bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incident opioid use and risk of hip fracture among persons with Alzheimer disease: a nationwide matched cohort study
Authors: Taipale Heidi , Hamina Aleksi , Karttunen Niina , Koponen Marjaana , Tanskanen Antti , Tiihonen Jari , Hartikainen Sirpa , Tolppanen Anna-Maija 
Published: October 2018

Abstract
The objective of this study was to investigate whether incident opioid use is associated with an increased risk of hip fractures among community-dwelling persons with Alzheimer disease (AD) and to assess the association in terms of duration of use and opioid strength. Among community-dwelling persons with AD diagnosed in 2010 to 2011 (N = 23,100), a matched cohort study comparing incident opioid users (N = 4750) with opioid nonusers (N = 4750) was constructed. Matching was based on age, sex, and time since AD diagnosis at opioid initiation. Data on drug use and hip fractures were retrieved from nationwide registers. Incident opioid users were identified with a 1-year washout. Cox proportional hazard models compared the risk of hip fracture between opioid use and nonuse, and were weighted with inverse probability of treatment (IPT), based on a propensity score. Age-adjusted incidence rate of hip fractures was 3.47 (95% confidence interval [CI] 2.62-4.33) during opioid use and 1.94 (95% CI 1.65-2.22) during nonuse. Opioid use was associated with an increased risk of hip fracture (IPT-weighted hazard ratio [HR] 1.96, 95% CI 1.27-3.02). The risk was observed during the first 2 months of use (IPT-weighted HR 2.37, 1.04-5.41) and attenuated after that. The results suggest an increase in the risk of hip fracture by increasing opioid strength; weak opioids IPT-weighted HR 1.75 (0.91-3.35), buprenorphine IPT-weighted HR 2.10 (1.41-3.13), and strong opioids IPT-weighted HR 2.89 (1.32-6.32). Further research is needed to find out whether the risk of injurious falls is avoidable by slow titration of opioid doses in the beginning of treatment.
Current approaches to instrumental assessment of swallowing in children
Authors: Dharmarathna Isuru , Miles Anna , Allen Jacqui E. 
Published: October 2018

Purpose of the review
This article reviews recent developments in the instrumental assessment of swallowing in children with a specific focus on research published between January 2017 and June 2018.

Recent findings
Instrumental swallowing assessments reported in the time period included: videofluoroscopic study of swallowing, digital cervical auscultation, dynamic ultrasound, high-resolution impedance manometry, nasal airflow thermistry and respiratory inductance plethysmography. Several studies were found exploring tools to objectively quantify videofluoroscopic study of swallowing data; swallowing from the mouth through to stomach was addressed including approaches to analysing mastication as well as evaluating oesophageal motility disorders.

Summary
Even though a vast range of instrumentation were studied, lack of clarity on clinical feasibility and objective measures that facilitate medical decision-making in practice mean further research is required to provide guidance on implementation. Promising novel approaches to aid the quantification of swallowing physiology from the mouth, pharynx and through to the oesophagus are emerging.
Evaluation of a Mixed Meal Test for Diagnosis and Characterization of PancrEaTogEniC DiabeTes Secondary to Pancreatic Cancer and Chronic Pancreatitis
Authors: Hart Phil A. , Andersen Dana K. , Mather Kieren J. , Castonguay Alicia C. , Bajaj Mandeep , Bellin Melena D. , Bradley David , Contreras Noemy , Habtezion Aida , Korc Murray , Kudva Yogish , Petrov Maxim S. , Whitcomb David C. , Yadav Dhiraj , Yuan Ying , Rinaudo Jo Ann S. , Srivastava Sudhir , Serrano Jose , Goodarzi Mark O. 
Published: October 2018

Abstract
Pancreatogenic diabetes mellitus is most commonly the result of chronic pancreatitis but can also occur secondary to pancreatic cancer. The early identification of pancreatogenic diabetes and distinction from the more prevalent type 2 diabetes are clinically significant; however, currently, there is no validated method to differentiate these diabetes subtypes. We describe a study, “Evaluation of a Mixed Meal Test for Diagnosis and Characterization of PancrEaTogEniC DiabeTes Secondary to Pancreatic Cancer and Chronic Pancreatitis: the DETECT study,” that seeks to address this knowledge gap. The DETECT study is a multicenter study that will examine differences in hormone and glucose excursions after a mixed meal test. The study will also create a biorepository that will be used to evaluate novel diagnostic biomarkers for differentiating these diabetes subtypes.
A Prospective Study to Establish a New-Onset Diabetes Cohort
Authors: Maitra Anirban , Sharma Ayush , Brand Randall E. , Van Den Eeden Stephen K. , Fisher William E. , Hart Phil A. , Hughes Steven J. , Mather Kieren J. , Pandol Stephen J. , Park Walter G. , Feng Ziding , Serrano Jose , Rinaudo Jo Ann S. , Srivastava Sudhir , Chari Suresh T. 
Published: October 2018

