bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gluteal Augmentation with Polymethyl Methacrylate: A 10-year Cohort Study
Authors: Chacur Roberto , Sampaio Menezes Honório , Maria Bordin da Silva Chacur Nívea , Dias Alves Danuza , Cadore Mafaldo Rodrigo , Dias Gomes Leandro , dos Santos Barreto Gisele 
Published: June 2019

Background:
Many techniques for buttocks augmentation have been developed and published, for a more natural, satisfactory, and safe result for the patient. It has been a challenge to find a technique that presented not only volume gain but also gluteal remodeling.

Methods:
A total of 1,681 patients who underwent gluteal augmentation with Polymethyl methacrylate (PMMA) between 2009 and 2018 were selected for this retrospective cohort study. Data collected included demographics, procedures data, and postoperative outcomes. Side effects were calculated and compared using the Student’s t test.

Results:
A total of 1,681 patients (1,583 women and 98 men) who underwent 2,770 gluteal fillings had their cases retrospectively analyzed. They were injected with 540,751.00 mL of PMMA injected. The patients’ mean age was 39 years, and the mean volume injected in each section was 237 mL during the first procedure and 147 mL during the second procedure. The authors observed 52 cases presenting side effects, representing a rate of 1.88% of 2,770 procedures carried out. The statistically significant (P = 0.02) presence of side effects was detected in relation to the total filling volume.

Conclusions:
This study has demonstrated that gluteal augmentation with PMMA is one of the best options for this type of procedure. In addition, the findings suggest that the guidelines concerning gluteal augmentation must include PMMA filler as an option because PMMA proved to cause few side effects, as demonstrated by this patient cohort.
Long-Term Stability With the Athens Protocol (Topography-Guided Partial PRK Combined With Cross-Linking) in Pediatric Patients With Keratoconus
Authors: Kanellopoulos Anastasios John , Vingopoulos Filippos , Sideri Anna Maria 
Published: June 2019

Purpose:
To evaluate the safety, efficacy, and stability of topography-guided partial PRK combined with corneal cross-linking (CXL) (the Athens Protocol [AP]) in pediatric patients with keratoconus over a 4-year follow-up period.

Methods:
This prospective study included 39 keratoconic eyes of 21 patients younger than 18 years with clinical and imaging evidence of keratoconus progression. Partial topography-guided excimer laser ablation in conjunction with high-fluence CXL was performed in all patients according to the AP. Uncorrected distance visual acuity, corrected distance visual acuity, refraction, keratometry, endothelial cell density, topography, and tomography using both Scheimpflug and optical coherence tomography (OCT) were evaluated for 4 years postoperatively.

Results:
At 4 years postoperative, there was significant improvement in mean uncorrected distance visual acuity from 0.51 ± 0.31 (decimal) to 0.65 ± 0.26 (decimal; P < 0.05). Mean corrected distance visual acuity improved from 0.71 ± 0.22 (decimal) preoperatively to 0.81 ± 0.19 (decimal; P < 0.05), respectively. Mean flat keratometry (K1) and mean steep keratometry (K2) readings reduced from 44.95 ± 3.71 D and 49.32 ± 5.05 D, respectively, preoperatively to 43.14 ± 2.95 D and 46.28 ± 4.87 D, respectively, (P < 0.05) at 4 years. The mean anterior maximum keratometry (Kmax) reading reduced from 56.81 ± 2.94 D preoperatively to 48.11 ± 3.17 D at 48 months. The mean index of height decentration was 0.105 ± 0.054 μm preoperatively and 0.049 ± 0.024 (P < 0.05) at 4 years postoperative. Mean preoperative corneal thickness at the thinnest point was 436.7 ± 42.6 μm preoperatively, 392.50 ± 45.68 μm at 12 months postoperative, and 418.42 ± 17.01 μm at 4-year follow-up. Late-onset deep corneal haze, a potential intrinsic complication of this technique in pediatric patients, was encountered in 2 cases at least 1 year after the procedure.

Conclusions:
Long-term results of the AP seem to be safe and effective in pediatric patients, with marked improvement in visual function and keratometric symmetry indices.
Permethrin Cream for the Treatment of Demodex Blepharitis
Authors: Hecht Idan , Melzer-Golik Asia , Sadi Szyper Naava , Kaiserman Igor 
Published: June 2019

Purpose:
To evaluate the safety and efficacy of permethrin 5% cream for the treatment of Demodex blepharitis.

Methods:
Patients with confirmed Demodex blepharitis were prospectively recruited and treated with permethrin 5% cream for 6 months. Blepharitis symptoms, ocular examination findings, ocular surface disease index, and ex vivo eyelash Demodex counts were regularly assessed.

