bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcomes of Second Intention Healing of the Lower Eyelid Margin After Mohs Micrographic Surgery
Authors: Trieu Diane N. , Drosou Anna , White Lucille E. , Goldberg Leonard H. 
Published: April 2019

BACKGROUND
Lower eyelid margin defects can be a reconstructive challenge. A possible alternative is second intention healing of the lower eyelid margin.

OBJECTIVE
To determine the cosmetic outcomes and patient satisfaction of second intention healing of the lower eyelid margin after Mohs micrographic surgery (MMS).

MATERIALS AND METHODS
A retrospective chart review was performed on patients who underwent MMS of the lower eyelid margin. Patient information was gathered on age, sex, diagnosis, postoperative size, number of Mohs stages, thickness of defect, and clinical photographs. The preoperative and postoperative photographs were evaluated with a physician assessment scale and patients completed a satisfaction survey.

RESULTS
In all 17 patients (100%), the cosmetic results obtained were considered good to excellent. The objective outcomes were graded as excellent, very good, good, satisfactory, unsatisfactory, and poor. The patient satisfaction survey was divided into excellent, good, satisfied, and unsatisfied. Patient satisfaction ranged from satisfied to excellent. The incidence of complications was low with one report of trichiasis.

CONCLUSION
Second intention healing of the lower eyelid margin can produce good cosmetic results and patients are generally satisfied with their outcomes.
Anthropometric and Genetic Factors Associated With the Exposure of Rifampicin and Isoniazid in Mexican Patients With Tuberculosis
Authors: Huerta-García Ana P. , Medellín-Garibay Susanna E. , Salazar-González Raúl A. , Ortiz-Álvarez Arturo , Magaña-Aquino Martín , Rodríguez-Pinal Cristian J. , Portales-Pérez Diana P. , Romano-Moreno Silvia , Milán-Segovia Rosa del Carmen 
Published: April 2019

Background:
Tuberculosis (TB) remains a critical infectious, contagious disease worldwide with high prevalence and mortality rate. The directly observed treatment short-course therapy includes rifampicin (RMP) and isoniazid (INH) for at least 6 months. The purposes of this scheme are to interrupt the transmissibility of the Mycobacterium tuberculosis complex and to avoid secondary complications. Low plasma concentrations of these anti-TB drugs have been associated with extended treatment duration, therapeutic failure, and relapse. The determination of anthropometric, genetic, and clinical variables that may affect plasma concentrations of RMP and INH might facilitate the detection of patients at increased risk of therapeutic failure.

Methods:
A prospective observational study was performed in patients with TB diagnosis. A fixed-dose combined formulation was administered following clinical guidelines, and 12 venous blood samples were collected within 24 hours after dose for the quantification of plasma levels of RMP and INH by high-performance liquid chromatography-ultraviolet. The plasma concentrations versus time for each drug in each patient were assessed by a noncompartmental approach to obtain Cmax, and the area under the concentration–time curve to the last observation point (AUC0–24 h) was calculated by the linear trapezoidal rule. Genetic polymorphisms of the enzyme involved in INH metabolism (NAT2) and proteins involved in RMP transport (glycoprotein‐P and OATP1B1) were determined.

Results:
A total of 34 patients aged between 18 and 72 years with the diagnosis of TB were included in the current study. A multivariate analysis was performed to determine the anthropometric and genetic characteristics that modified the Cmax and AUC0–24 h of RMP and INH. Results indicated that RMP Cmax and AUC0–24 h were affected by sex, dose/weight, and single nucleotide polymorphism of MDR1. In addition, age, body mass index, and NAT2 acetylator genotype were shown to determine the Cmax and AUC0–24 h for INH.

Conclusions:
Anthropometric, genetic, and dosage characteristics of Mexican patients with TB are an important source of risk for subtherapeutic plasma concentrations of anti-TB drugs. Factors such as lower-than-recommended RMP dose, male patients with TB, and MDR1 3435 genotype, in addition to age group, body mass index, and INH acetylator phenotype based on NAT2 genotype, should be considered during treatment.
Topical estrogen prescribing patterns for urogenital atrophy among women with breast cancer: results of a national provider survey
Authors: Richter Lee A. , Han Jim , Bradley Sarah , Lynce Filipa C. , Willey Shawna C. , Tefera Eshetu , Pollack Craig E. 
Published: April 2019

Abstract

Objective:
The aim of the study was to evaluate knowledge, attitudes, and practice patterns of physicians prescribing topical estrogen for women with urogenital atrophy and a history of breast cancer.

