bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Interesting Presentation of Lyme Pseudothrombophlebitis
Authors: Sandelich Stephen , DePiero Andrew 
Published: March 2019

Abstract
An 8-year-old boy presented to the emergency department with swelling and pain of his left knee and calf for approximately 1 week. His examination was significant for moderate knee effusion and swelling of the posterior calf with erythema and warmth of the affected areas. An ultrasound obtained at an outside hospital showed a large heterogeneous mass in the gastrocnemius, and a magnetic resonance imaging revealed a large, heterogeneous, rim-enhancing collection in the medial head of the left gastrocnemius muscle with surrounding myositis involving the gastrocnemius muscle. The child was taken to the operating room by the orthopedic team for drainage and irrigation of the knee effusion and of the collection in the gastrocnemius. The diagnosis of Lyme pseudothrombophlebitis was made through Lyme serology testing of aspirated fluid. He improved after this drainage but required a prolonged antibiotic course.
Elevated Depressive Symptoms Are a Stronger Predictor of Executive Dysfunction in HIV-Infected Women Than in Men
Authors: Rubin Leah H. , Springer Gayle , Martin Eileen M. , Seaberg Eric C. , Sacktor Ned C. , Levine Andrew , Valcour Victor G. , Young Mary A. , Becker James T. , Maki Pauline M. ,   for the Neuropsychology Working Groups of the Women's InterAgency HIV Study and the Multicenter AIDS Cohort Study
Published: March 2019

Background:HIV-infected (HIV+) women seem to be more vulnerable to neurocognitive impairment (NCI) than HIV+ men, perhaps in part due to mental health factors. We assessed the association between elevated depressive symptoms and NCI among HIV+ and HIV-uninfected (HIV−) women and men.Setting:Women's Interagency HIV Study and Multicenter AIDS Cohort Study.Methods:Eight hundred fifty-eight HIV+ (429 women; 429 men) and 562 HIV− (281 women; 281 men) completed the Center for Epidemiologic Studies Depression (16 cutoff) Scale and measures of psychomotor speed/attention, executive, and motor function over multiple visits (or time points). Women's Interagency HIV Study and Multicenter AIDS Cohort Study participants were matched according to HIV status, age, race/ethnicity, and education. Generalized linear mixed models were used to examine interactions between biological sex, HIV serostatus, and depression on impairment (T-scores <40) after covariate adjustment.Results:Despite a higher frequency of depression among men, the association between depression and executive function differed by sex and HIV serostatus. HIV+ women with depression had 5 times the odds of impairment on a measure of executive control and inhibition versus HIV− depressed women and 3 times the odds of impairment on that measure versus HIV+ depressed men. Regardless of group status, depression was associated with greater impairment on processing speed, executive (mental flexibility), and motor function (P's < 0.05).Conclusions:Depression contributes to NCI across a broad range of cognitive domains in HIV+ and HIV− individuals, but HIV+ depressed women show greater vulnerabilities in executive function. Treating depression may help to improve cognition in patients with HIV infection.
Kinetic [18F]-Fluoride of the Knee in Normal Volunteers
Authors: Haddock Bryan , Fan Audrey P. , Jørgensen Niklas R. , Suetta Charlotte , Gold Garry Evan , Kogan Feliks 
Published: March 2019

Purpose[18F]-sodium fluoride ([18F]NaF) is a well-established bone-seeking agent that has shown promise to assess bone turnover in a variety of disorders, but its distribution in healthy knee joints has not been explored. This study aimed to investigate parametric values for [18F]NaF uptake in various bone tissues types of the knee and their spatial distributions.MethodsTwelve healthy subjects were hand-injected with 92.5 MBq of [18F]NaF and scanned on a 3-T PET/MRI system. Listmode PET data for both knees were acquired for 50 minutes from injection simultaneously with MRI Dixon and angiography data. The image-derived input function was determined from the popliteal artery. Using the Hawkins model, Patlak analysis was performed to obtainKi(Kipat) values and nonlinear regression analysis to obtainKiNLR,K1,k3/(k2+k3), and blood volume. Comparisons for the measured kinetic parameters, SUV, and SUVmax were made between tissue types (subchondral, cortical, and trabecular bone) and between regional subsections of subchondral bone.ResultsCortical bone had the highest [18F]NaF uptake differing significantly in all measured parameters when compared with trabecular bone and significantly higher SUVmax andK1than subchondral bone. Subchondral bone also had significantly higher SUV, SUVmax, andKithan trabecular bone tissue. Regional differences were observed inK1andk3/(k2+k3) values.ConclusionsQuantitative [18F]NaF PET is sensitive to variations in bone vascularization and metabolism in the knee joint.
68Ga-DOTA-TATE in Neuroblastoma With Marrow Involvement
Authors: Torun Nese 
Published: March 2019

