bluuebunny/crossref_metadata_2025_split huggingface dataset:
Brace Compliance, Sex, and Initial Cobb Angle as Predictors of Immediate In-Brace Curve Correction in Adolescents With Scheuermann’s Kyphosis
Authors: Babaee Taher , Kamyab Mojtaba , Sanjari Mohammad Ali , Ahmadi Amir , Ganjavian Mohammad Saleh 
Published: October 2019

ABSTRACT

INTRODUCTION
Bracing is the most effective nonoperative treatment for adolescents with Scheuermann’s kyphosis; however, its outcome is not equal for all patients. The effects of potential predictive parameters for the outcome of bracing have not been well evaluated in the literature. The aim of the study was to investigate the potential prognostic factors that affect in-brace curve correction in adolescents with Scheuermann's kyphosis.

MATERIALS AND METHODS
In this prospective cohort study, patients with thoracic Scheuermann’s kyphosis treated with the Milwaukee brace with a curve of 55° to 86° were included. The primary prognostic factors for in-brace curve correction, including brace compliance and daily exercise by log book, pad pressure by a modified sphygmomanometer, joint hypermobility by Beighton's scale, patients’ sex, and initial Cobb angle were measured. Analyses considered multiple linear regression and independent sample t-test.

RESULTS
Nineteen boys (13.74 ± 1.55 years) and 33 girls (13.67 ± 1.61 years) were included in the study. The results of the multiple linear regression analysis showed that the degrees of in-brace curve correction were significantly associated with brace compliance and initial Cobb angle (R
2 = 0.48). The results of the independent t-test showed a significant difference in average curve correction, brace compliance, and in-brace pressure between girls and boys.

CONCLUSIONS
Results of the current study indicated that the amount of in-brace curve correction is primarily affected by brace compliance and initial Cobb angle. Brace compliance, curve correction, and pad pressure in boys were significantly higher than in girls.
Paget disease of the vulva an analysis of 24 cases
Authors: Loiacono Rosalia Maria Rita , Traversi Paola , Deliso Maria Assunta , Gargano Giulio , Kardhashi Anila , Francescato Roberta , Loizzi Vera , Spinelli Marta , Lovascio Serena , Fiorito Maura , Resta Leonardo , Popescu Ondina , Cicinelli Ettore , Cormio Gennaro 
Published: October 2019

AbstractPaget's disease can arise in the breast (mammary Paget disease) or in other locations (extramammary Paget disease) such as anogenital skin in both males and females (Paget disease of the vulva [PDV]). Underlying adenocarcinoma can be found in some cases. This study aims to report clinical aspects, surgical procedures, outcomes, and recurrences of patients with PDV.A retrospective chart review was conducted on patients with pathologically confirmed diagnosis of PDV managed at the Department of Obstetrics and Gynecology, University of Bari, and the “Giovanni Paolo II” National Cancer Institute in Bari, between 1998 and 2018.Records of 24 cases of PDV were examined. Median age of the patients at diagnosis was 69.3 (range 38–84), diagnosis of synchronous cancer was made in 2 cases and in 2 other cases of metachronous disease. Three patients had previously been diagnosed with other oncological diseases. All patients underwent surgery including wide local excision (6), simple vulvectomy (8), and extended vulvectomy (10). Lymphadenectomy was performed in 2 cases and reconstructions with advancement flaps in 7 cases. Four patients were found to have invasive disease and 1 had inguinal node involvement. Positive margins were found in 11 patients. Wound dehiscence and urethral stenosis were found in 4 and 1 case each. Eight recurrences (33.33%) were observed, regardless of positive surgical margins.PDV has a low rate of malignancy but a high rate of recurrence. It should be diagnosed early to avoid repeated surgery and to reduce symptoms and morbidity.
Effect of NO inhalation on ECMO use rate and mortality in infants born at or near term with respiratory failure
Authors: Wang Xiaoqing , Li Bowen , Ma Yuqing , Zhang Hong 
Published: October 2019

Abstract

Background:
The molecular studies showed that Nitric oxide (NO) is an essential factor which regulates pulmonary artery tension. However, the conclusions of existing clinical studies were inconsistent.

