bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prenatal transplantation of human amniotic fluid stem cells for spinal muscular atrophy
Authors: Peng Shao-Yu , Shaw Sheng-Wen S. 
Published: February 2018

Purpose of review
To review the current medical and stem-cell therapy for spinal muscular atrophy (SMA) and prenatal transplantation of amniotic fluid stem cells in the future.

Recent findings
SMA is an autosomal recessive inheritance of neurodegenerative disease, which is caused of the mutation in survival motor neuron. The severe-type SMA patients usually die from the respiratory failure within 2 years after birth. Recently, researchers had found that 3-methyladenine could inhibit the autophagy and had the capacity to reduce death of the neurons. The first food and drug administration-approved drug to treat SMA, Nusinersen, is a modified antisense oligonucleotide to target intronic splicing silencer N1 just recently launched. Not only medical therapy, but also stem cells including neural stem cells, embryonic stem cells, mesenchymal stem cells, and induced pluripotent stem cells could show the potential to repair the injured tissue and differentiate into neuron cells to rescue the SMA animal models. Human amniotic fluid stem cells (HAFSCs) share the potential of mesenchymal stem cells and could differentiate into tri-lineage-relative cells, which are also having the ability to restore the injured neuro-muscular function. In this review, we further demonstrate the therapeutic effect of using HAFSCs to treat type III SMA prenatally. HAFSCs, similar to other stem cells, could also help the improvement of SMA with even longer survival.

Summary
The concept of prenatal stem-cell therapy preserves the time window to treat disease in utero with much less cell number. Stem cell alone might not be enough to correct or cure the SMA but could be applied as the additional therapy combined with antisense oligonucleotide in the future.
Factors Associated With Pharyngeal Gonorrhea in Young People: Implications for Prevention
Authors: Javanbakht Marjan , Westmoreland Drew , Gorbach Pamina 
Published: February 2018

Background
The objective of this study was to examine the proportion of missed infections and correlates of pharyngeal gonorrhea among young people attending public sexually transmitted disease (STD) clinics.

Methods
We conducted a case-control study of 245 young men and women between April 2012 and May 2014. Participants were eligible for inclusion if they (1) were 15 to 29 years of age, (2) reported giving oral sex to a partner of the opposite sex in the past 90 days, and (3) attended 1 of 12 public STD clinics in Los Angeles County. Computer-assisted self-interviews were used to collect information on sexual behaviors and tests were conducted for pharyngeal and urogenital gonorrhea.

Results
Most participants were younger than 25 years (69%) and more than half were female (56%). We identified a total of 64 cases (27%) of gonorrhea, of which 29 (45%) were a urogenital only infection, 18 (28%) were a pharyngeal only, and 17 (27%) were dually infected at both sites. Pharyngeal testing increased case finding by 39% from 46 to 64 cases. After adjusting for age, sex, and number of sex partners, those who reported consistent pharyngeal exposure to ejaculate/vaginal fluids were 3 times as likely to have pharyngeal gonorrhea as compared with those without this exposure (adjusted odds ratio, 3.1; 95% confidence interval, 1.3–7.5).

Conclusions
A large proportion of gonorrhea cases among young people would be missed in the absence of pharyngeal testing. These results have implications for those who provide medical care to clients at STD clinics and highlight the need for pharyngeal screening recommendations and counseling messages related to strategies to reduce exposure to infected fluids.
Patient Disengagement From an HIV Preexposure Prophylaxis Program in a Sexually Transmitted Disease Clinic
Authors: Dombrowski Julia C. , Golden Matthew R. , Barbee Lindley A. , Khosropour Christine M. 
Published: February 2018

Abstract
Among 307 patients enrolled in an HIV preexposure prophylaxis (PrEP) program in the Public Health–Seattle & King County STD Clinic, 52 patients (17%) did not fill their PrEP prescription and 40% of those who started PrEP discontinued it at least once within 12 months.
Abdominoplasty Improves Low Back Pain and Urinary Incontinence
Authors: Taylor D. Alastair , Merten Steven L. , Sandercoe Gavin D. , Gahankari Dilip , Ingram Scott B. , Moncrieff Nicholas J. , Ho Kevin , Sellars Graham D. , Magnusson Mark R. 
Published: February 2018

Background:
The authors studied the incidence of low back pain and urinary incontinence in the postpartum population presenting for abdominoplasty, and the extent of improvement following the operation.

