bluuebunny/crossref_metadata_2025_split huggingface dataset:
MRI findings of AIDS-related giant facial Kaposi's sarcoma
Authors: Guan Chun-Shuang , Wang Xue-Mei , Lv Zhi-Bin , Yan Shuo , Sun Lei , Xie Ru-Ming 
Published: October 2018

Abstract

Rationale:
Kaposi's sarcoma (KS) is the most common malignant tumor in HIV-infected people and occurs mainly in the skin, mucous membranes, and lymph nodes. Approximately 33% of the initial skin manifestations of AIDS and approximately 35% to 79% of KS occur during disease progression. Otherwise, AIDS-related facial KS that was simultaneously examined by magnetic resonance imaging (MRI) is rare.

Patient concerns:
This case was a 30-year-old male homosexual, with left facial nodule for 14 months, and HIV infection was diagnosed 1 month previously. The patient was admitted to hospital because the nodule gradually expanded from 0.2 to 10.0 cm in diameter. Ultrasound examination showed edema of the subcutaneous tissue of the left facial mass, and the boundary was not clear between lesion and normal tissues. Magnetic resonance imaging (MRI) indicated that the left facial mass showed low signal intensity on T1-weighted imaging (T1WI) and T2-weighted imaging (T2WI), and a small amount of high signal intensity was seen in it. Diffusion-weighted imaging (DWI) and susceptibility-weighted imaging (SWI) showed low signal intensity. After enhanced scan, the tumor showed uneven enhancement.

Diagnoses:
The pathological biopsy indicated KS.

Interventions:
The patient began chemotherapy with the intravenous drip infusion of Doxorubicin Hydrochloride Liposome.

Outcomes:
The facial KS decreased and the facial swelling was relieved.

Lessons:
MRI could not only provide the diagnostic basis of KS for the therapy, but also could accurately determine the scope of the disease.
Infliximab versus cyclosporine for severe ulcerative colitis refractory to steroids
Authors: Wu Dongjie , Yang Zhen , Zhao Chen , Yao Liang 
Published: October 2018

Abstract

Background:
Infliximab and cyclosporine are two main therapies in treating acute severe ulcerative colitis (ASUC), our objective is to assess the effectiveness and safety of cyclosporine (CSA) versus infliximab (IFX) as rescue agents in patients with steroid-refractory ulcerative colitis (UC).

Methods:
We will search three databases from inception to May 2018, and 19 studies are identified that infliximab and cyclosporine as a treatment in steroid-refractory UC patients. The primary outcome was short-term response to treatment. Secondary outcomes included the rates of colectomy at 3 months, 12 months, 36 months, adverse drug reactions and mortality in those who received rescue therapy.

Results:
This update review will provide a high quality synthesis of current evidence of two treatment for steroid-refractory ulcerative colitis. The definition of severe colitis is according to Truelove and Witts’ criteria.

Conclusions:
In the treatment of steroid-resistant ulcerative colitis with infliximab and cyclosporine, there is no difference between the two treatments on short-term and long-term results.
Relationship between ultrasonographic and pathologic calcification patterns in papillary thyroid cancer
Authors: Kim Bu Kyung , Lee Eun Mi , Kim Jeong Hoon , Oak So Young , Kwon Su Kyoung , Choi Young Sik , Kim Young Ok 
Published: October 2018

Abstract
Ultrasonographic microcalcification is highly related to papillary thyroid cancer (PTC) and pathologic psammoma body is a poor prognostic factor. However, it is little known about whether the microcalcifications seen on ultrasonography are consistent with the pathologic psammoma bodies. We evaluated the relationship between ultrasonographic (US) calcification types and pathologic calcification features, and the consistency between observed pathologic and US calcifications.
US calcifications were classified into microcalcification (MC) and nonmicrocalcification (non-MC) types, and pathologic calcifications were classified into 3 types: psammoma bodies, stromal calcifications, and ossifications.
Among the 411 nodules that were reviewed by a pathologist, 38.9% (n = 160) had any type of US calcification. The larger the size of pathologic calcification, the more calcification was present in US (psammoma 46.1% < stromal 53.7% < ossification 73.3%). Psammoma bodies occurred in all US MC type. Ossification nodules occurred in nearly all (92.3%) non-MC type. The stromal-only nodules were 36.8% MC-type and 63.2% non-MC type. MC-type had a significantly higher odds ratio than non-MC type for predicting psammoma bodies according to the logistic regression.
The presence of MC in ultrasonography was consistent with the presence of psammoma bodies. This study suggests that US identification of MC may be a useful prognostic indicator of PTC aggressiveness.
Long-term effects and quality of life following definitive bile duct reconstruction
Authors: Otto Włodzimierz , Sierdziński Janusz , Smaga Justyna , Dudek Krzysztof , Zieniewicz Krzysztof 
Published: October 2018

