bluuebunny/crossref_metadata_2025_split huggingface dataset:
Updates on adjuvant chemotherapy and radiation therapy for endometrial cancer
Authors: Cowan Matthew , Strauss Jonathan B. , Barber Emma L. , Matei Daniela 
Published: December 2018

Purpose of review
This article will provide an opinion on adjuvant treatment of stage I–III endometrial cancer based on existing and evolving evidence.

Recent findings
For early-stage (I and II) intermediate risk endometrial cancer, vaginal brachytherapy reduces the risk of locoregional relapse. Recent studies have investigated the use of chemotherapy in early stage, high-risk patient population, but did not demonstrate a survival benefit. As such, chemotherapy is only recommended for selected patients at high risk for distant recurrence. On the other hand, for stage III disease, chemotherapy has a well established role. A landmark trial recently reported confirmed that chemoradiation improves recurrence-free survival compared with radiation alone in stage III endometrial cancer. However, in another randomized phase III trial, chemoradiotherapy was not superior to chemotherapy alone in this group, raising questions as to whether addition of radiation is necessary. Therefore, improved risk stratification using molecular markers in addition to traditional pathological criteria is critically needed to better predict the risk of local and systemic recurrence and to assist therapy decision-making.

Summary
Endometrial cancer care is evolving and recent pivotal trials highlight the significance of chemotherapy to the treatment of stage III endometrial cancer and not to the approach for stage I and II cancer. The role of radiation therapy for stage III disease is raised into question.
K-RIM (Corneal Rim) Angle Surgery Training Model
Authors: Arora Anish , Nazarali Samir , Sawatzky Lauren , Gooi Malcolm , Schlenker Matt , Ahmed Ike K. , Gooi Patrick 
Published: December 2018

Purpose:
To develop an angle surgery training model for training an array of microincisional glaucoma surgery (MIGS) procedures.

Methods:
We describe a method for preparing an angle surgery training model using human cadaveric corneoscleral rims. The model provides realistic tactile tissue simulation and excellent angle visualization requiring bimanual technique. Corneoscleral rims may be used multiple times and are prepared at low cost, allowing for a high volume of practice surgeries.

Results:
This model allows for practice in bimanual surgical training using the gonioscopy lens for visualize alongside surgical tools. The in vivo surgical conditions and limited tactile feedback are recreated using human cadaveric eyes which nonhuman models fail to provide. Our model is prepared at low cost, with relative ease and also provides appropriate positioning of Schlemm canal and for high volume of practice as the canal can be used in 90-degree segments.

Conclusions:
Few angle surgery training models currently exist and none provide these necessary features. The model presented here aims to meet the growing demand for adequate training models required for technically advanced MIGS techniques.
Topical Tacrolimus (FK506, Protopic) in the Treatment of Atopic Dermatitis
Authors: Nagrani Nicole K. , Zito Patrick M. 
Published: December 2018

ABSTRACT
Drugs are medications or substances that are used to modify physiologic responses and alleviate associated symptoms. In dermatology, medications and substances are utilized on a daily basis and include topical treatments to anesthetics in micrographic surgery to biologic-acting immunologic agents. The purposes of this section are to focus on drug, specifically how it works and how it is utilized, and to discuss routine alternatives (if available). In this column, we will focus on the uses, mechanism of action, adverse effects, and alternatives to topical tacrolimus (Protopic) in atopic dermatitis.
Optimizing respiratory management in resource-limited settings
Authors: Inglis Rebecca , Ayebale Emmanuel , Schultz Marcus J. 
Published: December 2018

Purpose of review
This review focuses on the emerging body of literature regarding the management of acute respiratory failure in low- and middle-income countries (LMICs). The aim is to abstract management principles that are of relevance across a variety of settings where resources are severely limited.

Recent findings
Mechanical ventilation is an expensive intervention associated with considerable mortality and a high rate of iatrogenic complications in many LMICs. Recent case series report crude mortality rates for ventilated patients of between 36 and 72%. Measures to avert the need for invasive mechanical ventilation in LMICs are showing promise: bubble continuous positive airway pressure has been demonstrated to decrease mortality in children with acute respiratory failure and trials suggest that noninvasive ventilation can be conducted safely in settings where resources are low.