Methods:
A cross-sectional survey of breast surgeons, urogynecologists, and gynecologists was distributed via their professional societies: the American Society of Breast Surgeons (ASBrS), the American Urogynecologic Society (AUGS), and the Society of Gynecologic Surgeons (SGS). Providers reported level of comfort prescribing vaginal estrogen for urogenital symptoms for women with different categories of breast cancer and current treatment: estrogen receptor (ER) negative, ER positive no longer on endocrine therapy, and ER positive currently on adjuvant endocrine therapy. General knowledge questions assessed agreement on a 5-point Likert scale to statements about vaginal estrogen safety and pharmacology.

Results:
A total of 820 physicians completed the survey: 437 responses from the ASBrS (response rate, 26.7%), 196 from AUGS (15%), and 187 from SGS (44.5%). The majority of physicians (84%), regardless of specialty, felt comfortable prescribing vaginal estrogen to women with a history of ER-negative cancer: 65.7% felt comfortable prescribing for women with ER-positive breast cancer no longer on endocrine therapy; 51.3% for women on an aromatase inhibitor; and 31.4% for women on tamoxifen. Urogynecologists were significantly more comfortable than breast surgeons prescribing vaginal estrogen for the lowest risk patients, whereas breast surgeons had the highest level of comfort for women currently on endocrine therapy.

Conclusions:
This study highlights heterogeneity in practice patterns both within and across specialties. The clinical variation seen in this study suggests providers may benefit from increased knowledge regarding vaginal estrogen.
Reversible alopecia associated with high blood mercury levels and early menopause: a report of two cases
Authors: Peters Jane B. , Warren Michelle P. 
Published: April 2019

Abstract

Objective:
The aim of this study was to report on two women in early menopause with alopecia and high mercury (Hg) levels which reversed with a decrease in toxic levels.

Methods:
Retrospective chart review and case studies in a reproductive endocrinology practice.

Results:
A 43-year-old woman initially evaluated for early menopause later experienced sudden circumscribed hair loss on the scalp. Blood tests indicated elevated Hg levels and further investigation revealed a diet high in tuna. Levels fell with elimination of dietary tuna. Another woman, 39 years old was complaining of severe hot flashes, night sweats, and menstrual irregularity also developed alopecia. Treated unsuccessfully for low testosterone, blood tests indicated high Hg levels and simultaneous hair loss was observed; recommendation to alter diet, including fish intake, was followed by a reversal of alopecia, along with a decrease in blood Hg levels. Literature searches were conducted with a focus on Hg toxicity or poisoning with symptom of alopecia.

Conclusions:
Women of reproductive age frequently seek treatment for what is thought to be hormone-related hair loss especially at menopause. Two women demonstrated a strong temporal correlation to high Hg levels associated with early menopause, which was reversible. The development of alopecia in the setting of mild Hg intoxication has not been reported in the medical literature despite its appearance in the popular press. Measurement of Hg levels should be considered in women with alopecia and its relationship to early menopause is unclear but bears further research.
Evaluation of the Parameter “Mean Impedance” for Representing Eustachian tube Functions During Pressure Increase and Decrease in Pressure Chamber Measurements
Authors: Schwarz David , Jansen Stefanie , Steinhauser Susanne , Meyer Moritz F. 
Published: April 2019

Hypothesis:
The hypothesis of the study is that the mean impedance (MI) during compression and decompression provides additional information of the Eustachian tube (ET) function.

Background:
The continuous impedance measurement in a pressure chamber can provide valuable information about the opening function of the ET.

Methods:
Around 55 ear-healthy volunteers were examined in a pressure chamber. These were subjected to a decompression phase and a compression phase. The pressure change was constantly 20 kPa/min. Using evaluation software, the MI could be determined for both ears in each case for the phases of compression and decompression.

Results:
In 49 participants, we could interpret the data successfully. On average, an output value (without pressure changes) of the impedance of 0.58 ±0.11 Pa on the right side and 0.43 ± 0.1 Pa on the left side were measured. During decompression, 0.098 ± 0.05 Pa (right) and 0.087 ± 0.043 Pa (left) could be determined. For compression, values of 0.086 ± 0.044 Pa on the right and 0.079 ± 0.045 Pa on the left were detected. The retest reliability was higher with an intraclass correlation coefficient for the decompression MI of 0.833 than the 0.772 compression MI.

