bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cavernous sinus-orbital apex aspergillus infection in a diabetic patient
Authors: Huang Yuanyuan , Gui Li 
Published: March 2019

Abstract

Rationale:
Cavernous sinus-orbital apex aspergillosis is a rare but serious complication of rhinosinusitis. Pathology results are scarce, and this condition is difficult to diagnose based on clinical and radiological results.

Patient concerns:
A 64-year-old woman presented with cavernous sinus-orbital apex syndrome. Axial and sagittal T1 contrast-enhanced magnetic resonance imaging (MRI) showed a right orbital apex mass abutting the right posterior ethmoid sinus, sphenoid sinus, and cavernous sinus.

Diagnosis:
Cavernous sinus and orbital apex aspergillosis.

Interventions:
Functional endoscopic sinus surgery was performed, and a biopsy of the lesion tissue was submitted for examination, which showed the presence of aspergillus.

Outcomes:
One year after surgical debridement, antifungal, and anticoagulation treatments, the patient is still asymptomatic without recurrence.

Lessons:
Early surgical debridement is crucial to confirm the diagnosis of cavernous sinus-orbital apex aspergillosis and prevent mortality. There is no evidence of negative effects of antibiotic and anticoagulation treatments. Despite controversy, among physicians, most opt to treat patients via anticoagulation therapy.
Presbylaryngis: a state-of-the-art review
Authors: Mallick Ali Sameer , Garas George , McGlashan Julian 
Published: March 2019

Purpose of review
Presbylaryngis is the term used to describe changes in the larynx with ageing. It represents an increasingly common complaint as global populations continue to grow and get older. Presbylaryngis has a significantly negative impact on patients’ quality of life and their ability to participate in society. This article will review the relevant literature on the incidence, pathophysiology, clinical evaluation, and treatment modalities for presbylaryngis.

Recent findings
The recently developed Ageing Voice Index (AVI) constitutes the first validated instrument for voice complaints specifically for the elderly. The evidence suggests that the bedrock of treating presbylaryngis centres on voice therapy. Thus, voice therapy should represent the primary treatment offered with surgery reserved for those failing to adequately respond. However, the comparative effectiveness of the different surgical interventions, namely injection laryngoplasty and thyroplasty, remains undetermined highlighting the need for larger, prospective, comparative studies.

Summary
Presbylaryngis is characterized by specific changes at the microscopic level resulting in age-related vocal fold atrophy. However, its presence alone does not always result in symptomatic dysphonia and equally, presbyphonia is often multifactorial involving the lower respiratory tract in addition to the larynx. Thus, the role of a multidisciplinary voice clinic for presbylaryngis cannot be overstated.
Sedation and the Food and Drug Administration Warning
Authors: Fishman Douglas S. , Andropoulos Dean B. , Lightdale Jenifer R. 
Published: March 2019

ABSTRACTPediatric gastroenterologists recommend and perform a range of procedures requiring sedation and anesthesia in young children. A recent warning from the US Food and Drug Administration (FDA) states that “repeated or lengthy use of general anesthetics and sedation drugs during surgeries or procedures in children younger than 3 years or in pregnant women during their third trimester may affect the development of children's brains.” 1 As it relates to time, the FDA warning details risks of “procedures lasting longer than 3 hours or if multiple procedures are required.” Pediatric gastroenterologists and related specialists should be aware of the warning and its relevance to their patients.
Sleep Quality Among Teenagers and Young Adults With Cancer
Authors: Fortmann Judith , Fisher Abigail , Hough Rachael , Gregory Alice , Pugh Gemma 
Published: March 2019

Background
Teenagers and young adults (TYAs) with cancer are known to suffer poor sleep quality and sleep disturbances; understanding the level of burden is essential to improving patient outcomes via supportive care interventions.

Objectives
To compare sleep quality and the prevalence of sleep disturbances among TYA cancer patients, TYA survivors, and general population TYAs with no history of cancer.

Methods
Teenager and young adult patients receiving active cancer treatment (n = 70), TYA cancer survivors (n = 151), and general population TYAs (n = 324) aged between 13 and 24 years completed the Pittsburgh Sleep Quality Index. Analyses of covariance were used to investigate potential group differences. Age at survey diagnosis, gender, ethnicity, and health status were included as covariates.