Objective:
This meta-analysis is aimed to determine whether the inhalation of NO could improve oxygenation and reduce rate of death and use of extracorporeal membrane oxygenation (ECMO).

Methods:
The strategies used to search PubMed, The Cochrane Central Register of Controlled trials in the Cochrane Library, Embase, Web of science, Clinical Trials Registry, and China Biology Medicine disc, from inception to February, 2018. The primary outcomes were death or use of ECMO, death before hospital discharge, use of ECMO before hospital discharge, change in PaO2 after treatment. We assess the risk of bias in each included study by Cochrane Handbook, and calculated typical estimates of RR, each with its 95% CI, and for continuous outcomes, WMD or a summary estimate for SMD, each with its 95% CI.

Results:
Nine randomized controlled trials (RCTs) with a total of 856 participants were included in this meta-analysis. This meta-analysis revealed that the experimental group had significantly lower death or use of ECMO (RR 0.66, 95% CI 0.57–0.77, I
2 = 0%, P < .00001) and lower use of ECMO before hospital discharge (RR 0.89, 95% CI 0.50–0.71, I
2 = 0%, P < .00001) compared to control group. And in the infants without diaphragmatic hernia, experimental group had significantly higher change in PaO2 after treatment (MD 50.40, 95% CI 32.14–68.66, P < .00001). The meta-analysis also showing a tendency to improve in the death before hospital discharge (RR 0.89, 95% CI 0.60–1.31, I
2 = 0%, P = .55) and the change in PaO2 after treatment of the infants with diaphragmatic hernia (MD 6.70, 95% CI −2.32 to 15.72, P < .00001, P = .15), but no difference between experimental group and control group.

Conclusion:
We found that NO inhalation can improve oxygenation and reduce rate of death and use of ECMO in this meta-analysis. Therefore, we recommend the use of NO inhalation for infants born at or near term with respiratory failure.
Type 2 myocardial infarction in general medical wards
Authors: Furie Nadav , Israel Ariel , Gilad Lee , Neuman Gil , Assad Fadia , Ben-Zvi Ilan , Grossman Chagai 
Published: October 2019

Abstract
Type 2 myocardial infarction (MI) is defined as myocardial necrosis due to imbalance between myocardial oxygen supply and demand. The objective of this study was to assess the features, treatments, and outcomes of patients with type 2 MI in comparison with patients with type 1 MI hospitalized in general medical wards. A retrospective review was performed on patients admitted to general medicine wards diagnosed with MI in Sheba Medical Center between January 1, 2016 and December 31, 2016. Comparative analysis between patients with type 1 and type 2 MI was performed. The study included 349 patients with type 1 MI and 206 patients with type 2 MI. The main provoking factors for type 2 MI were sepsis (38.1%), anemia (29.1%), and hypoxia (23.8%). Patients with type 2 MI were older (79.1 ± 11.9 vs 75.2 ± 11.7, P < .001) and had a lower rate of prior MI (23.3% vs 38.1%, P < .001) and percutaneous coronary intervention (PCI) (34% vs 48.7%, P = .023) compared with patients with type 1 MI. Patients with type 2 MI were significantly less prescribed antiplatelet therapy (79.1% vs 96%, P < .001) and statins (60.7% vs 80.2%, P < .001), and were less referred to coronary angiography (10.7% vs 54.4%, P < .001). Type 2 MI was associated with a significantly higher 1-year mortality rate compared with type 1 MI (38.8% vs 26.6%, P = .004), but after accounting for age and sex differences, this association lacked statistical significance. In conclusion, type 2 MI patients were older and had similar comorbidities compared with those with type 1 MI. These patients were less prescribed medical therapy and coronary intervention, and had a higher 1-year mortality rate. Establishing a clear therapeutic approach for type 2 MI is required.
Midazolam anaphylaxis during general anesthesia
Authors: Jeon Yeon Su , Shim JinWoo , Jun Eun Hwa , Choi Seung Tae , Jung Hong Soo 
Published: October 2019

Abstract

Rationale:
Midazolam is known as a safe drug and is widely used as a sedative and an anesthetic adjuvant. Therefore, there is a lack of awareness that midazolam can cause anaphylaxis. Midazolam anaphylaxis is rare, and only a few cases have been reported, but such a risk is always present. In this study, we report a case of midazolam anaphylaxis by an intravenous injection, in the prone position, during general anesthesia.

