bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of adding interoceptive exposure to intensive interdisciplinary treatment for adolescents with chronic pain: a randomized controlled trial
Authors: Flack Florentina , Stahlschmidt Lorin , Dobe Michael , Hirschfeld Gerrit , Strasser Alexa , Michalak Johannes , Wager Julia , Zernikow Boris 
Published: June 2018

Abstract
Fear of pain plays an important role in the maintenance of chronic pain. It may be reduced through exposure therapy. This 2-arm parallel samples randomized controlled trial aimed to investigate whether interoceptive exposure (IE) therapy enhances reductions in fear of pain (primary outcome), pain (pain intensity, pain-related disability, and school absence), and emotional characteristics (anxiety and catastrophizing) when implemented as an adjunctive treatment in the context of intensive interdisciplinary pain treatment for pediatric chronic pain patients. N = 126 adolescents, aged 11 to 17 years, who were receiving standard intensive interdisciplinary pain treatment were randomly assigned to either receive additional IE (n = 64) or additional relaxation therapy (RT) (n = 62). All patients were assessed at admission, discharge, and 3 months after discharge. The data of N = 104 patients were analyzed. Significant large reductions were found in the total score and subscale scores of the Fear of Pain Questionnaire for Children in both study groups (eg, total score [range 0-60; IE/RT]: admission M = 23.5/24.9; discharge M = 16.0/19.7; P < 0.001,

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= 0.27) and mainly large reductions in pain characteristics. There were no greater decreases in the IE group (P > 0.1). The exploratory analyses revealed that the patients with high fear of pain before treatment (P < 0.05,

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> 0.03) and the patients with abdominal pain (P < 0.04,

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> 0.25) showed greater decreases in their fear of pain (total and subscale score) in the IE group than in the RT group. In conclusion, the results suggest that IE is not particularly effective for all the pediatric chronic pain patients, but the patients with high fear of pain before treatment and with abdominal pain strongly benefit from this intervention.
Vestibular Sclerosis: Is This a New, Distinct Clinicopathological Entity?
Authors: Croker Bethany A. , Scurry James P. , Petry Frances M. , Fischer Gayle 
Published: June 2018

Objectives
The aims of this case series were to present a series of patients with clinical and histopathological findings consistent with a recently described condition vestibular sclerosis (VS) and to contribute to the current discussion of whether VS is a subset of lichen sclerosus (LS) or a distinct entity.

Materials and Methods
This case series of 6 women for a 12-month period was initiated from an ongoing collaboration between a gynecological dermatologist and an anatomical pathologist specializing in gynecological dermatopathology.

Results
We describe 6 women with white, hyperkeratotic patches and plaques confined to the vulvar vestibule with stromal sclerosis and an absence of inflammation on histology. All our patients were either perimenopausal or postmenopausal. The condition was either asymptomatic or characterized by mild to moderate dyspareunia. No patient had LS elsewhere on the vulva. There was no response to estrogen or topical corticosteroid therapy in symptomatic patients.

Conclusions
Vestibular sclerosis may be a new distinct clinicopathologial entity, which is in the differential diagnosis of white plaques and patches in the vulvar vestibule. The characteristic siting in the anterior vestibule only, in the presence of an otherwise normal vulva and absence of inflammation on histology, is a reason to separate this condition from LS.
Systematic Review of Treatment Outcome Measures for Vulvodynia
Authors: Sadownik Leslie A. , Yong Paul J. , Smith Kelly B. 
Published: June 2018

Objectives of the Study
To systematically evaluate the literature regarding vulvodynia treatment outcome measures.

Methods
A systematic literature search on OVID, PubMed, and PsycINFO databases was conducted from inception until May 2016. Studies were included/excluded based on prespecified criteria. Reported outcome measures were organized into 6 core outcome domains recommended by the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT): pain; physical functioning, emotional functioning, participant ratings of global improvement and satisfaction with treatment, symptoms and adverse events, and participant disposition.

