bluuebunny/crossref_metadata_2025_split huggingface dataset:
Einfluss eines Synbiotikums auf den Gewichtsverlauf
Authors: Axt-Gadermann Michaela , Lorenz Victoria 
Published: February 2018

ZusammenfassungAktuelle Untersuchungen belegen die Bedeutung des intestinalen Mikrobioms für die menschliche Gesundheit. Eine
Dysbiose hat nicht nur lokale Auswirkungen im Darm, sondern kann den gesamten Organismus betreffen und
verschiedene Stoffwechselstörungen begünstigen. Wird die Zusammensetzung des Mikrobioms durch Pro- und
Präbiotika positiv verändert, kann sich dies u. a. auch in einem verringerten Körpergewicht zeigen.
Ceramic-on-Ceramic in Total Hip Replacement Revision
Authors: Cucchi Davide , Gathen Martin , Streicher Robert , Wirtz Dieter 
Published: February 2018

Abstract
Background The use of Ceramic-on-Ceramic (CoC) bearings in primary total hip arthroplasty (THA) is increasing and has been intensively analysed. This bearing plays a particularly relevant role in young, active patients and shows advantages over other bearings in biocompatibility, wear rate and lubrication properties. On the contrary, CoC bearings in revision THA are seldom used and scarcely analysed. The aim of this study is to systematically review the available literature on CoC bearings in revision THA.
Methods A systematic research in the English literature was performed to identify all studies reporting results of THA revisions using ceramic-on-ceramic bearing. The initial search strategy revealed 555 articles for consideration. On the basis of eligibility criteria, 26 studies were included in this review.
Results Twenty-six studies, accounting for 1846 procedures, were eligible and included in the review. No studies of Level I were identified. Eighteen studies reported on revisions of CoC implants for various reasons, performed either with CoC or different bearings. In 111 patients a CoC bearing was used for the revision. Six studies consistently reported outcome measures for CoC bearing THA revisions, so that a quantitative synthesis of the data was possible. The range of follow-up across the six studies varied between 2.1 and 19 years, with a cumulative avearage follow-up of 9.3 years. A good functional result was documented, with a cumulative weighted mean for postoperative Harris Hip Score (HHS) of 87 points. The rate of dislocation in this group was 3.45% and the risk of fracture of an alumina ceramic head was 0.35% (1 study). Squeaking was reported as complication of CoC bearing THA revisions in three studies, with a calculated incidence of 0.52%.
Conclusion Modern CoC bearings show advantages in preclinical and retrospective studies over other bearings also in revision cases and are therefore to be considered a promising alternative for this kind of operation. Reasonable indications for CoC bearing in revision THA are revisions for aseptic loosening or recurrent dislocation in young patients, fractures of ceramic components, large acetabular defects or in patients that are allergic to bone cement components. Nevertheless, prospectively designed or randomized studies are lacking and needed to confirm CoC as optimal solution for revision THA cases.
Konflikte am Lebensende
Authors: Marquard Sara , Garthaus Marcus , Wendelstein Britta , Remmers Hartmut , Kruse Andreas 
Published: February 2018

Zusammenfassung
Hintergrund Die palliative Begleitung schwer kranker und sterbender Menschen in ambulanten und stationären Einrichtungen der Alten- und Krankenpflege wie auch der spezialisierten palliativen Versorgung erfordert multiprofessionelle Zusammenarbeit. Aufgrund der besonderen Belastungssituationen sowie der Charakteristika verschiedener Sterbeorte sind die Beteiligten mit zahlreichen Kommunikationsschwierigkeiten und damit verbundenen Konfliktfeldern konfrontiert.
Methodik Ziel war es, die Bedürfnisse und Erwartungen von Menschen in Palliativsituationen in der Interaktion mit Pflegenden zu erheben und herauszufinden, inwieweit Konfliktsituationen auftreten und wie diesen begegnet wird. Im Rahmen eines qualitativen Forschungsansatzes wurden 58 problemzentrierte Interviews mit Menschen in einer Palliativsituation in fünf unterschiedlichen Versorgungssettings (Palliativstation, Hospiz, Onkologie, stationäre Einrichtung der Altenhilfe, ambulante Versorgung) geführt und mittels qualitativer Inhaltsanalyse ausgewertet.
Ergebnisse Die Mehrheit der Befragten beschreibt institutionelle und personelle Rahmenbedingungen sowie das Verhalten der Pflegenden als konfliktursächlich. Im Bereich von Informationsasymmetrien zeigen sich Konflikte, die sich primär auf eine wechselseitige fehlende Offenheit, Ehrlichkeit und Transparenz beziehen.
Schlussfolgerung Gestützt auf Erkenntnisse des explorativen Forschungsprojekts soll im Rahmen eines geplanten Theorie-Praxis-Transferprojekts ein Beitrag zur Verbesserung der Versorgungsqualität am Lebensende geleistet werden.
Akupunktur bei Allergien – Erfahrungsheilkunde auf dem Weg zur Evidenz
Authors: Wullinger Michael 
Published: February 2018

