bluuebunny/crossref_metadata_2025_split huggingface dataset:
Supplemental Superior Buttress Plating for the Treatment of Posterosuperior Wall Acetabulum Fractures
Authors: Askam Brad , Sims Stephen 
Published: January 2019

Summary:
Posterosuperior wall acetabulum fractures are a unique and uncommon fracture pattern. Traditional plate fixation may not provide adequate fixation of these fracture fragments. This article presents a surgical technique and the results of a case series using a supplemental 1/3 tubular superior buttress plate to improve fracture reduction and better neutralize shear forces in the treatment of superior posterior wall fractures. Additionally, we compared failure rates of those posterior superior wall acetabular fractures treated with supplemental superior buttress plates to those treated with standard plate fixation and no supplemental superior buttress plates.
Improved Intraoperative Fluoroscopy for Pelvic and Acetabular Surgery
Authors: Routt Milton Lee (Chip) , Gary Joshua L. , Kellam James F. , Burgess Andrew R. 
Published: January 2019

Summary:
Over the past 3 decades, the evolution of pelvic and acetabular surgery has been supported by the advances in intraoperative pelvic fluoroscopic imaging technology. The new Ziehm RFD 3D C-arm unit provides routine fluoroscopic pelvic imaging but also offers rapid and high-quality real-time axial, sagittal, and coronal intraoperative imaging. This technology allows the surgeon to accurately assess fracture reduction, loose body removal, and implant locations while the patient is still under anesthesia. In this way, any necessary corrections can be performed before the patient leaves the operating room. Essentially, this technology should eliminate the need for revision surgeries. In this report, we present our initial experience using this new device.
Does Routine Postoperative Computerized Tomography After Acetabular Fracture Fixation Affect Management?
Authors: Elnahal Walid A. , Ward Anthony J. , Acharya Mehool R. , Chesser Timothy J. S. 
Published: January 2019

Introduction and Aims:
The use of routine postoperative computerized tomography (CT) scan after acetabular fracture reconstruction remains controversial. CT scan may provide more accurate detail regarding metalwork position, retained intra-articular fragments, and quality of reduction but does expose the patient to additional radiation dosage and incurs increased cost. The aim of this study was to evaluate a protocol of routine postoperative CT scan for all acetabular fractures after surgical fixation and assess the effect this has on patient management.

Patients and Methods:
The perioperative fluoroscopic images and postoperative plain radiographs of 122 patients who underwent surgical stabilization of a displaced acetabular fracture were reviewed and categorized into 3 groups: (1) safe, when there was no suspicion of metalwork malposition or intra-articular fragments; (2) inconclusive, when it was not possible to exclude malposition; or (3) definite malposition or intra-articular penetration of implants. The findings were compared with postoperative CT scans. The quality of reduction of the acetabular fracture was graded on plain radiographs using the Matta criteria and compared with the CT scan using a standardized technique.

Results:
Fractures that were categorized as safe on plain radiographs were confirmed to have no metalwork malposition on CT scan in 94% of the cases, with the other 6% having insignificant findings that did not require revision surgery. When plain radiographs were inconclusive (n = 17), 4 patients had metalwork malposition documented on CT scan and 2 of these required revision surgery. There was an increased risk of implant malposition with use of spring plates for posterior wall stabilization. There was significant variation between the quality of reduction when assessed with plain radiographs as compared with CT scans (P < 0.001). In 42% of the patients who were thought to have anatomic reduction on plain radiographic assessment, the reduction was either imperfect or poor based on CT assessment.

Conclusions:
CT scans were more accurate than plain radiographs in detecting metalwork malposition and in assessing quality of reduction of the acetabular fracture. The use of postoperative CT scans may be restricted to a group of fractures that have inconclusive or definite malpositioning of implants on perioperative or postoperative radiographs, especially with use of spring pates or to those patients in whom quality of reduction needs more accurate assessment for quality assurance or prognostic reasons.