Abstract
The study covered a cohort of 236 patients with transection of hepatic duct. It aimed to assess the long-term outcome of the reconstruction and a patient's quality of life.
The literature contains many controversies over timing of biliary reconstruction and who ought to repair the injury but just few reports on the long-term outcomes and patient's quality of life.
The bile duct system was reconstructed by hepaticojejunostomy in 236 patients. Of these, 139 patients were initially repaired at a public hospital and referred because of stricture (Group A, N = 59) or of an anastomosis dehiscence (Group B, N = 80); 97 were unrepaired and referred because of a surgical clip occluding the duct (Group C, N = 39) or bile leakage from an open duct (Group D, N = 58). All patients were surveyed in 2015 for quality of life using WHOQOL-BREF.
The mean time of follow-up was 150 months. The time without symptoms amounted to >5 years in 78.6% of patients. The mean time before anastomosis renewal ranged from 8.9 to 4.7 years (P < .04). Multivariate analysis showed infection, failure of reconstruction in public hospital, and female sex as factors responsible for poor long-term outcome.
Patients in Group C had better quality of life than the others (P < .001) with respect to physical health (median 67.85) and psychological condition (median 79.16). The overall mortality was 15.2%.
The long-term result of reconstruction depends on the cause of referral which, in turn, arises from subsequent intervention taken in local hospitals.
Association of MMP-8 rs2012390 and rs11225394 polymorphisms with osteonecrosis of the femoral head risks
Authors: Jiang Liangbin , Zhang Chungang , Wei Biaofang 
Published: October 2018

Abstract

Background:
The association of MMP-8 rs2012390 and rs11225394 polymorphisms with osteonecrosis of the femoral head (ONFH) risks was investigated in several studies with conflicting results. We performed the meta-analysis to evaluate the association between them.

Methods:
Potentially relevant literatures were searched from the electronic databases of PubMed, Web of Science, and Cochrane Library. All databases were searched up to May 6, 2018. The strength of associations of the MMP-8 rs2012390 and rs11225394 polymorphisms with ONFH risk was assessed by crude odds ratios (ORs) with their 95% confidence intervals (CIs) under different genetic models.

Results:
A total of 1469 cases diagnosed with ONFH and 1211 healthy controls were included in the current meta-analysis. A remarkable association between rs11225394 in the MMP-8 gene and an increased risk of ONFH was found (allele model: OR = 1.33, 95% CI = 1.09–1.61, P = .005; heterozygote model: OR = 1.39, 95% CI = 1.13–1.71, P = .002; dominant model: OR = 1.40, 95% CI = 1.14–1.73, P = .002, respectively). Meanwhile, a significant association between MMP-8 rs2012390 and the decreased risk of ONFH was found in heterozygote model (OR = 0.63, 95% CI = 0.51–0.77, P < .00001).

Conclusion:
The meta-analysis results showed a remarkable association between rs11225394 in MMP-8 gene and an increased risk of ONFH and a significant association between MMP-8 rs2012390 and the decreased risk of ONFH.
Impact of surgical ventricular restoration on early and long-term outcomes of patients with left ventricular aneurysm
Authors: Yan Jun , Jiang Shu-Lin 
Published: October 2018

Abstract
Left ventricular aneurysm (LVA) is a common complication of myocardial infarction. However, the optimal treatment for LVA remains controversial.
In this retrospective study, we analyzed the early and long-term clinical consequences of surgical ventricular restoration on 102 patients who had undergone repair between January, 2005 and January, 2015. The LVA repair approaches comprised of patch plasty (n = 28), linear repair (n = 40), and plication repair (n = 34).
Patient demographics were 60.8% male, and the mean age was 60.5 ± 7.2 years. The in-hospital mortality rate was 7.8% (8/102), including 6 patients who died from low cardiac output and 2 from multiorgan failure. During the early postoperative period, left ventricular sizes significantly decreased in the patch plasty and linear repair groups compared with the plication group. In addition, all 3 repair techniques greatly ameliorated left ventricular ejection fraction (P < .05), and there was no significant difference in survival rate between groups (P = .25).
Surgical ventricular restoration (linear repair, plication repair, and patch plasty) obtained equivalently appreciable outcomes for cardiac function improvement, perioperative mortality, and survival. Selection of a surgical technique for LVA patients should be optimized to individual patient conditions including the morphological characteristics of the aneurysm and ischemic scar.
Acute vertigo and sensorineural hearing loss from infarction of the vestibulocochlear nerve
Authors: Byun Seonghwan , Lee Ji Ye , Kim Bo Gyung , Hong Hyun Sook 
Published: October 2018