Abstract
A 22-month-old boy diagnosed with neuroblastoma was evaluated by bone scintigraphy and 123I-metaiodobenzylguanidine scintigraphy, and no metastases to skeletal system was detected. However, plain radiograph and MRI revealed suspected metastatic lesions. The patient was therefore evaluated by 68Ga-DOTA-TATE PET/CT, and 68Ga-DOTA-TATE uptake was observed in multiple bone and bone marrow areas, which were consistent with metastases. Biopsy was taken from the right iliac bone, and the pathological examination of the biopsy specimen was coherent with neuroblastoma invasion.
Retroperitoneal Pelvic Solitary Fibrous Tumor With High Tracer Uptake in 68Ga-DOTATOC PET/CT
Authors: Thuillier Philippe , Risson Jean-Romain , Eusen Yves , Uguen Arnaud , Abgral Ronan 
Published: March 2019

Abstract
We report the case of a 27-year-old woman referred to our department for the characterization of a 7 × 6-cm left ischio-anal fossa mass by Ga-DOTATOC PET/CT. Several diagnoses were previously mentioned, in particular, myxoid sarcoma but also pelvic paraganglioma. Urinary methoxylated derivates and blood chromogranin A tests were negative. PET/CT showed a high Ga-DOTATOC uptake of the mass that was strongly consistent with paraganglioma diagnosis. Histopathological analysis surprisingly revealed a solitary fibrous tumor without aggressive criteria.
Beware of False-Positive FDG PET/CT Interpretations for Presacral Recurrent Rectal Cancer
Authors: Pennings Jan P. , de Haas Robbert J. , de Jong Koert P. , Dierckx Rudi A.J.O. , Kwee Thomas C. 
Published: March 2019

Abstract
FDG PET/CT is considered an accurate method for the detection of recurrent rectal cancer in the pelvis. Excess presacral soft tissue is found in up to half of patients after (chemo)radiation and surgery for rectal cancer, and usually represents fibrosis that is metabolically inactive. However, presacral soft tissue that is FDG avid is generally considered suspicious for recurrent cancer. Nevertheless, FDG avidity in the presacral space not uncommonly proves to be due to benign inflammatory changes, and additional MRI may be diagnostically useful, as demonstrated in the presented 2 cases.
Does the Length of Dental Implants Inserted in Areas of Inferior Alveolar Nerve Lateralization Interfere on Mandibular Resistance to Fracture?
Authors: Brackmann Mariana Schaffer , Padovan Luis Eduardo Marques , Marcantonio Junior Elcio , Klüppel Leandro Eduardo 
Published: March 2019

Abstract
The aim of this study was to compare, in vitro, the mechanical resistance to vertical displacement of the mandible after osteotomy for lateralization of the inferior alveolar nerve and installation of dental implants. One hundred eighty polyurethane mandibles were equally divided into 6 groups: G1—intact hemi-mandibles (control group), G2—hemi-mandibles after osteotomy for lateralization of the inferior alveolar nerve, G3—hemi-mandibles with installation of 3 bicortical dental implants (3.75 × 13 mm), G4—hemi-mandibles with installation of 3 dental implants that did not reach the basal cortical bone (3.75 × 11 mm), G5—hemi-mandibles after osteotomy for lateralization of the inferior alveolar nerve and installation of 3 bicortical dental implants (3.75 × 13 mm) and G6—hemi-mandibles after osteotomy for lateralization of the inferior alveolar nerve and installation of 3 dental implants that did not reach the basal cortical bone (3.75 × 11 mm). The specimens were subjected to linear loading tests. The highest mean value of maximum load was found in G1 (412.36N ± 11.99), followed by G2 (396.87N ± 23.94), G3 (319.63N ± 57.28), G4 (303.34N ± 18.25), G5 (231.75N ± 63.64) and G6 (228.13N ± 20.75). Based on this data, it can be concluded that the bicorticalization (or not) of the implants was not a statistically significant risk factor for the vertical displacement of polyurethane hemi-mandibles.
Cerebral Revascularization Accelerates the Angiographic Staging Progression of the Operated Hemisphere in a Pediatric Patient With Moyamoya Disease
Authors: Yu Le-Bao , Ma Yong-Gang , Zhang Dong 
Published: March 2019

Background and Objective:
Angiographic staging progression in the operated hemisphere of patient with moyamoya disease (MMD) is a common phenomenon that neurosurgeons may encounter. However, few studies have been carried out to demonstrate the correlation between the operation and angiographic staging progression. This study aimed to reveal whether cerebral revascularization would affect the stage progression in patient with MMD.