ZusammenfassungGroßangelegte multizentrische Studien weisen die Akupunktur als evidenzbasierte Therapie der allergischen Rhinitis aus. Der Artikel beschreibt das Konzept der Traditionellen Chinesischen Medizin (TCM) bei der Behandlung des Heuschnupfens. Im Anschluss wird das modifizierte Vorgehen bei der Therapie einer Hausstaubmilbenallergie sowie einer Tierhaarallergie dargestellt. Es werden wichtige Studien zur Behandlung allergischer Erkrankungen mit Akupunktur sowie Konsequenzen, die sich daraus für die Behandlung in der Praxis ziehen lassen, beschrieben. Abschließend werden Möglichkeiten und Grenzen der Akupunktur und anderer Therapieverfahren der TCM bei der Behandlung von Heuschnupfen, Asthma und atopischem Ekzem aufgezeigt.
Eigenbluttherapie bei Allergie
Authors: Gündling Peter W 
Published: February 2018

ZusammenfassungDie Eigenbluttherapie wird seit vielen Jahren zur Regulation des Immunsystems nicht nur bei Allergien, sondern auch bei akuten und chronischen Infektionen bzw. Infektanfälligkeit erfolgreich eingesetzt. Die Eigenbluttherapie arbeitet mit dosierten Reizen, um eine Stärkung oder Adaptation des Immunsystems zu bewirken. Durch die Behandlung werden Abwehrmaßnahmen im Sinne einer Entzündung ausgelöst, was zur Aktivierung der Selbstheilungskräfte des Organismus führt. Zwar ist die wissenschaftliche Datenlage dieser Therapiemaßnahme noch relativ dünn, klinische Studien zur Behandlung von Neurodermitis und chronischer Urtikaria bestätigen jedoch die positiven Erfahrungen vieler Ärzte, Therapeuten und Patienten bei der Anwendung dieser Methode.
Development and validation of a scoring index to predict the presence of lesions in capsule endoscopy in patients with suspected Crohn’s disease of the small bowel: a Spanish multicenter study
Authors: Egea-Valenzuela Juan , González Suárez Begoña , Sierra Bernal Cristian , Juanmartiñena Fernández José Francisco , Luján-Sanchís Marisol , San Juan Acosta Mileidis , Martínez Andrés Blanca , Pons Beltrán Vicente , Sastre Lozano Violeta , Carretero Ribón Cristina , de Vera Almenar Félix , Sánchez Cuenca Joaquín , Alberca de las Parras Fernando , Rodríguez de Miguel Cristina , Valle Muñoz Julio , Férnandez-Urién Sainz Ignacio , Torres González Carolina , Borque Barrera Pilar , Pérez-Cuadrado Robles Enrique , Alonso Lázaro Noelia , Martínez García Pilar , Prieto de Frías César , Carballo Álvarez Fernando 
Published: February 2018

Background
Capsule endoscopy (CE) is the first-line investigation in cases of suspected Crohn’s disease (CD) of the small bowel, but the factors associated with a higher diagnostic yield remain unclear.

Objective
Our aim is to develop and validate a scoring index to assess the risk of the patients in this setting on the basis of biomarkers.

Patients and methods
Data on fecal calprotectin, C-reactive protein, and other biomarkers from a population of 124 patients with suspected CD of the small bowel studied by CE and included in a PhD study were used to build a scoring index. This was first used on this population (internal validation process) and after that on a different set of patients from a multicenter study (external validation process).

