bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of Cozen’s Phenomenon of the Proximal Tibia
Authors: Yang Brian W. , Shore Benjamin J. , Rademacher Emily , May Collin , Watkins Colyn J. , Glotzbecker Michael P. 
Published: March 2019

Background:
There has been little investigation into the epidemiology of Cozen’s phenomenon, genu valgum as a complication of proximal tibial metaphysis fractures. In this study, we present a large case series of proximal tibia fractures in children to describe the prevalence, epidemiology, and characteristics associated with Cozen’s phenomenon following proximal tibial fracture in children.

Methods:
We searched the orthopedic database at our institution for all patients aged 1 to 8 years old with proximal tibia fractures presenting for initial fracture management between January 1, 2014 and December 31, 2017. Demographic data, mechanism of injury, fracture characteristics, and the presence of a concurrent fibula fracture were determined from the medical records. Initial and follow-up valgus angulation was measured as the angle between a line perpendicular to the proximal tibial physis and a line drawn along the axis of the tibia. Differences in the rate of valgus angulation by mechanism of injury and fracture type were compared.

Results:
In total, 181 fractures in 181 patients were included in our study (98 male, 83 female). The average age at injury was 4.55 years (range, 1.02 to 7.95 y); 140 patients (77.3%, 140/181) had initial valgus angulation of <4 degrees; 20 of these patients (14.3%, 20/140) developed angulation of at least 4 degrees at some point during follow-up at an average of 0.8 months (range, 0.2 to 1.9 mo); 4 patients (20.0%, 4/20) with <4 degrees of initial angulation had persistent valgus angulation of 5 degrees at latest follow-up. Two of these patients were not scheduled to return because the provider did not determine the valgus angulation to be clinically meaningful. The 2 other patients were asymptomatic and continued to receive nonoperative management. No patients in our series required surgical correction of valgus deformity.

Conclusions:
Cozen’s phenomenon is an uncommon complication of proximal tibial metaphysis fractures. Eliminating unnecessary radiographs and clinical visits for our pediatric trauma patients will improve the quality and value of care delivery.

Level of Evidence:
Level IV.
Is There Value in Radiology Reads for Pediatric Supracondylar Fractures in the Outpatient Clinic?
Authors: Du Jerry Y. , Tamer Pierre , Wang Joanne H. , Liu Raymond W. 
Published: March 2019

Background:
Increased health care costs have driven assessment of value of common practices. The Joint Commission mandates the dual interpretation of musculoskeletal radiographs by radiologists and orthopedic surgeons in hospital-based clinic settings. However, the value of this practice has come under question. The purpose of this study was to investigate whether radiologist interpretations change orthopedists’ management during follow-up of pediatric supracondylar humerus fractures.

Methods:
A retrospective review was performed of pediatric elbow fractures at a single institution from January 2012 to December 2015. Patients with supracondylar humerus fractures and at least one clinic follow-up were included. For each radiograph, the orthopedic surgeon and radiologist interpretations were reviewed and a determination was made as to whether the radiologist interpretation affected management of the patient. In films with disagreement of displacement, Baumann angle and posterior displacement based on Gartland classification with Wilkins and Leitch modifications were measured. Timing of final radiologist and orthopedic interpretations were also assessed. Finally, billing charges of radiologist interpretations were assessed.

Results:
There were 441 pediatric supracondylar humerus fracture patients included in this study. All 441 patients had at least 1 clinic follow-up, 397 patients had at least 2 clinic follow-ups, and 123 patients had at least 3 clinic follow-ups, with a total of 716 elbow radiographs obtained. There were 17 cases (2.4%) where orthopedics and radiologist final interpretations disagreed regarding fracture displacement. In no cases did radiologist interpretations change orthopedic management. Radiographs that orthopedics interpreted as displaced were more likely to be posteriorly displaced (80.0% vs. 0.0%; P=0.002). However there was no difference in Baumann angle (P=0.125). Of the 716 films included, 28 radiologist interpretations were performed the day after the clinic visit (4%). Excluding these cases, there was an average of 57±3 minutes between radiograph acquisition and final interpretation. There were 352 cases where final orthopedic note filing time was documented, and 32% of these notes were finalized prior to the final radiologist interpretations. The total charges of radiologist interpretations was $18,772.