Methods:
This multicenter prospective study used validated questionnaires: the Oswestry Disability Index for back pain and the International Consultation on Incontinence Questionnaire–Urinary Incontinence–Short Form for urinary incontinence. Questionnaires were administered preoperatively and at 6 weeks and 6 months postoperatively.

Results:
Results cover 214 patients from nine centers. The mean age was 42.1 years, the mean parity was 2.5, and the mean body mass index was 26.3 kg/m2. The mean surgical statistics were as follows: weight removed, 1222 g; liposuction volume, 795 ml; and diastasis, 4.5 cm. Eighty-seven percent of the abdominoplasties were either radical, high lateral tension, or high oblique tension. The mean Oswestry Disability Index score preoperatively was 21.6 percent, and 8.8 percent had no back pain. The mean score was 8 percent at 6 weeks and 3.2 percent at 6 months. These results are statistically significant. The mean International Consultation on Incontinence Questionnaire score preoperatively was 6.5; of the patients assessed, 27.5 percent had no incontinence. This score fell to 1.6 at 6 weeks, and the same, 1.6, at 6 months. These results are also statistically significant. Preoperative predictors of back pain were body mass index greater than 25 kg/m2 and umbilical hernia; predictors of incontinence were age older than 40 years and vaginal deliveries. There were no significant predictors of postoperative back pain or urinary incontinence improvement at 6 months. All methods of abdominoplasty produced similar improvement.

Conclusion:
Abdominoplasty with rectus repair creates a significant improvement in the functional symptoms of low back pain and urinary incontinence.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
Thread-Lift Sutures: Still in the Lift? A Systematic Review of the Literature
Authors: Gülbitti Haydar Aslan , Colebunders Britt , Pirayesh Ali , Bertossi Dario , van der Lei Berend 
Published: February 2018

Background:
In 2006, Villa et al. published a review article concerning the use of thread-lift sutures and concluded that the technique was still in its infancy but had great potential to become a useful and effective procedure for nonsurgical lifting of sagged facial tissues. As 11 years have passed, the authors now performed again a systematic review to determine the real scientific current state of the art on the use of thread-lift sutures.

Methods:
A systematic review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines using the PubMed database and using the Medical Subject Headings search term “Rhytidoplasty.” “Rhytidoplasty” and the following entry terms were included by this Medical Subject Headings term: “facelift,” “facelifts,” “face Lift,” “Face Lifts,” “Lift,” “Face,” “Lifts,” “Platysmotomy,” “Platysmotomies,” “Rhytidectomy,” “Rhytidectomies,” “Platysmaplasty,” “and “Platysmaplasties.” The Medical Subject Headings term “Rhytidoplasty” was combined with the following search terms: “Barbed suture,” “Thread lift,” “APTOS,” “Suture suspension,” “Percutaneous,” and “Silhouette suture.” RefWorks was used to filter duplicates. Three of the authors (H.A.G., B.C., and B.L.) performed the search independently.

Results:
The initial search with all search terms resulted in 188 articles. After filtering the duplicates and the articles about open procedures, a total of 41 articles remained. Of these, the review articles, case reports, and letters to the editor were subsequently excluded, as were reports dealing with nonbarbed sutures, such as Vicryl and Prolene with Gore-Tex. This resulted in a total of 12 articles, seven additional articles since the five articles reviewed by Villa et al.

Conclusions:
The authors’ review demonstrated that, within the past decade, little or no substantial evidence has been added to the peer-reviewed literature to support or sustain the promising statement about thread-lift sutures as made by Villa et al. in 2006 in terms of efficacy or safety. All included literature in the authors’ review, except two studies, demonstrated at best a very limited durability of the lifting effect. The two positive studies were sponsored by the companies that manufacture the thread-lift sutures.
Is the Right Research Being Conducted to Advance Knowledge about Breast Reconstruction? An Analysis of the Research Pipeline
Authors: Checketts Jake X. , Gordon Joshua , Crawford Julia H. , Adams Haley , Duckett Laurie , Vassar Matt 
Published: February 2018

Background:
It has been estimated that up to 85 percent of research is of limited value or wasted, in part because of the wrong research questions being addressed. In this study, the authors identified research gaps for breast reconstruction using guideline recommendations based on low-quality or no evidence. The authors then evaluated whether research was currently being conducted to fill these gaps.

