bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fibromyxoid Sarcoma of the Kidney. A Case Report
Authors: Arancio Matteo , Ranzoni Stefania , Delsignore Alessandro , Maffei Nicola , Landi Giuseppe , Mina Alessandro , Marcato Maurizio , Martinengo Carlo 
Published: June 2018

Low grade fibromyxoid sarcoma is an uncommon soft tissue tumor. We present the case of a 83–year-old female who developed large mass in the right kidney. A nephrectomy was performed. The tumor measured 18,5×17,5×11,5 cm and on pathology evaluation was diagnosed as low grade fibromyxoid sarcoma. Currently, the patient is doing well without evidence of local recurrence and distant metastasis. Low grade fibromyxoid sarcoma of the Kidney is a very rare tumor. The metastasizing potential is high. Sometimes long interval between tumor presentation and metastasis is observed. The treatment of choice is surgery. The role of radiotherapy and chemotherapy is uncertain.
Rirs through Semi-Rigid Ureteroscope and Holmium Laser in the Treatment of Ureteral Stones Retropulsion
Authors: Ruoppolo M. , Milesi R. , Gozo M. , Fragapane G. 
Published: June 2018

Retrograde displacement of ureteral stones into the renal cavities during ureteroscopic lithotripsy represents a frequent and adverse event that leads to additional procedures (ESWL, PCNL, Retrograde Intra-renal lithotripsy with flexible instruments, DJ stent placement and subsequent EWSL) to obtain full clearence of calculi. All these procedures require a further time of treatment. Between 1/2008 and 3/2009, a total of 48 patients harbouring proximal (21 cases) and distal (27 cases) ureteral stones underwent Holmium Laser lithotripsy. In 3 patients previous percutaneous nephrostomy was performed to drain the excretory way. In 12 cases (25%) stone retropulsion occurred; in 3 patients in the upper calix and in 5 in the renal pelvis. Only in 4 cases the stone migrated in the lower or medium calix. In 8 cases we attempted the immediate treatment of intrarenal displaced stones by advancing the semi-rigid instrument into the renal cavities. In 2 cases the treatment aborted because of the shortness of ureteroscope. The instillation of lubricating lidocaine jelly prevented in 3 cases furher displacement of stone. Washing with saline solution through nephrostomic catheter allowed an effective mobilization of stone and an easy lasertripsy RIRS was successful in 4 cases. When flexible devices or immediate ESWL are not available, rigid or semi-rigid retrograde lithotripsy with holmium laser immediately performed after ureteral stone displacement represents a safe and effective method to treat displaced stones. Several tricks are required to obtain a good stone-free rate.
Emphysematous pyelonephritis: Case report and literature overview
Authors: Ziegelmüller Brigitte Katharina , Szabados Bernadett , Spek Annabel , Casuscelli Jozefina , Stief Christian , Staehler Michael 
Published: June 2018

Introduction: Emphysematous pyelonephritis is a rare necrotizing infection of the kidney with a poor prognosis. If it occurs in patients with a reduced general condition, this infection is life threatening. Early diagnosis is made by computed tomography. Treatment options are drainage and intensive care or immediate nephrectomy in severe cases. Case description: A 73-year-old woman in a poor general condition presented with a fulminant urosepsis. Computed tomography revealed an impressive abscess formation of the right kidney with free air retro and intraperitoneal. The diagnosis of emphysematous pyelonephritis was made. Besides septicemia, she had a multiorgan failure including kidney and liver function deterioration. Nephrectomy was performed immediately. The postoperative course was successful with a complete stabilization of the kidney and liver function and reconvalescence of the patient. Discussion: The widespread availability of imaging techniques leads to early diagnosis and a reduction of mortality of renal and periphrenic abscesses and even of emphysematous pyelonephritis. However, severe cases have a poor outcome and require aggressive and immediate therapy. Besides systemic antibiotic therapy and percutaneous and surgical drainage, radical nephrectomy is a viable therapy option and should be performed immediately in patients with several risk factors, poor prognosis, and extensive findings. Conclusion: Radical nephrectomy being performed immediately seems to be the optimal management in patients with acute emphysematous nephritis and urosepsis.
Rapid Progression of Knee Pain and Osteoarthritis Biomarkers Greatest for Patients with Combined Obesity and Depression: Data from the Osteoarthritis Initiative
Authors: Jacobs Cale A. , Vranceanu Ana-Maria , Thompson Katherine L. , Lattermann Christian 
Published: June 2018