Results
84.29% of TYA patients, 62.91% of TYA cancer survivors, and 65.12% of general population TYAs reported Pittsburgh Sleep Quality Index scores greater than 5, suggesting clinically significant sleep disorders. Teenager and young adult patients reported significantly poorer global sleep quality compared with TYA survivors (mean difference, 0.99; 95% confidence interval, 0.03–1.96; P = .044) and general population TYAs (mean difference, 1.34; 95% confidence interval, 0.26–2.41; P = .009). Teenager and young adult patients and survivors reported significantly poorer sleep latency (P = .003 for TYA patients, P = .035 for TYA survivors off treatment) and habitual sleep efficiency (P < .001 for TYA patients, P = .014 for TYA survivors) than general population controls.

Conclusions
The significant differences observed suggest young people with cancer, particularly those on treatment, may benefit from specialized sleep interventions.

Implications for Practice
Efforts to ensure health professionals have the knowledge and skills to provide advice about sleep to young people with cancer are needed.
The Reliability and Validity of the Turkish Version of the Lymphedema Life Impact Scale in Patients With Breast Cancer–Related Lymphedema
Authors: Orhan Ceren , Üzelpasaci Esra , Baran Emine , Nakip Gülbala , Özgül Serap , Aksoy Sercan , Akbayrak Türkan 
Published: March 2019

Background
Health-related quality of life is measured to detect the influence of lymphedema on physical, functional, and social aspects of life in patients with breast cancer–related lymphedema (BCRL).

Objective
This study aimed to perform the psychometric evaluation of the Lymphedema Life Impact Scale (LLIS) in Turkish patients with BCRL.

Methods
Patients with BCRL (n = 78) filled out the Turkish LLIS, Lymphedema Quality of Life, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30, and Quick Disability of Arm, Shoulder and Hand scales. Breast cancer survivors without BCRL (n = 35) completed only the Turkish LLIS. Psychometric properties were analyzed with the internal consistency, test-rest reliability, construct, criterion, and discriminant validity.

Results
The internal consistency of the Turkish LLIS was strong (Cronbach’s α coefficient >.70). Test-retest reliability was strong to very strong (intraclass correlation coefficients from 0.88 to 0.93; P < .001). Similar to the original structure of the scale, exploratory factor analysis identified 3 factors. Criterion validity was supported by moderate to strong correlations between the LLIS, Lymphedema Quality of Life, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30, and quick Disability of Arm, Shoulder and Hand. There were significant differences in the total and subscale scores of the LLIS between participants with and without BCRL (P < .05).

Conclusions
The present study provided the evidence to confirm reliability and clinical validity of the Turkish LLIS.

Implications of Practice
The Turkish LLIS is a reliable and valid condition-specific scale to measure the physical, functional, and psychological aspects of health-related quality of life in patients with BCRL.
Modeling the Effects of Stress, Anxiety, and Depression on Rumination, Sleep, and Fatigue in a Nonclinical Sample
Authors: Thorsteinsson Einar B. , Brown Rhonda F. , Owens Michelle T. 
Published: March 2019

AbstractStress and affective distress have previously been shown to predict sleep quality, and all the factors have been shown to predict fatigue severity. However, few prior studies have examined the likely indirect mediational relationships between stress, affective distress, and sleep quality in predicting fatigue severity, and the potential role played by ruminative thinking. A short questionnaire asked 229 participants about their recent experiences of stress, affective distress, rumination, sleep, and fatigue in a community sample. High stress, anxiety, and depression were related to more ruminative thinking, which in turn was related to poor sleep quality (composed of subjective sleep quality, daytime dysfunction, sleep latency, and sleep disturbance) and poor sleep quality predicted worse fatigue. The results suggest that rumination parsimoniously explains the tendency of stress and affective distress to contribute to poor sleep quality, and together with poor sleep, it may also contribute to worse fatigue in some individuals.
An Unusual Case of Homicide by Impalement With a Battering Ram
Authors: Franceschetto Lisa , Carlini Luigi , Lancia Massimo , Bacci Mauro 
Published: March 2019

