bluuebunny/crossref_metadata_2025_split huggingface dataset:
Simultaneous Hodgkin lymphoma and BRAF V600E -positive papillary thyroid carcinoma
Authors: Liu Shu , Zhao Yanru , Li Miaojing , Xi Jieying , Shi Bingyin , Zhu Huachao 
Published: January 2019

Abstract

Rationale:
Papillary thyroid carcinoma (PTC) is the most common endocrine malignancy. However, the simultaneous occurrence of PTC and Hodgkin Lymphoma (HL) was rarely reported.

Patient concerns:
We present a case of simultaneous BRAF

V600E

-positive PTC and HL in a 17-year-old female.

Diagnosis:
She was referred to our clinic with a painless lump in her left neck. A highly suspicious thyroid nodule and multiple enlarged lymph nodes in the neck were found by ultrasonography examination. The suspicious nodule was diagnosed as PTC by fine needle aspiration cytology.

Interventions:
A total thyroidectomy with bilateral lymph node dissection was performed and the microscopic examination revealed a 2-cm PTC with BRAF

V600E
mutation and HL (mixed cellularity) in the bilateral lymph nodes. PTC was postoperatively considered as T1bN0M0. Levothyroxine (125 μg/d) was administered to the patient for thyrotropin suppression therapy. Then the patient was referred to the Department of Hematology to receive 4 cycles of ABVD followed by 30 Gy involved-site radiotherapy and radioactive iodine (RAI) therapy for thyroid cancer.

Outcomes:
After two cycles of ABVD, multiple enlarged lymph nodes showed a significant response to the chemotherapy in the patient.

Lessons:
Simultaneous HL and BRAF

V600E
-positive PTC is extremely rare. Biopsy of the suspicious lymph nodes should be performed to confirm malignancy metastasizing from PTC or other lesions. Similarly, in HL patients with suspicious thyroid nodule, ultrasound-guided fine needle aspiration of thyroid nodule should be performed to exclude thyroid malignancy.
Surgical management of spinal metastases of thymic carcinoma
Authors: Liu Shuzhong , Zhou Xi , Song An , Huo Zhen , Li William A. , Rastogi Radhika , Wang Yipeng , Liu Yong 
Published: January 2019

Abstract

Rationale:
Metastatic thymic carcinoma in the spine is a rare disease with no standard curative managements yet. The objective of this study is to report a very rare case of spinal metastases of thymic carcinoma successfully operated by combination of instrumentation and cement augmentation together with adjuvant treatment. The management of these unique cases has yet to be well-documented.

Patient concerns:
A 57-year-old man presented with a 6-month history of continuous and progressive back pain. The patient, who had been diagnosed of thymic carcinoma (stage IV B) for 3 years, received surgical treatment of median sternotomy thymectomy, followed by 3 cycles of chemotherapy and 12 cycles of radiotherapy.

Diagnosis:
Magnetic resonance imaging (MRI) of spine showed spinal cord compression secondary to the epidural component of the T4 mass, with increased metastatic marrow infiltration of the left T4 vetebral body, which presented as a solid tumor. Post-operative pathology confirmed the diagnosis of spinal metastases of thymic carcinoma.

Interventions:
The patient underwent exploratory surgery, circumferential spinal cord decompression, cement augmentation and a stabilization procedure via a posterior approach.

Outcomes:
The patient's neurological deficits improved significantly after the surgery, and the postoperative period was uneventful at the 3-month follow-up visit. There were no other complications associated with the operation during the follow-up period.

Lessons:
Taken together, the lesion's clinical features, imaging results, and pathological characteristics are unique. Combined efforts of specialists from orthopedics, neurosurgery, thoracic surgery, and medical oncology led to the successful diagnosis and management of this patient. Metastatic thymic carcinoma of the spine, although rare, should be part of the differential diagnosis when the patient has a history of thymic carcinoma and presents with back pain and radiculopathy. We recommend the posterior approach for spinal decompression of the metastatic thymic carcinoma when the tumor has caused neurological deficits. Osteoplasty by cement augmentation is also a good choice for surgical treatment.
Effect of preoperative smoking cessation on postoperative pain outcomes in elderly patients with high nicotine dependence
Authors: Zhao Shuai , Chen Fan , Wang Dunwei , Wang Hongdan , Han Wei , Zhang Yuan 
Published: January 2019

Abstract

Objective:
To investigate the effect of smoking cessation before surgery on postoperative pain and analgesic consumption after thoracoscopic radical resection of lung cancer in elderly patients with high nicotine dependence.