Methods:
A total of 20 pediatric patients with bilateral MMD were included in this study. All enrolled patients were at the similar Suzuki angiographic staging on bilateral hemispheres and cerebral revascularization was performed in unilateral hemisphere. Angiographic examination was performed in the first year after the operation to evaluate the progression of the lesions.

Results:
Cerebral revascularizations including direct bypass or encephaloduroarteriosynangiosis were performed in 20 hemispheres. During the follow-up, the incidence of stage progression in the operated hemisphere was significantly higher than in the contralateral side (80.0% versus 20.0%, respectively; P = 0.036) and the interval of disease progression was significantly shorter in the operated side than in the contralateral side (mean interval time, 7.3 versus 10 months). Earlier Suzuki stage on hemisphere represented faster pace of stage progression compared with server Suzuki stage (OR = −0.612, P = 0.004), while neoformative collaterals had not significant correlation with the progression pace. The leptomeningeal collaterals from the posterior circulation decreased in almost all operated hemisphere, while gradually increasing in the contralateral hemisphere. Symptoms were improved in all patients after operation.

Conclusion:
Cerebral revascularization would significantly accelerate the angiographic staging progression on the treated hemisphere, while it would not cause the deterioration of the patient's condition. The progression pace was associated with Suzuki stage.
Craniofacial Skills: A 2-Site Validation of Assessments to Aid Plastic Surgery Resident Milestone Achievement in Technical Skills and Instrument Knowledge
Authors: Grunzweig Katherine A. , Son Ji , Kumar Anand R. 
Published: March 2019

Background:
Plastic surgery evaluates residents on milestones. This study defines a model of education including pre and post-test assessments paired with didactics intended for evaluating residents in the unique technical skills of craniofacial surgery.

Methods:
At the first institution, instrument identification, and time/accuracy of burr hole placement, craniotomy, and plating on Saw Bones Craniofacial Models were tested before and after a 7.5-hour craniofacial orthognathic surgery workshop. At the second institution, this was refined, removing plating, eliminating assessment of timing, and shortening didactics to standard osteotomies, instrument names, and common surgical approaches. The study population consisted of junior, mid-level, and senior residents on 2 different University craniofacial services.

Results:
Participant performance was analyzed by level of training: junior, midlevel and senior resident. In the first iteration, resident times improved significantly for all 4 tasks (P = 0.008, 0.035, 0.035, 0.016). Resident accuracy improved significantly for instrument naming (P = 0.003). Except for instrument naming, resident year did not impact improvement (timing: P = 0.062, 0.310, 0.125, 0.334; accuracy: P = 0.029, 0.664, 0.717, 0.306). In the second iteration, resident accuracy improved for all tasks (instrument naming P = 0.00002, burr holes P = 0.0031, craniotomy P = 0.08). There was no difference in rate of improvement between resident cohorts.

Conclusion:
The task-based assessment with resident education on basic craniofacial surgery skills, standard osteotomies, and instrument names directed resident learning and assessed resident knowledge. With the removal of time as a metric, all tasks improved in accuracy. The craniofacial skills task-assessment successfully evaluated milestone attainment in a reproducible model.
Craniofacial Anthropometric Profile of East Asians
Authors: Raveendran Maria 
Published: March 2019

Abstract
Facial anthropometric data has significant ethnic variation. East Asia, comprised of fourteen countries, represents a significant proportion of the global population. This systematic review presents the facial anthropometric data collected from these countries. The systematic review was conducted in accordance with PRISMA guidelines. An electronic search of the MEDLINE database returned 3054 articles. Twenty articles were considered eligible for inclusion. Nine studies were conducted in China, 1 in Indonesia, 2 in Japan,3 in Korea, 4 in Malaysia, and 1 was a multicentre study conducted in China, Japan, Thailand, and Vietnam. Qualitative and quantitative parameters were extracted from the20 studies. No data was found for the other East Asian countries. There is a paucity of facial anthropometric data for East Asian countries despite their high burden of craniofacial anomalies and a strong demand for cosmetic facial surgery, both of which would benefit from the collection of robust craniofacial norms. It is in the interest of both the craniofacial surgeon and the East Asian patient to collect baseline facial anthropometric data for this population.
Gender Confirmation Surgery: Moving Forward
Authors: Schechter Loren S. , Cohen Mimis 
Published: March 2019

