bluuebunny/crossref_metadata_2025_split huggingface dataset:
Recent Preoperative Lumbar Epidural Steroid Injection Is an Independent Risk Factor for Incidental Durotomy During Lumbar Discectomy
Authors: Labaran Lawal A. , Puvanesarajah Varun , Rao Sandesh S. , Chen Dennis , Shen Francis H. , Jain Amit , Hassanzadeh Hamid 
Published: March 2019

Study Design: Retrospective review. Objective: To investigate the association between lumbar epidural steroid injection (LESI) and incidental durotomy (ID) in patients with a diagnosis of disc herniation undergoing a primary discectomy. Methods: A Medicare patient database was queried for patients between the ages of 65 and 85 years who underwent a primary lumbar discectomy for a diagnosis of lumbar disc herniation or degeneration from 2008 to 2014. Our main cohort of 64 849 patients was then divided into 2 groups: patients who experienced a dural tear (N = 2369) and our matched (age, gender, and history of diabetes) control cohort of patients who did not (N = 62 480). All patients who had a history of LESI were further identified and stratified into 4 subgroups by duration between LESI and discectomy (<3 months, 3-6 months, 6 months to 1 year, and overall), and a comparison of the relative incidence of ID was made among these subgroups. A multivariate logistic regression analysis was employed to determine the relationship between LESI and ID. Results: Overall incidence of ID was 3.7%. There was a significant difference in incidence of LESI (27.1% vs 35.0%, P < .001) between our control and ID groups. An adjusted odds ratio (OR) showed that prior LESI within 3 to 6 months (OR 1.47, 95% CI 1.20-1.81, P < .001) and within less than 3 months (OR 1.46, 95% CI 1.24-1.72, P < .001) of surgery were significantly associated with ID. Conclusion: LESI increases the risk of ID in patients who undergo a subsequent lumbar discectomy within 6 months of injection.
Intramedullary nail versus external fixator for ankle arthrodesis in Charcot neuroarthropathy: A meta-analysis of comparative studies
Authors: Yammine Kaissar , Assi Chahine 
Published: March 2019

Purpose: Ankle Charcot neuroarthropathy presents a great challenge for treatment. While conservative treatments yield poor results, arthrodesis is considered the treatment of choice for unstable Charcot ankles. There are two methods used for ankle fusion: retrograde intramedullary nail (IMN) and external fixator (EF). Literature reports inconclusive results on which method is better for arthrodesis. Methods: The aim of this meta-analysis is to look for significant difference between the two techniques in terms of fusion rate and complications. Four comparative studies including 117 patients (117 interventions) were located and analyzed. Results: IMN was found to yield double fusion rate than EF ( p = 0.2) with 5 weeks less time to heal ( p = 0.4). While no significance was noted for revision surgery and amputation rates, EF yielded higher rates of hardware infection ( p = 0.01) and wound infection ( p = 0.01). The IMN method seems to offer quicker and better fusion rate when compared to EF with significantly lower postoperative infection rates. Conclusion: In the clinical context of high-risk patients such as the diabetic population, IMN technique could be a better option in the case of ulcer-free ankles/feet or in the presence of medial/lateral ulcers. In case of presence of plantar ulcers, EF might be a better choice to avoid the plantar approach for nail insertion. Future research with bigger sample sized and randomized studies are warranted for validation.
Neutrophils as regulators of the hematopoietic niche
Authors: Cossío Itziar , Lucas Daniel , Hidalgo Andrés 
Published: March 2019

Abstract
The niche that supports hematopoietic stem and progenitor cells (HSPCs) in the bone marrow is a highly dynamic structure. It maintains core properties of HSPCs in the steady state, and modulates their proliferation and differentiation in response to changing physiological demands or pathological insults. The dynamic and environment-sensing properties of the niche are shared by the innate immune system. Thus, it is not surprising that innate immune cells, including macrophages and neutrophils, are now recognized as important regulators of the hematopoietic niche and, ultimately, of the stem cells from which they derive. This review synthesizes emerging concepts on niche regulation by immune cells, with a particular emphasis on neutrophils. We argue that the unique developmental, circadian, and migratory properties of neutrophils underlie their critical contributions as regulators of the hematopoietic niche.
Neutrophils: back in the thrombosis spotlight
Authors: Noubouossie Denis F. , Reeves Brandi N. , Strahl Brian D. , Key Nigel S. 
Published: March 2019