Conclusions:
It is possible to measure MI in healthy subjects during compression and decompression. This value represents a good average in terms of the pressure tolerance of the middle ear. In future, studies will be required to determine whether MI will be a useful parameter in differentiating normal and abnormal ET function.
Global children's surgery: recent advances and future directions
Authors: Ullrich Sarah , Kisa Phyllis , Ozgediz Doruk 
Published: April 2019

Purpose of reviewTwo-thirds of the world's population lacks access to surgical care, many of them being children. This review provides an update on recent advances in global children's surgery.Recent findingsSurgery is being increasingly recognized as an essential component of global and child health. There is a greater focus on sustainable collaborations between high-income countries (HICs) and low-and-middle-income countries (HICs and LMICs). Recent work provides greater insight into the global disease burden, perioperative outcomes and effective context-specific solutions. Surgery has continued to be identified as a cost-effective intervention in LMICs. There have also been substantial advances in research and advocacy for a number of childhood surgical conditions.SummarySubstantial global disparities persist in the care of childhood surgical conditions. Recent work has provided greater visibility to the challenges and solutions for children's surgery in LMICs. Capacity-building and scale up of children's surgical care, more robust implementation research and ongoing advocacy are needed to increase access to children's surgical care worldwide.
Psychometrics of the SCL-90-R and Development and Testing of Brief Versions SCL-45 and SCL-9 in Infertile Couples
Authors: Martínez-Pampliega Ana , Herrero-Fernández David , Martín Sagrario , Cormenzana Susana 
Published: April 2019

Background
Although infertile couples are mentally healthy, dealing with infertility and assisted reproductive technology (ART) treatment is usually associated with psychological distress. It would therefore be useful to have short, multidimensional instruments to be able to identify people who present more intense emotional reactions and follow up their emotional distress throughout the ART.

Objectives
The goals of the study were to analyze the psychometric adequacy of the original 90-item version of the Symptom Checklist (SCL-90) in a sample of Spanish women and their partners undergoing ART, as well as to develop and analyze two brief versions of the SCL-90, given the absence of adequate short versions for this population.

Methods
A cross-sectional design for patients and their partners in the process of ART through in vitro fertilization was used. The two brief scales were obtained, which took into account the levels of variance explained by the items and confirmatory factor analysis.

Results
Two brief instruments were developed. The first, with 45 items (SCL-45-I Infertility), includes nine subdimensions: Somatization, Interpersonal Sensitivity, Obsessive-Compulsive Disorder, Depression, Anxiety, Hostility, Paranoid Ideation, Phobic Anxiety, and Psychoticism. The second instrument contains nine items (SCL-9-I or Global Severity Index [GSI]), one item for each dimension. Both instruments were psychometrically adequate (SCL-45-I: χ2/df = 7.24, RMSEA = .057, 95% CI [.056, .059], CFI = .97, NNFI = .97, SRMR = .049; SCL-9-I: χ2/df = 9.66, RMSEA = .068, 95% CI [.061, .076], CFI = .97, NNFI = .96, SRMR = .035). Measurement invariance analysis by gender was conducted, and the instruments were shown to be suitable for both men and women.

Discussion
The suitability of the SCL-90-R for use in ART was verified, and two valid instruments—useful and easy to use for nurses, psychologists, and other care providers—were developed.
Plasma Cystatin C Associates With HIV-Associated Neurocognitive Disorder but Is a Poor Diagnostic Marker in Antiretroviral Therapy–Treated Individuals
Authors: Kalayjian Robert C. , Robertson Kevin R. , Albert Jeffrey M. , Fichtenbaum Carl J. , Brown Todd T. , Taiwo Babafemi O. ,   for the ACTG 5303 Study Team
Published: April 2019

Objective:
To examine associations between plasma cystatin C and neurocognitive impairment (NCI) and its performance as a diagnostic marker before and during initial antiretroviral therapy (ART).

Methods:
Multivariable logistic regression and generalized estimating equations examined associations with NCI, determined by neuropsychological measurements, in participants of a 48-week randomized clinical trial of initial ART. Receiver operator characteristic curves examined diagnostic models of NCI.