Abstract
Facial surgery can help facilitate an individual's social transition and alleviate gender dysphoria. As such, surgical requests for feminizing and masculinizing procedures continue to increase. Surgical management requires knowledge of anatomy and anatomic differences as well as an understanding of social challenges faced by transgender and gender diverse individuals. Here, the authors provide a brief overview of gender confirmation surgery specific to the head and neck and craniofacial skeleton. In addition, the authors explore barriers to accessing healthcare for transgender and gender diverse individuals throughout the world.
Pros and Cons of the Transconjunctival Retroseptal Approach to the Isolated Orbital Floor Fracture
Authors: Riyadh Safaa , Abdulrazaq Saif Saadedeen , Mohammad Yuksel Yashar 
Published: March 2019

Abstract
To get access into the orbital floor 3 paths are commonly used which are transconjunctival, subciliary and subtarsal approaches. Each one of these approaches has its advantages and disadvantages. The study assessed the outcomes of the transconjunctival retroseptal approach, which reflects our experience in this type of surgery. Along 8 years, 26 patients received in the emergency room diagnosed with pure isolated orbital floor fractures, all of them admitted to the maxillofacial surgery department and approached by transconjunctival incision without lateral canthotomy. Three types of complications occurred: laceration of the lower eyelid, injury to the lacrimal system and entropion. All of these complications were managed accordingly with no long-term deficit. Although the transconjunctival approach without lateral canthotomy is limited to a certain degree, it has the advantages of hidden scar, easy, and short time to achieve.
Histologic and Radiographic Characteristics of Bone Filler Under Bisphosphonates
Authors: Yifat Manor , Hila Elias , Avraham Hirshberg , Inchingolo Francesco , Mortellaro Carmen , Peleg Oren , Mijiritsky Eithan 
Published: March 2019

Background:
Dental implants and bone augmentation are well-established procedures used for oral rehabilitation. There is an increasing interest in biological mediators used topically for prevention of bone resorption maybe enhancement of osseointegration of dental implants. The purpose of the manuscript is to describe preliminarily the effect of bisphosphonates on the ossification pattern of bone grafts in a rat model.

Material and Methods:
Twenty Wistar-derived male rats were divided into 2 groups study and control. Bone substitute was added to mandibular defects and was covered by a resorbable collagen membrane. In the study group, the membrane was soaked with bisphosphonates suspension. In the control group, the membrane was soaked with saline solution. Radiographic and histomorphometric evaluation were performed.

Results:
Radiographically, it was found that bone density was significantly higher in the study group. Histomorphometric analysis revealed a trend of higher bone volume fraction along with reduced bone substitute volume fraction in the study group, and increased number of osteoclasts and blood vessels in the control group.

Conclusions:
Within the limitations of our study it was found that there is a trend of increasing bone quantity and radiographic bone density by application of bisphosphonates.
Proposal of Standardization of Closure Techniques After Endoscopic Pituitary and Skull Base Surgery Based on Postoperative Cerebrospinal Fluid Leak Risk Classification
Authors: Ruggeri Andrea G. , Cappelletti Martina , Giovannetti Filippo , Priore Paolo , Pichierri Angelo , Delfini Roberto 
Published: March 2019

Abstract
Postoperative cerebrospinal fluid (CSF) leak still represents the main limitation of endonasal endoscopic surgery. The aim of the study is to classify the risk of postoperative leak and to propose a decision-making protocol to be applied in the preoperative phase based on radiological data and on intraoperative findings to obtain the best closure.
One hundred fifty-two patients were treated in our institution; these patients were divided into 2 groups because from January 2013 the closure technique was standardized adopting a preoperative decision-making protocol. The Postoperative CSF leak Risk Classification (PCRC) was estimated taking into account the size of the lesion, the extent of the osteodural defect, and the presence of intraoperative CSF leak (iCSF-L). The closure techniques were classified into 3 types according to PCRC estimation (A, B, and C).
The incidence of the use of a nasoseptal flap is significantly increased in the second group 80.3% versus 19.8% of the first group and the difference was statistically significant P < 0.0001. The incidence of postoperative CSF leak (pCSF-L) in the first group was 9.3%. The incidence of postoperative pCSF-L in the second group was 1.5%. An analysis of the pCSF-L rate in the 2 groups showed a statistically significant difference P = 0.04.
The type of closure programmed was effective in almost all patients, allowing to avoid the possibility of a CSF leak. Our protocol showed a significant total reduction in the incidence of CSF leak, but especially in that subgroup of patients where a leak is usually unexpected.
Four-factor prothrombin complex concentrate is associated with improved survival in trauma-related hemorrhage: A nationwide propensity-matched analysis
Authors: Zeeshan Muhammad , Hamidi Mohammad , Feinstein Ara J. , Gries Lynn , Jehan Faisal , Sakran Joseph , Northcutt Ashley , O'Keeffe Terence , Kulvatunyou Narong , Joseph Bellal 
Published: March 2019