Abstract
Reactive and clonal neutrophil expansion has been associated with thrombosis, suggesting that neutrophils play a role in this process. However, although there is no doubt that activated monocytes trigger coagulation in a tissue factor-dependent manner, it remains uncertain whether stimulated neutrophils can also directly activate coagulation. After more than a decade of debate, it is now largely accepted that normal human neutrophils do not synthetize tissue factor, the initiator of the extrinsic pathway of coagulation. However, neutrophils may passively acquire tissue factor from monocytes. Recently, the contact system, which initiates coagulation via the intrinsic pathway, has been implicated in the pathogenesis of thrombosis. After the recent description of neutrophil extracellular trap (NET) release by activated neutrophils, some animal models of thrombosis have demonstrated that coagulation may be enhanced by direct NET-dependent activation of the contact system. However, there is currently no consensus on how to assess or quantify NETosis in vivo, and other experimental animal models have failed to demonstrate a role for neutrophils in thrombogenesis. Nevertheless, it is likely that NETs can serve to localize other circulating coagulation components and can also promote vessel occlusion independent of fibrin formation. This article provides a critical appraisal of the possible roles of neutrophils in thrombosis and highlights some existing knowledge gaps regarding the procoagulant activities of neutrophil-derived extracellular chromatin and its molecular components. A better understanding of these mechanisms could guide future approaches to prevent and/or treat thrombosis.
Cross talk between neutrophils and the microbiota
Authors: Zhang Dachuan , Frenette Paul S. 
Published: March 2019

Abstract
The microbiota has emerged as an important regulator of the host immunity by the induction, functional modulation, or suppression of local and systemic immune responses. In return, the host immune system restricts translocation and fine tunes the composition and distribution of the microbiota to maintain a beneficial symbiosis. This paradigm applies to neutrophils, a critical component of the innate immunity, allowing their production and function to be influenced by microbial components and metabolites derived from the microbiota, and engaging them in the process of microbiota containment and regulation. The cross talk between neutrophils and the microbiota adjusts the magnitude of neutrophil-mediated inflammation on challenge while preventing neutrophil responses against commensals under steady state. Here, we review the major molecular and cellular mediators of the interactions between neutrophils and the microbiota and discuss their interplay and contribution in chronic inflammatory diseases and cancer.
The lived experience of people with diabetes using off‐the‐shelf prescription footwear in Singapore: a qualitative study using interpretative phenomenological analysis
Authors: Tan Sheena , Horobin Hazel , Tunprasert Thanaporn 
Published: March 2019

AbstractBackgroundDiabetic foot ulceration (DFUs) is increasingly prevalent in Singapore. Appropriate management is important since DFU brings with it an associated risk for lower limb amputations, high morbidity rates and costs. Footwear prescription has been a part of clinical guidelines to manage DFUs. However, adherence to prescription footwear is typically poor amongst patients. Reasons for this have been explored in Northern American and Western European studies, but not in Singapore's context. As cultural and climate differences limit transferability of findings from existing studies to individuals in Singapore, this study aims to explore the lived experiences of participants with diabetes using prescription footwear in Singapore.MethodsThis was a qualitative study using interpretative phenomenological analysis (IPA) to understand some people's personal experience of using off the shelf prescription footwear. A total of 8 people with diabetes who received prescription footwear as part of their diabetic foot management were recruited. All participants provided written consent and took part in a semi‐structured interview lasting up to an hour. Interviews were digitally recorded, transcribed and analysed using an IPA approach.Findings and discussionThe analysis identified the super‐ordinate themes of 1) security and 2) acceptance with sub‐themes of 1.1) risk and 1.2) protection and 2.1) personal and social acceptance and 2.2) social and cultural acceptance respectively that inter‐related to influence how participants' made footwear decisions. This process of evaluation was portrayed to be a fluctuant one, making it difficult to predict yet necessary to understand. A modified seesaw model of adherence is suggested to explain this decision‐making process.ConclusionsThe complex manner by which participants grappled with security and acceptance is often overlooked when footwear is prescribed, highlighting a need for a more collaborative clinician‐patient partnership for these issues to surface in clinical practice. Furthermore, prescription footwear should be seen more holistically. Empowering patients with choice to select from a range of therapeutic yet normalised footwear could increase the level of security and acceptance they experience with its use.
Correlation Between Tumor-Specific Mutated and Methylated DNA in Colorectal Cancer
Authors: Thomsen Caroline Brenner , Andersen Rikke F. , Lindebjerg Jan , Hansen Torben F. , Jensen Lars Henrik , Jakobsen Anders 
Published: March 2019