Results
Of the 206 articles identified for full-text screening, 33 met our criteria. One study adhered to all IMMPACT recommendations. The number of outcomes measured per study ranged from 1 to greater than 20. Patient-reported pain outcomes were found in the majority (27/33; 82%) of studies. Pain severity with intercourse was reported by 24 (73%) of 33 studies—9 different scales were used to measure this outcome. Clinician-reported outcomes were present in 14 (42%) of 33 studies. Methods of measuring vestibular sensitivity by “cotton swab” test were different in 8 of 10 studies. Other domains reported included; physical function (8/33 studies; 24%), sexual function (23/33 studies; 70%), and emotional function (13/33 studies; 39%). Symptoms and adverse events were reported by 15 (45%) of 33 studies. One study formally reported participant disposition using all the information recommended by CONSORT.

Conclusions
Comparison of clinical trial results in vulvodynia is not possible because of a lack of standard treatment outcome measures. Vulvodynia researchers should apply the IMMPACT criteria to guide the development of a minimum core set of standard outcome measures that measure holistic health.
Cerulein-Induced Acute Pancreatitis Affects Sphingomyelin Signaling Pathway in Rats
Authors: Konończuk Tomasz , Łukaszuk Bartłomiej , Mikłosz Agnieszka , Chabowski Adrian , Żendzian-Piotrowska Małgorzata , Kurek Krzysztof 
Published: June 2018

Objectives
Acute pancreatitis (AP) is a common and severe gastrointestinal inflammatory disease with poorly understood pathogenesis. We adopted cerulein-induced pancreatitis, a well-established rat model shearing similarities with human AP, to determine the disease background. Special interest was placed on sphingolipids, because their signaling pathways are involved in many pathological states including hepatic steatosis, heart infarction, or pancreatic origin type 1 diabetes.

Methods
Sphingolipid levels in the blood and pancreas were determined by the means of chromatography (thin-layer and high-performance liquid chromatography).

Results
We found that AP leads to activation of ceramide de novo synthesis pathway, as evidenced by a significant increment in sphinganine, that is, ceramide synthesis precursor, content (+3.8-fold). Surprisingly, despite the reported growth in sphinganine concentration, we observed a reduced (−38%) ceramide level in the pancreas of rats with AP. The results could be explained by subsequent hydrolysis of ceramide to other secondary messengers, that is, sphingosine (+4-fold) or sphingosine-1-phosphate (+3-fold).

Conclusions
Because it is known that sphingosine-1-phosphate and some of its analogs could have a protective role against AP complications, our findings may contribute to elaboration of new therapeutic strategies in the management of this severe medical condition.
Plasma Neurokinin A Levels Predict Survival in Well-Differentiated Neuroendocrine Tumors of the Small Bowel
Authors: Woltering Eugene A. , Voros Brianne A. , Thiagarajan Ramcharan , Beyer David T. , Ramirez Robert A. , Wang Yi-Zarn , Mamikunian Gregg , Boudreaux J. Philip 
Published: June 2018

Objectives
Elevated neurokinin A (NKA) levels are associated with poor prognosis in patients with small bowel neuroendocrine tumors. We hypothesized that patients with NKA levels that remain elevated despite treatment with surgical cytoreduction have a poor prognosis.

Methods
Patients diagnosed with small bowel neuroendocrine tumors who underwent surgical cytoreduction at our institution were identified. Demographics, histopathologic characteristics, and biochemical data were collected. Patients were grouped by the trend of their NKA levels (group 1, continuously normal; group 2, transiently elevated but normalized after therapy; group 3, remained elevated despite therapy). Survival rates were calculated from the date of the patient's first NKA level.

Results
Serial NKA values after surgical cytoreduction were monitored in 267 patients. Kaplan-Meier 2-year, 5-year, and 10-year survival rates were as follows: group 1 (n = 157), 97%, 89%, and 62%; group 2 (n = 78), 99%, 90%, and 78%; and group 3 (n = 32), 88%, 69%, and 0%. Survival rates were statistically significant between groups 1 and 3 and between groups 2 and 3 (P < 0.01).