Conclusions:
The results of this study suggest that dual-interpretation of radiographs obtained in the follow-up clinic setting does not add value in management of pediatric supracondylar humerus fractures.

Level of Evidence:
Level IV—case series.
Poor Evertor Muscle Activity Is a Predictor of Recurrence in Idiopathic Clubfoot Treated by the Ponseti Method: A Prospective Longitudinal Study With a 5-Year Follow-up
Authors: Little Zoe , Yeo Andrea , Gelfer Yael 
Published: March 2019

Background:
After successful primary correction of the deformity in idiopathic clubfoot with the Ponseti method, recurrence has been reported to affect up to 40% of children. So far, it has been difficult to predict which feet are at risk of recurrence, despite numerous studies investigating various potential risk factors. The foot abduction brace (FAB) has been the standard of care in preventing recurrence but, even with excellent compliance, recurrences still occur. Increasingly, evidence points to a congenital neuromuscular imbalance constituting the deforming forces present in clubfoot. Poor evertor muscle activity has been cited specifically as a potential risk factor for recurrence. The aim of this study is to evaluate whether poor evertor muscle activity on clinical examination can predict recurrence in idiopathic clubfoot at 5-year follow-up.

Methods:
Data were collected prospectively on patients treated at our tertiary physiotherapy-led Ponseti service between 2010 and 2015. Hospital ethical approval was obtained. Sex, age, laterality, Pirani score, number of casts, brace compliance, and evertor activity were recorded. Evertor muscle activity was scored in a semiquantitative repeatable manner: 0, 0.5, or 1 as previously described. Recurrence was defined as deterioration of any of the 4 components of the deformity following a previously complete correction.

Results:
In total, 104 patients (172 feet) were included in the study, 76 patients had good evertor activity, and 28 demonstrated poor evertor activity. The mean follow up was 62 months (range, 41 to 71 mo); 18.3% of the patients (19/104) had recurrence treated with repeat casting; 13.5% (14/104) of the patients required additional surgery following recasting. Recurrence was highly associated with poor evertor activity (P<0.01).

Conclusions:
Results at 5 years confirm that a semiquantitative evertor muscle activity assessment can predict recurrence and should be added to the routine clinical assessment in order to assist with individualizing patient’s treatment strategies.

Level of Evidence:
Level II.
The emergence of long-term survivors in recurrent and metastatic squamous cell head and neck cancer
Authors: Castet Florian , Brenes Jesús , Taberna Miren , Mesía Ricard 
Published: March 2019

Purpose of review
The systemic therapies available in recurrent and metastatic head and neck squamous cell carcinoma to date are palliative-intent treatments in most cases. However, a small subgroup of patients derives unconventional benefit and become long-term survivors, achieving cure in some cases. This review focusses on this group of patients, discusses recent literature and suggests plausible molecular hypothesis.

Recent findings
Human papillomavirus-related disease is known to confer a better prognosis in metastatic patients, probably because of its greater sensitivity to systemic therapies. This group of patients seems to have a greater immune activation, which could partly explain this fact. Moreover, the use of antiepidermal growth factor receptor therapies in the metastatic setting has doubled the prevalence of long-term survivors. One of the most plausible explanations is the immune-modulatory effect of cetuximab mediated by antibody-dependent cell-mediated cytotoxicity.
These facts, along with the recent encouraging results of checkpoint inhibitors in this disease, give hope that these therapies will not only improve survival but also increase the prevalence of long-term survivors.

Summary
Long-term survivors merit our utmost attention as an in-depth study of these patients could help us to better understand the tumour biology and allow us to develop robust biomarkers and effective targeted therapies, which could in turn lead to a true paradigm shift.
Combating Food Insecurity
Authors: Wilkinson Mark 
Published: March 2019

ABSTRACT:
Individuals and food-insecure households who rely on food banks have a higher likelihood of chronic health conditions. A study of the Action Family Program at a faith-based community center demonstrated how nurses can impact food bank recipients' health measures through health promotion interventions. Providing healthier food options with the weekly food distribution box, cooking demonstrations, health screenings, and health education resulted in reduced weight, and decreased systolic and diastolic blood pressure measurements.
Ukrainian Faith Community Nursing
Authors: Martin Mary , D'Andre Pam 
Published: March 2019

