bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dimensions of the Subaxial Lateral Mass
Authors: Schroeder Gregory D. , Kepler Christopher K. , McKenzie James C. , Casper David S. , Sutton Ryan , Hecht Andrew C. , O’Shaughnessy Brian A. , Skelly Andrea C. , Brodt Erika D. , Vaccaro Alexander R. 
Published: January 2019

Study Design:
This was a systematic review.

Objective:
To review and synthesize information on subaxial lateral mass dimensions in order to determine the ideal starting point, trajectory, and size of a lateral mass screw.

Summary of Background Data:
The use of lateral mass instrumentation for posterior cervical decompression and fusion has become routine as these constructs have increased rigidity and fusion rates.

Methods:
A systematic search of Medline and EMBASE was conducted. Studies that provided subaxial cervical lateral mass measurements, distance to the facet, vertebral artery and neuroforamen and facet angle made either directly (eg, cadaver specimen) or from patient imaging were considered for inclusion. Pooled estimates of mean dimensions were reported with corresponding 95% confidence intervals. Stratified analysis based on level, sex, imaging plane, source (cadaver or imaging), and measurement method was done.

Results:
Of the 194 citations identified, 12 cadaver and 10 imaging studies were included. Pooled estimates for C3–C6 were generally consistent for lateral mass height (12.1 mm), width (12.0 mm), depth (10.8 mm), distance to the transverse foramen (11.8 mm), and distance to the nerve. C7 dimensions were most variable. Small sex-based differences in dimensions were noted for height (1.2 mm), width (1.3 mm), depth (0.43 mm), transverse foramen distance (0.9 mm), and nerve distance (0.3–0.8 mm). No firm conclusions regarding differences between measurements made on cadavers and those based on patient computed tomographic images are possible; findings were not consistent across dimensions. The overall strength of evidence is considered very low for all findings.

Conclusions:
Although estimates of height, width, and depth were generally consistent for C3–C6, C7 dimensions were variable. Small sex differences in dimensions may suggest that surgeons should use a slightly smaller screw in female patients. Firm conclusions regarding facet angulation, source of measurement, and method of measurement were not possible.
Midazolam Dose Optimization in Critically Ill Pediatric Patients With Acute Respiratory Failure: A Population Pharmacokinetic-Pharmacogenomic Study
Authors: Zuppa Athena F. , Conrado Daniela J. , Zane Nicole R. , Curley Martha A. Q. , Bradfield Jonathan , Hakonarson Hakon , Gastonguay Madeleine S. , Moorthy Ganesh , Prodell Janice , Gastonguay Marc R. 
Published: January 2019

Objectives:
To develop a pharmacokinetic-pharmacogenomic population model of midazolam in critically ill children with primary respiratory failure.

Design:
Prospective pharmacokinetic-pharmacogenomic observational study.

Setting:
Thirteen PICUs across the United States.

Patients:
Pediatric subjects mechanically ventilated for acute respiratory failure, weight greater than or equal to 7 kg, receiving morphine and/or midazolam continuous infusions.

Interventions:
Serial blood sampling for drug quantification and a single blood collection for genomic evaluation.

Measurements and Main Results:
Concentrations of midazolam, the 1’ (1`-hydroxymidazolam metabolite) and 4’ (4`-hydroxymidazolam metabolite) hydroxyl, and the 1’ and 4’ glucuronide metabolites were measured. Subjects were genotyped using the Illumina HumanOmniExpress genome-wide single nucleotide polymorphism chip. Nonlinear mixed effects modeling was performed to develop the pharmacokinetic-pharmacogenomic model. Body weight, age, hepatic and renal functions, and the UGT2B7 rs62298861 polymorphism are relevant predictors of midazolam pharmacokinetic variables. The estimated midazolam clearance was 0.61 L/min/70kg. Time to reach 50% complete mature midazolam and 1`-hydroxymidazolam metabolite/4`-hydroxymidazolam metabolite clearances was 1.0 and 0.97 years postmenstrual age. The final model suggested a decrease in midazolam clearance with increase in alanine transaminase and a lower clearance of the glucuronide metabolites with a renal dysfunction. In the pharmacogenomic analysis, rs62298861 and rs28365062 in the UGT2B7 gene were in high linkage disequilibrium. Minor alleles were associated with a higher 1`-hydroxymidazolam metabolite clearance in Caucasians. In the pharmacokinetic-pharmacogenomic model, clearance was expected to increase by 10% in heterozygous and 20% in homozygous for the minor allele with respect to homozygous for the major allele.