Methods:
A total of 107 male patients, ages 60 to 70 years, undergoing elective thoracoscopic radical lung cancer surgery from July 2017 to July 2018 were enrolled into 3 groups: group A (highly nicotine-dependent and discontinued smoking <3 weeks before surgery, n = 36), group B (highly nicotine-dependent and discontinued smoking >3 weeks before surgery, n = 38), and group C (nonsmokers, n = 33). Postoperative sufentanil consumption, visual analog scale (VAS) pain scores at rest and during cough, rescue analgesia, opioid-related adverse events, and patient satisfaction were assessed from 0 to 48 h postoperatively.

Results:
Patient characteristics were comparable among the 3 groups. Sufentanil consumption and VAS pain scores from postoperative 0 to 48 h were significantly higher in groups A and B than in group C. In addition, group B had lower sufentanil consumption and pain scores than group A. No differences in the need for rescue analgesia, patient satisfaction, or occurrence of postoperative adverse events, including nausea, vomiting, respiratory depression, and oversedation, were observed among the 3 groups.

Conclusion:
Compared with nonsmokers, highly nicotine-dependent male patients who were deprived of cigarettes experienced more severe pain and required treatment with more sufentanil after thoracoscopic radical lung cancer surgery. Moreover, preoperative smoking cessation at least 3 weeks before surgery led to better postoperative pain outcomes than smoking cessation within 3 weeks of surgery.
Progress in the problem of relapsed or refractory acute myeloid leukemia
Authors: Mims Alice S. , Blum William 
Published: January 2019

Purpose of review
The majority of patients with acute myeloid leukemia (AML) die from disease recurrence and historically, treatment options in both the relapsed and refractory settings of this disease have been limited. However, new insights into the molecular characterization and biology of relapsed and refractory AML have led to novel therapeutics and improvement in outcomes in these settings. The current understanding of mechanisms of disease resistance and status of treatment options both currently available and under exploration in relapsed and refractory AML are summarized in this review.

Recent findings
The rapid approval of multiple therapeutic agents since 2017 has led to improvement in selected populations such as isocitrate dehydrogenase and fms-like tyrosine kinase 3-mutated relapsed and refractory AML with agents such as enasidenib, ivosidenib, and gilteritinib. Despite these advancements, the only current curative approach remains allogeneic transplantation and only for those minority of patients that are candidates. However, encouraging results are being seen with a multitude of novel small molecular inhibitors and immunotherapeutic approaches currently in clinical trials both as single agents and combination strategies in both upfront and relapsed/refractory AML.

Summary
Continued advancements in the knowledge of various mechanisms of relapse and resistance in AML are ongoing, leading to the realization that diverse treatment strategies are needed to both prevent and manage relapsed and refractory disease.
Evaluating Longitudinal Associations Between Depressive Symptoms, Smoking, and Biomarkers of Cardiovascular Disease in the CARDIA Study
Authors: Carroll Allison J. , Huffman Mark D. , Zhao Lihui , Jacobs David R. , Stewart Jesse C. , Kiefe Catarina I. , Liu Kiang , Hitsman Brian 
Published: January 2019

ABSTRACTObjectiveThe aim of the study was to evaluate associations between 15-year trajectories of co-occurring depressive symptoms and smoking with biomarkers of cardiovascular disease at year 15.MethodsIn the Coronary Artery Risk Development in Young Adults study, we modeled trajectories of depressive symptoms (Center for Epidemiologic Studies-Depression scale [CES-D]) and smoking (cigarettes per day [CPD]) among 3614 adults followed from year 0 (ages 18–30 years) through year 15 (ages 33–45 years). Biomarkers of inflammation (high-sensitivity C-reactive protein), oxidative stress (superoxide dismutase, F2-isoprostanes), and endothelial dysfunction (soluble intercellular adhesion molecule 1, soluble P-selectin) were assessed at year 15. We conducted separate linear regression analyses with CES-D trajectory, CPD trajectory, and their interaction with each of the five biomarkers.ResultsThe sample was 56% women, 47% black, and 40 years old on average at year 15. The CES-D trajectory by CPD trajectory interaction was not associated with any of the biomarkers (allp's > .01). Removing the interaction term, CES-D trajectory was associated with inflammation: higher levels of high-sensitivity C-reactive protein were observed in the subthreshold (β = 0.57,p= .004) and increasing depressive symptoms (β = 1.36,p< .001) trajectories compared with the no depression trajectory. CPD trajectory was associated with oxidative stress and endothelial dysfunction: compared with never smokers, heavy smokers had significantly higher levels of F2-isoprostanes (β = 6.20,p= .001), soluble intercellular adhesion molecule 1 (β = 24.98,p< .001), and soluble P-selectin (β = 2.91,p< .001).ConclusionsCo-occurring depressive symptoms and smoking do not seem to synergistically convey risk for cardiovascular disease via processes of inflammation, oxidative stress, or endothelial dysfunction. Nonetheless, these results advance our understanding of the complex relationships between modifiable risk factors and chronic disease.
Socioeconomic Adversity, Social Resources, and Allostatic Load Among Hispanic/Latino Youth: The Study of Latino Youth
Authors: Gallo Linda C. , Roesch Scott C. , Bravin Julia I. , Savin Kimberly L. , Perreira Krista M. , Carnethon Mercedes R. , Delamater Alan M. , Salazar Christian R. , Lopez-Gurrola Maria , Isasi Carmen R. 
Published: January 2019