Abstract

Rationale:
Acute unilateral audiovestibulopathy is a common neurotological syndrome. Differential diagnoses of acute unilateral audiovestibulopathy include viral infection, vascular insults, and tumors. Regarding vascular causes, ischemic stroke in the anterior inferior cerebellar artery (AICA) territory is known to be the leading cause of acute audiovestibular loss. Previous reports of AICA infarction with audiovestibulopathy failed to demonstrate magnetic resonance imaging (MRI)-positive vestibulocochlear infarctions. Only 1 report demonstrated acute infarction involving the vestibulocochlear nerve on diffusion weighted imaging (DWI)-MRI.

Patient concerns:
A 67 year old man complained of sudden left hearing loss and vertigo. The patient showed left horizontal gaze-evoked nystagmus (GEN) and the head impulse test (HIT) was positive on the left side. Videonystagmography revealed spontaneous rebound nystagmus toward the right side; head-shaking nystagmus toward the right side. The patient presented with left caloric paresis (20.1%). Pure tone audiometry (PTA) revealed severe sensorineural hearing loss on the left side.

Diagnosis:
MRI of temporal bone showed multifocal acute infarctions in the left inferior cerebellum. Moreover, images revealed tiny infarctions along the left vestibulocochlear nerve and the cochlea, implying acute vestibulocochlear nerve and labyrinthine infarction. There was no evidence of steno-occlusion of major cerebral vessels on MR angiography.

Interventions:
Immediate stroke management was done.

Outcomes:
Neurological symptoms gradually improved after 3 to 5 days.

Lessons:
We present a case illustrating a rare but significant finding of vestibulocochlear nerve infarction revealed by DWI-MRI. Prompt imaging protocol enabled the detection of significant findings in this patient with acute unilateral audiovestibulopathy. Clinicians should be aware of the vestibulocochlear nerve and labyrinth on MRI in patients with cerebellar stroke.
A pilot study to standardize and peer-review shift handoffs in an academic internal medicine residency program
Authors: Krowl Lauren , Gudlavalleti Aashrai , Patel Arpan , Panebianco Lauren , Kosters Michael , Dhamoon Amit S. 
Published: October 2018

Abstract
With increased oversight of residency work hours, there has been an increase in shift handoffs, which are prone to medical errors. To date, there are no evidence-based recommendations on essential elements of shift handoffs. We implemented a standardized shift-handoff rubric at an academic medicine residency program. Compliance, resident/faculty perceptions, and surrogate markers of patient safety were measured.
Shift-handoff documents were collected January-February 2016 (control) April-June 2016 (intervention). Signouts were scored based on inclusion of seven elements: Daily events, Overnight events, Code status, Follow up tasks, If/then statements, ‘sick or stable’ and History present illness. The mnemonic ‘DOCFISH’ was taught in a grand-rounds forum then embedded into a shift-handoff tool within our electronic health record (EHR). Senior residents were assigned to supervise/provide feedback on shift handoffs from April-June 2016. Faculty and resident perceptions regarding quality of shift handoffs was measured by the annual ACGME (Accreditation Council Graduate Medical Education) program survey.
Patient safety was measured by number of rapid-response teams (RRT) initiated for unstable vital signs. Handoffs were 74% complete in intervention group and 60% in control group (p < .0001). Median DOCFISH features present in patients that required RRT was 3 of 7 whereas, total post-intervention group had 5 of 7 (p < .001). ‘Daily events’ and ‘follow -up tasks’ were less frequent in patients that required RRT (20%, 67% respectively, p < .001).
Academic medical centers can implement standardized shift handoffs by embedding high-yield information in an EHR with peer-review. Information during shift changes that may have significant improvement on patient safety includes: ‘daily events’ and ‘follow -up tasks.’
Osteosarcoma in a Child Below 2 Years of Age: Case Report and Review of the Literature
Authors: Pascoe Edward M. , Free Matthew , Mackie Peter S. , Donnan Leo , O’Sullivan Mark , Sullivan Michael J. , Heath John A. 
Published: October 2018

Background:
Osteosarcoma in children below the age of 5 is extremely rare.

