bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mirogabalin for the management of postherpetic neuralgia: a randomized, double-blind, placebo-controlled phase 3 study in Asian patients
Authors: Kato Jitsu , Matsui Norimitsu , Kakehi Yoshihiro , Murayama Emiko , Ohwada Shoichi , Sugihara Masahiro 
Published: January 2019

Abstract
This study investigated the safety and efficacy of mirogabalin, a novel, potent, selective ligand of the α2δ subunit of voltage-dependent Ca2+ channels, for the treatment of postherpetic neuralgia (PHN). In this multicenter, double-blind, placebo-controlled phase 3 study, Asian patients ≥20 years with PHN were randomized 2:1:1:1 to placebo or mirogabalin 15, 20, or 30 mg/day for up to 14 weeks (NCT02318719). The primary efficacy endpoint was the change from baseline in average daily pain score at week 14, defined as a weekly average of daily pain (0 = “no pain” to 10 = “worst possible pain,” for the last 24 hours). Of 765 patients randomized, 763 received ≥ 1 dose of the study drug and were included in the analysis; 303, 152, 153, and 155 received placebo, mirogabalin 15, 20, or 30 mg/day, respectively. A total of 671 (87.7%) patients completed the study. At week 14, the difference in average daily pain score least squares mean vs placebo was −0.41, −0.47, and −0.77, respectively; all mirogabalin groups showed statistical significance. The most common treatment-emergent adverse events were somnolence, nasopharyngitis, dizziness, weight increase, and edema, and all of them were mild or moderate in severity. Mirogabalin was superior to placebo in all groups for relieving PHN and appeared well tolerated.
Distance to HIV and Antenatal Care: A Geospatial Analysis in Siaya County, Kenya
Authors: Kohler Pamela K. , Akullian Adam , Okanda John , Otieno George , Kinuthia John , Voss Joachim , Zierler Brenda , John-Stewart Grace 
Published: January 2019

Abstract
As maternal child health (MCH) programs expand in the setting of HIV, health systems are challenged to reach those most vulnerable and at the greatest need. Cross-sectional surveys of MCH clinics and recent mothers in the Siaya Health Demographic Surveillance System were conducted to assess correlates of accessing antenatal care and facility delivery. Of 376 recent mothers, 93.4% accessed antenatal care and 41.2% accessed facility delivery. Per-kilometer distance between maternal residence and the nearest facility offering delivery services was associated with 7% decreased probability of uptake of facility delivery. Compared with a reference of less than 1 km between home and clinic, a distance of more than 3 km to the nearest facility was associated with 25% decreased probability of uptake of facility delivery. Distance to care was a factor in accessing facility delivery services. Decentralization or transportation considerations may be useful to optimize MCH and HIV service impact in high-prevalence regions.
Evaluation of 3D Printed Temporal Bone Models in Preparation for Middle Cranial Fossa Surgery
Authors: Freiser Monika E. , Ghodadra Anish , Hirsch Barry E. , McCall Andrew A. 
Published: January 2019

Hypothesis:
Patient-specific 3D printed models are useful presurgical planning tools because they accurately represent the anatomy and drilling characteristics of the middle cranial fossa (MCF) approach to the internal auditory canal (IAC).

Background:
The MCF approach to the IAC can be challenging due to variability of the bony architecture along the floor of the middle fossa. Patient-specific 3D printed models may enhance surgeon knowledge of a given patient's anatomy when preparing for MCF surgery.

Methods:
Six temporal bone models were printed from photoacrylic resin based on CT data obtained from cadaveric specimens using a desktop stereolithography 3D printer. Critical structures to avoid injuring, the facial nerve and membranous labyrinth, were modeled as hollow cavities and filled with indicator paint. Two neurotologists each drilled three 3D printed models and the corresponding cadaveric specimens, and then completed a 41-item visual analog scale questionnaire (score range of each item: 0–10) to assess the model's accuracy, utility, and potential as a training tool.

Results:
Drilling the model was favorably rated (median score 9.2; range 7.3–9.6) for its ability to provide surgeons with an accurate mental image of the corresponding cadaveric anatomy. Overall similarity of feel of drilling the model in comparison to human bone was moderate (median 7.6; range 6.6–9.0). Surgeons would use this model to prepare for future cases (median 9.4; range 5.1–9.9) and felt it had excellent utility for training purposes (median 9.3; range 8.4–9.9).