Results
An index was designed in which every biomarker is assigned a score. Three risk groups have been established (low, intermediate, and high). In the internal validation analysis (124 individuals), patients had a 10, 46.5, and 81% probability of showing inflammatory lesions in CE in the low-risk, intermediate-risk, and high-risk groups, respectively. In the external validation analysis, including 410 patients from 12 Spanish hospitals, this probability was 15.8, 49.7, and 80.6% for the low-risk, intermediate-risk, and high-risk groups, respectively.

Conclusion
Results from the internal validation process show that the scoring index is coherent, and results from the external validation process confirm its reliability. This index can be a useful tool for selecting patients before CE studies in cases of suspected CD of the small bowel.
The Black-White Disparity in Sexually Transmitted Diseases During Pregnancy: How Do Racial Segregation and Income Inequality Matter?
Authors: Noah Aggie J. , Yang Tse-Chuan , Wang Wei-lin 
Published: February 2018

Background
We investigate the roles of residential racial segregation and income inequality for the black-white disparity in acquiring sexually transmitted diseases (STD) during pregnancy in a multilevel framework.

Methods
The analytic sample consisted of non-Hispanic white (n = 79,271) and non-Hispanic black (n = 17,669) mothers from 2012 population birth data from Pennsylvania. We used the 2009 to 2013 American Community Survey for neighborhood characteristics of mothers; we used multilevel models.

Results
First, neighborhood-level factors are important for understanding this disparity because racial segregation and income inequality are significantly associated with acquiring STD during pregnancy, regardless of race. Second, racial segregation moderates the relationships between race/ethnicity and the acquisition of STD during pregnancy. White mothers are more vulnerable to neighborhood segregation than black mothers, and black mothers are less likely to acquire STD during pregnancy than white mothers if they reside with co-ethnics. Third, mothers residing in the most socioeconomically disadvantaged neighborhoods—as indicated by both absolute and relative measures of income inequality—have the highest odds of acquiring STD during pregnancy, regardless of race.

Conclusions
Neighborhood-level segregation and income inequality are important for understanding the acquisition of STDs during pregnancy. Our findings have important implications for future research and for place-specific prevention and intervention to reduce the racial disparity in STD during pregnancy.
Detection of Perforators for Free Flap Planning Using Smartphone Thermal Imaging: A Concordance Study with Computed Tomographic Angiography in 120 Perforators
Authors: Pereira Nicolás , Valenzuela Diego , Mangelsdorff Günther , Kufeke Matías , Roa Ricardo 
Published: February 2018

Summary:
Design and preoperative planning of microsurgical flaps are fundamental steps for successful surgery. Currently, computed tomographic angiography is considered the gold standard, and new technologies such as thermography could complement its usefulness. The aim of this study was to determine the concordance between thermographic images obtained with a smartphone thermal camera and computed tomographic angiography for detecting perforators using the anterolateral thigh flap area as a model. A concordance study of diagnostic tests was performed in patients who underwent limb reconstruction in 2016. Perforators identified in thigh computed tomographic angiographic images and hotspots on thermographic images obtained by means of the FLIR ONE smartphone camera were compared based on the distance from the anterior superior iliac spine. The authors studied 20 patients, including 38 anterolateral thigh flap territories in total, and identified 117 perforators by computed tomographic angiography and 120 hotspots by thermography. The average mean distance from the anterior superior iliac spine using these methods was 193.14 mm, and the mean difference in distance was 2.37 mm, with both measurements being obtained within a radius of 20 mm, with a concordance kappa index of 0.975 (p < 0.001). Thermographic imaging presented a sensitivity of 100 percent and a specificity of 98 percent in detecting perforators. Thermographic images obtained with a smartphone thermal camera have a high concordance with the method considered the gold standard for perforator detection. In addition, its sensitivity and specificity are comparable to those of computed tomographic angiography, which makes it a very useful method for mapping perforators in free flap planning.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Diagnostic, II.
Consensus of Leaders in Plastic Surgery: Identifying Procedural Competencies for Canadian Plastic Surgery Residency Training Using a Modified Delphi Technique
Authors: Knox Aaron D. C. , Shih Jessica G. , Warren Richard J. , Gilardino Mirko S. , Anastakis Dimitri J. 
Published: February 2018

Background:
Transitioning to competency-based surgical training will require consensus regarding the scope of plastic surgery and expectations of operative ability for graduating residents. Identifying surgical procedures experts deemed most important in preparing graduates for independent practice (i.e., “core” procedures), and those that are less important or deemed more appropriate for fellowship training (i.e., “noncore” procedures), will focus instructional and assessment efforts.