Observation:
We report on a previously well 14-month-old male infant, who presented with a reluctance to weight-bear on his right leg and had an associated limp. Plain imaging and a magnetic resonance imaging scan demonstrated a lytic lesion in the right distal femur. An open surgical biopsy confirmed the diagnosis of osteosarcoma. There was no significant family history of cancer and genetic screening for Li-Fraumeni syndrome was negative.

Conclusions:
This case highlights the importance of timely consideration of osteosarcoma in an infant, when the clinical presentation and medical imaging are consistent with that diagnosis.
Pregnancy, Penile-anal Sex, and Other Sexual Behaviors in the United States, 2011–2015
Authors: Leichliter Jami S. , Aral Sevgi O. 
Published: October 2018

Abstract
We used the US national survey data to examine sexual behavior by pregnancy status and found that, overall, pregnant women did not differ from nonpregnant women in penile-anal sex and associated condom use. Compared with nonpregnant women, pregnant women had lower or similar reports of other sexual behaviors.
Tissue Expander Complications Do Not Preclude a Second Successful Implant-Based Breast Reconstruction
Authors: Poppler Louis H. , Mundschenk Minh-Bao , Linkugel Andrew , Zubovic Ema , Dolen Utku C. , Myckatyn Terence M. 
Published: October 2018

Background:
Implant-based breast reconstruction is the most common method of breast reconstruction in the United States, but the outcomes of subsequent implant-based reconstruction after a tissue expander complication are rarely studied. The purpose of this study was to determine the long-term incidence of implant loss in patents with a previous tissue expander complication.

Methods:
This is a retrospective review of the long-term outcomes of all patients with tissue expander complications at a large academic medical center from 2003 to 2013. Patients with subsequent tissue expander or implant complications were compared to those with no further complications to assess risk factors for additional complications or reconstructive failure.

Results:
One hundred sixty-two women were included in this study. The mean follow-up period was 8.3 ± 3.1 years. Forty-eight women (30 percent) went on to undergo a second tissue expander or implant placement. They did not differ from women who went on to autologous reconstruction or no further reconstruction. Of these, 34 women (71 percent) had no further complications and 38 women (79 percent) had a successful implant-based reconstruction at final follow-up. There were no patient or surgical factors significantly associated with a second complication or implant loss.

Conclusions:
Following tissue expander complications, it is reasonable to offer women a second attempt at tissue expansion and implant placement. This study demonstrates that long-term success rates are high, and there are no definitive patient or surgical factors that preclude a second attempt at implant-based breast reconstruction.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Risk, III.
Effect of Endogenous Vascular Endothelial Growth Factor on Flap Surgical Delay in a Rat Flap Model
Authors: Jiang Zhenmin , Li Xiucun , Chen Miao , Lu Laijin , Gong Xu 
Published: October 2018

Background:
Experimental evidence suggests that endogenous vascular endothelial growth factor (VEGF) may play a major role in the surgical delay phenomenon. The purpose of this study was to investigate the effect of endogenous VEGF on flap surgical delay.

Methods:
A total of 82 adult male Sprague-Dawley rats with an average weight of 330 g were used for these experiments. These experiments were then conducted in two parts. In part 1, 32 rats were used to assess the effectiveness of VEGF inhibitor through Western blot assay and enzyme-linked immunosorbent assay. In part 2, 50 rats were used to investigate the effect of VEGF on flap surgical delay by means of arteriography, histologic analysis, and flap viability.

Results:
The VEGF protein inhibition ratio reached the maximum (approximately 91.6 percent) in 5 to 7 days. The number of transverse arteries and the number of vessels greater than 0.1 mm in diameter on the 3-day delay duration and the 6-day delay duration were significantly greater than those of the normal group. The number of transverse arteries and the number of vessels greater than 0.1 mm in diameter on the 6-day inhibition duration were not significantly changed compared with the normal group. Microvascular density on the 6-day delay duration obviously increased, whereas the 6-day inhibition duration was not significantly changed in comparison to the normal group.