ABSTRACT

Objective
We examined associations among socioeconomic adversity, social resources, and allostatic load in Hispanic/Latino youth, who are at high risk for obesity and related cardiometabolic risks.

Methods
Participants were 1343 Hispanic/Latino youth (51% male; ages 8–16 years) offspring of Hispanic Community Health Study/Study of Latinos participants. Between 2012 and 2014, youth underwent a fasting blood draw and anthropometric assessment, and youth and their enrolled caregivers provided social and demographic information. A composite indicator of allostatic load represented dysregulation across general metabolism, cardiovascular, glucose metabolism, lipid, and inflammation/hemostatic systems. Socioeconomic adversity was a composite of caregiver education, employment status, economic hardship, family income relative to poverty, family structure, and receipt of food assistance. Social resources were a composite of family functioning, parental closeness, peer support, and parenting style variables.

Results
Multivariable regression models that adjusted for sociodemographic factors, design effects (strata and clustering), and sample weights revealed a significant, positive, association between socioeconomic adversity and allostatic load (β = .10, p = .035), and a significant, inverse association between socioeconomic adversity and social resources (β = −.10, p = .013). Social resources did not relate to allostatic load and did not moderate or help explain the association of adversity with allostatic load (all p values > .05).

Conclusions
Statistically significant, but small associations of socioeconomic adversity with both allostatic load and social resources were identified. The small effects may partially reflect range restriction given overall high socioeconomic adversity and high social resources in the cohort.
Quantitative Multiparametric Breast Ultrasound
Authors: Kapetas Panagiotis , Clauser Paola , Woitek Ramona , Wengert Georg J. , Lazar Mathias , Pinker Katja , Helbich Thomas H. , Baltzer Pascal A.T. 
Published: January 2019

Objectives
The aim of this study was to evaluate breast multiparametric ultrasound (mpUS) and its potential to reduce unnecessary breast biopsies with 1, 2, or 3 additional quantitative parameters (Doppler, elastography, and contrast-enhanced ultrasound [CEUS]) to B-mode and investigate possible variations with different reader experience.

Materials and Methods
This prospective study included 124 women (age range, 18–82 years; mean, 52 years), each with 1 new breast lesion, scheduled for ultrasound-guided biopsy between October 2015 and September 2016. Each lesion was examined with B-mode, elastography (Virtual Touch IQ [VTIQ]), Doppler, and CEUS, and different quantitative parameters were recorded for each modality. Four readers (2 experienced breast radiologists and 2 in-training) independently evaluated B-mode images of each lesion and assigned a BI-RADS (Breast Imaging Reporting and Data System) score. Using the area under the receiver operating characteristic curve (AUC), the most accurate quantitative parameter for each modality was chosen. These were then combined with the BI-RADS scores of all readers. Descriptive statistics and AUC were used to evaluate the diagnostic performance of mpUS.

Results
Sixty-five lesions were malignant. MpUS with B-mode and 2 additional quantitative parameters (VTIQ and CEUS or Doppler) showed the highest diagnostic performance for all readers (averaged AUCs, 0.812–0.789 respectively vs 0.683 for B-mode, P = 0.0001). Both combinations significantly reduced the number of false-positive findings up to 46.9% (P < 0.0001).

