bluuebunny/crossref_metadata_2025_split huggingface dataset:
Total Bile Acid Concentration in Duodenal Fluid Is a Useful Preoperative Screening Marker to Rule Out Biliary Atresia
Authors: Fukuoka Tomoya , Bessho Kazuhiko , Tachibana Makiko , Satomura Yoshinori , Konishi Akiko , Yasuda Kie , Kimura Takeshi , Hasegawa Yasuhiro , Ueno Takehisa , Miyoshi Yoko , Ozono Keiichi 
Published: May 2018

ABSTRACTObjectives:Duodenal tube test (DTT) is used as a preoperative screening to rule out biliary atresia (BA). In previous reports, DTT was assessed by the color of the duodenal fluid, but there were no quantitative criteria. The aim of this study was to examine the efficacy of DTT based on the total bile acid (TBA) concentration in duodenal fluid.Methods:This is a single‐center retrospective study of infants with cholestasis who underwent DTT from 2008 to 2016 at the Osaka University Hospital. The cut‐off values of maximum TBA in duodenal fluid (dTBA), dTBA/serum TBA ratio (sTBA), and dTBA/serum gamma‐glutamyl transpeptidase (sGGT) ratio were assessed for the accuracy in excluding BA.Results:A total of 37 infants were included in this study; 16 infants with BA and 21 infants with other causes of intrahepatic cholestasis. dTBA demonstrated sensitivity of 100% and specificity of 90.5% with the cut‐off value of 16.8 μmol/L. Specificity was further improved to 95.2% with dTBA/sTBA ratio (cut‐off value: 0.088) and 100% with dTBA/sGGT ratio (cut‐off value: 0.076 μmol/U). DTT could be performed 0.8 ± 1.4 days after admission. Hypoglycemia was developed in 1 infant.Conclusions:DTT evaluated by dTBA, dTBA/sTBA ratio, and dTBA/sGGT ratio had high accuracy to rule out BA and could avoid unnecessary surgery in some infants.
Interrater and Intrarater Reliability of the Congenital Muscular Torticollis Severity Classification System
Authors: Oledzka Magdalena M. , Kaplan Sandra L. , Sweeney Jane K. , Coulter Colleen , Evans-Rogers Debbie L. 
Published: May 2018

Purpose:
To establish inter- and intrarater reliability for determining severity grades of the congenital muscular torticollis severity classification system (CMT-SCS).

Methods:
A prospective reliability study with 145 physical therapists recorded severity ratings on 24 randomly-ordered patient cases including age of infant, cervical range of motion, and presence or absence of sternocleidomastoid mass. To compute intrarater reliability, cases were randomly reordered and graded by 82 of the original raters.

Results:
For the CMT-SCS, overall reliability was good with an interrater reliability intraclass correlation coefficient (ICC) (2,1) of 0.83 (95% confidence interval [CI], 0.74-0.91) and an intrarater reliability ICC (3,1) of 0.81 (95% CI, 0.66-0.91).

Conclusions:
The CMT-SCS has good reliability for infants up to 12 months of age. Physical therapists can use the scale for initial assessment of infants suspected to have CMT. The CMT-SCS should be standard documentation for infants with CMT.
Does Partner Selection Mediate the Relationship Between School Attendance and HIV/Herpes Simplex Virus-2 Among Adolescent Girls and Young Women in South Africa: An Analysis of HIV Prevention Trials Network 068 Data
Authors: Stoner Marie C. D. , Edwards Jessie K. , Miller William C. , Aiello Allison E. , Halpern Carolyn T. , Julien Aimée , Rucinski Katherine B. , Selin Amanda , Twine Rhian , Hughes James P. , Wang Jing , Agyei Yaw , Gómez-Olivé Francesc Xavier , Wagner Ryan G. , Laeyendecker Oliver , Macphail Catherine , Kahn Kathleen , Pettifor Audrey 
Published: May 2018

Objective:
School attendance prevents HIV and herpes simplex virus-2 (HSV-2) in adolescent girls and young women, but the mechanisms to explain this relationship remain unclear. Our study assesses the extent to which characteristics of sex partners, partner age, and number mediate the relationship between attendance and risk of infection in adolescent girls and young women in South Africa.

Design:
We use longitudinal data from the HIV Prevention Trials Network 068 randomized controlled trial in rural South Africa, where girls were enrolled in early adolescence and followed in the main trial for more than 3 years. We examined older partners and the number of partners as possible mediators.

Methods:
We used the parametric g-formula to estimate 4-year risk differences for the effect of school attendance on the cumulative incidence of HIV/HSV-2 overall and the controlled direct effect (CDE) for mediation. We examined mediation separately and jointly for the mediators of interest.