Results:
Twenty-three patients were recruited, of which 2 were lost to follow up and 21 entered the analysis. Mean patient age was 57.2 ± 16.8 years (range: 24–82 years), and 13 (62%) were women. Mean Demodex counts improved after treatment from 1.36 ± 1.233 to 0.48 ± 0.6 parasites per eyelash (P = 0.03), and the overall blepharitis symptoms score improved from 42.9 ± 22 to 32.7 ± 21 (P = 0.01). Improvement in disease symptoms (scored on a scale between 0 and 4) was noted including feeling of dry eye (2.85 ± 1.3–1.85 ± 1.7, P = 0.006), discharge (1.86 ± 1.7–1.00 ± 1.1, P = 0.040), and dandruff-like debris (1.69 ± 1.7–0.9 ± 1.6, P = 0.033), as well as clinical findings including a decrease in scaling (on a scale of 1–5; 1.43 ± 0.9–0.86 ± 0.7, P = 0.006) and corneal staining with fluorescein (on a scale of 1–4; 1.29 ± 0.4–1.05 ± 0.2, P = 0.040). No change in the ocular surface disease index score was noted (37.5 ± 24.1–41.63 ± 42.5, P = 0.913), and no adverse events were reported.

Conclusions:
Treatment of Demodex blepharitis with permethrin 5% cream resulted in a decrease in parasite burden and improvement in blepharitis signs and symptoms, with no reported adverse events. Permethrin might be a safe and effective alternative for the treatment of blepharitis associated with Demodex infection.
Are BALB/c Mice Relevant Models for Understanding Sex-Related Differences in Gene Expression in the Human Meibomian Gland?
Authors: Chen Xiaomin , Sullivan Benjamin D. , Darabad Raheleh Rahimi , Liu Shaohui , Kam Wendy R. , Sullivan David A. 
Published: June 2019

Background:
A compelling feature of dry eye disease is that it occurs predominantly in women. We hypothesize that this female prevalence is linked to sex-related differences in the meibomian gland (MG). This gland plays a critical role in maintaining the tear film, and its dysfunction is a major cause of dry eye disease. To understand the factors that underlie MG sexual dimorphism and promote dry eye in women, we seek to identify an optimal model for the human MG. Our goal was to determine whether a murine MG is such a model. Toward that end, we examined whether sex differences in MG gene expression are the same in BALB/c mice and humans.

Methods:
Eyelid tissues were collected from humans (n = 5–7/sex) and BALB/c mice (n = 9/sex). MGs were isolated and processed for the evaluation of gene expression by using microarrays and bioinformatics software.

Results:
Our analysis of the 500 most highly expressed genes from human and mouse MGs showed that only 24.4% were the same. Our comparison of 100 genes with the greatest sex-associated differences in human and mouse MGs demonstrated that none were the same. Sex also exerted a significant impact on numerous ontologies, Kyoto Encyclopedia of Genes and Genomes pathways, and chromosomes, but these effects were primarily species-specific.

Conclusions:
Our results indicate that BALB/c mice are not optimal models for understanding sex-related differences in gene expression of the human MG.
Tetanus presenting primarily as periocular discomfort in a patient who underwent surgery for sleep apnea
Authors: Park Donghwi , Kim Jung Soo , Heo Sung Jae 
Published: June 2019

Abstract

Rationale:
Tetanus is caused by a neurotoxin (tetanospasmin) secreted by a spore forming gram-positive, anaerobic rod-shaped motile bacillus, Clostridium tetani. The most common symptoms of tetanus are trismus (100%), dysphagia (70.5%), dysarthria (35.2%), and neck stiffness (29.4%). Respiratory failure, laryngeal spasm, seizure, chest pain, nausea/vomiting, opisthotonus, back pain, and rigid abdominal wall can also be observed during progression of the disease. However, there has been no report of periocular discomfort as an initial manifestation after endoscopic sleep surgery in a patient with tetanus. Here, we report a patient who underwent endoscopic sleep surgery with a concurrent diagnosis of tetanus infection presenting with atypical periocular discomfort as the initial symptom.

Patient concerns:
A 63-year-old man complaining of sleep apnea, snoring, and daytime sleepiness visited our department. He subsequently underwent sleep surgery (anterior pharyngoplasty with tonsillectomy, septoplasty, microdebrider-assisted inferior turbinoplasty, and an endoscopic sinus surgery) for the treatment of his newly diagnosed obstructive sleep apnea. After 3 weeks of surgery, he visited the outpatient clinic of our department with right side periocular discomfort.