Conclusions:
This work leveraged available knowledge on nonheritable and heritable factors affecting midazolam pharmacokinetic in pediatric subjects with primary respiratory failure requiring mechanical ventilation, providing the basis for a future implementation of an individual-based approach to sedation.
The Development of Chronic Critical Illness Determines Physical Function, Quality of Life, and Long-Term Survival Among Early Survivors of Sepsis in Surgical ICUs*
Authors: Gardner Anna K. , Ghita Gabriela L. , Wang Zhongkai , Ozrazgat-Baslanti Tezcan , Raymond Steven L. , Mankowski Robert T. , Brumback Babette A. , Efron Philip A. , Bihorac Azra , Moore Frederick A. , Anton Stephen D. , Brakenridge Scott C. 
Published: January 2019

Objectives:
This study sought to examine mortality, health-related quality of life, and physical function among sepsis survivors who developed chronic critical illness.

Design:
Single-institution, prospective, longitudinal, observational cohort study assessing 12-month outcomes.

Setting:
Two surgical/trauma ICUs at an academic tertiary medical and level 1 trauma center.

Patients:
Adult critically ill patients that survived 14 days or longer after sepsis onset.

Interventions:
None.

Measurements and Main Results:
Baseline patient characteristics and function, sepsis severity, and clinical outcomes of the index hospitalization were collected. Follow-up physical function (short physical performance battery; Zubrod; hand grip strength) and health-related quality of life (EuroQol-5D-3L, Short Form-36) were measured at 3, 6, and 12 months. Hospital-free days and mortality were determined at 12 months. We compared differences in long-term outcomes between subjects who developed chronic critical illness (≥ 14 ICU days with persistent organ dysfunction) versus those with rapid recovery. The cohort consisted of 173 sepsis patients; 63 (36%) developed chronic critical illness and 110 (64%) exhibited rapid recovery. Baseline physical function and health-related quality of life did not differ between groups. Those who developed chronic critical illness had significantly fewer hospital-free days (196 ± 148 vs 321 ± 65; p < 0.0001) and reduced survival at 12-months compared with rapid recovery subjects (54% vs 92%; p < 0.0001). At 3- and 6-month follow-up, chronic critical illness patients had significantly lower physical function (3 mo: short physical performance battery, Zubrod, and hand grip; 6 mo: short physical performance battery, Zubrod) and health-related quality of life (3- and 6-mo: EuroQol-5D-3L) compared with patients who rapidly recovered. By 12-month follow-up, chronic critical illness patients had significantly lower physical function and health-related quality of life on all measures.

Conclusions:
Surgical patients who develop chronic critical illness after sepsis exhibit high healthcare resource utilization and ultimately suffer dismal long-term clinical, functional, and health-related quality of life outcomes. Further understanding of the mechanisms driving the development and persistence of chronic critical illness will be necessary to improve long-term outcomes after sepsis.
Repair of Anterior Ear Defects Using Transcartilage Island Pedicle Flaps
Authors: Dyson Mary E. , Orangi Maideh , Goldberg Leonard H. , Kimyai-Asadi Arash 
Published: January 2019

BACKGROUND
Surgical reconstruction of the anterior surface of the ear (concha, antihelix, scapha, and triangular fossa) is complicated by the paucity of mobile local skin.

OBJECTIVE
This is a retrospective study of the transcartilage island pedicle flap for reconstruction of surgical defects of the anterior ear.

METHODS AND MATERIALS
Two hundred thirty-two Mohs micrographic surgery defects were included in the study. The technique involves circumferential incision of the flap in the postauricular sulcus, transfer of the flap to the anterior ear through a surgically created cartilage slit, suturing of the flap on the anterior surface of the ear, and repair of the secondary postauricular defect. Preoperative, intraoperative, and postoperative details of each case were tabulated and analyzed.

RESULTS
The mean defect size was 1.9 × 1.5 cm. Complications included flap edema (n = 6, 2.6%), postoperative bleeding (n = 4, 1.7%), partial thickness flap necrosis (n = 2, 0.9%), pinning back of the ear (n = 2, 0.9%), and central flap dimpling (n = 2, 0.9%). There was 1 acute staphylococcal abscess and 1 sterile abscess that developed 13 months postoperatively. All complications resolved with medical or surgical management.