Conclusions
Quantitative mpUS with 2 different triple assessment modalities (B-mode, VTIQ elastography, CEUS, or Doppler) shows the best diagnostic performance for breast cancer diagnosis and leads to a significant reduction of false-positive biopsy recommendations, for both experienced and inexperienced readers.
Preferential Associated Malformation in Patients With Anotia and Microtia
Authors: Shibazaki-Yorozuya Reiko , Nagata Satoru 
Published: January 2019

Objective:
Few epidemiological studies have investigated the external ear malformations anotia and microtia. The authors’ study aimed to investigate the relationships between age, sex, type of microtia, and birth place and associated malformation as seen in 1 private Japanese clinic.

Methods:
Cases of anotia/microtia that presented in Nagata Microtia and Reconstructive Plastic Surgery Clinic (Saitama, Japan) between 2005 and 2018 were included in the study. The authors identified 1896 patients with anotia/microtia with or without associated malformation. Most were primary cases, with some secondary reconstruction cases wherein the primary surgery was performed at another hospital. Cases were classified with Nagata classification; lobule type, small concha type, concha type, and anotia. Cryptotia was also observed in this study.

Results:
Among the patients, 61.1% were male, 85.4% had unilateral defects (69.0% LB), and 59.1% had a right-sided defect. Most patients were less than 1 year old (15.0%) or 8 to 10 years old (5.5%–6.3%) on first examination, while 58% were from the Kanto region, including Tokyo. Regarding concomitant disorders, 32.7% had an accompanying malformation, while 13.3% had associated syndromes (eg, craniofacial microsomia, Treacher Collins syndrome). To conclude, in the authors’ clinic, most cases of anotia/microtia were LB, unilateral, and seen in male patients. Information regarding several characteristic clinical features was obtained, especially that clefts and musculoskeletal deformities of the skull/face and jaw were the main accompanying malformations.
Anatomical Study and Clinical Application of Free Thoracoacromial Artery True-Perforator Flap for Reconstruction of the Face
Authors: Iida Takuya , Yoshimatsu Hidehiko 
Published: January 2019

Introduction:
The clavicular region is acknowledged as one of the most suitable donor sites for reconstruction of the face or neck. Recently, a free thoracoacromial artery (TAA) perforator (TAAP) flap was reported as a new option for reconstruction of the face. However, the TAAP flap has several drawbacks including tedious intramuscular dissection of the pedicle and loss of availability of a pectoralis major flap as a bailout option in case of cancer recurrence. We performed an anatomical study of the TAAP and developed a novel TAA “true-perforator” flap, in which we can preserve the main trunk of the TAA.

Patients and Methods:
Anatomical study of the TAAPs was performed in 6 patients while elevating a deltopectoral flap or a pedicled TAAP flap. Location and diameter of the perforators were recorded. Based on these anatomical findings, we developed a novel free TAA true-perforator flap, which we used for the reconstruction of a facial defect after cancer resection.

Results:
The most dominant TAAP was identified 4.8-cm (4 to 7-cm) caudally from the upper border of the deltopectoral triangle along the cephalic vein and 1.7-cm (0.5 to 2-cm) medially from the cephalic vein. The diameter of the TAAPs at the level of fascial penetration was 0.78-mm (0.6 to 1.0-mm). The pedicle could be elongated up to 3-cm with proximal dissection. Clinical case showed a satisfactory aesthetic result with minimal donor-site morbidity.

Conclusions:
A free TAA true-perforator flap can be a new option for the reconstruction of the face with many advantages including reduced donor-site morbidity and satisfactory aesthetic outcome.
Biological Response to Recombinant Human Bone Morphogenetic Protein-2 on Bone-Implant Osseointegration in Ovariectomized Experimental Design
Authors: Song Yanbin , Wan Linzhong , Zhang Shuangyue , Du Yifei 
Published: January 2019

Objective:
The aim of this study is to investigate the effects of recombinant human bone morphogenetic protein-2 (rhBMP-2) on bone-implant osteointegration in osteoporotic rats.

Materials and Methods:
Thirty-six female Wistar rats were randomly divided into 3 groups: sham-operation (SHAM), ovariectomized (OVX), and ovariectomized with rhBMP-2 (OVX + rhBMP-2). The bone density of right tibia was observed with x-ray and the serum alkaline phosphatase (ALP) activity was measured preovariectomy and postovariectomy using an ALP-kit. In OVX + rhBMP-2 group, rhBMP-2 was embedded in the peri-implant area, while SHAM and OVX groups did not contain rhBMP-2. Four and eight weeks after implantation, the rats were killed and the right tibia with implants was taken by x-ray. Histologic changes were investigated by hematoxylin and eosin staining, scanning electron microscope (SEM), and energy dispersive spectrometer examinations.