Patient concerns:
A 62-year-old woman was intravenously administered 1 mg midazolam during general anesthesia, and sudden severe hypotension, bronchospasm, decreased oxygen saturation, erythema, and diarrhea occurred.

Diagnosis:
Midazolam anaphylaxis was presumptively diagnosed by clinical symptoms and was confirmed by an intradermal test after 9 weeks.

Interventions:
The patient was treated with 100% oxygen, large volume of fluid, epinephrine, phenylephrine, ephedrine, dexamethasone and prednisolone, ranitidine, and flumazenil.

Outcomes:
Severe hypotension and decreased oxygen saturation were resolved within 20 minutes of the onset of anaphylaxis, and the patient was discharged after 3 days without any sequelae.

Lessons:
Midazolam anaphylaxis is very rare, but it can happen always. Therefore, the possibility of anaphylaxis due to midazolam should be considered and always be prepared for treatment.
Open ligamentous complex disruption of the lateral ankle without dislocation or fracture
Authors: Chun Dong-Il , Kim Jahyung , Won Sung Hun , Yi Young , Kim Yong-Been , Cho Jaeho 
Published: October 2019

Abstract

Introduction:
Lateral ligamentous complex injury without fracture or dislocation is rare in the literature. Due to the rare injury, it is not clear yet about the proper treatment. This case report suggests a specific diagnosis of this injury as well as an appropriate surgical method.

Patient concerns:
In one-month period of time, 2 male soldiers participating in recreational basketball game presented with open wound on the lateral aspect of ankle without associated dislocation or fracture when they attempted to rebound the ball which consequently made them land on another player's foot.

Diagnosis:
Total rupture of the lateral ligament complex with open wound was found without any associated fracture or dislocation.

Interventions:
Open repair of the ruptured ligaments and capsule was performed.

Outcomes:
Patients returned to his own job's duty with none to minimal limitation in sport and activities of daily living at 9 to 10 months after the injury.

Conclusion:
Although open disruption of the lateral ligamentous complex without fracture or dislocation is rare, an adequate assessment and prompt surgical repair led to satisfactory outcome.
Microtia epigenetics
Authors: Chen Xia , Zhang Ruhong 
Published: October 2019

Abstract

Introduction:
Microtia is a congenital malformation of the external and middle ear caused by the abnormal development of the first and second zygomatic arch and the first sulcus. There is currently no consensus concerning the pathogenesis and etiology of microtia; genetic and environmental factors may play a role. Gene-based studies have focused on finding the genes that cause microtia and on gene function defects. However, no clear pathogenic genes have so far been identified. Microtia is multifactorial; gene function defects cannot completely explain its pathogenesis. In recent years, the epigenetic aspects of microtia have begun to receive attention.

Conclusions:
Analysis of the existing data suggests that certain key genes and pathways may be the underlying cause of congenital microtia. However, further exploration is needed.
Sex-specific association of monocyte count to high-density lipoprotein ratio with SYNTAX score in patients with suspected stable coronary artery disease
Authors: Xu Weifeng , Guan Haiwang , Gao Da , Pan Jingnan , Wang Zicheng , Alam Mahboob , Lian Jiangfang , Zhou Jianqing 
Published: October 2019