Summary
The management of patients with acute respiratory failure in LMICs should focus on avoiding intubation where possible, improving the safety of mechanical ventilation and expediting weaning. Future directions should involve the development and trialing of robust and context-appropriate respiratory support technology.
Airway pressure release ventilation in children
Authors: Lalgudi Ganesan Saptharishi 
Published: December 2018

Purpose of review
In patients with acute respiratory distress syndrome (ARDS), airway pressure release ventilation (APRV) has been purported to have several physiological benefits. This review synthesizes recent research evaluating APRV mode and provides perspectives on the utility of this mode in children with ARDS.

Recent findings
Two single-center clinical trials on APRV, one adult and one pediatric, have been published this year. These two trials have not only elicited editorials and letters that highlight some of their strengths and weaknesses but also rekindled debate on several aspects of APRV. Despite their contradicting results, both trials provide significant insights into APRV strategies that work and those that may not. This review places the newer evidence in the context of existing literature and provides a comprehensive analysis of APRV use in children.

Summary
There have been significant recent advancements in our understanding of the clinical utility of APRV in children with ARDS. The recent trial highlights the urgent need to evolve a consensus on definition of APRV and identify strategies that work. Pending further research, clinicians should avoid the use of a zero-P
LOW Personalized-APRV strategy as a primary ventilation modality in children with moderate–severe ARDS.
Role of Prices, Utilization, and Health in Explaining Texas Medicaid Newborn Care Spending Variation
Authors: Ganduglia Cazaban Cecilia , Kim Youngran , Goodman David C. , Avritscher Elenir B. , Vogel Bruce , Franzini Luisa 
Published: December 2018

Background:
Newborn care is one of the most frequent types of hospitalization and Medicaid covers over 50% of all births nationwide. However, little is known about regional variation in Medicaid newborn care spending and its drivers.

Objectives:
To measure the contribution of market-level prices, utilization, and health risk on regional variation in spending among newborn Medicaid population in Texas.

Research Design and Methods:
The study used 2014 Texas Medicaid newborn claims and encounters linked to birth and death certificate data. Newborn care spending was defined as Medicaid payments per newborn hospital stay, including hospital transfers, from birth through discharge home or death. Spending was further categorized into inpatient facility and related professional spending. Variation in spending across neonatal intensive care regions was decomposed into price and utilization, accounting for input price and health risk differences.

Results:
Newborn care spending across Texas regions varied significantly (coefficient of variation, 0.31), with most of the variation attributed to spending on inpatient facility services (91%). Both price (41%) and utilization (27%) played a role in explaining this variation, after adjusting for health status (29%) and input price (4%). Though most regions with the highest spending indexes had high price and utilization indexes, some had high spending driven mostly by high prices and others by high utilization.

Conclusions:
Significant regional variations in price, utilization, and health status exist in Medicaid newborn care across Texas in 2014. Disentangling the effect of each driver is important to address spending variation and improve efficiency in newborn care.
Why some organ allografts are tolerated better than others: new insights for an old question
Authors: Hull Travis D. , Benichou Gilles , Madsen Joren C. 
Published: December 2018

Purpose of reviewThere is great variability in how different organ allografts respond to the same tolerance induction protocol. Well known examples of this phenomenon include the protolerogenic nature of kidney and liver allografts as opposed to the tolerance-resistance of heart and lung allografts. This suggests there are organ-specific factors which differentially drive the immune response following transplantation.Recent findingsThe specific cells or cell products that make one organ allograft more likely to be accepted off immunosuppression than another are largely unknown. However, new insights have been made in this area recently.SummaryThe current review will focus on the organ-intrinsic factors that contribute to the organ-specific differences observed in tolerance induction with a view to developing therapeutic strategies to better prevent organ rejection and promote tolerance induction of all organs.
Quality initiatives in pediatric transplantation
Authors: Kelly Beau , Squires James E. , Feingold Brian , Hooper David K. , Mazariegos George V. 
Published: December 2018

Purpose of review
Pediatric transplantation faces unique challenges in implementing dynamic quality improvement measures because of proportionally smaller volumes compared to adults, logistics of being integrated successfully within larger or complex hospital systems, lack of adult-affiliated transplant centers, varying focus in prioritization of relevant outcome metrics, and potential lack of sufficient resources.