Level of Evidence:
Level IV; Diagnostic -Investigating a diagnostic test.
Anterior Intrapelvic Approaches: Fracture Patterns You May Want to Reconsider
Authors: Morellato John , Hogue Matthew , O'Toole Robert V. , Sciadini Marcus F. , Nascone Jason 
Published: January 2019

Summary:
The anterior intrapelvic approach with a lateral window is gaining popularity for the surgical treatment of anterior fracture patterns of the acetabulum. Certain fracture patterns and characteristics present challenges when using anterior approaches. This article aims to describe some of the fracture patterns that may be particularly difficult to address using the anterior intrapelvic approach with or without the lateral window.
Efficacy, Pharmacokinetics, and Immunogenicity is Not Affected by Switching From Infliximab Originator to a Biosimilar in Pediatric Patients With Inflammatory Bowel Disease
Authors: van Hoeve Karen , Dreesen Erwin , Hoffman Ilse , Van Assche Gert , Ferrante Marc , Gils Ann , Vermeire Séverine 
Published: January 2019

Background:
Rising evidence demonstrates that there are no differences in efficacy and safety between infliximab (IFX) originator and IFX biosimilar CT-P13 in the treatment of inflammatory bowel diseases (IBDs). However, most data are derived from adult patients, and data on pharmacokinetics are limited. The authors evaluated long-term IFX trough levels, immunogenicity, and remission rates in children with IBD who switched from IFX originator to biosimilar CT-P13.

Methods:
In this single-center study, all children with Crohn disease and ulcerative colitis receiving maintenance IFX therapy were switched from originator to biosimilar CT-P13. Demographics, disease activity indices, and IFX drug levels were collected from 6 months before (baseline) till 6 months after switching to CT-P13. All data are presented as median (interquartile range).

Results:
A total of 42 children (26 Crohn disease and 16 ulcerative colitis), with a median duration on IFX originator of 13.5 (6.8–35.5) months before switching to CT-P13, were included. No significant changes in IFX trough levels occurred after switching. The median baseline IFX trough level was 5.7 mcg/mL (3.8–9.3) versus 6.5 mcg/mL (3.9–8.6) at month 6 after switching (P = 0.900). Antibodies to IFX appeared in one patient after switching. The proportion of patients in clinical and/or biological remission did not significantly change after switching (all P > 0.05). No significant changes were observed in C-reactive protein, erythrocyte sedimentation rate, albumin, weight, and body mass index after the switch. Safety profile was also comparable.

Conclusions:
Pediatric patients with IBD on IFX originator can be successfully switched during maintenance to biosimilar CT-P13 without affecting efficacy, pharmacokinetics, immunogenicity, or safety.
Measuring Unbound Versus Total Piperacillin Concentrations in Plasma of Critically Ill Patients: Methodological Issues and Relevance
Authors: Colman Sofie , Stove Veronique , De Waele Jan J. , Verstraete Alain G. 
Published: January 2019

Background:
Piperacillin is considered a moderately protein-bound antibiotic (20%–40%), with albumin being an important binding protein. Although infrequently used in practice, different methods to measure the fraction unbound (fu) are available, but uncertainty remains as to what the most appropriate method is. The main goal of this study was to estimate the impact of the methodology used to measure unbound piperacillin in plasma on the fu of piperacillin; we compared ultrafiltration (UF) at 4°C and 37°C with the reference method, equilibrium dialysis. In addition, we analyzed the impact of other proteins on the fu.

Methods:
Anonymized left-over Li-heparin plasma samples (n = 41) from 30 critically ill patients who were treated with piperacillin were used for the analyses.

Results:
We found that the piperacillin fu, determined by UF, is on average 8% higher at 37°C (91%) than at 4°C (83%). There were no systematic or proportional differences between UF at 4°C and equilibrium dialysis at 4°C. This emphasizes the importance of the temperature during UF, which should therefore be clearly stated in publications that report on the methodology of UF. No significant impact of the albumin-, IgA-, total protein-, or α1-acid glycoprotein concentration on the fu was found. The fu found in this study was higher than the generally assumed fu value of 60%–80%. A possible explanation lies in the studied population or in the temperature used. Based on our results, routine monitoring of unbound piperacillin in intensive care unit patients is not recommended.