Objective To compare the progression of biochemical biomarkers of osteoarthritis (OA), knee pain, and function between nonobese patients (NON), obese patients without depression (OBESE), and obese patients with comorbid depression (O + D). Design Utilizing the FNIH OA Biomarkers Consortium dataset, we categorized knee OA patients into NON, OBESE, and O + D groups based on body mass index and Center for Epidemiological Studies–Depression (CES-D) scores. Subjective symptoms (Knee injury and Osteoarthritis Outcome Score Quality of Life subscale (KOOS QOL), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Pain and Physical Function scores, and the Short Form–12 (SF-12) Physical Component Score [PCS]) and objective measures of cartilage degradation and bone remodeling (urinary CTXII and CTXIα) were compared among groups at baseline and 2-year follow-up. Results Of the 600 patients, 282 (47%) were NON, 285 (47.5%) OBESE, and 33 (5.5%) O + D. The O + D group had significantly worse pain and function both at baseline and 2-year follow-up ( P < 0.001 for all comparisons) as evidenced by self-reported measures on KOOS QOL, WOMAC Pain, WOMAC Physical Function, and SF-12 PCS. The O + D group also demonstrated significant increases in CTXII ( P = 0.01) and CTXIα ( P = 0.005), whereas the NON and OBESE groups did not. Conclusions The combination of inferior knee pain, physical function, and significantly greater increases in biomarkers of cartilage degradation and bony remodelling suggest a more rapid progression for obese OA patients with comorbid depression. The link between systemic disease, inflammatory burden, and progressive cartilage degradation is in line with increasing concerns about a degenerative synovial environment in early osteoarthritic knees that progress to treatment failure with biologic restoration procedures.
Direct and indirect effects of central and general adiposity on cardiovascular diseases: The Tehran Lipid and Glucose Study
Authors: Bakhtiyari Mahmood , Schmidt Nicole , Hadaegh Farzad , Khalili Davood , Mansournia Nasrin , Asgari Samaneh , Mansournia Mohammad A 
Published: June 2018

Aim The mechanisms linking body mass index to cardiovascular disease are still not clearly defined. The purpose of this study was to find out how much of the effect of central and general adiposity on cardiovascular disease is mediated through blood pressure, cholesterol, and glucose, and how much is independent of these factors. Methods and results The study population included participants, aged ≥30 years, free of cardiovascular disease at baseline with median follow-up of 13.9 years. The total effects were broken down into natural direct and indirect effects using the inverse odds weighting method in the context of survival models. Systolic blood pressure, total serum cholesterol, and fasting plasma glucose as the primary measure of blood glucose were used as mediators. Blood pressure and cholesterol with indirect hazard ratios of 1.09 (95% confidence interval: 1.006–1.18) and 1.35 (95% confidence interval: 1.12–1.62) were the most important mediators for overweight-cardiovascular disease and obesity-cardiovascular disease relationships, respectively. The proportion mediated of overweight was 22% (6–47%) for blood pressure, 18% (5–37%) for blood glucose, and 20% (7–43%) for cholesterol. The same measure for obesity was 65% (35–91%) for cholesterol. For central adiposity, blood pressure, glucose, and cholesterol were the most important mediators with proportion mediated of 36% (17–72%), 23% (9–48%), and 21% (8–45%), respectively. Conclusions The findings of this study show that proper control of cardiometabolic risk factors of blood pressure, blood glucose, and dyslipidemia in an adult population can be effective to significantly reduce the effects of general and abdominal adiposity on cardiovascular diseases.
Psychosis
Authors: Schrimpf Lindsey A. , Aggarwal Arpit , Lauriello John 
Published: June 2018

ABSTRACT

PURPOSE OF REVIEW
Psychosis is a psychiatric condition that has significant overlap with neurologic disease. This article is intended to educate the neurologist on the psychiatric manifestations of psychosis and its evaluation, diagnosis, and treatment. How to differentiate a primary psychiatric cause of psychosis from psychosis secondary to a medical or neurologic condition is also reviewed.

RECENT FINDINGS
Current research in psychotic disorders has focused increasingly on negative symptoms and cognitive impairment in psychotic illness, as it is now recognized that these cause the greatest impact on functional deficits for patients. A number of new medications have also been introduced to target negative symptoms and cognitive deficits in psychotic illness. These have new implications in terms of treatment overlap with medications being prescribed by providers in psychiatry, neurology, and general practice.