Methods:
Canadian plastic surgery program directors, the Canadian Society of Plastic Surgeons Executive Committee, and peer-nominated experts participated in an online, multiround, modified Delphi consensus exercise. Over three rounds, panelists were asked to sort 288 procedural competencies into five predetermined categories within core and noncore procedures, reflecting increasing expectations of ability. Eighty percent agreement was chosen to indicate consensus.

Results:
Two hundred eighty-eight procedures spanning 13 domains were identified. Invitations were sent to 49 experts; 37 responded (75.5 percent), and 31 participated (83.8 percent of respondents). Procedures reaching 80 percent consensus increased from 101 (35 percent) during round 1, to 159 (55 percent) in round 2, and to 199 (69 percent) in round 3. The domain “burns” had the highest rate of agreement, whereas “lower extremity” had the lowest agreement. Final consensus categories included 154 core, essential; 23 core, nonessential; three noncore, experience; and 19 noncore, fellowship.

Conclusions:
This study provides clarity regarding which procedures plastic surgery experts deem most important for preparing graduates for independent practice. The list represents a snapshot of expert opinion regarding the current training environment. As our specialty grows and changes, this information will need to be periodically revisited.
Nipple-Areola Complex Reconstruction
Authors: Gougoutas Alexander J. , Said Hakim K. , Um Grace , Chapin Anne , Mathes David W. 
Published: February 2018

Learning Objectives:
After studying this article, the participant should be able to: 1. Understand how to determine nipple-areola complex positioning on the reconstructed breast. 2. Understand the multitude of local flap and distant graft options for nipple-areola complex reconstruction. 3. Draw at least three fundamental nipple-areola complex reconstruction patterns. 4. Understand the forces that are responsible for flattening of the reconstructed papule. 5. Understand the current techniques used in secondary nipple-areola complex reconstructions.

Summary:
Nipple-areola complex reconstruction and tattooing represent the final two stages of breast reconstruction. Nipple-areola complex reconstruction is typically accomplished with the use of local flaps, local flaps with augmentation grafts, or a combination thereof. Regardless of the technique used, however, all nipple-areola complex reconstructions lose a degree of projection over time. Options for secondary reconstruction include the use of local tissue flaps alone or in combination with acellular biological matrices.
The Infratip Lobule Butterfly Graft: Balancing the Transition from the Tip Lobule to the Alar Lobule
Authors: Rohrich Rod J. , Afrooz Paul N. 
Published: February 2018

Summary:
The nasal alae and the soft-tissue triangles are delicate structures, the contours of which are largely dependent on soft tissue and the indirect influence of the lower lateral cartilages. Creating appropriate and continuous contour from the tip lobule to the alar lobule can be challenging. The alar contour graft is one reliable method of achieving predictable contour. However, alar contour grafts of ideal length may be scarce. The butterfly graft is a simple, reliable, and predictable method of providing support in the region of the soft triangle, and spans the region between the tip lobule and alar lobule, thereby balancing the transition between these regions.
FDG PET/CT Findings in a Localized Reactive Lymphoid Hyperplasia of the Spleen
Authors: Ito Yoshiaki , Nakahara Tadaki , Nishihara Yuichi , Shiraishi Junichi , Jinzaki Masahiro 
Published: February 2018

Abstract
A 38-year-old man with sigmoid colon cancer underwent a preoperative contrast-enhanced CT which incidentally revealed a modestly enhancing splenic mass. FDG PET/CT showed mildly increased uptake in the splenic lesion in contrast to prominently increased uptake in the colonic tumor. In addition, the splenic mass demonstrated only slightly increased signal intensity in diffusion-weighted MRI, suggesting low probability of metastasis. Splenectomy nonetheless was performed at surgery of the colon cancer. The histopathologic examination showed aggregated lymphoid follicles with germinal centers in the splenic lesion and made the diagnosis of localized reactive lymphoid hyperplasia a rare benign lymphoid tumor.
BSREM Reconstruction for Improved Detection of In-Transit Metastases With Digital FDG-PET/CT in Patients With Malignant Melanoma
Authors: Aljared Arwa , Alharbi Abdullah Awad , Huellner Martin W. 
Published: February 2018