Abstract
Recently, the monocyte count to high-density lipoprotein cholesterol ratio (MHR) was found to be associated with the SYNTAX score in patients with both stable coronary artery disease (CAD) and acute coronary syndrome (ACS). The MHR was significantly higher in male patients. However, the sex-specific association of MHR with SYNTAX score in stable CAD was not well explored. Thus, the present study aimed to investigate the association of MHR and presence and severity of CAD evaluated by coronary angiography and the SYNTAX score in males and females.
In total, 873 patients who received selective coronary angiography between March 2017 and July 2018 were included in the present study. Patients were divided into 3 groups according to MHR tertiles. The MHR was calculated by dividing the monocyte count by the high-density lipoprotein cholesterol level. CAD was defined as at least 50% diameter stenosis of a major coronary artery, including the right coronary, left main coronary, left anterior descending, and left circumflex arteries. The SYNTAX score was calculated by 2 experienced interventional cardiologists. SYNTAX score ≥23 was defined as a high SYNTAX score.
Males showed a significantly higher MHR (12.2 [8.9–15.5] vs 9.3 [6.2–12.1], P < .001), accompanied by a higher prevalence of CAD (68.1% vs 53.4%, P < .001). Male sex remained an independent predictor of elevated MHR after correction for confounding factors (adjusted odds ratio [OR] 3.102, P = .001). The association between MHR and SYNTAX score was confirmed only in male stable patients with CAD (r = 0.113, P = .036). Multivariate logistic regression analysis showed that MHR was an independent predictor of SYNTAX score ≥23 only in male patients with CAD. The receiver-operating characteristic curve showed a predictive value of MHR for high SYNTAX score only in males.
A higher MHR in males and a positive correlation of MHR with SYNTAX score were observed only in male stable patients with CAD. Such an easily obtained index may help interventional cardiologists detect high-risk patients before coronary catheterization, but its application may be restricted to males.
A case report of pelviscopic resection of invasive hydatidiform mole
Authors: Lee Hyun Joo , Kim Yun Sook 
Published: October 2019

Abstract

Rationale:
Invasive moles occur in the fertile period, with about 95% occurring after previous mole removal and the remaining 5% occurring after several other pregnancies.

Patient concerns:
A 27-year-old patient developed a rare invasive mole two months after a missed abortion.

Diagnoses:
A transvaginal ultrasound scan revealed a 3.6 × 2.9 × 2.4 cm sized lesion with cystic vascular areas within it, within the myometrium of the right fundal posterior region of the uterus. There was no metastasis to other organs.

Interventions:
After administration of methotrexate, the level of beta-human chorionic gonadotropin (ß-hCG) was elevated and liver enzymes were also markedly elevated. She wanted to retain fertility for future pregnancies. After laparoscopic removal of the myometrial invasive mole, the incision site was sutured with a 3-0 V-LocTM.

Outcomes:
One year later, a natural pregnancy occurred and a cesarean section was performed at 36 weeks.

Lessons:
This is the first reported case of its type. Our case demonstrated that pelviscopic removal of an invasive mole is possible if there are no other metastases, and that future pregnancy and childbirth are still feasible in women of reproductive age.
Detection and management of atypical femur fractures
Authors: Divan Vidita , Rao Sudhaker D. , Dhaliwal Ruban 
Published: October 2019

Purpose of review
This article summarizes the risk factors for atypical femur fractures (AFF), discusses current and emerging imaging modalities for early identification of AFF, and offers recommendations for prevention and management of AFFs based on the current concepts.

Recent findings
Antiresorptive therapies are widely recommended for prevention and treatment of osteoporosis. Despite their well established effectiveness to reduce fracture risk, emerging concerns related to potential adverse effects have led to a substantial decline in the use of bisphosphonates. Although, the pathogenesis of AFF has not yet been elucidated, the bulk of evidence supports that the well known therapeutic benefits of bisphosphonate far outweigh the relatively low risk of AFFs. Recommendations for early identification of patients at risk for AFF using radiographic imaging have been established. Consensus on the management of AFF and osteoporosis in patients with AFF needs to be formulated.

Summary
AFF is a rare event associated with long-term bisphosphonate therapy, which represents an apparent paradox in the management of osteoporosis. Improved understanding of pathogenetic mechanisms will be helpful in further refining of screening guidelines and standardization of management and treatment strategies.
What is the Outcome of Patients Affected by Intraductal Papillary Mucinous Neoplasms Without High-Risk Stigmata?
Authors: Ricci Claudio , Ingaldi Carlo , Migliori Marina , Pagano Nico , Santini Donatella , Alberici Laura , Serra Carla , Calculli Lucia , Di Marco Mariacristina , Minni Francesco , Casadei Riccardo 
Published: October 2019

Objectives
The objectives of the study were to define the natural history of intraductal papillary mucinous neoplasms (IPMNs) without high-risk stigmata (HRS) and to identify factors capable of influencing outcome and management.