Diagnoses:
Four days after presenting with periocular discomfort, he was diagnosed with tetanus by presenting trismus, jaw pain, dysphagia, and ptosis at an emergency department of a different hospital.

Interventions:
Tetanus immunoglobulin and antibiotics were administered.

Outcomes:
His symptoms then resolved after a month without sequelae.

Lessons:
Although periocular discomfort is atypical and is not uncommon after nasal and oral surgeries, care should be taken when patients present with periocular pain because it could be a rare initial symptom of tetanus.
Diagnostic usefulness of molecular detection of Coxiella burnetii from blood of patients with suspected acute Q fever
Authors: Bae Moonsuk , Jin Choong Eun , Park Joung Ha , Kim Min Jae , Chong Yong Pil , Lee Sang-Oh , Choi Sang-Ho , Kim Yang Soo , Woo Jun Hee , Shin Yong , Kim Sung-Han 
Published: June 2019

Abstract
Diagnosis of Q fever is difficult due to the lack of distinct clinical features that distinguish it from other febrile diseases. Serologic testing is the gold standard method for diagnosing Q fever, but antibody formation may not be detectable for 2 to 3 weeks from symptom onset, limiting early diagnosis. We thus evaluated the diagnostic utility of polymerase chain reaction (PCR) to detect Coxellia burnetii DNA in serum from patients with suspected acute Q fever.
All adult patients with suspected acute Q fever were prospectively enrolled at a tertiary-care hospital from January 2016 through July 2018. Acute Q fever was diagnosed using clinical and laboratory criteria: fever with at least one other symptoms (myalgia, headache, pneumonia, or hepatitis) and single phase II immunoglobulin G (IgG) antibody titers ≥1:200 or immunoglobulin M (IgM) antibody titer ≥1:50 (probable), or a fourfold increase or seroconversion in phase II IgG antibody titers as measured by indirect immunofluorescence assays between paired samples (confirmed). We performed PCR targeting the transposase gene insertion element IS1111a of C. burnetii.
Of the 35 patients with suspected acute Q fever, 16 (46%) were diagnosed with acute Q fever including 8 probable and 8 confirmed cases; the remaining 19 (54%) were diagnosed with other febrile diseases. The proportion of males diagnosed with Q fever was higher than those diagnosed with other febrile diseases (88% vs 44%, P = .03), but there were no other significant differences in clinical characteristics between the 2 groups. The Q fever PCR sensitivity was 81% (95% confidence interval [CI], 54–96), specificity was 90% (95% CI, 67–99), positive predictive value was 87% (95% CI, 63–96), and negative predictive value was 85% (95% CI, 67–94).
Q fever PCR testing using blood from patients with suspected acute Q fever seems to be a rapid and useful test for early diagnosis of Q fever.
Effects of wine on blood pressure, glucose parameters, and lipid profile in type 2 diabetes mellitus
Authors: Ye Jianhua , Chen Xufeng , Bao Ligang 
Published: June 2019

Abstract

Background:
Previous studies identified conflicting results about the effects of wine intake on glucose parameters and the risk of cardiovascular diseases in type 2 diabetes mellitus (T2DM). The present study further investigated the association between wine digestion and these outcomes in T2DM patients.

Material and methods:
A search of PubMed, Embase, and Scopus databases (up to November 2018) was performed for randomized interventional trials which evaluated the effect of wine on blood pressure (BP), glucose parameters and lipid profiles in T2DM people. We used a variety of tests: fixed and random effects models, Q Cochrane test and I
2 index, Egger and Begg tests, forest plots, and sensitivity analysis in our study.

Results:
A total of 9 randomized interventional studies were included in this meta-analysis. Overall, significant association between wine intake with diastolic BP (weighted mean difference [WMD] = 0.10; 95% confidence interval [95% CI]: −0.01 to 0.20, P = .03 I
2 = 13%) and total cholesterol (TC) (WMD = 0.16, 95% CI: 0.02–0.31, P = .03, I

2
= 6%), whereas no noticeable differences in glucose parameters, systolic BP, low-density lipoprotein cholesterol (LDLC), triglyceride (TG) and high-density lipoprotein cholesterol (HDLC) were identified between wine and controls groups (fasting glucose [FG],WMD = −0.00, 95% CI: −0.58 to 0.58; fasting insulin [FI], −0.22, −2.09 to 1.65; HbAc1%, −0.16, −0.40 to 0.07; systolic blood pressure, 0.12, −0.05 to 0.28; LDLC, −0.02, −0.25 to 0.21; TG, −0.34, −1.31 to 0.64; HDLC, 0.22, −0.08 to 0.53].