Conclusions:
Patient-specific 3D printed models provide an anatomically accurate and favorable tool for preparing for MCF surgery.
The Use of the Exoscope in Lateral Skull Base Surgery: Advantages and Limitations
Authors: Garneau Jonathan C. , Laitman Benjamin M. , Cosetti Maura K. , Hadjipanayis Constantinos , Wanna George 
Published: January 2019

Objective:
We describe our experience using the extracorporeal video microscope, the “exoscope” for various applications within the field of lateral skull base surgery.

Study Design:
A retrospective case series was performed investigating patient demographics, indications for surgery, procedure type, operative time, approach to the skull base, complications, adequacy of visualization, and surgeon comfortability.

Patients:
Six cases were performed with a three dimensional surgical exoscope, obviating the use of a traditional binocular microscope.

Setting:
Academic, tertiary referral center.

Main Outcome Measures:
Type of surgical approach, operative time, patient demographics, surgical complications, and surgeon comfortability.

Results:
The following procedures were performed; four vestibular schwannoma resections via suboccipital craniotomy and two combined transmastoid and transtemporal approaches for temporal lobe encephalocele repairs. The average operative time was 227 and 577 minutes for temporal lobe encephalocele repairs and vestibular schwannoma cases, respectively. No intraoperative complications were encountered during these cases. None of the procedures required abandonment of the exoscope in favor of the microscope during the procedure. Advantages include high-resolution three-dimensional visualization, increased degrees of freedom for exoscope adjustment, and reduced surgeon fatigue in a fixed, unnatural posture. Limitations include decreased depth perception and increased operative time.

Conclusion:
The exoscope system is a safe and effective alternative or adjunct to the existing binocular operating microscope for lateral skull based procedures. The exoscope provides the surgeon with a comfortable, high-resolution visualization without compromising surgical exposure and patient safety.

Level of evidence: 4
Fluids and hyperosmolar agents in neurocritical care: an update
Authors: Farrokh Salia , Cho Sung-Min , Suarez Jose I. 
Published: January 2019

Purpose of review
To discuss recent updates in fluid management and use of hyperosmolar therapy in neurocritical care.

Recent findings
Maintaining euvolemia with crystalloids seems to be the recommended fluid resuscitation for neurocritical care patients. Buffered crystalloids have been shown to reduce hyperchloremia in patients with subarachnoid hemorrhage without causing hyponatremia or hypo-osmolality. In addition, in patients with traumatic brain injury, buffered solutions reduce the incidence of hyperchloremic acidosis but are not associated with intracranial pressure (ICP) alteration. Both mannitol and hypertonic saline are established as effective hyperosmolar agents to control ICP. Both agents have been shown to control ICP, but their effects on neurologic outcomes are unclear. A recent surge in preference for using hypertonic saline as a hyperosmolar agent is based on few studies without strong evidence.

Summary
Fluid resuscitation with crystalloids seems to be reasonable in this setting although no recommendations can be made regarding type of crystalloids. Based on current evidence, elevated ICP can be effectively reduced by either hypertonic saline or mannitol.
Acute kidney injury in cirrhosis: implications for liver transplantation
Authors: MacDonald Andrew J. , Nadim Mitra K. , Durand François , Karvellas Constantine J. 
Published: January 2019

Purpose of review
Acute kidney injury (AKI) in cirrhosis consists of varying phenotypes, with hepatorenal syndrome (HRS) representing a single entity. Prompt recognition and diagnosis of AKI cause identifies appropriate therapeutic measures. This review provides an overview of AKI definitions, highlights challenges in quantifying renal impairment in cirrhosis, lists novel diagnostic AKI biomarkers, and summarizes transplantation implications.