Abstract
Impalement injuries occur when a large foreign body traverses or penetrates a body cavity or extremity. Nowadays, impalement injuries are uncommon and are usually a consequence of a fall onto a blunt object or a road accident. The authors report a case of a woman found dead in her apartment, seemingly killed by a firearm injury to the abdomen. However, after the autopsy was carried out, it became clear that the injuries had the features of an impalement. After the inquiry, the murder weapon was identified as a battering ram, used by the robbers to break into the house of the woman. This is the first case ever described in literature where a battering ram has been used to impale someone. This case emphasizes the importance of an accurate description of injuries, also with photographs, in order to achieve effective recognition of the wound patterns as they may correspond to specific and unusual weapons.
Tuberculosis Surveillance in Taiwan Forensic Autopsy Cases
Authors: Hu Hsuan-Yun , Wei Shyh-Yuh , Wu Tai-Yun , Huang Wei-Hsiang , Pan Chih-Hsin 
Published: March 2019

AbstractTuberculosis (TB) is one of the most important public health issues worldwide, and global efforts have altered the TB epidemic. This study analyzed 71 cases of TB at autopsy notified via Taiwan Medical Examiner Surveillance for Lethal Infectious Disease (Taiwan Med-X) between 2012 and 2017 and applied immunohistochemistry to formalin-fixed lung tissue. Tuberculosis was present in 0.57% (71/12,369) forensic autopsy cases in the institute. Among the study cases, 30 (42.3%) cases were newly diagnosed with TB at autopsy, whereas 41 (57.7%) cases were notified before death and have still seen the TB pathological changes. Regarding the death investigation, cause of death was TB accounted for 46.5%, and non-TB, 53.5% (including trauma, 26.8%; other diseases, 19.7%; drowning, 4.2%; and drug abuse, 2.8%, respectively). Compared with the staining signal, immunohistochemistry has better sensitivity than acid-fast staining. This study provides a reassessment of the reference value to estimate the burden of disease caused by TB and emphasizes the importance of biosafety in an autopsy room.
Impact of Ankle-Foot Orthosis on Gait Efficiency in Ambulatory Children With Cerebral Palsy
Authors: Betancourt Jean P. , Eleeh Prince , Stark Stacy , Jain Nitin B. 
Published: March 2019

Objective
Children with cerebral palsy experience functional limitations because of excessive muscle weakness, spasticity, and impaired motor control. They are prescribed ankle-foot orthoses to assist with ambulation. Our objective was to analyze stride length and dorsiflexion data comparing the effectiveness of “ankle-foot orthoses” with “barefoot or shoes only” on ambulatory children with cerebral palsy.

Design
An electronic literature search was conducted. Studies were screened by two reviewers based on our inclusion criteria: prospective cohort study or randomized clinical trial, participants younger than 18 yrs with a primary diagnosis of cerebral palsy, ankle-foot orthoses with a control group, 20 combined participants in the experimental and control groups for cohort studies, and 10 participants for randomized clinical trials.

Results
Seventeen studies were selected. Pooled results of the meta-analyses showed that stride length was significantly better in the ankle-foot orthoses group as compared with the control group (mean difference between groups = 0.05 m (95% confidence interval = 0.04–0.06). The dorsiflexion angle (5 studies, 124 participants) was improved in patients with ankle-foot orthoses as compared with barefoot or shoes only (mean difference between groups = 8.62 degrees (95% confidence interval = 8.05–9.2).

Conclusions
Children with cerebral palsy using ankle-foot orthoses had improved stride length and dorsiflexion angle during gait in a pooled meta-analyses of cohort studies and clinical trials.
The Preparation of the Recipient Site in Fat Grafting: A Comprehensive Review of the Preclinical Evidence
Authors: Oranges Carlo M. , Striebel Julia , Tremp Mathias , Madduri Srinivas , Kalbermatten Daniel F. , Harder Yves , Schaefer Dirk J. 
Published: March 2019

Background:
Several methods to prepare the recipient site in fat grafting have been proposed in recent decades. However, to date, these procedures have never been reviewed exhaustively. The purpose of the present study is to provide a comprehensive overview of the different techniques to prepare the recipient site for fat grafting as they were investigated in preclinical studies, with resulting outcomes and underlying mechanisms of action.