Conclusions:
Based on the prediction model, we can state that in intensive care patients the fu of piperacillin is 91% (SD 7%), determined with UF at 37°C.
Lung and Heart Injury in a Nonhuman Primate Model of Partial-body Irradiation with Minimal Bone Marrow Sparing: Histopathological Evidence of Lung and Heart Injury
Authors: Parker George A. , Li Na , Takayama Kyle , Farese Ann M. , MacVittie Thomas J. 
Published: January 2019

Abstract
Male rhesus macaques were subjected to partial-body irradiation at 10, 11, or 12 Gy with 5% bone marrow protection. Animals were euthanized when dictated by prospectively determined clinical parameters or at approximately 180 d following irradiation. Histological sections of lung and heart were stained with hematoxylin and eosin as well as a battery of histochemical and immunohistochemical stains. Histopathological alterations in the lung were centered on fibrosis, inflammation, and reactive/proliferative changes in pneumocytes. These changes were noted in animals necropsied after approximately 85–100 d postirradiation and extending through the observation period. Interstitial and pleural fibrosis demonstrated by Masson’s trichrome staining were associated with increased alpha smooth muscle actin and collagen 1 immunohistochemical staining. Areas of interstitial fibrosis had reduced microvascular density with CD31 immunohistochemical staining. Accumulations of CD163- and CD206-positive alveolar macrophages were present in areas of interstitial fibrosis. Unidentified cells termed “myxoid” cells in alveolar walls had histochemical and immunohistochemical staining characteristics of epithelial-, endothelial-, or pericyte-mesenchymal transition states that were developing myofibroblast features. Distinctive focal or multifocal alveolar-bronchiolar hyperplasia had microscopic features of preneoplastic proliferation. Delayed radiation-associated changes in the heart consisted primarily of myocardial fibrosis, with rare histological evidence of myofiber degeneration.
Physical Therapist Determination of Discharge Disposition in the Acute Care Setting
Authors: Shoemaker Michael J. , Gutowski Amanda , Mallgren Megan , Oliver Laura , Van Dam Ashley , McLeod Jessica , Mohney Emily 
Published: January 2019

Purpose:The purpose of this retrospective chart review study was to determine whether physical therapists (PTs) were accurate in determining home discharge (DC) disposition as measured by all cause- and mobility-related readmissions and to examine the extent to which predictors of readmission are associated with PT DC disposition decision making.Methods:A retrospective medical record review was completed for 322 patients with at least 1 PT visit who were discharged to home from a large tertiary care teaching hospital. Demographic and clinical data were collected. Multivariate binary logistic regression was used to determine predictors of readmission and PT DC recommendations for location, social support, and post–acute PT services.Results:Only 2 of 287 (0.70%) patients recommended for home DC by PT were readmitted and 4 of the 287 (1.39%) returned to the emergency department for mobility-related problems. Having 24-hour social support available upon DC was the only significant predictor of all 3 PT DC recommendations; otherwise, no extensive overlap of predictors was found among the regression models.Conclusions:The results of the present study affirm the accuracy of PT determination of safe DC to home, and although no extensive overlap of the predictors of readmission and PT decision making was found, the relationships among the various predictors are hypothesis-generating as to the way in which PT decision making might help reduce non–mobility-related readmissions.
Challenges and obstacles in the transition process through the eyes of the gastroenterologist
Authors: Hald Mette , Carlsen Katrine , Nordgaard-Lassen Inge , Wewer Vibeke 
Published: January 2019

Background
Adult and pediatric care have different views and ways of handling the patients and the parents, which may result in insufficient coordination and communication of transfer. The young patient, the parents, the pediatric, and the adult provider constitute four central actors in transition and transfer, and they have different roles, approaches, and needs. Our aim was to clarify the challenges and background for each actor.

Materials and methods
Statements from semistructured interviews of adult gastroenterologists and nurses were analyzed and interpreted by social scientific principles. The interviews were conducted individually, and each interview was completed within 30 min. The interviews were taped, transcribed, and sent to the interviewees for approval.

Results
The analysis of the statements included a description of the motives, perspectives, and approaches of the interviewees as well as an exploration and interpretation of the underlying meaning, patterns, and models. The main points of the article are illustrated through excerpts from the interviews and concluded in the recommendations.