Abstract
The National Cancer Institute and the National Institute for Diabetes and Digestive and Kidney Diseases initiated the Consortium for the Study of Chronic Pancreatitis, Diabetes, and Pancreatic Cancer (CPDPC) in 2015 (the CPDPC's origin, structure, governance, and research objectives are described in another article in this journal). One of the key objectives of CPDPC is to assemble a cohort of 10,000 subjects 50 years or older with new-onset diabetes, called the NOD cohort. Using a define, enrich, and find early detection approach, the aims of the NOD study are to (a) estimate the 3-year probability of pancreatic ductal adenocarcinoma (PDAC) in NOD (define), (b) establish a biobank of clinically annotated biospecimens from presymptomatic PDAC and control new-onset type 2 diabetes mellitus subjects, (c) conduct phase 3 validation studies of promising biomarkers for identification of incident PDAC in NOD patients (enrich), and (d) provide a platform for development of a future interventional screening protocol for early detection of PDAC in patients with NOD that incorporates imaging studies and/or clinical algorithms (find). It is expected that 85 to 100 incidences of PDAC will be diagnosed during the study period in this cohort of 10,000 patients.
Standard Operating Procedures for Biospecimen Collection, Processing, and Storage
Authors: Fisher William E. , Cruz-Monserrate Zobeida , McElhany Amy L. , Lesinski Gregory B. , Hart Phil A. , Ghosh Ria , Van Buren George , Fishman Douglas S. , Rinaudo Jo Ann S. , Serrano Jose , Srivastava Sudhir , Mace Thomas , Topazian Mark , Feng Ziding , Yadav Dhiraj , Pandol Stephen J. , Hughes Steven J. , Liu Robert Y. , Lu Emily , Orr Robert , Whitcomb David C. , Abouhamze Amer S. , Steen Hanno , Sellers Zachary M. , Troendle David M. , Uc Aliye , Lowe Mark E. , Conwell Darwin L. 
Published: October 2018

Abstract
High-quality and well-annotated biorepositories are needed to better understand the pathophysiology and biologic mechanisms of chronic pancreatitis (CP) and its consequences. We report a methodology for the development of a robust standard operating procedure (SOP) for a biorepository based on the experience of the clinical centers within the consortium to study Chronic Pancreatitis, Diabetes and Pancreas Cancer Clinical Centers (CPDPC), supported by the National Cancer Institute and the National Institute for Diabetes and Digestive and Kidney Diseases as a unique multidisciplinary model to study CP, diabetes, and pancreatic cancer in both children and adults. Standard operating procedures from the CPDPC centers were evaluated and consolidated. The literature was reviewed for standard biorepository operating procedures that facilitated downstream molecular analysis. The existing literature on biobanking practices was harmonized with the SOPs from the clinical centers to produce a biorepository for pancreatic research. This article reports the methods and basic principles behind the creation of SOPs to develop a biorepository for the CPDPC. These will serve as a guide for investigators developing biorepositories in pancreas research. Rigorous and meticulous adherence to standardized biospecimen collection will facilitate investigations to better understand the pathophysiology and biologic mechanisms of CP, diabetes, and pancreatic cancer.
Ectopic Thymoma of the Right Atrium: A Case Report
Authors: Li Li , Duan Xuejing , Wang Haiping , Sun Yang , Lu Yang , Xu Hongyu , Wang Qingzhi , Wang Hongyue 
Published: October 2018

Abstract
Ectopic thymoma arising in organs other than the thymus is rare. To date, there is no report of intracardiac ectopic thymoma in the English language literature. We report a rare case of a right atrial ectopic thymoma. A 61-year-old woman presented with puffiness of face and shortness of breath. Cardiac computed tomography revealed a large right atrial mass with near-total occlusion of the chamber and extension into the superior vena cava and inflow tract of the right ventricle. She underwent resection of the right atrial mass. The final pathological diagnosis was intracardiac ectopic thymoma.
Follicular Dendritic Cell Sarcoma With NF2 Mutation
Authors: Karrs Jeremiah Xavier , Gohlke Amanda Lynn , Poklepovic Andrew , Oliveira Andre M. , Richard Hope , Pavlick Dean C. , Smith Steven Christopher 
Published: October 2018