Methods:
The PubMed/MEDLINE database was queried to search for preclinical investigations on the preparation of the recipient site in fat grafting using the following algorithm: ((recipient site) AND (fat grafting) OR (lipofilling) OR (lipograft)). A priori criteria were applied to review the resulting articles.

Results:
Thirteen animal studies met inclusion criteria. Overall, five techniques were identified: external volume expansion, implantation of alloplastic material (silicone sheets), administration of cell-proliferation factors (i.e., vascular endothelial growth factor, adipose tissue–derived stromal vascular fraction, and interleukin-8), ischemia, and microneedling. A positive effect on cellular activity (cell proliferation and angiogenesis) was demonstrated by all studies and achieved with all techniques. Seven of the eight authors who examined this aspect reported enhancement of fat graft survival.

Conclusions:
Improvement of fat grafting surgical outcomes is documented preclinically using different recipient-site preparation techniques, particularly through enhancement of vascularization and soft-tissue expansion. This understanding will lead to further clinical research, especially for those cases where improvement of the recipient site is recommended, such as contracted scars or preirradiated tissues.
Abdominoplasty in the Obese Patient: Risk versus Reward
Authors: Batac Joseph , Hamade Malack , Hamade Hassan , Glickman Laurence 
Published: March 2019

Background:
The incidence of obesity is on the rise worldwide. Many surgeons elect not to perform abdominoplasty on patients with a high body mass index, fearing an increased risk of perioperative complications. In this study, the authors compare the outcomes of obese and nonobese patients who underwent abdominoplasty.

Methods:
A retrospective chart analysis was performed on all patients who underwent abdominoplasty by a single surgeon from 2009 to 2016. Complication rates were compared in obese and nonobese patients. Patients were excluded if they did not undergo a full abdominoplasty, underwent a combined surgical procedure, or underwent liposuction in an area outside of the abdomen or flanks at the time of the abdominoplasty.

Results:
A total of 83 patients were included: 62 nonobese and 21 obese patients. The obese group had a higher average body mass index (34. 9 kg/m2 versus 25.1 kg/m2; p < 0.001). Follow-up time was similar (310 days versus 265 days; p = 0.468). No significant differences were seen with regard to perioperative seroma formation (14.2 percent versus 22.5 percent; p = 0.419)), wound dehiscence (9.5 percent versus 11.29 percent; p = 0.822), hematoma formation (4.7 percent versus 1.6 percent; p = 0.438), or surgical-site infection (9.5 percent versus 8.0 percent; p = 0.835). No instances of venous thromboembolism were observed.

Conclusions:
Abdominoplasty, with or without concurrent liposuction, in obese patients, is a safe and effective procedure with similar perioperative complication rates as the nonobese patient population. No significant differences were observed in perioperative complications.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Risk, II.
The Smile Index: Part 2. A Simple, Prognostic Severity Scale for Unilateral Cleft Lip
Authors: Yao Caroline A. , McCullough Meghan , Auslander Allyn , Imahiyerobo Thomas A. , Vanderburg Richard , Magee William P. 
Published: March 2019

Background:
There is no universally accepted classification system for unilateral cleft lip that objectively quantifies the spectrum of disease, making it difficult to evaluate postoperative outcomes in the context of preoperative severity.

Methods:
Anthropometric measurements and photographs were prospectively collected from unilateral cleft lip patients in Morocco, Bolivia, Vietnam, and Madagascar. Columellar angle, cleft width, nostril widths, vertical lip heights, and horizontal vermillion lengths were measured preoperatively and postoperatively. “Unacceptable” postoperative outcomes were defined as those with a cleft-side/non–cleft-side vertical lip height discrepancy greater than 3 mm, based on previous sociologic and cleft outcome studies.

Results:
Of the 147 patients studied, 22 had unacceptable outcomes. Univariate logistic and multivariate logistic stepwise models showed that among preoperative characteristics, cleft width ratio (preoperative cleft width divided by commissure width) was the most significant predictor for unacceptable outcomes, controlling for surgeon experience. Cleft width ratio was normally distributed. Two severity categories were created based on iterative data and regression analysis: “severe” (cleft width ratio >0.5) and “not-severe” (cleft width ratio <0.5). Severe patients had a higher likelihood of unacceptable outcomes versus not-severe patients (OR, 2.9; 95 percent CI, 1.1 to 7.7; p = 0.029; 27 percent versus 11 percent). The probability of having unacceptable outcomes for severe individuals was higher versus not-severe individuals (positive predictive value, 73 percent versus 89 percent).