Conclusion:
This meta-analysis revealed that moderate wine consumption among T2DM patients could reduce the level of diastolic blood pressure and TC, but not glucose parameters and other cardiovascular risk factors.
Fetal, neonatal, and infant death in central China (Hubei)
Authors: Deng Yanfei , Wang Rongshuai , Zhou Xiaowei , Ren Liang , Liu Liang 
Published: June 2019

Abstract
Data based on forensic autopsy in neonates and infants in China are rare in the literature. The purpose of this study is to evaluate the characteristics of fetal, neonatal, and infant death and to determine the main cause of death among them.
A retrospective analysis of fetal and infant forensic autopsies referred to the Tongji Forensic Medical Center (TFMC) in Hubei, central China, during a 16-year period between January 1999 and December 2014, was performed.
In this period, there were 1111 males and 543 females; the total male-to-female ratio (MFR) was 2.05:1. There were 173 fetal and infant autopsies conducted, comprised of 43 fetal, 84 neonatal (<28 days) and 46 infant (4 weeks to 1 year) cases. The annual case number ranged from 5 in 2004 to 18 in 2014 (annual mean of 10.8). MFR was 1.75:1. About 94% of these deaths (163/173) resulted from natural causes, 6 cases (3.5%) were accidental deaths, and 4 (2.3%) resulted from homicide (4 abandoned babies). Among fetuses, the most common causes of death were placental and umbilical cord pathologies (28%, 12/43), followed by intrapartum asphyxia resulting from amniotic fluid aspiration (AFA) or meconium aspiration syndrome (MAS) (18.6%, 8/43), congenital malformation (14%, 6/43), and intrapartum infection (9.3%, 4/43). A majority of neonatal deaths (66.7%, 56/84) died within 24 hours of birth. The main causes of neonatal death were asphyxia resulting from AFA, MAS, or hyaline membrane disease, and congenital malformation. The main causes of infant (1–12 months) death were infectious diseases, including pneumonia, meningitis, and viral brainstem encephalitis.
This study was the 1st retrospective analysis of autopsies of fetal, neonatal, and infant death in TFMC and central China. We delineate the common causes of early demise among cases referred for autopsy, and report a male preponderance in this population. Our data observed that placental and/or umbilical cord pathology, asphyxia due to AFA, and/or MAS, and pneumonia were the leading causes of fetal, neonatal, and infant death, respectively. And it can inform clinical practitioners about the underlying causes of some of the most distressing cases in their practices.
Post-operative giant hiatal hernia
Authors: Felix Valter Nilton , Yogi Ioshiaki , Senday Daniel , Coimbra Fernando Tadeu , Martinez Faria Kauy Victor , Belo Silva Matheus Felipe , Previero Elias da Silva Gabriel 
Published: June 2019

Abstract
To verify the results of the treatment of post-operative giant hiatal hernia (POGH).
The POGH becomes each time more frequent after surgical treatment of the gastroesophageal reflux.
Fifteen patients (6 females and 9 males; 43.66 ± 5.05 years old; BMI 22.13 ± 1.92) were referred to our Service, for surgical treatment of a type III POGH 30.4 ± 1.76 months after treatment of gastroesophageal reflux disease. The need for a reoperation was determined mainly by dysphagia.
Reoperation was completed laparoscopically in all patients and the mean postoperative hospital stay was 3.2 ± 1.2 days (range, 1–6 days). Mortality was 0% and there were not postoperative complications. They became asymptomatic along follow-up of 2.86 ± 1.40 years. Around 1 year from the procedure, patients were submitted to control exams and barium esophagogram revealed well positioned esophago-gastric junction and signs of intact fundoplicature, the same observation having been done at esophageal endoscopy. Esophageal manometry showed preserved peristaltism, increase of resting pressure and extension of the intra-abdominal LES and significant raise of amplitude of deglutition waves at distal third of the esophagus. No reflux was observed at post-operative 24-hour pH testing.
The corrective surgery of POGH can often be completed laparoscopically in experienced hands. Successful results can be obtained performing reduction of the hernia, sac excision, crural repair, anti-reflux procedure and long anterior gastropexy.
Cost-effectiveness analysis of infant feeding modalities for virally suppressed mothers in Canada living with HIV
Authors: Keshmiri Reyhaneh , Coyte Peter C. , Laporte Audrey , Sheth Prameet M. , Loutfy Mona 
Published: June 2019

Abstract

Objective:
The aim of the study was to determine whether exclusive breastfeeding or exclusive formula feeding is more cost-effective when a Canadian mother with HIV is adherent to antiretroviral therapy and has full virologic suppression.