Results:
The serum ALP level was significantly higher in ovariectomized rats compared with that before ovariectomy (P < 0.05), while no difference was found in SHAM rats. At 12 weeks after ovariectomy, radiographic and histologic findings showed significant osteoporotic changes in proximal tibial metaphyses of OVX rats, including reduced cortical bone density and enlargement of bone marrow cavity compared with SHAM ones. The results of implantation verified new bone formation around implants in OVX + rhBMP-2 and SHAM groups, indicating favorable bone healing and osseointegration. No bone resorption was found in OVX + rhBMP-2 group, while some soft tissue was observed in bone-implant interface in SHAM group. In OVX group, there was no effective bone-implant osseointegration and mature bone formed around implants, and some implants were even lost due to chronic inflammation. The percentage of calcium and phosphorous atoms was significantly higher and the percentage of sulfur element was significantly lower in peri-implant area in OVX + rhBMP-2 and SHAM groups than that in OVX group.

Conclusion:
rhBMP-2 could enhance the osseous healing and restore bone-implant osseointegration in osteoporotic rats.
Management of Mandibular Fractures Using Locking and Nonlocking Miniplates
Authors: Wusiman Patiguli , Tayie Alifu , Ling Wang , Moming Adili 
Published: January 2019

Purpose:
The study proposed to determine the superiority between locking plate and nonlocking miniplate for mandibular fractures (MFs) treatment.

Methods:
A comprehensive electronic search examining Medline-Ovid, Embase, and PubMed databases language without date was performed in February 2018. Inclusion criteria were studies in humans, including randomized controlled trials, controlled clinical trials, with the aim of comparing the 2 techniques. The quality of studies was assessed, and the relative risk (RR) with its corresponding 95% confidence interval (CI) was assessed to measure the effect size.

Results:
Thirteen publications were enrolled into the analysis. The results showed that there were significant differences in overall complications (RR, 0.62; 95% CI, 0.351–1.094; P = 0.06), postoperative infection (RR, 0.503, 95% CI, 0.223–1.136) when comparing locking miniplates with nonlocking miniplates in treating mandible fractures. The incidence of malocclusion showed a statistically significant difference in the outcome favoring locking miniplates (fixed: RR, 0.503; 95% CI, 0.125–2.030; P = 0.06). In addition, the use of locking miniplates had a lower postoperative maxillomandibular fixation rate than the use of nonlocking miniplates (RR, 0.414; 95% CI, 0.196–0.872; P = 0.002).

Conclusion:
The result of meta-analysis revealed that use of locking plate is superior to the nonlocking plate in the reducing of postoperative complication rates in the management of MFs.
Short- and Long-Term Outcomes by Procedure Type for Nonsagittal Single-Suture Craniosynostosis
Authors: Bennett Katelyn G. , Hespe Geoffrey E. , Vercler Christian J. , Buchman Steven R. 
Published: January 2019

Background:
Minimally invasive approaches for the treatment of single-suture craniosynostosis are sometimes touted as equivalent to cranial vault reconstruction. While techniques for sagittal synostosis have been reviewed previously, evidence regarding open and less invasive surgical techniques for metopic, coronal, and lambdoid synostosis has yet to be reviewed.

Methods:
Systematic searches were performed using Embase.com and PubMed. Included studies reported short- or long-term outcomes, compared at least 2 standard techniques, discussed single-suture coronal, metopic, or lambdoid craniosynostosis, and enrolled at least 20 study participants. Two authors screened titles and abstracts, and also performed full text review and data extraction. Given heterogeneous outcomes, qualitative synthesis was performed after data extraction.

Results:
The search strategy yielded 2348 articles. Of these, 313 were removed as duplicates, and 1935 were excluded during title/abstract review. After full text review of 100 articles, 19 were selected for data extraction. The heterogeneity of outcomes precluded meta-analysis and required qualitative synthesis. While short-term outcomes indicated decreased morbidity of minimally invasive techniques, only 2 articles presented long-term reoperation rates. One study reported higher reoperation rates in the less invasive technique, and the second reported no reoperations in the median follow-up period of 33 months.

Conclusion:
Studies comparing long-term outcomes between different surgical techniques for single-suture craniosynostosis remain deficient. The development of standardized outcome measures is essential, and prospective, multicenter studies are necessary to assess the long-term efficacy of these procedures.