Results:
Cystatin C was associated with NCI before ART [odds ratio (OR) 3.4 (95% CI: 1.2 to 9.4) for each 2-fold increase in baseline levels] and during 48 weeks of ART, in models that excluded baseline measurements [OR 3.0 (1.2 to 7.8) for each 2-fold increase in time-updated levels]. The strength of association increased with more severe impairment using HIV-associated neurocognitive disorder criteria [OR 2.2 (0.8 to 6.0) with asymptomatic NCI and OR 4.0 (1.5 to 11.0) with mild neurocognitive disorder or HIV-associated dementia vs. no impairment, for each 2-fold increase in time-updated levels] or by global development score [OR 2.6 (1.1 to 6.3) with mild impairment and OR 4.6 (1.1 to 18.9) with moderate or severe impairment vs. no impairment]. Cystatin C performed poorly as a diagnostic marker for NCI, however, with an area under the receiver operator characteristic curve of 0.58 at baseline and 0.54 at week 48.

Conclusions:
Higher plasma cystatin C levels were significantly associated with NCI, but these levels did not seem to be useful as a diagnostic marker for this condition.
Risk and Predictors of Esophageal and Stomach Cancers in HIV-Infected Veterans: A Matched Cohort Study
Authors: Thrift Aaron P. , Kramer Jennifer R. , Hartman Christine M. , Royse Kathryn , Richardson Peter , Dong Yongquan , Raychaudhury Suchismita , Desiderio Roxanne , Sanchez Dina , Anandasabapathy Sharmila , White Donna L. , Chiao Elizabeth Y. 
Published: April 2019

Background:
To evaluate the risks of esophageal and stomach carcinomas in people living with HIV (PLWH) compared with the general population and risk factors for these cancers in PLWH.

Setting:
Retrospective cohort study in the Veterans Health Administration.

Methods:
We compared incidence rates for esophageal and stomach cancers in 44,075 HIV-infected male veterans with those in a matched HIV-uninfected cohort (N = 157,705; 4:1 matched on age and HIV-index date). We used Cox regression models to estimate Hazard ratios (HRs) and 95% confidence intervals (CIs) for associations with HIV infection and for cancer risk factors in PLWH.

Results:
In unadjusted models, HIV infection was associated with increased risks of esophageal squamous cell carcinoma (ESCC; HR, 2.21; 95% CI: 1.47 to 3.13) and gastric cardia cancer (HR, 1.69; 95% CI: 1.00 to 2.85) but associated with lower risk of esophageal adenocarcinoma (EAC; HR, 0.48; 95% CI: 0.31 to 0.74). After adjusting for age, race/ethnicity, smoking and alcohol use, HIV infection remained statistically significantly associated with elevated risk for ESCC [adjusted hazard ratio (aHR), 1.58; 95% CI: 1.02 to 2.47], especially among HIV-infected patients with CD4 count ≤200 (aHR, 2.20; 95% CI: 1.35 to 3.60). HIV infection was not associated with risks of EAC (aHR, 0.82; 95% CI: 0.53 to 1.26), gastric cardia (aHR, 0.80; 95% CI: 0.33 to 1.94), or noncardia (aHR, 1.06; 95% CI: 0.61 to 1.84) cancers. Risk factors for these cancers in HIV-infected patients were otherwise similar to those in general population (eg, Helicobacter pylori for gastric noncardia cancer).

Conclusion:
HIV-infected individuals with low CD4 count are at highest risk for ESCC, but HIV infection was not independently associated with EAC or gastric cancer after adjusting for confounders.
The Impact of Blast Implosions and Bullet Injury on Maxillary Air Sinus
Authors: Al-Quisi Ahmed Fadhel , Al-Anee Auday M. , Mohammed Abbas Sabah 
Published: April 2019

Background:
Successive waves and generations of terrorists attacked the Iraqis in the years following the fall of the regime in Iraq in 2003, after the US invasion of the country under the pretext of weapons of mass destruction. Hence, the Iraqi people enrolled in ongoing war with these armed groups which led to massive casualties due to blasts and missile injuries.
Mechanism of blasts injury can be classified into primary, secondary, tertiary, and quaternary. While bullet injuries can be classified into low and high-energy injuries, the type and severity of the injury will influence the type of management, together with facilities available in the authors’ hospitals.
In this study the authors aim to compare between the effects of blast implosions and penetrating missiles on the maxillofacial air containing cavities, specifically the maxillary sinuses.