SUMMARY
This article discusses the current methods for evaluating, diagnosing, and treating psychosis. Psychosis as a primary mental health disorder is a diagnosis of exclusion, as psychosis can be a direct symptom of underlying medical or neurologic disease. Delirium and dementia are the two most important disorders to rule out. This article will help readers be more prepared to assess and treat the patient with psychosis.
Obsessive-Compulsive Disorder
Authors: Richter Peggy M. A. , Ramos Renato T. 
Published: June 2018

ABSTRACTPURPOSE OF REVIEWThis article reviews current knowledge regarding diagnosis, pathophysiology, and treatment trends in obsessive-compulsive disorder (OCD), a severe, underrecognized, and chronic condition frequently encountered in neurologic practice.RECENT FINDINGSWith a lifetime prevalence estimated at 2.5%, OCD is a common condition that can also present comorbidly with neurologic disease. The core symptoms of OCD are obsessions and compulsions. Obsessions are intrusive repetitive thoughts, urges, images, or impulses that trigger anxiety and that the individual is not able to suppress. Compulsions are repetitive behaviors or mental acts occurring in response to an obsession with the intention of reducing the distress caused by obsessions. Neuroimaging, neuropsychological, and pharmacologic studies suggest that the expression of OCD symptoms is associated with dysfunction in a cortico-striato-thalamo-cortical circuit. Evidence-based treatments for OCD comprise pharmacotherapy and cognitive-behavioral therapy. Selective serotonin reuptake inhibitors (SSRIs) are the first-line drugs recommended for OCD, but significant differences exist in their use for OCD compared to their use for other mood and anxiety conditions, including the need for higher dosage, longer trials necessitated by a longer lag for therapeutic response, and typically lower response rates. Cognitive-behavioral therapy, based on the principles of exposure and response prevention, shows results superior to pharmacologic treatments with lower relapse rates on long-term follow-up and thus should be considered in the treatment plan of every patient with OCD.SUMMARYOCD and obsessive-compulsive symptoms are frequently encountered in the neurologic clinic setting and require a high index of suspicion to effectively screen for them and an illness-specific therapeutic approach.
Coding for Behavioral Neurology and Psychiatry
Authors: Villanueva Raissa , Cohen Bruce H. 
Published: June 2018

ABSTRACT
Medical coding is highly technical, and proper use of both Current Procedural Terminology (CPT) and the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) is difficult because of the considerable detail of the code definitions, the changes implemented yearly, and the vast change a few years ago with the transition to ICD-10-CM. Although basic office visit and hospital visit Evaluation and Management (E/M) codes have not changed in decades, new cognitive care codes have been added to the cognitive codes that fall under E/M. Accuracy in documentation is essential as the basis for precision in coding, which will result in both best practice and proper payment from payers.
Clinical Assessment of Prefrontal Lobe Functions
Authors: Henri-Bhargava Alexandre , Stuss Donald T. , Freedman Morris 
Published: June 2018

ABSTRACTPURPOSE OF REVIEWWhereas it was previously thought that there was a single overarching frontal lobe syndrome, it is now clear that several distinct cognitive and behavioral processes are mediated by the frontal lobes. This article reviews these processes and the underlying neuroanatomy and provides an approach to the assessment of prefrontal lobe functions at the bedside.RECENT FINDINGSCognitive and behavioral frontal lobe functions are mediated by the prefrontal regions rather than the frontal lobes as a whole. At least five separate prefrontal functions have been defined: energization, task setting, monitoring, behavioral/emotional regulation, and metacognition. Energization is mediated by the superior medial prefrontal cortices bilaterally, task setting by the left lateral frontal cortex, monitoring by the right lateral prefrontal cortex, behavioral/emotional regulation by the orbitofrontal cortex, and metacognition by the frontal poles. Only task setting and monitoring are considered executive functions.SUMMARYDistinct cognitive and behavioral processes are mediated by different parts of the frontal lobe. Lesions in these areas result in characteristic clinical deficits that are discussed in this article. Key messages are that prefrontal regions mediate the higher cortical functions (as opposed to the frontal lobes in general) and that prefrontal functions are not equivalent to executive functions.
Bedside Approach to the Mental Status Assessment
Authors: Tang-Wai David F. , Freedman Morris 
Published: June 2018

ABSTRACT

PURPOSE OF REVIEW
This article presents a clinically useful approach to obtaining the history and performing the mental status examination of patients with cognitive, language, or behavioral problems.