PURPOSE Analysis of circulating tumor DNA (ctDNA) is a potential improvement in precision medicine. In colorectal cancer (CRC), somatic mutations such as RAS and RAF in the blood (mut-ctDNA) are investigated for prognostic and predictive purposes. However, they are only present in approximately 60% of patients. Recently, ctDNA has been detected in patients with RAS/ RAF wild type (WT) by methylated ctDNA (meth-ctDNA). The aim of this study was to compare mutated DNA with methylated DNA in malignant and nonmalignant tissue and plasma from CRC cohorts to establish a universal biomarker for ctDNA in all patients with CRC. MATERIALS AND METHODS Tissue (n = 170) and plasma (n = 147) samples were analyzed for RAS/ RAF mutations and neuropeptide Y methylation by droplet digital polymerase chain reaction. Tissue originated from nonmalignant WT and RAS/ RAF-mutated adenomas, tumor-adjacent colorectal tissue, and WT and RAS/ RAF-mutated tumor tissue. Plasma samples represented healthy donors and localized and metastatic CRCs. RESULTS The level of neuropeptide Y–methylated DNA in the tissue cohorts differed between nonmalignant and malignant/premalignant tissues with minimal overlap. Furthermore, meth-ctDNA was detected in plasma from 100% of patients with metastatic disease, compared with 67% of those with localized disease and 8% of healthy donors. Median fraction of meth-ctDNA in metastatic and localized cancers was 13.25% and 0.04%, respectively. Correlation between mut-ctDNA and meth-ctDNA was high ( r = 0.77 and 0.80 in localized and metastatic settings, respectively). CONCLUSION Mut-ctDNA is interchangeable with meth-ctDNA in patients with CRC. On the basis of our results, meth-ctDNA should be considered a universal biomarker in metastatic CRC, but additional investigations of clinical utility are warranted.
Energy Deficiency Suppresses Bone Turnover in Exercising Women With Menstrual Disturbances
Authors: Southmayd Emily A , Williams Nancy I , Mallinson Rebecca J , De Souza Mary Jane 
Published: March 2019

AbstractContextIn exercising women, energy deficiency can disrupt the balance of bone formation and resorption, resulting in bone loss and an altered rate of bone turnover, which may influence future bone mineral density and fracture risk.ObjectiveTo assess the effects of energy status and estrogen status on bone turnover.DesignCross-sectional.SettingThe Women’s Health and Exercise Laboratory at Pennsylvania State University.ParticipantsExercising women (n = 109) operationally defined as energy deficient or replete based on total triiodothyronine concentration and as estrogen deficient or replete based on menstrual cycle history and reproductive hormone metabolites.Main Outcome MeasuresBone formation index [procollagen type I N-terminal propeptide (P1NP) concentration corrected for average P1NP concentration in healthy reference group, i.e., [P1NP]i/median [P1NP]ref], bone resorption index [serum C-terminal telopeptide (sCTx) concentration corrected for average sCTx concentration in healthy reference group, i.e., [sCTx]i/median [sCTx]ref], bone balance (ratio of bone formation index to bone resorption index to indicate which process predominates), and bone turnover rate (collective magnitude of bone formation index and bone resorption index to indicate overall amount of bone turnover).ResultsThe combination of energy and estrogen deficiency resulted in less bone formation and a lower rate of bone turnover compared with women who were estrogen deficient but energy replete. Regardless of estrogen status, energy deficiency was associated with decreased bone resorption as well. No main effects of estrogen status were observed.ConclusionsThe results highlight the critical role that adequate energy plays in the regulation of bone turnover, especially bone formation, in exercising women with menstrual disturbances.
Dietary Calcium Intake and Bone Loss Over 6 Years in Osteopenic Postmenopausal Women
Authors: Bristow Sarah M , Horne Anne M , Gamble Greg D , Mihov Borislav , Stewart Angela , Reid Ian R 
Published: March 2019