Results:
We found that young women with high attendance in school had a lower cumulative incidence of HIV compared with those with low attendance (risk difference = −1.6%). Partner age difference (CDE = −1.2%) and the number of partners (CDE = −0.4%) mediated a large portion of this effect. In fact, when we accounted for the mediators jointly, the effect of schooling on HIV was almost removed, showing full mediation (CDE = −0.3%). The same patterns were observed for the relationship between school attendance and cumulative incidence of HSV-2 infection.

Conclusion:
Increasing school attendance reduces the risk of acquiring HIV and HSV-2. Our results indicate the importance of school attendance in reducing partner number and partner age difference in this relationship.
Spectral Computed Tomography Angiography With a Gadolinium-based Contrast Agent
Authors: Nadjiri Jonathan , Pfeiffer Daniela , Straeter Alexandra S. , Noël Peter B. , Fingerle Alexander , Eckstein Hans-Henning , Laugwitz Karl-Ludwig , Rummeny Ernst J. , Braren Rickmer , Rasper Michael 
Published: May 2018

Purpose:
Computed tomography angiography (CTA) requires IV application of iodine-based contrast agents. There are several medical conditions in which application is not advisable or even feasible, especially for elective examinations. Novel techniques such as monoenergetic reconstructions from dual-energy computed tomographic (CT) data have been shown to increase radiation attenuation of gadolinium (Gd)-based contrast agents in a phantom model. Therefore, the purpose of the present investigation was to evaluate the technical feasibility and image quality of clinical spectral CTA with a Gd-based contrast agent.

Materials and Methods:
Eleven consecutive patients with common indications for thoracic CTA and contraindications for iodine-based contrast agents were examined using clinical routine doses (0.2 mmol/kg) of Gd-based contrast agent with spectral CT. Monoenergetic reconstructions of the spectral data set were computed.

Results:
We performed 11 Gd-enhanced CTAs: 9 aortic angiographies, 1 coronary angiography, and 1 angiography of the pulmonary arteries. Image quality of the monoenergetic reconstructions with 40 keV (monoE40) was considered diagnostic by 2 experienced radiologists in each patient; the conventional CT reconstructions did not reach diagnostic image quality. MonoE40 reconstruction resulted in a substantial, ∼2-fold increase of intravascular Gd attenuation compared with the conventional images (P<0.0001). No relevant change of attenuation was observed for the myocardium or the skeletal muscle.

Conclusions:
With spectral CT and reconstruction of monoenergetic images with extrapolated 40 keV, Gd-based contrast agent thoracic angiography with clinical doses of Gd is technically feasible. Gd-based CTA seems a valuable alternative in patients with contraindications for iodine-based contrast media.
The Role of Platelet Concentrates in Facial Fat Grafting
Authors: Xiong Shaoheng , Qiu Lihong , Zhao Jianhui , Zheng Hui , Cui Dong , Su Yinjun , Yi Chenggang 
Published: May 2018

Abstract
Autologous fat grafting is increasingly being used as a method for the repair of facial soft tissue defects and facial rejuvenation, given its low risk of adverse effects and high efficacy. However, the unpredictability of graft retention is a limitation of this procedure. In addition, there is no standard procedure to date for autologous fat grafting. Different methods have been developed to increase the retention of grafted fat. For instance, platelet concentrates have been used to directly deliver bioactive factors to grafted fat. Platelet concentrates also provide incidental therapeutic benefits by enhancing the persistence of fat grafted in the face via the release of growth factors and cytokines. In this review, we describe current strategies for improving the survival of facial fat grafts, mainly focusing on the application of growth factors/cytokines and platelet concentrates to fat grafting.
Adult Laryngeal Ossified Hemangioma: Difficulties in Differential Diagnosis
Authors: Aluffi Valletti Paolo , Toso Andrea , Gorris Christel , Dell’Era Valeria , Golinelli Gloria , Pia Francesco 
Published: May 2018

Abstract
Adult laryngeal hemangiomas are uncommon and often poorly symptomatic. The authors describe a laryngeal hemangioma with acute airway obstruction and radiologic findings suggesting a chondrosarcoma-like neoplasm, while pathologic features were consistent with an ossified hemangioma. The presence of fields of bone metaplasia into a classical cavernous hemangioma is an unusual phenomenon which, to our knowledge, was never previously described in the larynx. Difficulties concerning the differential diagnosis and modality of treatment are also discussed.
Mesenchymal Chondrosarcoma of the Orbit Attached to the Optic Nerve
Authors: Bagheri Abbas , Abbaszadeh Mohammad , Torbati Peyman , Rezaei Kanavi Mozhgan 
Published: May 2018