CONCLUSION
Transcartilage island pedicle flaps may be considered for single-stage surgical reconstruction of defects involving the anterior ear.
Squamous Cell Carcinoma of the Nail Unit: A Clinical Histopathologic Study and a Proposal for Classification
Authors: Dika Emi , Starace Michela , Patrizi Annalisa , Fanti Pieralessandro A. , Piraccini Bianca Maria 
Published: January 2019

BACKGROUND
There is no consensus on the classification, grading, and the treatment of nail squamous cell carcinoma (NSCC).

OBJECTIVE
The aim of the study was to propose a possible classification of NSCC.

MATERIALS AND METHODS
Nail squamous cell carcinoma referred from January 2006 till December 2014 was included. On the basis of the clinical presentation, patients with NSCC were divided in 2 groups. Group A tumors presented as nodular or ulcerated masses of the nail bed, whereas Group B tumors presented as hyperkeratotic bands. In these 2 groups, differences in proportions (sex, histopathologic grading, and treatment performed) were evaluated with the chi-square test.

RESULTS
Forty-one NSCCs were included. The groups of NSCC differed regarding: (1) the age of the patients, (2) histopathology, and (3) surgical approach.

CONCLUSION
Nail squamous cell carcinomas may originate from 2 different epithelia, presenting a diverse clinical behavior. The correct identification and diagnosis of each subgroup of NSCC could be helpful in standardizing management of this tumor. Future studies considering human papillomavirus subtyping and including a major number of tumors should be performed to confirm or reject the authors' hypothesis.

Limitations
This is a retrospective study, presenting the data and the experience of a single institute.
The female sexual function index: reliability and validity in Spanish postmenopausal women
Authors: Pérez-Herrezuelo Isabel , Hita-Contreras Fidel , Martínez-Amat Antonio , Aibar-Almazán Agustín , Cruz-Díaz David , Wangensteen Rosemary , Ochoa Alexander Achalandabaso , Díaz-Mohedo Esther 
Published: January 2019

Abstract

Objective:
To examine the reliability and validity of the Spanish version of the Female Sexual Function Index (FSFI) and its ability to discriminate between women with and without female sexual dysfunction (FSD) among Spanish postmenopausal women.

Methods:
A total of 152 postmenopausal women completed the Spanish version of FSFI. Internal consistency, test-retest reliability, and construct validity (exploratory factor analysis) were analyzed. Concurrent and divergent validity were assessed using a visual analog scale for overall satisfaction with sexual life and the Hospital Anxiety and Depression Scale, respectively. To determine the ability and the accuracy of the FSFI total score in discriminating between women with and without FSD, a receiver-operating characteristic curve analysis was performed.

Results:
Factor analysis suggested a three-factor structure (explained variance 77.77%). The Spanish FSFI showed substantial-to-excellent test-retest reliability, with good internal consistency in the FSFI total score (Cronbach's alpha = 0.964), and also in its three dimensions. The FSFI total and domains scores showed strong (r > 0.50) and significant correlations (P < 0.01) with overall satisfaction with sexual life (concurrent validity), and low correlations with anxiety and depression (divergent validity). The Spanish FSFI total score and dimensions were significantly able to discriminate between women with and without FSD (P < 0.05), with an optimal cut-off point of <24.95 for the FSFI total score (64.15% sensitivity and 75.76% specificity).

Conclusions:
The Spanish FSFI is a valid and reliable instrument for assessing and discriminating for FSD among Spanish postmenopausal women.
Secular trends and associated factors of age at natural menopause in Taiwanese women
Authors: Shen Te-Yi , Chen Hsin-Jen , Pan Wen-Harn , Yu Tsung 
Published: January 2019

Abstract

Objective:
Age at natural menopause (ANM) is considered an indicator for chronic disease and mortality risk in later life. Research suggests that ANM appears to vary across geographic regions and ethnicities. The aim of this study was to explore the secular trends and factors associated with ANM in Taiwanese women.

Methods:
We used data from three cross-sectional phases of the Nutrition and Health Survey in Taiwan. In all, 4,111 women aged 35 years and over were included. Information on ANM and sociodemographics, lifestyle, and health factors were collected using household questionnaires. A Cox proportional-hazards model was used to determine the association of ANM with relevant factors, and a life table method was used to estimate median ANM.

Results:
Life table method estimated the median ANM to be 50 years. ANM was getting later for women born in younger cohorts (hazard ratio [HR] 0.87 per 10-year difference, 95% confidence interval [CI] 0.81-0.95). ANM was also later among women who achieved higher educational levels (HR 0.91 per one-category difference, 95% CI 0.86-0.96) and who had been married (HR 0.64, 95% CI 0.42-0.96). ANM occurred later for parous than for nulliparous women. Multivariable analysis found no significant associations of ANM with age at menarche, smoking, or alcohol drinking.