AbstractContextCalcium intakes are commonly lower than the recommended levels, and increasing calcium intake is often recommended for bone health.ObjectiveTo determine the relationship between dietary calcium intake and rate of bone loss in older postmenopausal women.ParticipantsAnalysis of observational data collected from a randomized controlled trial. Participants were osteopenic (hip T-scores between −1.0 and −2.5) women, aged >65 years, not receiving therapy for osteoporosis nor taking calcium supplements. Women from the total cohort (n = 1994) contributed data to the analysis of calcium intake and bone mineral density (BMD) at baseline, and women from the placebo group (n = 698) contributed data to the analysis of calcium intake and change in BMD. BMD and bone mineral content (BMC) of the spine, total hip, femoral neck, and total body were measured three times over 6 years.ResultsMean calcium intake was 886 mg/day. Baseline BMDs were not related to quintile of calcium intake at any site, before or after adjustment for baseline age, height, weight, physical activity, alcohol intake, smoking status, and past hormone replacement use. There was no relationship between bone loss and quintile of calcium intake at any site, with or without adjustment for covariables. Total body bone balance (i.e., change in BMC) was unrelated to an individuals’ calcium intake (P = 0.99).ConclusionsPostmenopausal bone loss is unrelated to dietary calcium intake. This suggests that strategies to increase calcium intake are unlikely to impact the prevalence of and morbidity from postmenopausal osteoporosis.
Characterization of high- and low-risk hepatocellular adenomas by magnetic resonance imaging in an animal model of glycogen storage disease type 1A
Authors: Resaz Roberta , Rosa Francesca , Grillo Federica , Basso Luca , Segalerba Daniela , Puglisi Andrea , Bosco Maria Carla , Mastracci Luca , Neumaier Carlo E. , Varesio Luigi , Eva Alessandra 
Published: March 2019

ABSTRACT
Hepatocellular adenomas (HCAs) are benign tumors, of which the most serious complications are hemorrhage and malignant transformation to hepatocellular carcinoma (HCC). Among the various subtypes of HCA, the β-catenin-activated subtype (bHCA) is associated with greatest risk of malignant transformation. Magnetic resonance imaging (MRI) is an important tool to differentiate benign and malignant hepatic lesions, and preclinical experimental approaches may help to develop a method to identify MRI features associated with bHCA. HCAs are associated with various pathologies, including glycogen storage disease 1a (GSD1a). Here, we utilized a mouse model for GSD1a that develops HCA and HCC, and analyzed the mice in order to distinguish low-risk from high-risk tumors. Animals were scanned by MRI using a hepato-specific contrast agent. The mice were sacrificed after MRI and their lesions were classified using immunohistochemistry. We observed that 45% of the animals developed focal lesions, and MRI identified four different patterns after contrast administration: isointense, hyperintense and hypointense lesions, and lesions with peripheral contrast enhancement. After contrast administration, only bHCA and HCC were hypointense in T1-weighted imaging and mildly hyperintense in T2-weighted imaging. Thus, high-risk adenomas display MRI features clearly distinguishable from those exhibited by low-risk adenomas, indicating that MRI is a reliable method for early diagnosis and classification of HCA, necessary for correct patient management.
Nucleotide exchange factor Rab3GEP requires DENN and non-DENN elements for activation and targeting of Rab27a
Authors: Sanzà Paolo , Evans Richard D. , Briggs Deborah A. , Cantero Marta , Montoliu Lluis , Patel Shyamal , Sviderskaya Elena V. , Itzen Aymelt , Figueiredo Ana C. , Seabra Miguel C. , Hume Alistair N. 
Published: March 2019

ABSTRACT
Rab GTPases are compartment-specific molecular switches that regulate intracellular vesicular transport in eukaryotes. GDP/GTP exchange factors (GEFs) control Rab activation, and current models propose that localised and regulated GEF activity is important in targeting Rabs to specific membranes. Here, we investigated the mechanism of GEF function using the Rab27a GEF, Rab3GEP (also known as MADD), in melanocytes as a model. We show that Rab3GEP-deficient melanocytes (melan-R3GKO) manifest partial disruption of melanosome dispersion, a read-out of Rab27a activation and targeting. Using rescue of melanosome dispersion in melan-R3GKO cells and effector pull-down approaches we show that the DENN domain of Rab3GEP (conserved among RabGEFs) is necessary, but insufficient, for its cellular function and GEF activity. Finally, using a mitochondrial re-targeting strategy, we show that Rab3GEP can target Rab27a to specific membranes in a GEF-dependent manner. We conclude that Rab3GEP facilitates the activation and targeting of Rab27a to specific membranes, but that it differs from other DENN-containing RabGEFs in requiring DENN and non-DENN elements for both of these activities and by lacking compartment-specific localisation.
Shear wave elastography in differentiating between benign and malignant cervical lymph nodes in patients with oral carcinoma
Authors: Sasaki Yoshihiko , Ogura Ichiro 
Published: March 2019