Abstract
Mesenchymal chondrosarcoma (MCS) is a rare tumor in the orbit. Although optic nerve displacement is a common finding in intraorbital MCS, optic nerve tissue involvement in tumor has rarely been reported in huge tumors associated with intracranial extension. Herein the authors report a patient with MCS involving optic nerve tissue without intracranial extension. A 59-year-old woman with a 2-month history of progressive proptosis and normal vision presented to us. Computed tomography revealed a clearly outlined heterogeneous mass with calcified foci in its center, which was attached to the optic nerve, magnetic resonance imaging showed the mass to be isointense to gray matter on T1- and T2-weighted images. She underwent lateral orbitotomy and partial tumor excision. Histopathologic study confirmed MCS. She refused exenteration till 1 year but the tumor recurred and her vision decreased to no light perception. Then exenteration was performed with obtaining free margin and she is now free of tumor after 6 months without radiotherapy or chemotherapy. Mesenchymal chondrosarcoma must be differentiated from more common calcified tumors attached to optic nerve like meningioma.
Three-Dimensional Printed Model and Transantral Endoscopy to Orbital Fracture Repair
Authors: Moura Lucas Borin , Carvalho Pedro Henrique de Azambuja , Gabrielli Marisa Aparecida Cabrini , Pereira-Filho Valfrido Antonio 
Published: May 2018

Abstract
Orbital fractures are high prevalent and result in several complications such as diplopia, muscular entrapment, visual impairment, and enophthalmos. The goal of orbital reconstruction is to restore orbital anatomy, volume, and globe symmetry. This case report aims to describe the use of transantral endoscopy and 3D printed model for treatment of an orbital floor fracture. A 54-year-old woman presented orbital floor fracture with diplopia and extraocular muscle entrapment. The surgical treatment was performed using a standard titanium mesh bended over 3D printed model, and transantral endoscopy to verify fracture extension and implant adaptation. The postoperative evaluation demonstrates correction of diplopia and ocular motility restriction. Computed tomography scan showed reestablishment of the orbital anatomy. The association of transantral endoscopy and 3D printed models is a feasible technique to improve orbital reconstruction.
Faciocervical Reconstruction Using a Large Expanded Forehead Island Flap Grafted Using a Microsurgical Technique for Burned Cicatricial Contracture Correction
Authors: Han Bing , Fan Jincai , Liu Liqiang , Tian Jia , Gan Cheng , Yang Zengjie , Jiao Hu , Zhang Tiran , Liu Zheng , Zhang Hua 
Published: May 2018

Abstract
Extrinsic cicatricial contracture is still one of the most common and frustrating complications in the faciocervical area after severe burns. Because of these contractured scars, patients not only suffer from aesthetic issues but also local dysfunction, especially when it comes to the faciocervical region. Esthetical and functional reconstruction of these regions remains a great challenge for reconstructive surgeons. This report presents a 28-year-old man with postburn mentocervical adhesion treated successfully with a large expanded forehead island flap. Cosmetic and functional results have been achieved in this patient during long-term follow-ups.
Intestinal Fatty Acid Binding Protein is Associated With Mortality in Patients With Acute Heart Failure or Cardiogenic Shock
Authors: Kastl Stefan P. , Krychtiuk Konstantin A. , Lenz Max , Distelmaier Klaus , Goliasch Georg , Huber Kurt , Wojta Johann , Heinz Gottfried , Speidl Walter S. 
Published: May 2018

ABSTRACT

Background:
Acute heart failure and cardiogenic shock are associated with an impaired intestinal perfusion, which may lead to a release of cytoplasmatic proteins by hypoxic epithelial injury. Intestinal fatty acid binding protein (iFABP), highly specific for the small bowel enterocyte, may pose a useful novel and very sensitive biomarker for predicting outcome of these patients.
The aim of this study was to investigate whether circulating levels of iFABP are associated with mortality in patients with acute heart failure or cardiogenic shock requiring intensive care unit (ICU) admission.

Methods:
We included 90 consecutive patients with cardiogenic shock (74.4%) or severe acute heart failure (25.6%) admitted to a cardiac ICU. Blood samples were taken at day 0 and day 3. Median age was 64.7 (49.4–74.3), 76.7% of patients were male and median NT-proBNP levels were 4,986 (1,525–23,842) pg/mL. 30-day survival was 64.4%.