Conclusions:
The results suggest that women in the younger cohorts, with higher educational levels, and who are parous and married may have later ANM. The trend effect of secular time and educational levels on ANM may reflect the influences of socioeconomic/nutritional status in their childhood or throughout their lifetime.
A Population-based Observational Study of Childhood Encephalitis in Children Admitted to Pediatric Intensive Care Units in England and Wales
Authors: Iro Mildred A. , Sadarangani Manish , Nickless Alecia , Kelly Dominic F. , Pollard Andrew J. 
Published: January 2019

Background:
Encephalitis is a serious neurologic condition that can result in admission to intensive care. Yet, there are no studies on pediatric intensive care unit (PICU) admission rates and usage of intensive care resources by children with encephalitis in England and Wales. The objectives of this study were to (1) define the PICU incidence and mortality rates for childhood encephalitis, (2) describe the usage of intensive care resources by children with encephalitis admitted to PICU and (3) explore the associated cost from PICU encephalitis admissions.

Methods:
Retrospective analysis of anonymized data for 1031 children (0–17 years) with encephalitis admitted (January 2003 to December 2013) to PICU in England and Wales.

Results:
The PICU encephalitis incidence was 0.79/100,000 population/yr (95% confidence interval [CI]: 0.74–0.84), which gives an annual total of 214 bed days of intensive care occupancy for children admitted with encephalitis and an estimated annual PICU bed cost of £414,230 (interquartile range: 198,111–882,495) for this cohort. PICU encephalitis admissions increased during the study period (annual percentage change = 4.5%, 95% CI: 2.43%–6.50%, P ≤ 0.0001). In total, 808/1024 (78.9%) cases received invasive ventilation while 216/983 (22.0%) and 50/890 (5.6%) cases received vasoactive treatment and renal support, respectively. There were 87 deaths (8.4%), giving a PICU encephalitis mortality rate of 0.07/100,000 population (0–17 years)/yr (95% CI: 0.05–0.08).

Conclusions:
These data suggest that encephalitis places a significant burden to the healthcare service. More work is needed to improve outcomes for children with encephalitis.
Sedatives in neurocritical care: an update on pharmacological agents and modes of sedation
Authors: Opdenakker Olivier , Vanstraelen Anna , De Sloovere Veerle , Meyfroidt Geert 
Published: January 2019

Purpose of review
In this article, the specific and general indications for sedatives in the neurocritical care unit are discussed, together with an overview on current insights in sedative protocols for these patients. In addition, physiological effects of sedative agents on the central nervous system are reviewed.

Recent findings
In the general ICU population, a large body of evidence supports light protocolized sedation over indiscriminate deep sedation. Unfortunately, in patients with severe acute brain injury, the evidence from randomized controlled trials is scarce to nonexistent, and practice is supported by expert opinion, physiological studies and observational or small interventional trials. The different sedatives each have different beneficial effects and side-effects.

Summary
Extrapolating the findings from studies in the general ICU population suggests to reserve deep continuous sedation in the neuro-ICU for specific indications. Although an improved understanding of cerebral physiological changes in patients with brain injury may be helpful to guide individualized sedation, we still lack the evidence base to make broad recommendations for specific patient groups.
Among Medicare Patients With Hepatocellular Carcinoma, Non–alcoholic Fatty Liver Disease is the Most Common Etiology and Cause of Mortality
Authors: Hester Danubia , Golabi Pegah , Paik James , Younossi Issah , Mishra Alita , Younossi Zobair M. 
Published: January 2019

Goals:
The main purpose of this study was to assess the recent trends in mortality and health care utilization of hepatocellular carcinoma (HCC) among Medicare population in the United States.

Background:
The incidence of HCC is increasing in the United States.

Materials and Methods:
Data were obtained for a sample of Medicare beneficiary from 2005 to 2014. Diagnosis of HCC and etiology of liver disease were based on ICD-9 codes. Temporal trends in HCC rates, clinical, demographical and utilization parameters were analyzed by joinpoint regression model.