Recent findings
Biomarkers (neutrophil gelatinase-associated lipocalin, kidney injury molecule-1, interleukin-18, and liver-type fatty acid-binding protein) may assist in the identification of underlying acute tubular necrosis. Of these, neutrophil gelatinase-associated lipocalin is the most promising; however, significant overlap occurs among AKI phenotypes, with diagnostic values yet to be defined. Mainstay treatment of HRS consists of albumin and vasopressors. Acute-on-chronic liver failure grade independently predicts response to terlipressin treatment. Many end-stage liver disease patients with AKI have underlying chronic kidney disease with important implications on pre and postliver transplantation mortality. Simultaneous liver–kidney transplant candidacy is based on low likelihood of renal recovery.

Summary
Novel biomarkers may assist in identification of acute tubular necrosis and persistent/severe AKI. Norepinephrine has been suggested to be inferior to terlipressin, with additional research required. Increasing acute-on-chronic liver failure grade correlates with lower likelihood of vasopressor response in HRS. Severe preliver transplantation AKI confers significantly worse postliver transplantation renal outcomes.
Dyslipidemia in nonalcoholic fatty liver disease
Authors: Amor Antonio J. , Perea Verónica 
Published: January 2019

Purpose of review
To summarize recent findings regarding the characterization of lipoprotein disturbances in nonalcoholic fatty liver disease (NAFLD) and their relationship with cardiovascular disease (CVD) and make recommendations for the management of this situation.

Recent findings
Advanced lipoprotein profile (using NMR spectroscopy) has shown profound lipoprotein derangements which are overlooked with conventional analyses: increased number and size of very low-density lipoproteins particles, increased number of low-density lipoprotein particles (especially small sized), smaller high-density lipoprotein particles, and an increase in the triglyceride content of all these lipoproteins. Other changes such as impaired functionality of high-density lipoprotein particles have also been observed. Beyond low-density lipoprotein-related parameters, the importance of triglyceride-rich lipoproteins in the pathogenesis of atherosclerosis has recently gained interest. Several studies suggest that these lipoproteins may have an independent role in CVD in NAFLD populations. Although outcome studies with lipid-lowering drugs in NAFLD are lacking, treatment with both statins, and especially, triglyceride-lowering drugs could be promising for these populations at high residual cardiovascular risk.

Summary
In addition to being the main determinant of dyslipidemia, disturbances in triglyceride-rich lipoproteins are thought to be the key factor of increased CVD risk in NAFLD. Treatments specifically aimed at modifying these derangements warrant further study in this high-risk population.
Risk factors for valvular calcification
Authors: Chen Hao Yu , Engert James C. , Thanassoulis George 
Published: January 2019

Purpose of review
Recent literature is examined to identify established and emerging risk factors for valvular calcification, specifically calcific aortic valve disease and mitral annular calcification.

Recent findings
Strong evidence implicates older age, male sex, cigarette smoking, elevated blood pressure, dyslipidaemia, adiposity, and mineral metabolism as risk factors for calcific aortic valve disease. Emerging evidence suggests family history and lipoprotein(a) are additional risk factors. Recently, large-scale genome-wide analyses have identified robust associations for LPA, PALMD, and TEX41 with aortic stenosis. Factors predisposing to mitral annular calcification are less well characterized. Older age, cigarette smoking, increased BMI, kidney dysfunction, and elevated triglycerides are associated with greater risk of mitral annular calcification, but conflicting evidence exists for sex and C-reactive protein.

Summary
Established and emerging risk factors for calcific aortic valve disease, including some that overlap with atherosclerosis, may represent targets for pharmacological intervention. Mitral annular calcification is comparatively less well understood though some atherosclerosis risk factors do appear to increase risk.
Cannabinoid toxicity in pediatrics
Authors: Blohm Eike , Sell Peter , Neavyn Mark 
Published: January 2019

Purpose of review
The advent of legalized cannabis in multiple regions of the United States has rendered the drug more accessible to pediatric patients. Pediatricians and Pediatric Emergency Medicine Providers face new challenges in counseling both patients and their parents, diagnosing exploratory ingestions of cannabinoids in toddlers, and managing complications of prolonged, heavy cannabis use in adolescents. The purpose of this review article is to provide clinicians a succinct summary of recent literature regarding tetrahydrocannabinol (THC) pharmacokinetics, pharmacodynamics, impacts on development, as well as presentations of acute and chronic toxicity.