Abstract
Block sequential regularized expectation maximization (BSREM) is a Bayesian penalized-likelihood reconstruction algorithm for PET, which reaches full convergence without the detriment of deteriorating the image quality by noise. Therefore, BSREM might have implications particularly for the detection of small lesions, which may be beneficial in melanoma patients. Our case of a 70-year-old man with metastasized malignant melanoma illustrates the impact of such a novel iterative PET reconstruction algorithm. Whereas the lymph node metastases are seen with the latest generation ordered subset expectation maximization reconstruction, the in-transit metastases are identified straightforward only with BSREM reconstruction.
18F-FDG PET/CT for Molecular Imaging of Hepatoblastoma in Beckwith-Wiedemann Syndrome
Authors: Derlin Thorsten , Hartung Dagmar , Hueper Katja 
Published: February 2018

Abstract
Beckwith-Wiedemann syndrome (BWS) is a rare congenital overgrowth disorder variably characterized by macrosomia, macroglossia, congenital hypoglycemia, and hemihyperplasia. The BWS predisposes affected individuals to embryonal tumors during childhood. The BWS is caused by abnormal gene regulation in a particular region of chromosome 11. We present the case of a 1-year-old boy with BWS who underwent an 18F-FDG PET/CT scan for restaging of hepatoblastoma. On the 18F-FDG PET scan, increased tracer accumulation was observed in hepatoblastoma lesions. In addition, marked hemihyperplasia was noted. This case highlights the usefulness of 18F-FDG PET/CT for restaging of hepatoblastoma in BWS.
Does the Degree of the Mastoid Pneumatization Affect the Side of Bell Palsy?
Authors: Güneş Selçuk , Çelik Mustafa , Çolak Ceylan , Olgun Burak 
Published: February 2018

Objective:
The aim is to investigate the impact of degree of mastoid pneumatization on the affected side of Bell palsy (BP).

Study Design:
Retrospective study in tertiary academic hospital.

Methods:
In total, 52 patients who were diagnosed with as BP were included in the study. Each patient was staged using House–Brackmann (HB) staging system. All patients underwent temporal bone computed tomography imaging. House–Brackmann scores, side of the BP, and mastoid pneumatization of all of patients were evaluated in the present study.

Results:
Regarding the degree of the mastoid pneumatization, there were no significant differences between the affected side and the unaffected side (P = 0.439). The degree of the mastoid pneumatization of the affected side and the unaffected side did not differ between males and females (P = 0.918 for the affected side, P = 0.765 for the unaffected side, respectively). A negative correlation between the age and mastoid pneumatization of each side was found (P = 0.001, P = 0.025, respectively). There was no significant correlation between HB score and the degree of the mastoid pneumatization of each side (P = 0.789, P = 0.703).

Conclusion:
As a conclusion, the degree of the mastoid pneumatization is not one of the risk factors for BP. Further randomized studies with larger numbers of patients are needed to confirm these findings.
Scanning Electron Microscopy Evaluation of Root Surfaces After Instrumentation With Two Piezoelectric Devices
Authors: Rotundo Roberto , Cozzolino Valerio , Mortellaro Carmen , Scarano Antonio 
Published: February 2018

Abstract
Scanning electron microscopy evaluation of root surfaces after ultrasonic instrumentation was performed with 2 different metallic tips on piezoelectric devices. Fresh extracted teeth were collected for experimental observation and randomly divided into 2 groups: Test Group, where the root surfaces were treated using an iron, rough, double nano-structural coated (T-Black), corindone-treated tip, and Control Group where the root surfaces were treated with a conventional iron smooth tip. A scanning electronic microscope analysis was performed and the surface roughness and the amount of residual debris were evaluated. Descriptive and inferential statistics were performed. Twenty specimens were analyzed, 10 per group and a total of 21.4 × 106 μm2 has been observed. On treated area percentage of debris after ultrasonic scaling in Test Group was 1.9 ± 1.8%, while in Control Group it was 5.7 ± 4.3%. Within the limits of the study, it seems that the efficacy of the novel iron, rough, double nano-structural coated (T-Black), corindone-treated structure tip showed greater performance in terms of root surface debridement than the conventional iron smooth tip. The possibility to use a single tool (ultrasonic device with a specific tip) for the root planing procedure within the nonsurgical mechanical therapy may represent a significant advantage for the clinicians. The tested novel tip seems to be able to show the requested ideal characteristics. However, further clinical studies are needed to demonstrate the in vitro results.