Conclusions
Serial monitoring of plasma NKA levels is useful in identifying patients who have a poor prognosis. Elevated NKA levels can indicate the need for immediate therapeutic intervention.
Association Between Opioid Use and Survival Time in Patients With Unresectable Pancreatic Cancer
Authors: Oh Tak Kyu , Do Sang-Hwan , Yoon Yoo-Suk , Song In-Ae 
Published: June 2018

Objectives
Patients with pancreatic cancer generally experience increasing pain as their disease progresses, making the titration of opioids difficult. This study aimed to determine a correlation between prescribed opioid doses and survival time in patients with unresectable pancreatic cancer.

Methods
This retrospective observational cohort study in a tertiary care institution reviewed the medical records of patients diagnosed with unresectable pancreatic cancer and treated over a 10-year period.

Results
We screened 1152 patients with unresectable pancreatic cancer, and 566 were eligible for inclusion in this study. There was a statistically significant negative correlation between initial opioid dose and survival time from initial opioid dose (correlation coefficient, −0.184; P < 0.01) and survival time from initial pancreatic cancer diagnosis (correlation coefficient, −0.177; P < 0.01). In addition, there were 0.8% and 0.6% increases in initial opioid dosage (morphine equivalent daily dose) and rate of increasing opioid dose (morphine equivalent daily dose per month), respectively, associated with the risk of early death (≤180 days, P < 0.05).

Conclusions
Correlations between patient survival, initial opioid dose, final opioid dose, and the rate of increase of opioid dosage could provide useful information for clinicians treating unresectable pancreatic cancer patients.
Association Between Hepatitis B Infection and Pancreatic Cancer
Authors: Desai Rupak , Patel Upenkumar , Sharma Shobhit , Singh Sandeep , Doshi Shreyans , Shaheen Sana , Shamim Sofia , Korlapati Lakshmi Shirisha , Balan Shuba , Bray Christopher , Williams Renee , Shah Nihar 
Published: June 2018

Objectives
The aim of this study was to assess the role of hepatitis B (HepB) infection in the causation of pancreatic cancer and the predictors of pancreatic cancer and mortality.

Methods
We identified pancreatic cancer patients 11 to 70 years of age from the 2013–2014 National Inpatient Sample. Pearson χ2 test and Student’s t-test were used for categorical and continuous variables, respectively. We assessed the association of HepB and pancreatic cancer and the independent mortality predictors by multivariate analyses.

Results
Of 69,210 pancreatic cancer patients, 175 patients with a history of HepB and 69,035 patients without a history of HepB were identified. Compared with the pancreatic cancer–non-HepB group, the pancreatic cancer–HepB group consisted more of younger (mean, 60.4 [standard deviation, 7.4] years vs 68.2 [standard deviation, 12.1] years), male, black, and Asian patients with low household income and nonelective admissions. The odds of developing pancreatic cancer among the HepB patients were significantly higher (adjusted odds ratio, 1.24; 95% confidence interval, 1.056–1.449; P = 0.008). Black race, age ≥ 65 years, and male sex demonstrated greater odds of mortality.

Conclusions
This study concluded up to a 24% increased likelihood of pancreatic cancer among the HepB patients. Blacks showed greater odds of pancreatic cancer and related mortality.
Mortality Risk Using a Pediatric Quick Sequential (Sepsis-Related) Organ Failure Assessment Varies With Vital Sign Thresholds*
Authors: Peters Cheryl , Murthy Srinivas , Brant Rollin , Kissoon Niranjan , Görges Matthias 
Published: June 2018

Objectives:
We evaluated adapting the quick Sequential (Sepsis-Related) Organ Failure Assessment score (fast respiratory rate, altered mental status, low blood pressure) for pediatric use by selecting thresholds from three commonly used definitions: Pediatric Logistic Organ Dysfunction 2, Pediatric Advanced Life Support, and International Pediatric Sepsis Consensus Conference. We examined their respective performance in identifying children who had a discharge diagnosis of infection at high risk of mortality using PICU registry data, with additional focus on the influence of age on performance.

Design:
Analysis of retrospective data obtained from the Virtual Pediatric Systems PICU database. The performance in predicting observed mortality was assessed for the three candidate approaches using receiver operating characteristics analysis, including age group effects.

Setting:
The Virtual Pediatric Systems database contains data on diagnosis, clinical markers, and outcomes in prospectively collected clinical records from 130 participating PICUs in the United States and Canada.