Recent findings
Many young children being admitted to the hospital for cannabis toxicity have been exposed to high concentration products, such as edibles, resins, or vaping fluid. These products contain extremely high concentrations of cannabinoids, and lead to sedation, respiratory depression, and other adverse effects. Chronic toxicity associated with cannabis consumption includes neurocognitive changes and cannabinoid hyperemesis syndrome.

Summary
Clinicians should provide guidance for pediatric patients and their caregivers to reduce the risk of accidental cannabis exposure, particularly with high concentration products. In addition, clinicians should consider chronic cannabis exposure when evaluating certain complaints, such as chronic vomiting or educational performance at school.
Laparoscopic right hepatectomy for living donor
Authors: Kwon Choon Hyuck David , Choi Gyu-Seong , Joh Jae-Won 
Published: January 2019

Purpose of review
Many institutions have started or are planning to start a purely laparoscopic right hepatectomy (PLRH) for adult living donor recipients but the experience is relatively very limited. The present review will look at the current status of PLRH and go over some of the technical details important for a safe operation. Necessary elements and different strategies to start a safe and reproducible PLRH program will be discussed.

Recent findings
Several publications with a relatively large number of cases have been published in the last few years. The initial results of PLRH seem to be comparable to open donor hepatectomy when performed by surgeons with sufficient expertise laparoscopic and donor hepatectomy.

Summary
With the ongoing accumulation of experience in laparoscopic liver surgery and living donor liver transplantation, it is most likely that PLRH will be performed more widely than the present time. Institutions should implement a step-by-step approach with proctorship, standardization of surgical procedures and a balanced selection criterion for donors for a safe transition from open method to a PLRH program.
The finances of a liver transplant program
Authors: Cook Makenzie , Zavala Edward 
Published: January 2019

Purpose of review
The current review provides an overarching examination of liver transplant finances and factors contributing to cost of care.

Recent findings
Transplant hospitals must seek to optimize areas of revenue and cut costs as the cost of transplantation continues to rise and public policies strain reimbursement.

Summary
Transplantation remains a complicated multipayor system that requires focused attention and care. With rising costs and increased focus on quality in the healthcare market, it is integral that both the clinical and business teams work together to strive for optimization of costs and revenue.
The parallel paradigm between intestinal transplant inflammation and inflammatory bowel disease
Authors: Belyayev Leonid , Loh Katrina , Fishbein Thomas M. , Kroemer Alexander 
Published: January 2019

Purpose of review
A significant shift in our understanding of the molecular and cellular basis for inflammatory bowel disease (IBD) mirrors research that has been ongoing in intestinal transplantation. The blurring of lines between these two disease states creates an avenue into potential therapeutic interventions which take advantage of these molecular similarities.

Recent findings
Traditional knowledge of T-cell involvement in IBD has expanded to highlight the role of T helper 17 (Th17) cells as key effector cells. A similar role has been demonstrated in cellular rejection of intestinal allografts. Genetic polymorphism related to the propagation and function of Th17 cells has been found to confer significant risk of developing autoimmune conditions. Interleukin-23, a cytokine identified as crucial to the expansion of Th17 cells, has become a validated molecular target in psoriatic arthritis and IBD, and could become a target for intestinal transplant therapies.

Summary
Intestinal transplant rejection and IBD share a similar phenotype, especially as it relates to key effector cells and gene polymorphisms. Improvements in our understanding of the immune-pathogenesis of IBD, as well as molecular targeting exploiting that knowledge, provide a potential route to improve outcomes for intestinal transplant patients.
Statin Use and Risk of Pancreatic Cancer
Authors: Zhang Yun , Liang Mingming , Sun Chenyu , Qu Guangbo , Shi Tingting , Min Min , Wu Yile , Sun Yehuan 
Published: January 2019

Objective
The aim of this study was to explore the relationship between statin use and the risk of pancreatic cancer.

Methods
Electronic databases were searched to identify relevant studies published until January 2018. The pooled relative risks (RRs) and 95% confidence intervals (CIs) were calculated with random-effects model. Subgroup analyses and sensitivity analysis were also conducted. Cochran Q test and I
2 statistic were used to evaluate the heterogeneity.