INTRODUCTION
Post-traumatic hemorrhage is the most common preventable cause of death in trauma. Numerous small single-center studies have shown the superiority of four-factor prothrombin complex concentrate (4-PCC) along with fresh frozen plasma (FFP) over FFP alone in resuscitation of trauma patients. The aim of our study was to evaluate outcomes of severely injured trauma patients who received 4-PCC + FFP compared to FPP alone.

METHODS
Two-year (2015–2016) analysis of the American College of Surgeons-Trauma Quality Improvement Program database. All adult (age ≥18 years) trauma patients who received 4-PCC + FFP or FFP alone were included. We excluded patients who were on preinjury anticoagulants. Patients were stratified into two groups: 4-PCC + FFP versus FFP alone and were matched in a 1:1 ratio using propensity score matching for demographics, vitals, injury parameters, comorbidities, and level of trauma centers. Outcome measures were packed red blood cells, plasma and platelets transfused, complications, and mortality.

RESULTS
A total of 468 patients (4-PCC + FFP, 234; FFP alone, 234) were matched. Mean age was 50 ± 21 years; 70% were males; median injury severity score was 27 [20–36], and 86% had blunt injuries. Four-PCC + FFP was associated with a decreased requirement for packed red blood cells (6 units vs. 10 units; p = 0.02) and FFP (3 units vs. 6 units; p = 0.01) transfusion compared to FFP alone. Patients who received 4-PCC + FFP had a lower mortality (17.5% vs. 27.7%, p = 0.01) and lower rates of acute respiratory distress syndrome (1.3% vs. 4.7%, p = 0.04) and acute kidney injury (2.1% vs. 7.3%, p = 0.01). There was no difference in the rates of deep venous thrombosis (p = 0.11) and pulmonary embolism (p = 0.33), adverse discharge disposition (p = 0.21), and platelets transfusion (p = 0.72) between the two groups.

CONCLUSIONS
Our study demonstrates that the use of 4-PCC as an adjunct to FFP is associated with improved survival and reduction in transfusion requirements compared to FFP alone in resuscitation of severely injured trauma patients. Further studies are required to evaluate the role of addition of PCC to the massive transfusion protocol.

LEVEL OF EVIDENCE
Therapeutic studies, level III.
Exposure of von Willebrand Factor on Isolated Hepatocytes Promotes Tethering of Platelets to the Cell Surface
Authors: Gustafson Elisabet , Hamad Osama A. , Deckmyn Hans , Barbu Andreea , Ekdahl Kristina N. , Nilsson Bo 
Published: March 2019

Background.
Hepatocyte transplantation (Hctx) is a potentially attractive method for the treatment of acute liver failure and liver-based metabolic disorders. Unfortunately, the procedure is hampered by the instant blood-mediated inflammatory reaction (IBMIR), a thromboinflammatory response elicited by the vascular innate immune system, causing activation of the coagulation and complement systems and clearance of transplanted cells. Observations have also revealed platelets adhered to the surface of the hepatocytes (Hc). To establish Hctx as a clinical treatment, all factors that trigger IBMIR need to be identified and controlled. This work explores the expression of von Willebrand factor (VWF) on isolated Hc resulting in tethering of platelets.

Methods.
VWF on Hc was studied by flow cytometry, confocal microscopy, immunoblot, and real-time polymerase chain reaction. Interaction between Hc and platelets was studied in a Chandler loop model. Adhesion of platelets to the hepatocyte surface was demonstrated by flow cytometry and confocal microscopy.

Results.
Isolated Hc constitutively express VWF on their cell surface and mRNA for VWF was found in the cells. Hc and platelets, independently of coagulation formed complexes, were shown by antibody blocking studies to be dependent on hepatocyte-associated VWF and platelet-bound glycoprotein Ibα.

Conclusions.
VWF on isolated Hc causes, in contact with blood, adhesion of platelets, which thereby forms an ideal surface for coagulation. This phenomenon needs to be considered in hepatocyte-based reconstitution therapy and possibly even in other settings of cell transplantation.