Recent findings
To address these challenges, multiinstitutional collaborations have developed which have proven increasingly effective in driving awareness and quality improvement measures to supplement regulatory efforts in the pediatric population. Relevant work from the Pediatric Heart Transplant Society and Studies in Pediatric Liver Transplantation will be highlighted. The introduction of learning networks such as the Improving Renal Outcomes Collaborative and the Starzl Network for Excellence in Pediatric Transplantation have further focused on continuous learning initiatives in renal and liver transplantation using collaboration and patient informed measures.

Summary
Optimal transplant performance improvement is fully integrated into health delivery at all points of the patient pathway. Progress in performance improvement will require ongoing integration of big data solutions, improved patient engagement and technology solutions.

Video Abstract:

http://links.lww.com/COOT/A4
The relationship between inflammatory markers extracted from complete blood count and active pulmonary tuberculosis
Authors: Valizadeh Ardalan Pooya , Servatyari Karo , Kashefi Hajar , Afrasiabian Shahla , Abdi Mohammad , Ahmadi Abbas 
Published: December 2018

Background:
Pulmonary tuberculosis (PTB) is a fatal infectious disease and remains a major global health problem especially in undeveloped countries. Delay in diagnosis and treatment may cause worsening of the disease, increasing the risk of mortality and easily spreading. This investigation aims to explore the correlation between inflammatory markers extracted from complete blood count (CBC) including red cell distribution width (RDW), neutrophil-to-lymphocyte ratio, RDW to platelet count ratio (RPR), platelet-to-lymphocyte ratio, and other inflammatory markers with active PTB disease. These biomarkers are easily accessible in least possible time and low facility centers even in undeveloped regions to detect inflammation.

Method:
This is a retrospective cohort study. Recorded laboratory and clinical data of 45 diagnosed PTB patients hospitalized in Tohid Hospital (Sanandaj, Iran) were gathered by scanning the records from September 2013 to February 2017. Forty-five age-matched and sex-matched healthy individuals were included as controls. All CBC tests were done by Sysmex KX21N. All Leukocyte differential counts were done by blinded skilled hematologist.

Results:
PTB patients had a significantly higher RPR values compared with control group (0.041 versus 0.058, P = 0.0001). Neutrophil counts, RDW, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and C-reactive protein values were also higher in patient with active PTB opposed to control group.

Conclusion:
RPR is a novel useful inflammatory marker easily done and calculated from a routine CBC report which can be used as a supportive available markers to help the management of patients suffering from active PTB. The inclusion of RPR in all CBC reports is recommended.
Assessing Uncertainty in an Anatomical Site-Specific Gonorrhea Transmission Model of Men Who Have Sex With Men
Authors: Spicknall Ian H. , Mayer Kenneth H. , Aral Sevgi O. , Romero-Severson Ethan O. 
Published: December 2018

Background
Increased gonorrhea detection highlights the need for additional prevention efforts. Gonorrhea may only be acquired when there is contact between infected and uninfected anatomical sites. With 3 sites of infection, this leads to 7 plausible routes of men who have sex with men (MSM) transmission: urethra-to-rectum, rectum-to-urethra, urethra-to-oropharynx, rectum-to-oropharynx, oropharynx-to-urethra, oropharynx-to-rectum, and oropharynx-to-oropharynx. We characterize the uncertainty and potential importance of transmission from each anatomical site using a deterministic compartmental mathematical model.

Methods
We developed a model of site-specific gonococcal infection, where individuals are infected at 0, 1, 2, or all 3 sites. Sexual behavior and infection duration parameters were fixed similar to a recent model analysis of Australian MSM. Markov chain Monte Carlo methods were used to sample the posterior distribution of transmission probabilities that were consistent with site-specific prevalence in American MSM populations under specific scenarios. Scenarios were defined by whether transmission routes may or may not transmit by constraining specific transmission probabilities to zero rather than fitting them.

Results
Transmission contributions from each site have greater uncertainty when more routes may transmit; in the most extreme case, when all routes may transmit, the oropharynx can contribute 0% to 100% of all transmissions. In contrast, when only anal or oral sex may transmit, transmission from the oropharynx can account for only 0% to 25% of transmission. Intervention effectiveness against transmission from each site also has greater uncertainty when more routes may transmit.