Abstract
Follicular dendritic cell sarcoma (FDCS) is recognized as a diagnostically challenging neoplasm requiring rigorous exclusion of more common entities and high index of suspicion for diagnosis. Here, we report an aggressive case of FDCS arising in the mediastinum, which due to sampling limitations and the inherent difficulty of diagnosis required extensive workup with multiple samples prior to definitive classification. The patient was a 35-year-old woman who presented with progressive dyspnea and mediastinal mass on imaging studies. The initial sampling of the lesion had histologic features raising consideration of FDCS, but was too limited to allow definitive diagnosis, while progressing rapidly enough to require administration of chemotherapy even prior to classification. Repeat samples obtained via fine-needle aspiration and bronchoscopy enabled the diagnosis of FDCS, and high-throughput sequencing revealed apparently pathogenic NF2 mutations previously not reported in this disease. Unfortunately, the patient died of widely metastatic disease, which we comprehensively documented at autopsy. Together, these observations provide previously unreported insights into the end stage of this disease and experience relevant to its prospective recognition and workup.
A Case of Small Cell Carcinoma With Adenocarcinoma Found in a Rectal Fissure
Authors: Harinath Lakshmi , Mohanty Alok , Pai Reetesh K. , Islam Mohammed , Silverman Jan F. 
Published: October 2018

Abstract
Small cell carcinomas are aggressive high-grade malignancies most commonly diagnosed in the lung, but can also be found in extrapulmonary sites such as the breast, kidney, urinary bladder, uterus, ovary, pancreas, hepatobiliary tree, thymus, skin, and salivary glands. Although the gastrointestinal system has an abundance of neuroendocrine cells, small cell carcinomas in this region have a low incidence. We present the case of a 51-year-old man with a history of pain with bowel movements and recent weight loss. Colonoscopy was performed, which revealed a rectal fissure with a lesion involving the rectum and anal canal. Biopsy of the lesion revealed invasive carcinoma with 2 distinct morphologies, a poorly differentiated small cell component and a minor adenocarcinoma component. We discuss the differential diagnosis of small cell carcinoma that includes mixed adenoneuroendocrine carcinomas and other neuroendocrine neoplasms.
Gene therapy for neuropathic pain using dorsal root ganglion–targeted helper-dependent adenoviral vectors with GAD67 expression
Authors: Ogawa Nobuhiro , Terashima Tomoya , Oka Kazuhiro , Chan Lawrence , Kojima Hideto 
Published: October 2018

Abstract

Introduction:
Currently available medications for neuropathic pain are of limited efficacy. Moreover, they are administered systemically and are associated with significant side effects. Ideally, one can circumvent systemic side effects if such treatment can be administered by delivery of the therapeutic agent directly to the diseased neurons. Towards this end, we previously reported the production of a recombinant helper-dependent adenovirus (HDAd) armed with a tissue-specific homing peptide to deliver transgenes targeting sensory neurons with high efficacy.

Objectives:
To develop an effective gene therapy for neuropathic pain by producing a dorsal root ganglion (DRG)-targeted HDAd vector that specifically expresses glutamic acid decarboxylase (GAD) 67 (HDAd-DRG-GAD67).

Methods:
We produced spinal nerve transection (SNT) mice as a neuropathic pain model and delivered HDAd-DRG-GAD67 by injection into spinal nerve or intrathecally to these animals. We evaluated the therapeutic efficacy by measuring ion channel gene expression and quantifying mechanical allodynia, a representative symptom of neuropathic pain, in treated animals.

Results:
Glutamic acid decarboxylase expression by HDAd-DRG-GAD67 reduced allodynia significantly in SNT mice. In addition, HDAd-DRG-GAD67 had a much greater transduction efficacy and expressed the therapeutic gene for a much longer time and at a lower dose of viral particles than wild-type HDAd. We found that SNT induced the upregulation of Cav3.2 mRNA in the DRG and GAD67 overexpression suppressed the elevation. Furthermore, the HDAd-DRG-GAD67–induced allodynia amelioration occurred even when we delayed intrathecal delivery of the therapeutic vector to day 7 after SNT.