Methods:
The authors extracted grade C and D options, which are based on limited evidence, from the American Society of Plastic Surgeon’s clinical practice guideline for breast reconstruction. For each option, the authors created Participants, Intervention, Comparator, Outcome questions and search strings using a systematic process. Searches were conducted of ClinicalTrials.gov and the World Health Organization’s International Clinical Trials Registry Platform to locate new and ongoing studies. The authors also catalogued studies on breast reconstruction funded by the Plastic Surgery Foundation.

Results:
Of the 10 research gaps, only six were being addressed by new and ongoing research. Timing of reconstruction (immediate or delayed) and use of acellular dermal matrix were most frequently studied. Preoperative referral of a plastic surgeon before mastectomy, complications associated with preoperative breast size, effects of hormone therapy on postoperative outcomes, and methods for detecting local recurrence after mastectomy were not being addressed by new research. Studies funded by the Plastic Surgery Foundation showed a similar pattern.

Conclusions:
Of the areas identified, some have received more attention than others. Gaps remain. The authors’ results should spark interest in conducting research on these topics and, by so doing, strengthen the clinical practice guideline recommendations.
Two-Point Discrimination Predicts Pain Relief after Lower Limb Nerve Decompression for Painful Diabetic Peripheral Neuropathy
Authors: Wang Qi , Guo Zhuang-Li , Yu Yan-Bing , Yang Wen-Qiang , Zhang Li 
Published: February 2018

Background:
Peripheral nerve decompression surgery has been reported to be effective for pain reduction in patients with painful diabetic peripheral neuropathy. The aim of this study was to characterize which patients may have more pain relief benefits in the lower limbs after nerve decompression surgery.

Methods:
A retrospective study was conducted. Pain levels were measured with the Numerical Rating Scale. Treatment effects were classified by either substantial relief (at least 50 percent reduction in Numerical Rating Scale score compared with preoperative Numerical Rating Scale score) or nonsubstantial relief (<50 percent reduction or worse in Numerical Rating Scale score) at 12 months based on established criteria. Sex, age, body mass index, duration of diabetes mellitus, duration of diabetic peripheral neuropathy pain, preoperative Numerical Rating Scale score, and two-point discrimination were evaluated using univariate and logistic regression analysis.

Results:
The mean preoperative Numerical Rating Scale score (8.65 ± 1.29) decreased significantly 6 days (3.56 ± 2.22; p < 0.01), 6 months (3.03 ± 2.11; p < 0.01), and 12 months (3.44 ± 2.36; p < 0.01) after surgery; 64.7 percent of patients had substantial pain relief at 12 months. According to univariate and logistic regression analysis, better two-point discrimination was associated with substantial pain relief (OR, 3.700; p = 0.046, logistic regression analysis).

Conclusions:
Nerve decompression surgery was able to alleviate pain in patients with painful diabetic peripheral neuropathy. Two-point discrimination may be a predictive factor for the prognosis of painful diabetic peripheral neuropathy after nerve decompression surgery.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Risk, III.
Double Triangular Cartilage Excision Otoplasty
Authors: Gualdi Alessandro , Cambiaso-Daniel Janos , Gatti Jonatann , Wurzer Paul , Sljivich Michaela , Scherer Saja S. , Pietramaggiori Giorgio , Bertossi Dario , Botti Chiara , Botti Giovanni 
Published: February 2018

Background:
Prominent ears have a negative impact on patients’ psychosocial well-being. There are numerous surgical correction techniques described, but the majority have high complication and recurrence rates. In this article, the authors present a stitchless technique that takes advantage of different approaches to minimize complications and recurrences.

Methods:
The authors prospectively studied patients who underwent a bilateral double triangular cartilage excision otoplasty in an outpatient setting. This prominent ear setback technique is based on a specific cartilage excision to mechanically collapse the ear without using any sutures through the cartilage. Postoperatively, surgical complications were classified according to the Clavien-Dindo classification. The patient-reported outcome was analyzed after completion of a questionnaire 6 months after surgery, and another clinical follow-up appointment was arranged 12 months after surgery.