Patients:
Children who had a discharge diagnosis of infection in a participating PICU between 2009 and 2014, for which all required data were available.

Interventions:
None.

Measurements and Main Results:
Data from 40,228 children revealed an overall mortality of 4.22%. Area under the receiver operating characteristics curve (95% CI) was 0.760 (0.749–0.771) for Pediatric Logistic Organ Dysfunction 2 with mechanical ventilation, 0.700 (0.689–0.712) for Pediatric Advanced Life Support, and 0.709 (0.696–0.721) for International Pediatric Sepsis Consensus Conference. When split by age group, the performance of Pediatric Logistic Organ Dysfunction 2 with mechanical ventilation was lowest in the youngest neonates (under 1 wk old), with an area under the receiver operating characteristics curve (95% CI) of 0.724 (0.656–0.791), and in the teenagers (13–18 yr), with an area under the receiver operating characteristics curve of 0.710 (0.682–0.738), yet it still outperformed Pediatric Advanced Life Support and International Pediatric Sepsis Consensus Conference in both groups.

Conclusions:
Among critically ill children who had a discharge diagnosis of infection in the PICU, quick Sequential (Sepsis-Related) Organ Failure Assessment score performs best when using the Pediatric Logistic Organ Dysfunction 2 age thresholds with mechanical ventilation, while all definitions performed worse at extremes of pediatric age. Thus, mortality risk varies with vital sign thresholds, and although Pediatric Logistic Organ Dysfunction 2 with mechanical ventilation performed marginally better, it is unlikely to be of use to clinicians. More work is needed to develop a robust and relevant pediatric sepsis risk score.
Quality and Safety in Health Care, Part XLII
Authors: Harolds Jay A. 
Published: June 2018

Abstract
Implantable cardioverter defibrillators for both primary and secondary prevention have been successful in decreasing sudden cardiac death. The Implantable Cardioverter Defibrillator Registry was established partly for reimbursement for primary prevention. However, the registry also has been helpful in better understanding the risks and appropriate selection of patients to receive these devices, serving as an impetus for quality improvement by giving outcome information to the contributing institutions regarding their performance relative to the national results, and increasing research. It is also expected to be helpful to compare results from different devices and provide information to the public.
Progression of Focal to Diffuse Thyroid Uptake Detected by 18F-FDG PET/CT
Authors: Thuillier Philippe , Crouzeix Geneviève , Descourt Renaud , Salaun Pierre-Yves , Abgral Ronan 
Published: June 2018

Abstract
A 49-year-old man was referred to our department for an assessment of a cerebral metastasis of unknown primary with 18F-FDG PET/CT. This imaging led to detection of a suspected pulmonary primary carcinoma, as well as an incidental left focal thyroid uptake. An ultrasonography, performed a month later, revealed a thyroiditis aspect. An anti-PD1 immunotherapy was also proposed 2 months later after confirmation of a lung adenocarcinoma. A second baseline FDG PET/CT surprisingly showed a diffuse thyroid uptake. A fine-needle aspiration biopsy of thyroid parenchyma finally revealed a diffuse involvement from lung adenocarcinoma (ie, primary lung metastasis to the thyroid gland).
Utility of 68Ga-PSMA-11 PET/CT in Imaging of Glioma—A Pilot Study
Authors: Sasikumar Arun , Kashyap Raghava , Joy Ajith , Charan Patro Kanhu , Bhattacharya Parthasarathy , Reddy Pilaka Venkata Krishna , Oommen Karuna Elza , Pillai Maroor Raghavan Ambikalmajan 
Published: June 2018

Background
Imaging of gliomas remains challenging. The aim of the study was to assess the feasibility of using 68Ga-PSMA-11 PET/CT for imaging gliomas.

Methods
Fifteen patients with glioma from 2 centers were included in the study. Ten patients were treated cases of glioblastoma with suspected recurrence. Two patients were sent for assessing the nature (primary lesion/metastasis) of space-occupying lesion in the brain; 3 patients were imaged immediately after surgery and before radiotherapy. Target-to-background ratios (TBR) for the brain lesions were calculated using contralateral cerebellar uptake as background.