Conclusion:
HDAd-mediated DRG-targeted gene therapy delivering GAD67 is an efficacious treatment for neuropathic pain in SNT mice.
Flap Preconditioning with the Cyclic Mode (Triangular Waveform) of Pressure-Controlled Cupping in a Rat Model: An Alternative Mode to the Continuous System
Authors: Hong Yoon Gi , Kim Sung Chan , Koh Kyung S. 
Published: October 2018

Background:
Improving flap survival is essential for successful soft-tissue reconstruction. Although many methods to increase the survival of the distal flap portion have been attempted, there has been no widely adopted procedure. The authors evaluated the effect of flap preconditioning with two different modes (continuous and cyclic) of external volume expansion (pressure-controlled cupping) in a rat dorsal flap model.

Methods:
Thirty rats were randomly assigned to the control group and two experimental groups (n = 10 per group). The continuous group underwent 30 minutes of preconditioning with −25 mmHg pressure once daily for 5 days. The cyclic group received 0 to −25 mmHg pressure for 30 minutes with the cyclic mode once daily for 5 days. On the day after the final preconditioning, caudally based 2 × 8-cm dorsal random-pattern flaps were raised and replaced in the native position. On postoperative day 9, the surviving flap area was evaluated.

Results:
The cyclic group showed the highest flap survival rate (76.02 percent), followed by the continuous and control groups (64.96 percent and 51.53 percent, respectively). All intergroup differences were statistically significant. Tissue perfusion of the entire flap showed similar results (cyclic, 87.13 percent; continuous, 66.64 percent; control, 49.32 percent). Histologic analysis showed the most increased and organized collagen production with hypertrophy of the attached muscle and vascular density in the cyclic group, followed by the continuous and control groups.

Conclusion:
Flap preconditioning with the cyclic mode of external volume expansion is more effective than the continuous mode in an experimental rat model.
Craniometric Analysis of Endoscopic Suturectomy for Bilateral Coronal Craniosynostosis
Authors: Rottgers S. Alex , Syed Hasan R. , Jodeh Diana S. , Jeelani Yasser , Yang Edward , Meara John G. , Proctor Mark R. 
Published: October 2018

Background:
Endoscopic suturectomy and helmeting represents a successful first-line surgical treatment for bilateral coronal craniosynostosis. Its effect on cranial morphology has not been previously described.

Methods:
Patients were identified who had bilateral coronal craniosynostosis treated with endoscopic suturectomy and postoperative helmeting at Boston Children’s Hospital between 2005 and 2013 and who underwent preoperative and postoperative computed tomography. Two normative patient populations were identified from our trauma registry with computed tomographic scans completed at the same age as our pretreatment and posttreatment scans. Craniometric indices were used to quantify the effect of treatment.

Results:
Twenty-seven patients were identified who underwent bilateral coronal suturectomy. Twelve patients had preoperative and postoperative computed tomographic studies. Eight patients (66.7 percent) were syndromic. The average ages for preoperative and postoperative computed tomographic scan were 1.1 months (range, 0.03 to 2.6 months) and 19.6 months (range, 10.8 to 37.5 months). Thirteen patients with an average age of 1.1 months (range, 0.5 to 1.6 months) were identified as a preoperative control group. Fourteen patients with an average age of 18.5 months (range, 15.5 to 22.9 months) were identified as a postoperative control group. The anterior cranial height stabilized with treatment and the anterior cranial base length increased. The anterior cranial height–to–anterior cranial base length ratio significantly decreased with treatment (p = 0.128). Frontal bossing normalized with endoscopic suturectomy (craniosynostosis versus control: preoperatively, p = 0.001; postoperatively, p = 0.8). Cephalic indices also normalized with treatment (craniosynostosis versus control: preoperatively, p = 0.02; postoperatively, p = 0.13). No cases of hydrocephalus were observed.

Conclusion:
Endoscopic suturectomy and helmeting improves anterior turricephaly and corrects frontal bossing and brachycephaly in patients with bilateral coronal craniosynostosis.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
Delayed Postconditioning with External Volume Expansion Improves Survival of Adipose Tissue Grafts in a Murine Model
Authors: Wei Shuyi , Liu Wenyue , Gundogan Buket , Moscoso Andrea V. , Orgill Dennis P. , Giatsidis Giorgio 
Published: October 2018

Background:
External volume expansion improves the survival of adipose tissue grafts by preoperatively conditioning (“preconditioning”) tissues that will receive the graft. External volume expansion’s mechanisms of action (induction of angiogenesis and of adipogenesis) could improve graft survival also when applied postoperatively (“postconditioning”).

Methods:
Fifty-six 8-week-old athymic (nu/nu) mice received dorsal subcutaneous grafts of human lipoaspirate (0.3 ml each) bilaterally before undergoing external volume expansion (left dorsum) or no treatment (right dorsum, controls). External volume expansion was started either on the same day of (immediate group), 2 days after (early group), or 1 week after surgery (delayed group). At follow-up, grafts were analyzed for tissue survival, remodeling, adipogenesis, and angiogenesis using histology. The authors subsequently assessed the effects of the delayed application of external volume expansion adopting a foam-shaped interface to deliver the treatment.