Patients and methods:
Twenty-eight patients (26 male patients [92.85%] and 2 [7.14%] female patients) with maxillary sinus wall fractures were admitted to the authors’ maxillofacial surgery Department in the Hospital of specialized surgeries/Baghdad Medical city from July 2014 to November 2016.

Results:
Seventy-six percent of the total bullet injuries affect the left side of the face, while shell injuries tend to affect the right side of the face by 60% than the left side.
Direct maxillary sinus injuries constitute 76.9% of the injuries caused by bullets, while it constitutes only 40% of shell injuries.

Conclusion:
Bullet injuries are associated with more severe comminuted fractures in addition to involvement of multiple neighboring bones and this may lead to extensive bone loss, while postoperative complications and infection are more common with improvised explosive devices injuries.
Surgical Management of the Nose in Relation With the Fronto-Orbital Area to Change and Feminize the Eyes’ Expression
Authors: Di Maggio Marcelo Ruben , Nazar Anchorena Joaquin , Dobarro Juan Cruz 
Published: April 2019

Abstract
Gender affirmation surgeries in male-to-female transition patients include breast augmentation, genital construction, and facial feminization. Facial features serve an integral role in identifying an individual's gender, with certain characteristics perceived as feminine or masculine.
The nose, as the centerpiece of the middle third of the face, is an important component of facial attractiveness and gender identity. Thus, reduction rhinoplasty is a mainstay of the facial feature remodeling (FFRS) and facial feminization surgery (FFS).
The authors usually divide the surgery planning in 2 steps, obviously depending on each patient needs, but generally speaking, the authors do the upper part of the head in one stage and the mandible and face lift in another.
If the patient only requires frontal bone surgery and softening of the orbital rims, the authors always perform the nose surgery in this stage. If a mandible reduction is needed, combined with a face-lift, the authors do it in another procedure, usually separated between 7 to 10 days from the other surgery. In these cases, the authors begin with the lower part of the face on the first stage and then, the frontal bone and rhinoplasty on the second.
The fronto naso-orbital complex is one of the main facial areas that determine the identification of facial gender, the nose plays a crucial role in FFS of the middle third. The main goal of rhinoplasty in FFRS is to change masculine nasal features to feminine ones by performing dorsal reduction, tip refinement, and narrowing the nasal bones, most often using an external approach and cartilaginous grafts to provide good tip support and long-term stability. Lip-lift and frontonasal recontouring can be technically complementary to rhinoplasties associated with facial features remodeling and feminization.
Staged Treatment of Chest Wall Radiation-Induced Ulcer With Negative Pressure Wound Therapy and Latissimus Dorsi Myocutaneous Flap Transplantation
Authors: Li Xiuqi , Zhang Fan , Liu Xujin , Cao Zilong , Liu Pei , Xia Lin , Du Min 
Published: April 2019

Abstract
Chest wall ulcer induced by postmastectomy radiation therapy (PRMT) remains challenging for plastic surgeons because of the reduced blood supply, fibrosis, and impaired cellular potential in the irradiated area. In this study, chest wall ulcer was treated with negative pressure wound therapy (NPWT) and the latissimus dorsi myocutaneous (LDM) flap reconstruction in 2 stages. A retrospective study was performed on consecutive patients with chronic radiation-induced ulcers in chest wall from June 2012 to June 2017. Surgical debridement and NPWT were performed in the first stage and the chest wall reconstructed by the LDM flap transplantation after extensive debridement in the second stage. There were 10 female patients with chest wall ulcers with a mean age of 60.3 years. The average duration of the ulcers was 21.2 months and the ulcers varied from 1 × 2 to 5 × 7 cm2. Histological examination denied any recurrent breast cancer or radiation-related malignancy. Negative pressure wound therapy was applied with 100 to 125 mm Hg negative pressure during a period of 5 to 7 days in the first stage. The LDM flap varied from 11 × 15 to 15 × 20 cm2. The mean follow-up was 25.9 months. All the flaps survived well with satisfactory appearance and there was no donor-site morbidity or ulcer recurrence during the follow-up period. The staged treatment of the chest wall radiation ulcer incorporated the benefits of NPWT and LDM flap. It is beneficial in increasing the blood and nutrient supply to the irradiated tissue, enhancing the debridement and promoting tissue healing, thus improving the flap survival and decreasing the ulcer recurrence.