Results:
Study cohort included 13,648 Medicare recipients with HCC (mean age: 70.0 y, 62.8% male and 76.0% white). Non–alcoholic fatty liver disease (NAFLD) was the most common cause of HCC in the inpatient (32.07%) and outpatient (20.22%) followed by hepatitis C virus (HCV) (19.2% and 9.75%, respectively). Between 2005 and 2014, HCC rate per 100,000 Medicare recipients increased from 46.3 to 62.8 [average annual percentage change (AAPC) =3.4%, P<0.001]. Rate of HCV-HCC increased from 6.18 to 16.54 (AAPC=11.8%, P<0.001) while the NAFLD-HCC increased from 9.32 to 13.61, P<0.001). Overall 1-year mortality decreased from 46.2% to 42.1% (AAPC=−1.7%, P=0.004). Total charges increased from $67,679 to $99,420 (AAPC=5.1%, P<0.001) for inpatients and from $11,933 to $32,084 (P<0.001) for outpatients. On comparison of patients with hepatitis B virus-HCC, those with NAFLD-HCC (odds ratio: 1.87, P<0.001) had higher risk of mortality. On comparison of patients with hepatitis B virus-HCC, those with HCV-HCC had higher charges (percent change: 24.33%, 95% confidence interval: 1.02%-53.02%, P=0.040).

Conclusions:
Although HCC rates are increasing, the overall mortality is decreasing. NAFLD is the most important cause of HCC and an independent predictor of HCC in the outpatient setting for Medicare patients with HCC.
Effectiveness of fixed-dose combination of paritaprevir, ritonavir, ombitasvir, and dasabuvir in patients with chronic hepatitis C virus infection and chronic kidney diseases: real-life experiences
Authors: Örmeci Necati , Sezgin Orhan , Karaali Ridvan , Aygen Bilgehan , Turan Dilara , Yaras Serkan , Erdem İlknur , Yildiz Orhan , Karakaya Fatih , Ateş Kenan , Asiller Özgün Ö. 
Published: January 2019

Introduction
Both hepatitis C virus infection (HCV) and chronic kidney disease (CKD) have been comorbid illnesses with increasing morbidity and mortality. The present study was conducted to present real-life experiences about treatment of HCV and CKD with a fixed-dose combination of paritaprevir 150 mg/day, ritonavir 100 mg/day as a booster, ombitasvir 25 mg/day, and dasabuvir 250 mg twice/day, the PROD regimen.

Patients and methods
This was a multicenter, retrospective cohort study. Seventy-five patients with both HCV and CKD were treated with a PROD-based regimen with or without ribavirin. Fifty-three of 75 patients were on maintenance hemodialysis program. Seven patients had compensated liver cirrhosis. The patients with genotype 1a or compensated liver cirrhosis were treated with the PROD regimen and ribavirin in a dose of 200 mg every other day for 12 weeks. The patients with genotype 1b were treated with PROD for 12 weeks. The patients with genotype 4 were treated with a combination of paritaprevir, ritonavir, ombitasvir, and ribavirin 200 mg every other day.

Results
All patients except one were HCV-RNA negative (98.6%) at the end of treatment. One patient had decompensated after the fourth day of therapy. She stopped the treatment, and she was exitus after 2 months. Two patients died of reasons not related to the drugs 2 months after negativity of HCV-RNA. Sustained viral rate 12 weeks after treatment was found in 96% of the patients.

Conclusion
The PROD regimen was very effective and safe for treatment in patients with HCV and CKD who were in stages 4 and 5.
Alloimmunity and Cholestasis After Liver Transplantation in Children With Progressive Familial Intrahepatic Cholestasis
Authors: Krebs‐Schmitt Dorothee , Briem‐Richter Andrea , Brinkert Florian , Keitel Verena , Pukite Ieva , Lenhartz Henning , Fischer Lutz , Grabhorn Enke 
Published: January 2019

ABSTRACTObjectives:Bile salt export pump (BSEP) deficiency is an important reason for chronic cholestasis leading to liver transplantation (LT) in early childhood. The underlying pathology is a dysfunction of BSEP due to various mutations in the ABCB11 gene. Cases of clinical recurrence after LT due to alloantibodies directed against BSEP (antibody‐induced BSEP deficiency [AIBD]) have been reported. Most of these patients could be controlled by intensified immunosuppression.Methods:We here report on 3 children with BSEP‐deficiency and end‐stage liver disease, which developed AIBD after LT refractory to extensive immunosuppressive and immunomodulatory treatments; retransplantation was necessary in all 3 patients. In 1 patient, a stem cell transplantation was performed successfully.Results:AIBD seems to be induced by triggering factors such as initial impaired graft function or infections after LT.Conclusions:The underlying mutation may play a role in this process. Intensifying immunosuppression may be able to control AIBD, but some cases seem to be refractory to treatment and require retransplantation. Stem cell transplantation may provide a new therapeutic option for cases refractory to conservative treatment.