Results:
Sixty patients (120 ears) with an average age of 24 years were studied, and the overall complication rate was 6 percent. Three ears (2.5 percent) developed superficial cutaneous necrosis at the anterior concha, and one ear (1 percent) required an additional correction for unsatisfactory pinna rotation. Also, 2.5 percent of the patients experienced a grade I complication, and 1 percent of the patients experienced a grade IIIa complication according to the Clavien-Dindo classification. No wound infections, hematomas, or hypertrophic scars were observed, and the patient-reported outcome showed satisfaction with the results.

Conclusions:
The authors’ findings show that the double triangular cartilage excision otoplasty is a safe procedure with low complication/recurrence rates. This stitchless technique should be included in each surgeon’s repertoire as an alternative to previously published surgical techniques.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
Evaluation of Electronic Medical Records on Nurses' Time Allocation During Cesarean Delivery
Authors: Tan Merrick , Lipman Steven , Lee Henry , Sie Lillian , Carvalho Brendan 
Published: February 2018

Background
The impact of the electronic medical record (EMR) on nursing workload is not well understood. The objective of this descriptive study was to measure the actual and perceived time that nurses spend on the EMR in the operating room during cesarean births.

Methods
Twenty scheduled cesarean births were observed. An observer timed the circulating nurse's EMR use during each case. Immediately after each case, the nurse completed a questionnaire to estimate EMR time allocation during the case and their desired time allocation for a typical case. They were also asked about time allotted to various activities preoperatively, intraoperatively, and postoperatively for a typical cesarean birth.

Results
Mean observed nurse EMR time was 36 ± 12 minutes per case, 40% ± 10% of the duration of the cesarean delivery. Nurses tended to estimate greater time spent on the EMR; the perceived mean proportion of time spent on the EMR (55%) was greater than the actual timed value of 40% (P = 0.020). Nurse's desired amount of time spent on the EMR was 22% ± 15% of the case duration, significantly less than actual time spent on the EMR (P = 0.007).

Conclusions
On average, nurses spent 40% of their intraoperative time on the EMR during cesarean births, and this time burden was distributed across the perioperative period. These findings highlight the time burden of EMRs and suggest that EMR functionality should be better aligned with end-user needs. Future studies are needed to better understand the impacts of intraoperative EMR use on patient safety and patient/nursing/clinician communication.
68Ga DOTATATE PET/CT Imaging of Elastofibroma Dorsi
Authors: Ishiyama Mitsutomi , Vesselle Hubert 
Published: February 2018

Abstract
Sixty six-year-old woman status post ileocecal resection for well-differentiated neuroendocrine tumor in the terminal ileum 7 years ago, who is on octreotide therapy for liver metastases. 68Ga DOTATATE PET/CT showed soft tissue masses with mildly increased radiotracer uptake in the bilateral subscapular/infrascapular regions. In retrospective image review, these soft tissue masses were first noted 7 years prior and have gradually increased in size over the years. Given the characteristic location and imaging findings, these masses are consistent with benign elastofibroma dorsi instead of metastasis.
FDG PET/CT Findings of Polymorphic Posttransplant Lymphoproliferative Disorders in a Transplanted Kidney
Authors: Yang Yuanyuan , Wang Wei , Kan Ying , Liu Jie , Yang Jigang 
Published: February 2018

Abstract
A 55-year-old woman underwent simultaneous liver-kidney transplantation because of polycystic liver and kidney. Six months later, FDG PET/CT was acquired to evaluate possible lesions in the renal graft, which demonstrated abnormal 18F-FDG accumulation in the renal pelvic lesions without other abnormality. The subsequent pathology examination after biopsy demonstrated the polymorphic posttransplant lymphoproliferative disorders.
Should 18F-FDG PET/CT Be Routinely Performed in the Clinical Staging of Locally Advanced Gastric Adenocarcinoma?
Authors: Perlaza Pilar , Ortín Jaime , Pagès Mario , Buxó Elvira , Fernández-Esparrach Gloria , Colletti Patrick M. , Rubello Domenico , Mayoral Maria , Sánchez Nuria , Ruiz Cristina , Ginés Angels , Fuster David 
Published: February 2018

Purpose
The aim of this study was to evaluate 18F-FDG PET/CT compared with conventional imaging techniques in the clinical management of patients with locally advanced gastric cancer (LAGC).