Conclusions
Even under ideal conditions (ie, when site-specific gonococcal prevalence, relative rates of specific sex acts, and duration of infection at each anatomical site are known and do not vary), the relative importance of different anatomical sites for gonococcal infection transmission cannot be inferred with precision. Additional data informing per act transmissibility are needed to understand site-specific gonococcal infection transmission. This understanding is essential for predicting population-specific intervention effectiveness.
Rapidly Spreading Human Immunodeficiency Virus Epidemic Among Older Males and Associated Factors: A Large-scale Prospective Cohort Study in Rural Southwest China
Authors: Chen Huanhuan , Wu Xinghua , Chen Li , Lu Huaxiang , Tang Zhenzhu , Shen Zhiyong , Pan Stephen W. , Ruan Yuhua , Shao Yiming 
Published: December 2018

Background
Increasing risk of human immunodeficiency virus (HIV) heterosexual transmission can raise the potential for a more diffuse and generalized epidemic. In response to the paucity of data on HIV incidence among heterosexuals in China, we conducted a large-scale, population-based cohort study located in rural southwest China.

Methods
Baseline enrollment for the study was conducted from 2013 to 2014 and follow-up at 12 months was from 2014 to 2015 among adults 20 years or older in 3 rural counties of Southwest China. Study participants were informed of the study by brochures and leaflets distributed in outreach activities. Interviews and blood collection were conducted in private rooms. Blood samples were tested for HIV infection.

Results
The HIV prevalence of the sample was 0.29% (95% confidence interval [CI], 0.27–0.30) (2063 of 722,795) among the total adult population of 1,090,296 potential participants 20 years or older at baseline. Of the 720,732 individuals who tested HIV-negative at baseline, 493,990 (69%) completed the follow-up. Overall HIV incidence was 2.73 (95% CI, 2.38–3.08) per 10,000 person-years (PY) (235 of 860,627 PY). Human immunodeficiency virus incidence was associated with males, older age, less than secondary schooling and not currently being married. Human immunodeficiency virus incidence was 71.28 (95% CI, 35.21–107.35) per 10,000 PY among males aged 50 to 69 years who had less than secondary schooling and were divorced or widowed. Heterosexual sex was the dominant transmission mode for HIV seroconversions (99.0%).

Conclusions
Older heterosexual males were at disproportionate risk of HIV infection. Health authorities in China need to develop and implement innovative interventions suitable for the broader population of older heterosexuals.
Resistance Profile of Neisseria gonorrhoeae in KwaZulu-Natal, South Africa Questioning the Effect of the Currently Advocated Dual Therapy
Authors: Rambaran Santhuri , Naidoo Kavitha , Dookie Navisha , Moodley Prashini , Sturm Adriaan Willem 
Published: December 2018

Background
We report on the antimicrobial resistance profile of Neisseria gonorrhoeae isolates and the distribution of tetM genes in isolates with high-level tetracycline resistance in KwaZulu-Natal, South Africa.

Methods
Male and female patients presenting with urethral and/or vaginal discharge were recruited into the study. Urethral and cervical secretions were cultured on New York City agar. Confirmatory tests for N. gonorrhoeae included Gram stain, catalase, oxidase, and carbohydrate utilization tests. Beta-lactamase was tested by means of the chromogenic cephalosporin test. Minimum inhibitory concentrations were determined using agar dilution with multipoint inoculation. Polymerase chain reaction with gel electrophoresis was used to detect the presence and type of the tetM gene.

Results

N. gonorrhoeae was isolated from the specimens of 319 (26%) of the 1220 recruited patients. Of these 319 isolates, 71% were resistant to 3 or more drugs. Resistance to azithromycin was found in 68% of the isolates. All isolates showed high-level tetracycline resistance with minimum inhibitory concentration values of 16 and 32 mg/mL. The tetM gene was present in 293 (92%). The American type was found in 264 (90%) and the Dutch type in 29 (10%). Twenty-six (8%) did not carry a tetM gene.