Conclusion
(I) Pediatricians and adult gastroenterologist need to rethink their view on patients aged 15–20 years and understand that they are different from other patients and do have different demands. (II) Transfer should be considered a three-part process: (a) transition at the pediatric department, (b) a coordinated transfer, and (c) a consolidation phase after transfer. (III) Adolescent patients need proper education and empowerment during transition. (IV) Parents need to be timely prepared including an adjustment and redefinition of their roles.
Effectiveness of 8-week sofosbuvir/ledipasvir in the adolescent chronic hepatitis C-infected patients
Authors: El-Khayat Hesham , Kamal Enas M. , Yakoot Mostafa , Gawad Manal A. , Kamal Naglaa , El Shabrawi Mortada , Sameh Yehia , Haseeb Alaa , Fouad Yasser , Attia Dina 
Published: January 2019

Background
The sustained virological response (SVR) rate for the 12-week sofosbuvir (SOF)/ledipasvir (LVD) treatment of adolescent genotype-4 patients is high. The aim of this study is to evaluate 8 versus 12-week treatment efficacy and safety in adolescent genotype-4 patients.

Patients and methods
In total, 157 chronic hepatitis C-infected adolescent patients (mean age 14±2 years, 62% males) were included in this study. All patients received a morning dose of SOF (400 mg)/LVD (90 mg) as a single tablet for 8 and 12 weeks. Laboratory and biochemical monitoring were performed at weeks 4 and 8, end of treatment (8/12) and 12 weeks after the end of treatment (SVR12).

Results
In total, SVR12 was 98% [95% confidence interval (CI): 96–100] for all treated patients. For patients treated for 12 weeks, SVR12 was 97.6% (95% CI: 96–101) (82/84 patients), and 98.6% (95% CI: 93–101) (72/73) patients for those treated for 8 weeks. For both regimens, no serious adverse effects, treatment discontinuation or cases of death were detected. The main adverse effects for the 8-week patient group were fatigue (2.8%), headache (1.4%), nausea (1.4%) and epigastric tenderness (1.4%). For the 12-week-treated group, adverse events were epigastric tenderness (1.2%), nausea (1.2%), diarrhoea (2.4%) and rash (2.4%). Three patients were lost to follow-up: two were in the 12-week treatment group and one was in the 8-week group. All of them reached end of treatment but were lost before SVR12. No relapsers were observed in either group.

Conclusion
Eight weeks of treatment of SOF/LVD combination is equally effective and safe as 12 weeks in adolescent genotype-4 patients.
Fostering Cross-Sector Partnerships
Authors: Holland Diane E. , Vanderboom Catherine E. , Harder Tanya M. 
Published: January 2019

Purpose/Objectives:
The purpose of this study was to describe lessons learned during the development and implementation of a community care team (CCT) and the applicability of this model in movement toward cross-sector team-based care coordination.

Primary Practice Setting:
Primary care.

Findings/Conclusions:
Cross-sector CCTs composed of primary care and community service providers are a care coordination approach that attends to the individual's social determinants of health, enhances the individual's capacity to manage treatment and self-care demands of multiple chronic health conditions, improves the care experience, and impacts well-being. A collaborative CCT decreased the use of acute care services and the costs of care.

Implications for Case Management Practice:
As reported in this study, use of interprofessional collaborative health care teams in planning care and services for individuals is a standard of practice for case management. Cross-sector partnerships provide the opportunity to maximize the contributions of health care and community service providers that address both chronic health conditions and social determinants of health, minimize fragmentation and costs of care, and promote collaborative care coordination. Community care teams offer sophisticated care coordination not otherwise available to medically complex high-need individuals who require assistance in navigating the medical and financial systems that exist in health care today.
Molecular Testing for EGFR Mutations and ALK Rearrangements in the Cytological Specimens From the Patients With Non–Small Cell Lung Cancer
Authors: Wang Xiaoyan , Chen Shaoxiong , Emerson Robert E. , Wu Howard H. , Cramer Harvey M. , Curless Kendra , Chang Hsim Yee , Zhang Shaobo , Randolph Melissa L. , Cheng Liang 
Published: January 2019

Objective:
The aim of this study was to investigate epidermal growth factor receptor (EGFR) gene mutations and anaplastic lymphoma kinase (ALK) gene rearrangements using cytological specimens from the patients with a diagnosis of primary or metastatic lung non–small cell carcinoma.