Conclusion:
Endogenous VEGF is an initiating factor of the surgical delay effect by controlling choke vessel dilation and neovascularization within the choke zones.
Tacrolimus and Single Intraoperative High-dose of Anti-T-lymphocyte Globulins Versus Tacrolimus Monotherapy in Adult Liver Transplantation
Authors: Iesari Samuele , Ackenine Kevin , Foguenne Maxime , De Reyck Chantal , Komuta Mina , Bonaccorsi Riani Eliano , Ciccarelli Olga , Coubeau Laurent , Lai Quirino , Gianello Pierre , Lerut Jan 
Published: October 2018

Objective:
The aim of the study is to evaluate whether intra-operative induction with anti-lymphocytic serum (ALS) is superior to no induction in adult liver transplantation (LT).

Background:
The efficacy of ALS induction remains inconclusive in LT, because of poorly designed trials.

Methods:
A randomized controlled trial was conducted, including 206 adults (>15 years) and comparing tacrolimus monotherapy (TAC, n = 109) and tacrolimus plus a single, intraoperative, high-dose (9 mg/kg), rabbit anti-T-lymphocyte globulins (ATLG; n = 97). All patients had similar follow-up, including Banff-scored biopsies. Rejection was considered clinically relevant and treated if pathologic and biochemical changes were concordant. The primary endpoint was immunosuppression minimization to monotherapy; secondary endpoints were biopsy-proven rejection, clinical rejection, patient (PS) and graft (GS) survival.

Results:
At 1 year, 79/81 (96.3%) ATLG and 101/102 (99.0%) TAC patients were steroid-free (P = 0.585); 28 (34.6%) ATLG, and 31 (30.4%) TAC patients were on double-drug immunosuppression (P = 0.633). One-year PS and GS of ATLG and TAC patients were 84% and 92% (P = 0.260) and 76% and 90% (P = 0.054).
Despite significantly a fewer day-7 moderate-to-severe acute cellular rejections (ACR) in ATLG group (10.0% vs 24.0% in TAC group, P = 0.019), cumulative proportion of patients experiencing steroid-sensitive (11.3% ATLG vs 14.7% TAC, P = 0.539), steroid-resistant (2.1% ATLG vs 3.7% TAC, P = 0.686) and chronic rejection (1.0% ATLG vs 0.9% TAC, P = 1.000) were similar. ATLG administration brought about greater hemodynamic instability and blood products use (P = 0.001).

Conclusions:
At 1 year from LT, ATLG induction did not significantly affect immunosuppressive load, treated rejection, patient, and graft survival. The observed adverse events justify a modification of dosing and timing of ATLG infusion. Long-term results are required to judge the ATLG possible benefits on immunosuppressive load and tolerance induction.
A family of transcription factors that limit lifespan: ETS factors have conserved roles in longevity
Authors: Dobson Adam J. , Boulton-McDonald Richard , Houchou Lara , Ren Ziyu , Hoti Mimoza , Rodriguez-Lopez Maria , Gkantiragas Alexis , Gregoriou Afroditi , Bähler Jürg , Ezcurra Marina , Alic Nazif 
Published: October 2018

ABSTRACTIncreasing average population age, and the accompanying burden of ill health, is one of the public health crises of our time. Understanding the basic biology of the ageing process may help ameliorate the pathologies that characterise old age. Ageing can be modulated, often through changes in gene expression where regulation of transcription plays a pivotal role. Activities of Forkhead transcription factors (TFs) are known to extend lifespan, but detailed knowledge of the broader transcriptional networks that promote longevity is lacking. This study focuses on the E twenty-six (ETS) family of TFs. This family of TFs is large, conserved across metazoa, and known to play roles in development and cancer, but the role of its members in ageing has not been studied extensively. InDrosophila, an ETS transcriptional repressor,Aop, and an ETS transcriptional activator,Pnt, are known to genetically interact withFoxoand activatingAopis sufficient to extend lifespan. Here, it is shown thatAopandFoxoeffect a related gene-expression programme. Additionally,Aopcan modulateFoxo’s transcriptional output to moderate or synergise withFoxoactivity depending on promoter context, bothin vitroandin vivo.In vivogenome-wide mRNA expression analysis in response toAop,PntorFoxoindicated, and further experiments confirmed, that combinatorial activities of the three TFs dictate metabolic status, and that direct reduction ofPntactivity is sufficient to promote longevity. The role of ETS factors in longevity was not limited toPntandAop. Knockdown ofEts21corEip74EFin distinct cell types also extended lifespan, revealing that lifespan is limited by transcription from the ETS binding site in multiple cellular contexts. Reducing the activity of theC. elegansETS TFLin-1also extended lifespan, a finding that corroborates established evidence of roles of this TF family in ageing. Altogether, these results reveal the ETS family of TFs as pervasive and evolutionarily conserved brokers of longevity.