Objectives: To evaluate shear wave elastography in differentiating between benign and malignant cervical lymph nodes in patients with oral carcinoma. Methods: 77 patients with oral squamous cell carcinoma were examined by B-mode and shear wave elastography with a 14 MHz linear transducer. The integrated shear wave elastography software allowed the operator to place regions of interest of various sizes within the elastography window, and automatically displayed shear elastic modulus data (kPa) for each region of interest. The relationship between size and shear elastic modulus of cervical lymph nodes was assessed by Pearson's rank correlation test. The shear elastic modulus of cervical lymph nodes in benign and malignant were evaluated using the Mann–Whitney U test. The analyses were used with a 5% significance level. Results: We plotted shear elastic modulus (X) against minimal axial diameter of cervical lymph nodes (Y), and observed a significant correlation [ Y = 0.091 X + 4.648 (R2 = 0.603, p = 0.000, N = 77)]. Furthermore, the shear elastic modulus of the malignant cervical lymph nodes (105.9 ± 5.2 kPa) was higher than that of benign (11.9 ± 4.4 kPa, p = 0.000). Conclusions: The shear wave elastography is an effective technique for the objectively and quantitatively diagnosis of cervical lymph node metastases of the oral carcinoma.
A declaração do Estado de Coisas Inconstitucional frente às consequentes externalidades negativas
Authors: Rosa André Luís Cateli , Carmo Valter Moura do 
Published: March 2019

O presente artigo visa a abordar a validade da teoria do Estado de Coisas Inconstitucional frente ao ordenamento jurídico pátrio. Para tanto, demonstra a gênese dessa teoria por meio de sua aplicação pela Corte Constitucional colombiana e a forma pela qual foi acolhida pelo Supremo Tribunal Federal, tudo levando em consideração fundamentos da República Federativa do Brasil, consagrados pela Constituição Federal, tais como democracia e igualdade, sem prejuízo de análise da eficiência, da qual devem se revestir todas as decisões da administração pública. Com o intuito de se verificar a validade da teoria diante dos termos propostos, utiliza como sistema de referência “Direito e Economia”, que analisa as externalidades proporcionadas em função da aplicação das leis e orienta para que se concretize da forma que proporcione maior eficiência, levando-se em consideração o diálogo entre Direito e Economia, sem prejuízo de se observar o ordenamento jurídico vigente. Destarte, uma criteriosa revisão de literatura e jurisprudência foi utilizada no estudo. Tais consequências são apresentadas na investigação, vinculadas à apreensão da análise econômica do Direito, às externalidades, aos direitos sociais e ao Estado de Coisas Inconstitucional. Após a análise pontual de tais institutos, procedeu-se com sua integração para sobejar a presente proposta interpretativa, núcleo vital deste estudo. O raciocínio teleológico, portanto, progride rumo à mescla desses institutos. Em conclusão, verificou-se que a teoria encontra obstáculos para prosperar frente aos dispositivos que balizam a Constituição Federal de 1988.
A rare presentation of Kikuchi Disease with Hemolytic Uremic Syndrome
Authors: Khan Salwa Tauseeq , Naqvi Rubina , Rashid Rahma , Naqvi Sana Abbas 
Published: March 2019

Kikuchi disease (KD) or also known as Kikuchi Fujimoto disease is named after scientists Kikuchi and Fujimoto who describe the disease in Japan in 1972. KD originally reported from Asia but later case reports from different regions of world have been published. It is a benign condition of necrotizing histiocytic lymphadenitis which mimic like Lymphoma, diagnosis of KD is based on histo-pathological findings from lymphnodes. It is a rare condition and mostly case reports have been published, it can have an association with other pathologies. We aim to report a case where KD has been found in a young woman in association with hemolytic uremic syndrome and acute kidney injury.
How to cite this:Khan ST, Naqvi R, Rashid R, Naqvi SA. A rare presentation of Kikuchi Disease with Hemolytic Uremic Syndrome. Pak J Med Sci. 2019;35(2):586-588. doi: https://doi.org/10.12669/pjms.35.2.735
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.