Methods
A prospective study between January 2010 and December 2011 in patients with suspected LAGC was conducted in our hospital. 18F-FDG PET/CT, contrast-enhanced CT (CECT), endoscopic ultrasound, and laparoscopy were performed in all cases. Standard whole-body 18F-FDG PET/CT images were obtained centered on the stomach at 1 and 2 hours after injection of 4.0 MBq/kg of 18F-FDG. Findings were confirmed by histopathology or by imaging follow-up in nonoperable patients.

Results
Fifty consecutive patients with confirmed LAGC (20 women, 30 men) with a mean ± SD age of 65.7 ± 12.1 years were included. Using Lauren classification, 24 patients were intestinal subtype, and 26 were diffuse subtype. Thirty-five patients with locoregional lymph node involvement and 22 with distant metastases were confirmed as peritoneal metastases (n = 15), retroperitoneal (n = 2) or mediastinal lymph nodes (n = 1), and liver (n = 3) or bone metastases (n = 1). Patients with signet ring carcinoma showed significantly less 18F-FDG uptake (P = 0.001). SUVmax correlated with tumor grading (P < 0.05). Standard and delayed 18F-FDG PET/CT and CECT images identified LAGC in 24, 27, and 28 of 30 patients, respectively. The sensitivity and specificity for 18F-FDG PET/CT and CECT to detect metastases were 68% and 100% and 64% and 93%, respectively. Contrast-enhanced CT and 18F-FDG PET/CT diagnosed only 6 of the 15 patients with confirmed peritoneal metastases. The impact in therapeutic management of 18F-FDG PET/CT and CECT was 24% and 22%, respectively. Kaplan-Meier survival curves for the LGAC showed a significant correlation between SUVmax and overall survival using an SUVmax threshold of less than 3.96 (P = 0.04).

Conclusions

18F-FDG PET/CT should be recommended for staging of LAGC; however, 18F-FDG PET/CT and CECT cannot replace laparoscopy to rule out peritoneal metastases. Delayed 18F-FDG PET/CT images show an increase of 18F-FDG uptake in most cases, improving LAGC detection. The grade of 18F-FDG uptake represents a significant prognostic tool in this series.
Metastasis to the Sellar/Suprasellar Region in a Patient With Endometrial Carcinoma Detected by 18F-FDG PET/CT
Authors: Salvatore Barbara , D’Amico Domenico , Fonti Rosa 
Published: February 2018

Abstract
Metastases to pituitary gland, suprasellar region or skull base from endometrial carcinoma are an extremely rare occurrence. We report the case of a 77-year-old woman with metastasis to the sellar/suprasellar region from endometrial carcinoma revealed by 18F-FDG PET/CT and confirmed by subsequent CT and MRI of the brain. This case highlights the usefulness of a whole-body imaging methodology such as 18F-FDG PET/CT in the detection of distant and/or atypical sites of metastasis therefore being of help in guiding towards the correct diagnosis.
Spontaneous Resolution of an Orbital Mass After Delivery: A Diagnostic Challenge
Authors: Dadaci Zeynep , Kadiyoran Cengiz , Golen Mustafa , Cizmecioglu Hilal Akay 
Published: February 2018

Abstract
The authors report a 35-year-old woman who presented 1 month after delivery with the complaint of pain behind her left eye which started during her pregnancy. The patient described increased fullness with dependent head position and pain on left gaze but she had no proptosis and her ocular examination was normal. Magnetic resonance imaging (MRI) revealed an intraconal mass with inhomogeneous contrast enhancement. As the authors did not suspect malignity and her ocular examination was normal without any signs of inflammation, the authors followed the patient closely. Repeat MRI obtained 6 months after delivery revealed complete resolution of the mass. Upon disappearance of the lesion, the authors reviewed the case thoroughly and decided that orbital venous anomaly with intralesional hemorrhage/thrombosis was the most probable diagnosis. As hemorrhage or thrombosis occurring in orbital vascular anomalies may be a diagnostic challenge because of the localized lesion and distinct borders, careful interpretation of clinical characteristics and MRI findings and close follow-up is important in interpretation of orbital mass lesions, especially in pregnant or puerperal women.