Results:
Patients with serum levels of iFABP at day 0 in the highest quartile (iFABP ≥ 588.4 pg/mL) had a 2.5-fold risk (P = 0.02) of dying independent of demographics, NT-proBNP levels, and vasopressor use. Extensively elevated admission levels of iFABP above the 90th percentile (iFABP ≥ 10208.4 pg/mL) were associated with an excessive mortality rate of 88.9%. In contrast, iFABP levels at day 3 were not associated with outcome.

Conclusion:
Circulating levels of iFABP at admission predict mortality. This suggests that early inadequate perfusion of the small intestine may be associated with a dramatically decreased survival in patients with cardiogenic shock or severe acute heart failure.
A different form of injury prevention: Successful screening and referral for human immunodeficiency virus and hepatitis C virus in a trauma population
Authors: Privette Alicia R. , White Benjamin , Ferguson Pamela L. , Norcross E. Douglas , Richey Lauren E. 
Published: May 2018

BACKGROUND
In the United States, millions of patients are living with human immunodeficiency virus (HIV) and hepatitis C virus (HCV) (0.44% and 1.5%) and many are currently undiagnosed. Because highly effective treatments are now available, early identification of these patients is extremely important to achieve improved clinical outcomes. Prior data and trauma-associated risk factors suggest a higher prevalence of both diseases in the trauma population. We hypothesized that a screening program could be successfully initiated among trauma activation patients and that a referral and linkage-to-care program could be developed.

METHODS
Hepatitis C virus and HIV screening tests were added to standard trauma activation laboratory orders at an academic Level I Trauma Center. Confirmatory viral load was sent when indicated. Patients with positive results were educated about their disease and referred to disease-specific follow-up. Data were collected prospectively from January 1, 2016, until June 30, 2017. Total and new diagnosis, referral rates, and linkage-to-care rates were analyzed.

RESULTS
One thousand eight hundred ninety-eight patients arrived as trauma activations. One thousand two hundred seventeen (64.1%) patients were screened (Level A, 75.6%; Level B, 60.2%). Seven percent of the screened patients were initially positive, and 5.5% were confirmed positive. Rates of both HIV (1.1%) and HCV (4.4%) were almost triple the national average. Overall, 3.3% screened positive for a new diagnosis. For HCV, the rate of new diagnosis was twice the national average (3%). Over 85% of all cases were referred for follow-up, and the combined linkage-to-care rate was 43.3%.

CONCLUSION
The majority of patients were screened and referred for follow-up, indicating successful implementation of our trauma screening program. Routine screening of trauma patients should be considered to increase diagnosis rate, increase linkage-to-care rates, and decrease disease transmission. These screening efforts would help bridge the health care gap that exists in the trauma population due to lower insurance rates and limited access to primary care.

LEVEL OF EVIDENCE
Therapeutic/Care management, level III.
Prevalence and treatment of depression and posttraumatic stress disorder among trauma patients with non-neurological injuries
Authors: Bell Teresa M. , Vetor Ashley N. , Zarzaur Ben L. 
Published: May 2018

BACKGROUND
Psychological impairment among injury survivors is well documented. Little is known about the prevalence of treatment of psychological impairment, however. We aimed to determine the proportion of injury survivors treated for depression and posttraumatic stress disorder (PTSD) in the year after injury as well as to determine potential barriers to treatment.

METHODS
Adults (18 and older) admitted to a Level I trauma center with an injury severity score greater than 10 but without traumatic brain injury or spinal cord injury were eligible for study inclusion. The Center for Epidemiological Studies—Depression and PTSD CheckList—Civilian Versions surveys were administered during the initial hospitalization and repeated at 1, 2, 4, and 12 months after injury. Patients were asked if they received treatment specifically for depression or PTSD at each follow-up. Factors associated with treatment were determined using multivariable logistic regression analysis.

RESULTS
Five hundred injury survivors were enrolled in this prospective observational study. Of those, 68.4% of patients screened positive for depression at some point in the year after their injury (53.3%, 1 month; 49.9%, 2 months; 49.0%, 4 months; and 50.2%, 12 months). Only 22.2% of depressed patients reported receiving treatment for depression; 44.4% of patients screened positive for PTSD (26.6%, 1 month; 27.8%, 2 months; 29.8%, 4 months; and 30.0%, 12 months), but only 9.8% received treatment for PTSD. After adjusting for other factors, compared to commercial insurance status, self-pay insurance status was negatively associated with treatment for PTSD or depression (odds ratio, 0.44; 95% confidence interval, 0.21–0.95).