Conclusions
The current syndromic management with dual ceftriaxone and azithromycin is due to the high level of azithromycin resistance factually single-drug therapy. High-level tetracycline resistance based on a resistance mechanism other than ribosome protection by the tetM gene product is present in N. gonorrhoeae infecting South African patients.
A Practical Roadmap for Writing of Medical Scientific Publications
Authors: Ugarte-Gil Manuel Francisco , Alarcón Graciela S. 
Published: December 2018

Abstract
In this article, we are providing a general description of the process of moving a research project from completion to publication; we are describing the process of assigning authors, the drafting of the manuscript, the review process, and how to respond to comments received from reviewers and editors. This roadmap is meant to stimulate the scientific productivity of junior researchers across the continent.
99mTc-MIBI Uptake in a Benign Thymic Cyst
Authors: Lee Hwan , Gault Christopher R. , Cheng Gang , Shah Jagruti C. , Pantel Austin R. 
Published: December 2018

Abstract
A 34-year-old man with end-stage renal failure status post rejection of a deceased donor kidney transplant presented with bone pain in the setting of elevated serum parathyroid hormone and calcium levels. A 99mTc-MIBI SPECT/CT was performed before planned subtotal parathyroidectomy. SPECT/CT imaging revealed a 1.9-cm anterior mediastinal lesion with radiotracer uptake on both the immediate and delayed images. Surgical pathology of the lesion showed a benign thymic cyst with no parathyroid component.
Diffuse Large B-Cell Lymphoma Recurring as Neurolymphomatosis on FDG PET/CT
Authors: Ganeshalingam Rueben , Roach Paul , Schembri Geoffrey Paul 
Published: December 2018

Abstract
Two patients with diffuse large B-cell lymphoma relapsing as neurolymphomatosis diagnosed on FDG PET/CT are presented. Both patients were treated initially with chemotherapy and had a complete metabolic response. Patient 1 represented with lower-limb pain. An FDG PET/CT demonstrated intense uptake throughout the sciatic nerves bilaterally extending distally with relapse confirmed on biopsy. Patient 2 represented to hospital with worsening mobility, neuropathic pain, and facial asymmetry. An FDG PET/CT demonstrated relapse within the spinal cord, left sciatic nerve, and facial nerve branches. Neurolymphomatosis is an uncommon finding on FDG PET/CT and can be the only site of relapse.
Richter Syndrome Presenting With Colon Localization
Authors: Lavalle Mariadea , Minordi Laura Maria , Hohaus Stefan , Manfredi Riccardo , Rufini Vittoria 
Published: December 2018

Abstract
A 75-year-old man, who had been diagnosed with small lymphocytic lymphoma with cervical localization, underwent 18F-FDG PET/CT with iodinated contrast medium due to the appearance of cervical swelling suspected of illness relapse. PET/CT revealed intense 18F-FDG uptake in multiple cervical and subdiaphragmatic lymph nodes and in the left parotid. Moreover, diffuse uptake and wall thickening of the colon were evident; endoscopy with biopsy revealed a diffuse large B-cell lymphoma. Transformation into a more aggressive lymphoma occurs in 2% to 8% of small lymphocytic lymphoma, the so-called Richter syndrome. Extranodal localization in the sigmoid colon is an extremely rare site for transformed lymphoma.
Arterial Phase 18F-Fluorocholine PET/CT in Hepatocellular Carcinoma
Authors: Legendre Alexandre , Collet Guillaume , Lahousse Hélène , Aziz Anne-Laure , Petyt Grégory 
Published: December 2018

Abstract
A 57-year-old man was referred to our institution for 18F-fluorocholine PET/CT to characterize a pulmonary nodule in a context of hepatocellular carcinoma. 18F-FDG PET/CT did not show any uptake of the pulmonary nodule. 18F-fluorocholine PET/CT showed high uptake of the pulmonary nodule, confirming its metastatic origin. Furthermore, liver early dynamic acquisitions allowed better visualization of the hepatocellular carcinoma during the “arterial phase” than at equilibrium.
Incidental 18F-NaF Uptake in Drug-Induced Gynecomastia
Authors: Kothekar Esha , Raynor William Y. , Al-Zaghal Abdullah , Werner Thomas J. , Alavi Abass 
Published: December 2018

Abstract
Gynecomastia is not uncommon in men older than 50 years of age and is characterized by glandular proliferation of breast tissue. Non-physiologic gynecomastia is mostly caused by a variety of external medical interventions. Medications that belong to classes of antiandrogens, antipsychotics, or antibiotics alter the levels of estrogen and testosterone and are commonly implicated in patients with gynecomastia. We are presenting a case of bilateral 18F-NaF uptake in the breast tissue of a 56-year-old man with known history of prostate cancer.