Methods
This is a retrospective study of patients affected by IPMNs without HRS. Survival analyses included overall survival, disease-specific survival, and years of life lost. Uni- and multivariate analyses were carried out to identify factors capable of predicting years of life lost.

Results
Three hundred fifty-six patients were analyzed. Fifty-three patients (14.9%) died: no postoperative mortality, 6 (1.7%) patients from pancreatic cancer and 47 (13.2%) from reasons not related to the disease. Mean overall survival and disease-specific survival were 199.4 (SD, 16.6) and 281 months (SD, 6.9), respectively. The years of life lost of the sample observed with respect to the general population were 2 years and 3 months (15 years and 3 months vs 17 years and 6 months). Younger age, length of follow-up more than 3 years, and surgery significantly increased the years of life lost.

Conclusions
The patients affected by IPMNs without HRS rarely died from the disease. Young age (<65 years) and follow-up more than 3 years seemed to be the only factors capable of influencing the outcome and management.
Standardization of Reading Charts: A Review of Recent Developments
Authors: Radner Wolfgang 
Published: October 2019

ABSTRACT
This review gives an overview of the current status of standardization by statistical evaluation of reading charts. First begun only 20 years ago, the statistical evaluation of reading charts now reflects an increasing clinical and scientific interest in standardized, comparable, and reproducible reading charts.
For clinical or research purposes in human subjects, standardization of psychophysical tests and their test items by statistical evaluation is mandatory because it provides experimental control. Initial attempts at reading chart standardization were made by characterizing the test items, either in terms of a selection of unrelated words or in terms of sentences representing a constant number of characters, including spaces. As initiated by the RADNER Reading Charts, standardization of reading charts (and test items) by statistical evaluation has gained increasing clinical and scientific interest in the last two decades and has later also been applied to some of the other modern reading charts. A literature search was performed with respect to reading charts that (a) have been produced in accordance with the recommendations of the International Council of Ophthalmology (geometrical print size progression), (b) have been statistically analyzed, and/or (c) use clearly characterized test items (conceptually and statistically). These reading charts are as follows: the Bailey-Lovie Word Reading Charts, the Colenbrander Cards, the RADNER Reading Charts, the MNREAD Acuity Charts, the Smith-Kettlewell Reading Test (SKread Test), the C-Read Charts, and the Balsam Alabdulkader-Leat (BAL) Chart. The test items of these charts have been characterized either empirically or by statistical analysis and selection. The extent of the statistical evaluation of the reading charts varies. Despite their different methodological approaches, these reading charts represent an advancement that has made possible the useful comparison and reproducible evaluation of near visual performance.
The Impact of Exposure Therapy on Resting Heart Rate and Heart Rate Reactivity Among Active-Duty Soldiers With Posttraumatic Stress Disorder
Authors: Bourassa Kyle J. , Stevens Elizabeth S. , Katz Andrea C. , Rothbaum Barbara O. , Reger Greg M. , Norr Aaron M. 
Published: October 2019

ABSTRACT

Objective
Posttraumatic stress disorder (PTSD) is linked to poor health, including cardiovascular disease. These effects may be a result of increased tonic cardiovascular function and cardiovascular reactivity. Despite PTSD’s negative health burden, relatively little is known about whether frontline treatments for PTSD may alleviate cardiovascular risk.

Methods
The current study was a secondary analysis of a larger intervention study of active-duty soldiers with PTSD (n = 104; mean [SD] age = 30.6 [6.7] years; 6% women) randomized to an exposure therapy—either prolonged exposure (PE) or virtual reality exposure (VRE)—or a waitlist control condition. We examined change in participants’ resting heart rate (HR) and HR reactivity from baseline (before randomization) to midtreatment and posttreatment using residualized change regression models.

Results
The results of the study demonstrated decreased resting HR (B = −5.06, p = .024) and HR reactivity (B = −2.46, p = .005) from baseline to posttreatment of PE and VRE relative to waitlist. Exploratory analyses found that changes in resting HR and HR reactivity were not significantly correlated with either self-reported or clinician-rated PTSD symptom change.

Conclusions
These results suggest that PE and VRE for PTSD may alleviate some cardiovascular health risk associated with PTSD, improving cardiovascular functioning.

RCT Registration:
ClinicalTrials.gov (identifier: NCT01193725).