Results
Among the 10 cases with suspected recurrence, scan was positive in 9, subsequent surgery was done, and histopathology proved it to be true recurrence. In the scan-negative case on follow-up, no evidence of disease could be made clinically or radiologically. Among the other cases the presence or absence of disease could be unequivocally identified on the 68Ga-PSMA-11 brain scan and correlated with the histopathology or other imaging. Apart from the visual assessment quantitative assessment of the lesions with TBR also showed a significantly high TBR value for those with true disease compared with those with no disease.

Conclusions
In the evaluation of gliomas, 68Ga-PSMA-11 PET/CT brain imaging is a potentially useful imaging tool. The use of 68Ga-PSMA-11 brain PET/CT in evaluation of recurrent glioma seems promising. Absence of physiological uptake of 68Ga-PSMA-11 in the normal brain parenchyma results in high TBR values and consequently better visualization of glioma lesions.
18F-Fluciclovine Uptake by an Incidentally Detected Hepatocellular Carcinoma in a Case of Biochemically Recurrent Prostate Cancer
Authors: Sannananja Bhagya , Shah Hardik Uresh , Behnia Fatemeh 
Published: June 2018

Abstract
Prostate cancer is one of the most common cancers affecting men worldwide with a high recurrence rate following therapy. 18F-fluciclovine, is a US Food and Drug Administration–approved radiopharmaceutical for PET imaging in biochemically recurrent prostate cancer. It targets increased amino acid transporters in the cell membrane of cancer cells. We report a case of incidentally detected hepatocellular carcinoma showing 18F-fluciclovine uptake in a 71-year-old man with biochemically recurrent prostate cancer.
Detection of Metastatic Meningioma to the Liver Using 68Ga-DOTA-Octreotate PET/CT
Authors: Villanueva-Meyer Javier E. , Magill Stephen T. , Lee Julieann C. , Umetsu Sarah E. , Flavell Robert R. 
Published: June 2018

Abstract
We present a case of metastatic meningioma detected on 68Ga-DOTA-octreotate PET. A 52-year-old woman presented with multiply recurrent multifocal meningioma. A staging 68Ga-DOTATATE PET/CT demonstrated focal radiotracer uptake within the known intracranial meningiomas. In addition, a DOTATATE-avid mass was found in the liver that was biopsied, confirming metastatic meningioma. This report suggests that 68Ga-DOTATATE PET/CT should be considered whenever screening meningioma patients for metastases.
Prostate-specific membrane antigen for prostate cancer theranostics: from imaging to targeted therapy
Authors: Arsenault Frédéric , Beauregard Jean-Mathieu , Pouliot Frédéric 
Published: June 2018

Purpose of review
In recent years, major advances in molecular imaging of prostate cancers (PCa) were made with the development and clinical validation of highly accurate PET tracers to stage and restage the disease. Prostate-specific membrane antigen (PSMA) is a transmembrane protein highly expressed in PCa, and its expression has led to the development of PSMA-binding radiopharmaceuticals for molecular imaging or radioligand therapy (RLT). We herein review the recent literature published on diagnostic and therapeutic (i.e. theranostic) PSMA tracers.

Recent findings
Development in small PSMA-targeted molecules labeled with gallium-68 and fluorine-18 show promising results for primary staging and detection of disease at biochemical recurrence using PET/computed tomography (PET/CT). Studies show a higher sensitivity and specificity, along with an improved detection rate over conventional imaging (CT scan and bone scan) or choline PET tracers, especially for restaging after prostate-specific antigen failure following loco-regional therapy. In addition, some PSMA tracers can be labeled with beta-minus and alpha particle emitters, yielding encouraging response rates and low toxicity, and potentially offering a new line of targeted therapy for metastatic castration-resistant PCa.

Summary
PSMA-targeted tracers have shown unprecedented accuracy to stage and restage PCa using PET/CT. Given their specific biodistribution toward PCa tissue, PSMA RLT now offers new therapeutic possibilities to target metastatic PCa. Prospective multicenter randomized studies investigating the clinical impact of PSMA–targeted molecules are urgently needed.