RECENT FINDINGS
Laboratory and imaging biomarkers are being developed for accurate diagnosis of neurobehavioral disorders, yet few are currently available for clinical use. Moreover, not all centers have access to these potential tools. Practicing clinicians are therefore left primarily with their skills of history taking and examination. Although geared for research, diagnostic criteria have been refined over the past several years and can nevertheless aid the clinician with the diagnosis of disorders such as mild cognitive impairment, Alzheimer disease, frontotemporal dementia, dementia with Lewy bodies, the primary progressive aphasias, corticobasal syndrome, vascular cognitive impairment, and posterior cortical atrophy. Regularly revised criteria reflect ongoing knowledge gained from in-depth studies of these disorders.

SUMMARY
The focused history and mental status examination remain essential tools for the evaluation and diagnosis of neurologic disorders affecting cognition, language, and behavior.
Resuscitation of Endotheliopathy and Bleeding in Thoracic Aortic Dissections: The VIPER-OCTA Randomized Clinical Pilot Trial
Authors: Stensballe Jakob , Ulrich Annette G. , Nilsson Jens C. , Henriksen Hanne H. , Olsen Peter S. , Ostrowski Sisse R. , Johansson Pär I. 
Published: June 2018

BACKGROUND:
Thoracic aorta dissection is an acute critical condition associated with shock-induced endotheliopathy, coagulopathy, massive bleeding, and significant morbidity and mortality. Our aim was to compare the effect of coagulation support with solvent/detergent-treated pooled plasma (OctaplasLG) versus standard fresh frozen plasma (FFP) on glycocalyx and endothelial injury, bleeding, and transfusion requirements.

METHODS:
Investigator-initiated, single-center, blinded, randomized clinical pilot trial of adult patients undergoing emergency surgery for thoracic aorta dissection. Patients were randomized to receive OctaplasLG or standard FFP as coagulation factor replacement related to bleeding. The primary outcome was glycocalyx and endothelial injury. Other outcomes included bleeding, transfusions and prohemostatics at 24 hours, organ failure, length of stay in the intensive care unit and in the hospital, safety, and mortality at 30 and 90 days.

RESULTS:
Fifty-seven patients were included to obtain 44 evaluable on the primary outcome. The OctaplasLG group displayed significantly reduced damage to the endothelial glycocalyx (syndecan-1) and reduced endothelial tight junction injury (sVE-cadherin) compared to standard FFP. In the OctaplasLG group compared to the standard FFP, days on ventilator (1 day [interquartile range, 0–1] vs 2 days [1–3]; P = .013), bleeding during surgery (2150 [1600–3087] vs 2750 [2130–6875]; P = .046), 24-hour total transfusion and platelet transfusion volume (3975 mL [2640–6828 mL] vs 6220 mL [4210–10,245 mL]; P = .040, and 1400 mL [1050–2625 mL] vs 2450 mL [1400–3500 mL]; P = .027), and goal-directed use of prohemostatics (7/23 [30.4%] vs 13/21 [61.9%]; P = .036) were all significantly lower. Among the 57 patients randomized, 30-day mortality was 20.7% (6/29) in the OctaplasLG group and 25% (7/28) in the standard FFP group (P = .760). No safety concern was raised.

CONCLUSIONS:
In this randomized, clinical pilot trial of patients undergoing emergency surgery for thoracic aorta dissections, we found that OctaplasLG reduced glycocalyx and endothelial injury, reduced bleeding, transfusions, use of prohemostatics, and time on ventilator after surgery compared to standard FFP. An adequately powered multicenter trial is warranted to confirm the clinical importance of the findings.
Study of Solvent Effect in 2, 5-DPAPMC Dye Using Different Solvent Polarity Parameters and Estimation of Dipole Moments
Authors: J Thipperudrappa 
Published: June 2018