Results:
At 28-day follow-up, delayed postconditioning with external volume expansion significantly improved the survival of grafts (18 percent) compared with controls (viable graft thickness ratio, 58 ± 15 percent versus 49 ± 13 percent) and increased the density of blood vessels within the graft (63 percent; blood vessels per 10× magnification field, 44 ± 12 versus 27 ± 11). Other groups did not experience significant changes. Adoption of external volume expansion with a foam-shaped interface similarly improved outcomes and further reduced fibrosis within the grafts.

Conclusions:
Postoperative delayed application of external volume expansion modestly improves the survival of adipose tissue grafts by inducing adipogenesis and angiogenesis. Use of a foam-shaped interface decreases the fibrosis induced in the grafts.
Evaluation of Donor Morbidity following Single-Stage Latissimus Dorsi Neuromuscular Transfer for Facial Reanimation
Authors: Lee Kyeong-Tae , Lee Young Jae , Kim Ara , Mun Goo-Hyun 
Published: October 2018

Background:
Single-stage latissimus dorsi neuromuscular transfer has been a valuable option for dynamic smile reanimation. However, there is a paucity of studies evaluating the potential donor morbidity in such cases. The present study aimed to comprehensively analyze the donor morbidity following functional latissimus dorsi muscle transfer.

Methods:
Patients who underwent single-stage functional latissimus dorsi muscle transfer for smile reanimation between 2002 and 2016 were reviewed. Postoperative complications and functional impairments at the donor sites were evaluated. The Quick-Disabilities of the Arm, Shoulder and Hand questionnaire was used for assessing postoperative donor-site function.

Results:
Sixty patients, including 12 pediatric (18 years or younger) patients, were analyzed. Mean length of a harvested thoracodorsal nerve was 14.9 cm. Fourteen patients were treated with a dual innervation technique, in which both a descending and a transverse branch of the thoracodorsal nerve were harvested. Donor complications were observed in seven cases; all of them were seromas and resolved by simple aspiration. No other complications including scoliosis and sensory and/or motor disturbances in the upper extremities were encountered. Fifty patients responded to the Quick-Disabilities of the Arm, Shoulder and Hand questionnaire at a median follow-up of 51 months. The average score was 2.64, and all but three patients scored less than 10. No variables, including patient age (pediatric versus adult) and the use of a dual-innervation technique, affected the donor morbidities, including the functional deficits.

Conclusion:
Single-stage latissimus dorsi neuromuscular transfer for facial reanimation might be associated with a low rate of complications and minimal functional morbidity at the donor site.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
A Cardiac Metastasis of Follicular Thyroid Carcinoma With Partly Squamous Cell Differentiation
Authors: Stegger Lars , Rahbar Kambiz , Schülke Christoph , Huss Sebastian , Wenning Christian 
Published: October 2018

Abstract
PET using the radiotracer 18F-fluorodeoxyglucose (FDG) was performed in a patient who presented with elevated thyroglobulin (Tg) levels several years after initial therapy of follicular thyroid carcinoma (oncocytic variant) and in whom high-dose radioiodine (131I) failed to locate recurrent tumor or to decrease Tg levels. A focal fluorodeoxyglucose uptake in the apical septum of the heart did not have a discernible correlate in echocardiography or MRI for more than 12 months. Finally, a metastasis of the follicular thyroid carcinoma with partly squamous cell differentiation was confirmed and treated by resection and stereotactic body radiotherapy.
Increased FDG Uptake and Chronic Lung Changes in a Case of Persistent Lipoid Pneumonia
Authors: Ansari-Gilani Kianoush , Faraji Navid , Gilkeson Robert C. 
Published: October 2018

Abstract
Lipoid pneumonia is uncommon disease caused by presence of macroscopic fat in the lung parenchyma commonly originating from exogenous source secondary to aspiration or inhalation of animal fats or mineral or vegetable oils. Alternatively, it can be due to endogenous fat accumulated in the alveoli in the setting of chronic bronchial obstruction or inflammation. The imaging findings include ground-glass opacities, consolidation, nodules, and masses. Presence of macroscopic fat on CT is helpful; however it might not always be present. Increased FDG uptake can be present secondary to ongoing inflammation mimicking malignancy. Tissue diagnosis might be needed in some cases.