Materials and Methods:
A total 307 cases were submitted for EGFR mutational analysis and 265 cases for ALK analysis. The cytological specimen sources included lung, lymph node, liver, bone, adrenal gland, mesentery mass, and body fluids/bronchial brushing. EGFR mutations in the exons 18 to 21 were analyzed with Qiagen EGFR Pyro Kits. Fluorescence in situ hybridization (FISH) studies for ALK rearrangement inv(2)(p21; p23) were performed on the paraffin-embedded cell block sections utilizing dual-color Vysis LSI ALK Break Apart Probe Kit.

Results:
Among 307 fine needle aspirate cases for EGFR analysis, 302 cases (269 from cell blocks, 33 from direct smears) had sufficient material for EGFR test. Five cases failed due to inadequate cellularity. Twenty six of 302 (8.6%) cases were positive for EGFR mutations. A total of 265 cases submitted for ALK analysis included 240 cases of fine needle aspirate, 25 cases of pleural fluid/pericardial fluid/bronchial washings. Eight cases failed because of low cellularity, whereas 257 of 265 cases had sufficient material for ALK FISH study. Nine of 257 cases (3.5%) revealed ALK rearrangement by FISH.

Conclusions:
The current study demonstrates that cytological specimens can yield sufficient material for EGFR mutations and ALK rearrangement test. Our study reveals that 8.6% of EGFR mutation rate and 3.5% of ALK rearrangement rate in the cytology specimens from the patients with primary or metastatic lung non–small cell carcinoma.
Cranial Anchored Mandible Distraction Osteogenesis
Authors: Dong Elaine , Dempsey Robert F. , Wirthlin John O. , Buchanan Edward P. 
Published: January 2019

Abstract
Multiple or large distance mandibular distraction osteogenesis (MDO) in the older child is often complicated by iatrogenic temporomandibular joint (TMJ) pathology. The transmission of significant force to the TMJ in these particular patients is due to the greater distance of distraction required and the relative inelasticity of the soft tissue envelope. The authors present a clinical report of a successful asymmetrically vectored large distance MDO in a 13-year-old female with bilateral craniofacial microsomia with Goldenhar syndrome. During distraction, the TMJ joints were effectively unloaded from the forces of distraction using external bilateral cranial anchored devices (Cranio-Mandibular Fixator; KLS Martin, Jacksonville, FL). Angle's occlusion, facial angle, and evidence of TMJ pathology were assessed.
Acute Posterior Multifocal Placoid Pigment Epitheliopathy Complicated by Fatal Cerebral Vasculitis
Authors: Maamari Robi N. , Stunkel Leanne , Kung Nathan H. , Ferguson Cole J. , Tanabe Jody , Schmidt Robert E. , Dahiya Sonika , Dhand Amar , Van Stavern Gregory P. , Rajagopal Rithwick , Harocopos George J. 
Published: January 2019

Abstract:
A 21-year-old man experienced unilateral vision loss associated with multiple atrophic chorioretinal lesions. He was treated for a presumptive diagnosis of acute retinal necrosis, but his vision did not improve with antiviral therapy. Over the course of several weeks, his symptoms progressed to involve both eyes. The fellow eye showed characteristic yellow-white placoid lesions, prompting treatment with oral corticosteroids for acute posterior multifocal placoid pigment epitheliopathy (APMPPE). Despite high-dose therapy with prednisone 80 mg daily, the patient developed the acute onset of mental status changes within the next several days. Neuroimaging revealed multifocal large-vessel strokes associated with cerebral edema; these infarcts led to herniation and death. Postmortem histopathologic examination confirmed granulomatous inflammation in both ocular and cerebral vasculatures. Together with findings from multimodal imaging obtained throughout this patient's clinical course, our findings support the notion that granulomatous choroiditis is the mechanism of the ocular lesions seen in APMPPE. This granulomatous inflammation can also affect cerebral vessels, leading to strokes.