Results
Twenty-six studies were included that contained more than 3 million participants and 170,000 pancreatic cancer patients. The overall result demonstrated a significant decrease in pancreatic cancer risk with statin use (RR, 0.84; 95% CI, 0.73–0.97; P = 0.000; I
2 = 84.4%). In subgroup analyses, nonsignificant association was detected between long-term statin use and the risk of pancreatic cancer (RR, 0.98; 95% CI, 0.86–1.11; P = 0.718; I
2 = 0.0%). Meanwhile, there was nonsignificant association between the use of lipophilic statins and the risk of pancreatic cancer (RR, 0.98; 95% CI, 0.84–1.15; P = 0.853; I
2 = 27.2%). No publication bias was found in this meta-analysis.

Conclusions
The overall result of this meta-analysis supports the hypothesis that statins have a protective effect on pancreatic cancer. Furthermore, high-quality randomized clinical trials and cohort studies are needed to confirm these findings.
Temporal Trends in Incidence and Outcomes of Acute Pancreatitis in Hospitalized Patients in the United States From 2002 to 2013
Authors: Brindise Elizabeth , Elkhatib Imad , Kuruvilla Aneesh , Silva Rogelio 
Published: January 2019

Objectives
We sought to examine temporal trends in incidence and outcomes of acute pancreatitis (AP) in hospitalized adult patients in the United States.

Methods
Subjects were obtained from the Healthcare Cost and Utilization Project–Nationwide Inpatient Sample database using International Classification of Diseases, Ninth Revision, Clinical Modification codes for the years 2002–2013. Incidence of AP, all-cause mortality, cost, and duration of hospitalization were assessed.

Results
We identified 4,791,802 cases of AP. A significant increase in the incidence of AP was observed from 9.48 cases per 1000 hospitalizations in 2002 to 12.19 per 1000 hospitalizations in 2013 (P < 0.001). In-hospital mortality decreased from 2.99 cases per 100 cases in 2002 to 2.04 cases per 100 cases in 2013 (P < 0.001). Mean length of stay decreased from 6.99 (standard deviation [SD], 9.37) days in 2002 to 5.74 (SD, 7.94) days in 2013 (P < 0.001). Cost of hospitalization increased from $27,827 (SD, $54,556) in 2002 to $49,772 (SD, $106,205) in 2013 (P < 0.001).

Conclusions
Hospital admissions for AP in adults increased significantly in the United States from 2002 to 2013. In-hospital all-cause mortality and mean length of stay significantly decreased. In contrast, total cost of hospitalization rose.
Sinistral Portal Hypertension in Acute Pancreatitis
Authors: Xie Chao Lian , Wu Chang Qiang , Chen Yong , Chen Tian Wu , Xue Hua Dan , Jin Zheng Yu , Zhang Xiao Ming 
Published: January 2019

Objective
The aim of the study was to study the prevalence and characteristics of sinistral portal hypertension (SPH) in acute pancreatitis (AP) and its correlation with the severity of AP.

Methods
Retrospectively studied 633 patients with AP admitted to our institution and underwent magnetic resonance imaging (MRI). Diagnosis of SPH was based on clinical manifestations, laboratory tests, and MRI. The venous system and pancreatitis were evaluated on T1 weighted imaging, T2 weighted imaging, and dynamic-enhancement MRI. Data on patients' demographics, etiology, organ failure, MR severity index, and clinical outcomes were all collected.

Results
The SPH was detected in 21 patients (3.3%, 21/633). There was no statistical difference in organ failure between patients with SPH and without SPH (P > 0.05). The prevalence of SPH in males and females was 5.1% (17/336) versus 1.3% (4/297) (χ2 = 6.775, P = 0.009), in edematous and necrotizing AP was 0.4% (2/510) versus 15.5% (19/123) (χ2 = 65.413, P = 0.000), and in mild, moderate, and severe AP, based on MR severity index, were 0.6% (2/334) versus 2.9% (8/276) versus 47.8% (11/23) (χ2 = 55.977, P = 0.000), respectively.

Conclusions
The SPH rarely occurs in AP, and its risk is higher in males. Its presence is strongly associated with the local conditions of pancreatitis.