Conclusions:
Preoperative cleft width ratio greater than 0.5 is associated with having an unacceptable surgical outcome. The authors propose a simple, objective, and clinically reproducible scale to unify the language of unilateral cleft lip severity, as a step toward improving algorithms of care, directing surgical technique, guiding patient/family discussions, and optimizing patient outcomes.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Risk, III.
Plastic Surgery and Social Media: Examining Perceptions
Authors: Chopan Mustafa , Sayadi Lohrasb , Clark Eric M. , Maguire Kevin 
Published: March 2019

Background:
Social media play an important role in plastic surgery, yet there are limited studies in the literature to guide plastic surgeons’ social networking practices. To address this deficiency and provide further insight, the authors set out to investigate the public’s attitude toward plastic surgery using Twitter, a popular social media platform. The authors examined a large body of messages (tweets) related to plastic surgery using novel techniques of natural language processing and sentiment analysis.

Methods:
The authors collected over 1 million tweets with the keywords “plastic,” “cosmetic,” “aesthetic,” and “reconstruction” surgery spanning from 2012 to 2016 from the Twitter Gardenhose feed. Using hedonometrics, the authors extracted the average happiness/positivity (h
avg) of tweets and created word-shift graphs to determine the most influential words.

Results:
The positivity scores for keywords “plastic,” “cosmetic,” “aesthetic,” and “reconstruction” surgery were 5.72, 6.00, 6.16, and 6.09, respectively. In relation to “plastic,” keywords “cosmetic” and “aesthetic” were more positive because they lacked antagonistic words, such as “fake,” “ugly,” “bad,” “fails,” or “wrong.” The keyword “reconstruction,” however, was more positively associated than the term “plastic” because of an increase in positive words, such as “honor,” “amazing,” “successful,” and “respect.”

Conclusions:
Tweets containing the term “plastic” surgery trended toward negativity, and may be explained by the increase in unfavorable, associative words. Conversely, related terms such as “aesthetic,” “cosmetic,” and “reconstruction” were more favorably regarded because of the lack of antagonistic words and the presence of supportive words. The authors’ results are informative and may serve to guide plastic surgeons’ social media practices.
Strategies for Reconstruction of the Plantar Surface of the Foot: A Systematic Review of the Literature
Authors: Crowe Christopher S. , Cho Daniel Y. , Kneib Cameron J. , Morrison Shane D. , Friedrich Jeffrey B. , Keys Kari A. 
Published: March 2019

Background:
Reconstruction of the plantar surface of the foot is challenging because of its distinctive anatomy and microarchitecture. Unfortunately, no single coverage option meets the needs of all patients and defects. A comprehensive literature review is presented to better define available reconstructive options for resurfacing the plantar foot.

Methods:
A systematic literature search was performed to identify articles relating to reconstruction of the plantar skin and soft tissue. The PubMed, Embase, and Scopus databases were queried for published articles. After the exclusion of duplicate records, 1624 articles were available for review. A total of 280 unique articles were included for analysis, with a total of 2684 individual reconstructions.

Results:
Of the articles reviewed, 10 percent described a skin grafting technique, 53 percent described a locoregional flap, 32 percent described free tissue transfer, and 5 percent described multiple reconstructive methods. Isolated heel defects were the most frequently reconstructed subunit of the plantar foot (73 percent). The latissimus dorsi muscle was the most commonly used free flap, whereas the reverse sural artery flap was the most commonly used locoregional flap. Protective sensation was noted in most locoregional and free flap reconstructions, regardless of primary neurotization; however, improved two-point discrimination was noted when neurofasciocutaneous flaps were used. Complication rates varied widely, although rates of flap loss approached those of flaps performed at other anatomical sites.

Conclusions:
Numerous methods exist for reconstructing the plantar surface. Proper flap selection should be determined by the size of the defect, the availability of donor tissue, and the surgeon’s experience and comfort with the reconstructive technique.