46% and 95% of individuals with trough values of 7–11 and 11–15 µg/mL, respectively. Monte Carlo simulations showed that 60–80 mg/kg/d doses are needed to optimize vancomycin therapy.

Conclusions:
In conclusion, targeting vancomycin trough levels above 15 µg/mL in pediatrics would overshoot the target AUC0–24h above 400 and expose them to unnecessary adverse events.
Utility of the Performance of Lumbar Puncture for Febrile Children With Status Epilepticus in the Bacterial Conjugate Vaccine Era
Authors: Haro Kaoru , Igarashi Ryota , Hoshina Takayuki , Kojiro Masumi , Kusuhara Koichi 
Published: February 2018

Background:
The necessity of lumbar puncture for the differentiation of central nervous system infection in children with febrile status epilepticus (FSE) remains controversial. The aim of the present study is to investigate the diagnostic necessity of lumbar puncture for children with FSE after the introduction of bacterial conjugate vaccines into the infant immunization program.

Methods:
Our retrospective cohort study was performed in children 6 to 60 months of age who were admitted to the pediatric ward at Kitakyushu General Hospital from January 1, 2011, to December 31, 2015, for seizures with fever. Of these patients, we compared the clinical characteristics between the patients initially diagnosed as having FSE and complex febrile seizures excluding FSE (non-FSE).

Results:
Of the eligible 333 children, 98 and 235 children were classified into FSE and non-FSE groups, respectively. The proportion of the children who underwent lumbar puncture in FSE group was significantly higher than that in non-FSE group (P < 0.0001). On the other hand, no significant difference in the proportion of the patients with abnormal cerebrospinal fluid findings was seen between the 2 groups. There was no patient with bacterial meningitis. The proportion of patients with encephalitis/encephalopathy in FSE group (n = 7, 7.1%) was significantly higher than that in non-FSE group (n = 0, P = 0.0003). However, only 1 of 6 patients with encephalitis/encephalopathy who underwent lumber puncture showed pleocytosis in cerebrospinal fluid.

Conclusions:
Routine lumbar puncture for the differentiation of severe central nervous system infection cannot be recommended in children with FSE.
A Fatal Case of Hemophagocytic Lymphohistiocytosis in a Patient With Ehrlichiosis
Authors: Khoury Jad A. , Mickey Walter , Marrocco Michael , Katyal Anup 
Published: February 2018

Abstract
We present a case of Ehrlichia-induced hemophagocytic lymphohistiocytosis (HLH), which resulted in a fatal outcome. Hemophagocytic lymphohistiocytosis is a rare syndrome of abnormal activation of the cellular immune system, which can be potentially fatal. Infections are a common trigger of the secondary form of the syndrome. We review the literature for published reports of Ehrlichia-induced HLH, all of which have resulted in a favorable outcome. We try to analyze the reasons for the poor outcome in our case including the possibility of central nervous system involvement with HLH. Early recognition and treatment of HLH and its associated central nervous system involvement may improve outcome.
A Case of Pyelonephritis With Bacteremia Caused by Gardnerella Vaginalis in a Man
Authors: Pritchard Haley 
Published: February 2018

Abstract

Gardnerella vaginalis is known to be associated with bacterial vaginosis and has less frequently been reported to contribute to polymicrobial gynecologic and postsurgical infections in women. It is not considered to be a common cause of disease in men. We now report a case of pyelonephritis with G. vaginalis bacteremia in a male patient with nephrolithiasis. We found 10 other cases of Gardnerella infection in men and reviewed the predisposing factors, case descriptions, treatments, and outcomes. Infection due to G. vaginalis in men is rare, but it should be considered to be a potential pathogen men, especially in those with urogenital tract abnormalities.