CONCLUSION
Depression and PTSD are common in non-neurotrauma patients in the year following injury. Greater collaboration between those caring for injury survivors and behavioral health experts may help improve psychological outcomes after injury.

LEVEL OF EVIDENCE
Therapeutic/Care management, level IV.
High-dose Factor XIII administration induces effective hemostasis for trauma-associated coagulopathy (TAC) both in vitro and in rat hemorrhagic shock in vivo models
Authors: Nagashima Futoshi , Inoue Satoshi , Koami Hiroyuki , Miike Toru , Sakamoto Yuichiro , Kai Keita 
Published: May 2018

BACKGROUND
Trauma-associated coagulopathy (TAC) is an early and primary complication in severe trauma patients. Factor XIII (FXIII) is reported to stabilize a clot in the late phase of the coagulation cascade. The goal of this study was to investigate whether the administration of FXIII improves the condition of TAC both in vitro and in vivo.

METHODS
We evaluated the effects of different doses, including a very high dose of FXIII (3.6–32.4 IU/mL) on tissue-plasminogen activator–induced hyperfibrinolysis and the combined condition of dilutional coagulopathy and tissue-plasminogen activator–induced hyperfibrinolysis in vitro. The coagulation status was analyzed by rotational thromboelastometry (ROTEM) and Sonoclot. Then, we evaluated the effect of high-dose FXIII (300 IU/kg) for severe coagulopathy in vivo using a rat liver trauma model in which coagulopathy similar to TAC was observed. Survival time and the amount of intra-abdominal bleeding of rats were measured, and a coagulation test was also performed. Histologic evaluations of rats’ lung and kidney after FXIII administration were completed.

RESULTS
High-dose FXIII significantly improved clot strength as well as increased resistance to hyperfibrinolysis in vitro which was confirmed by ROTEM. Platelet function on Sonoclot was significantly increased by FXIII in a dose-dependent manner. Factor XIII significantly decreased the total amount of bleeding and prolonged the survival time compared to control (control vs FXIII: 108.9 ± 11.4 vs 32.6 ± 5.5 mL/kg; p < 0.001; 26.0 ± 8.8 vs 120 minutes, p < 0.001) in a rat model. Rotational thromboelastometry parameters and platelet function on Sonoclot were significantly improved in the FXIII (+) group compared to control. No adverse effects of FXIII were detected histologically.

CONCLUSION
Factor XIII not only generated stable clot resistance to hyperfibrinolysis but also enhanced platelet function by facilitating clot retraction. High-dose FXIII administration therapy has significant clinical impact for severe trauma accompanied with TAC.

STUDY TYPE
Human in vitro and rat in vivo experimental study.
Hyperfiltration-mediated Injury in the Remaining Kidney of a Transplant Donor
Authors: Srivastava Tarak , Hariharan Sundaram , Alon Uri S. , McCarthy Ellen T. , Sharma Ram , El-Meanawy Ashraf , Savin Virginia J. , Sharma Mukut 
Published: May 2018

Abstract
Kidney donors face a small but definite risk of end-stage renal disease 15 to 30 years postdonation. The development of proteinuria, hypertension with gradual decrease in kidney function in the donor after surgical resection of 1 kidney, has been attributed to hyperfiltration. Genetic variations, physiological adaptations, and comorbidities exacerbate the hyperfiltration-induced loss of kidney function in the years after donation. A focus on glomerular hemodynamics and capillary pressure has led to the development of drugs that target the renin-angiotensin-aldosterone system (RAAS), but these agents yield mixed results in transplant recipients and donors. Recent work on glomerular biomechanical forces highlights the differential effects of tensile stress and fluid flow shear stress (FFSS) from hyperfiltration. Capillary wall stretch due to glomerular capillary pressure increases tensile stress on podocyte foot processes that cover the capillary. In parallel, increased flow of the ultrafiltrate due to single-nephron glomerular filtration rate elevates FFSS on the podocyte cell body. Although tensile stress invokes the RAAS, FFSS predominantly activates the cyclooxygenase 2-prostaglandin E2-EP2 receptor axis. Distinguishing these 2 mechanisms is critical, as current therapeutic approaches focus on the RAAS system. A better understanding of the biomechanical forces can lead to novel therapeutic agents to target FFSS through the cyclooxygenase 2-prostaglandin E2-EP2 receptor axis in hyperfiltration-mediated injury. We present an overview of several aspects of the risk to transplant donors and discuss the relevance of FFSS in podocyte injury, loss of glomerular barrier function leading to albuminuria and gradual loss of renal function, and potential therapeutic strategies to mitigate hyperfiltration-mediated injury to the remaining kidney.