The solvent effect on absorption and fluorescence spectra of a ketocyanine dye 2,5-di[(E)-1-(4- dipropylaminophenyl) methylidine]-1-cyclopentanone (2,5-DPAPMC) is analysed using Lippert-Mataga bulk polarity function, Reichardt’s microscopic solvent polarity parameter and Kamlet’s multipl e linear regression approach. The spectral properties better follows Reichardt’s microscopic solvent polarity parameter than Lippert-Mataga bulk polarity parameter. This indicates the presence of both general solute – solvent interactions and specific interactions. Kamlet’s multiple linear regression approach indicates the major role of polarizability/dipolarity solvent influence than HBD and HBA. The spectral data in different solvents is used to estimate excited state dipole moment using theoretically determined ground state dipole moment. The excited state dipole moment of dye is found to be larger than its corresponding ground state dipole moment and, ground and excited state dipole moments are not parallel, but subtends an angle of 29 o .
Public Attitude towards Mental Illness in Bangalore: An Exploratory Study
Authors: Menon Geetha P , T Murali , Rao Kiran 
Published: June 2018

The aim of the present study was to examine the attitudes towards people with mental illness in the city of Bangalore. The sample consisted of 400 people living in different parts of the city. They were assessed on socio-demographic data sheet, Orientation to Mental Illness Scale, Exposure, Knowledge and Social Distance Scale and Attitudes towards Mental Illness Scale. The Data collected were analyzed using descriptive statistics, Chi-square test, Student t-test, ANOVA, ANCOVA, Pearson’s correlation and Step-wise Multiple Regression Analysis. The study reveals that the common man had neutral orientation to mental illness and is moderate in their attitudes to mental illness. However, many were not informed regarding legal provisions available for the mentally ill and rehabilitation services existing in the community. Although the public was fairly low on social distance, this did not apply to intimate relationships such as sharing a room or marriage. Socio-demographic factors, especially like that of education, had an impact on the attitudes of many to mental illness, with the higher educated being better aware and more positive towards the mentally ill. The study brings out the need for programmes to raise the awareness among the ordinary citizen on various aspects of mental illness including existing legal provisions for the mentally ill in the community and rehabilitation services.
Keywords: Public attitude, rehabilitation, mental illness
Handling the Psychological Distress of Parents of Children with Autism Spectrum Disorders:
Authors: V Indiramma , Uthaman Seema P , Srinath Shoba 
Published: June 2018

Autism Spectrum Disorders are pervasive developmental disorders affecting many children today. Parenting a child with special needs, such as children with autism, is very taxing, as they need intensive and life-long intervention in diverse areas. This paper is an attempt to assess the need of those parents of children with autism and to develop an intervention programme to take care of the psychosocial issues. The study had two phases. In the first phase 120 parents of children with autism spectrum disorders were interviewed using a semi structured interview schedule and GHQ 28. In the second phase, an intervention module was prepared and implemented with 20 parents. The results show that the mean psychological distress was significantly higher for mothers compared to fathers. The scores on subscales show that mothers have higher level of somatic symptoms, anxiety and insomnia, social dysfunction and depression compared to fathers. The pre and post analysis of the group intervention shows that there is a drop in the level of distress and increase in the awareness on child’s illness in parents after the group intervention. The findings show that addressing parental needs in a group setting can be very effective and beneficial in helping parents reduce their distress levels and hence making them better equipped to look after their child with a disability like autism.
Keywords: Autism, parent intervention module, psychological distress, group work
Mapping Dowry Exchanges: Snapshots of Nineteenth Century Palm Leaves
Authors: Payyappilly Ignatius 
Published: June 2018

The Palm leave records of the Syrian Christian communities in Kerala, belonging to eighteenth and nineteenth century, remain as evidences of the practice of dowry (Stridhanam) among the Syrian Christians and donations such as passaram, nadavazhakkam, kurippanam, kudappanam etc made to the churches and priests in relation to the marriage. Records say that this social custom, also known as Stridhanam was a crucial point of marriage and it was very often a matter of dispute and family problems. In spite of all disputes and difficulties existed in the Syrian Christian families and in the society at large because of this custom, no church record could be traced against this system. This paper is an attempt to explore and analyse the nature and practice of this social custom among Syrian Christians in the nineteenth century, who are Christian in faith and religion but are not different from the Hindus in their social customs and practices. Likewise, this paper is an attempt to analyse the social and cultural impacts of dowry (stridhanam) and the attitude of the society as well as that of Church authorities towards this custom and how did they tax the people in connection with the marriage.
Keywords: Dowry; stridhanam; syrian christians; passaram; nadavazhakkam; palm leave records; christian marriage