Design:
Current Canadian guidelines recommend that mothers with HIV practice exclusive formula feeding. This contradicts the updated World Health Organization (WHO) guidelines which recommend that mothers with HIV should breastfeed for ≥12 months while receiving support for antiretroviral therapy adherence. Due to the economic and health risks and benefits associated with each modality, there remains expert disagreement on whether the WHO recommendations should be adopted in high-income countries.

Methods:
A microsimulation model was developed to estimate lifetime costs and effectiveness (i.e., infant's quality-adjusted life years) of a hypothetical group of 1,000,000 initially healthy, HIV-negative infants, if the mother with HIV was on antiretroviral therapy with full virologic suppression and either exclusive breastfeeding or exclusive formula feeding. The model was developed from the economic perspective of the Ontario Ministry of Health, taking into account direct costs associated with infant feeding modality as well as related indirect costs born out of the child's lifetime health outcomes. Uncertainties related to model parameters were evaluated using one-way and probabilistic sensitivity analyses.

Results:
In comparison to exclusive formula feeding, exclusive breastfeeding was the dominant feeding modality (i.e., less costly and more effective) yielding cost-savings of $13,812 per additional quality-adjusted life year gained. Neither one-way nor probabilistic sensitivity analyses altered the conclusions.

Conclusions:
Despite the risk of HIV transmission, exclusive breastfeeding was more cost-effective than exclusive formula feeding. These findings merit review of current infant feeding guidelines for mothers with HIV living in high-income countries.
A case report of resected ectopic malignant meningioma with lung metastasis
Authors: Murakami Kotaro , Takahashi Hidenobu , Omori Tomokazu , Uchida Osamu , Hirano Hiroshi , Kawate Norihiko , Ikeda Norihiko 
Published: June 2019

Abstract

Introduction:
Meningioma is mostly a benign tumor, but sometimes it is malignant, and there have been reports of distant metastases.

Patient concerns:
The patient, a woman in her 40s, was under follow-up after resection of an ectopic malignant meningioma originating in the left axilla. She was referred to our department because of a nodule shadow in the right lung on chest computed tomography (CT) 3 years and 5 months postoperatively.

Diagnosis:
Chest CT showed a 1.0 cm nodule shadow in the right S4, which was positive on positron emission tomography-CT; no abnormality was found in any other organ. Therefore, it was considered to be a metastatic lung tumor.

Interventions:
Right middle lobe partial resection was performed using thoracoscopic surgery, and a diagnosis of pulmonary metastasis of ectopic malignant meningioma was made by histopathology and immunohistochemistry.

Outcomes:
In this case, complete resection was possible.

Conclusion:
Meningioma occurs mainly in the cranium, and occurrence in the soft tissue of the extremities is extremely rare. To our knowledge, ours is the first report of a histologically malignant ectopic meningioma with metastasis to the thoracic cavity.
Ischemic stroke in the combined territories of the septum pellucidum and the cingulate gyrus
Authors: Xu Sui-Yi , Xi Fu-Chun , Wu Xiao-Wei , Li Chang-Xin 
Published: June 2019

Abstract

Introduction:
Cases of isolated septum pellucidum infarction have not yet been reported. To date, there are only 2 stroke reports involving septum pellucidum infarction. The etiology of septum pellucidum infarction was subcallosal artery (ScA) injury. The abnormalities were strictly confined to the septum pellucidum and the right cingulated gyrus, making this the first case to report such confined abnormalities.

Patient concerns:
In this report, we present a case of ischemic stroke confined to the septum pellucidum and cingulated gyrus in a 48-year-old male patient who presented with transient ischemic attack-like paroxysmal lower left limb weakness.

Diagnosis:
Even no obvious abnormalities were revealed by an emergency computed tomography, the infarction in the combined territories of the septum pellucidum and the cingulate gyrus was detected on magnetic resonance imaging.

Interventions:
Aspirin with clopidogrel was administered for 3 weeks as a secondary preventive drug. Clopidogrel was selected as a long-term antiplatelet drug based on a thromboelastogram.

Outcomes:
The patient showed no positive signs related to the nervous system in the hospital, and there was no recurrence during the 3-month follow-up.

Conclusions:
Infarction in the septum pellucidum and cingulate gyrus is rare and has atypical clinical manifestations. Physical examination may not yield obvious positive signs. False-negative computed tomography findings of the head may result in misdiagnosis. Thus, it is necessary to perform whole-brain magnetic resonance imaging in time. Moreover, ScA protection should be paid attention to during surgery for anterior communicating artery aneurysm.