ABSTRACT:
Ukraine has been an independent country since the fall of Communism in 1991. Its history has been and continues to be marked by war. Through the story of one patient, this article describes the ministry of faith community nursing in the capital city, Kiev. Through an ongoing partnership, the Association for Christian Nurses and Volunteers-Welfare Organization (BLAGO) teaches nurses and volunteers the principles of faith community nursing, with the goal of establishing faith community nursing practice in each state/oblast.
Christ-Focused Service-Learning
Authors: Matthew Stephanie , Roark Elizabeth , Hockett Eloise 
Published: March 2019

ABSTRACT:
Service-learning is an experiential process of action and reflection that allows students to expand their knowledge through real-world activities that benefit others. Service-learning opportunities for baccalaureate nursing students in Kenya have provided many ongoing examples of learning from our Kenyan collaborators. Receiving ministry from those we came to serve, allows allows us, in turn, to demonstrate Christ's humility. In this article, we share specific stories of how various community partners ministered in unexpected ways to our teams of students and faculty, as we served in Kenya through healthcare and education.
Comparison of Mohs Surgery and Surgical Excision in the Treatment of Localized Sebaceous Carcinoma
Authors: Su Chang , Nguyen Kevin A. , Bai Harrison X. , Christensen Sean R. , Cao Ya , Tao Yongguang , Karakousis Giorgos , Zhang Paul J. , Zhang Guiying , Xiao Rong 
Published: March 2019

BACKGROUND
It remains controversial if Mohs surgery is superior to surgical excision in treating localized sebaceous carcinoma.

OBJECTIVE
To compare Mohs surgery and surgical excision for treating patients with localized sebaceous carcinoma.

MATERIALS AND METHODS
The US National Cancer Database was used to identify patients with histologically confirmed Stage 0 to 2 sebaceous carcinoma from 2004 to 2014. Clinicopathologic and socioeconomic factors were compared between treatment groups using the chi-square test. Overall survival (OS) was evaluated by log-rank test, multivariable Cox proportional hazard regression, and propensity score–matched analysis. Relative survival analyses compared with age- and sex-matched US population were performed.

RESULTS
Of 1,265 patients, 234 received Mohs surgery and 1,031 received surgical excision. Mohs surgery had a higher rate of negative margin (p = .004). On multivariate Cox regression analysis, Mohs surgery was associated with longer OS than surgical excision (HR: 0.703, 95% CI: 0.496–0.995, p = .047). The survival benefit of Mohs surgery persisted on relative survival analysis and propensity score–matched analysis (p = .0385), after matching the 2 groups on patient and disease characteristics.

CONCLUSION
Patients who received Mohs surgery had significantly longer OS when compared with those who received surgical excision. Prospective clinical trials comparing these treatment paradigms are warranted.
Expertise in Head and Neck Cutaneous Reconstructive Surgery
Authors: Deng Min , Higgins H. William , Lesiak Kendra , Decker Ashley B. , Regula Christie G. , Stevenson Mary L. , Raphael Brian , Depry Jennifer , Scott Jeffrey F. , Bangash Haider , Ochoa Shari A. , Ibrahimi Omar A. , Shafai Aria , Bordeaux Jeremy S. , Carucci John A. , Cook Jonathan L. , Goldman Glenn D. , Rohrer Thomas E. , Lawrence Naomi 
Published: March 2019

BACKGROUND
The management of skin cancers has evolved with the development of Mohs micrographic surgery and a greater emphasis on surgical training within dermatology. It is unclear whether these changes have translated into innovations and contributions to the reconstructive literature.

OBJECTIVE
To assess contributions from each medical specialty to the cutaneous head and neck oncologic reconstructive literature.

METHODS
The authors conducted a systematic review of the head and neck reconstructive literature from 2000 through 2015 based on a priori search terms relating to suture technique, linear closure, advancement, rotation, transposition and interpolation flaps, and identified the specialty of the senior authors.

RESULTS
The authors identified 74,871 articles, of which 1,319 were relevant. Under suture technique articles, the senior authors were primarily dermatologists (58.2%) and plastic surgeons (20.3%). Under linear closure, the authors were dermatologists (48.1%), plastic surgeons (22.2%), and otolaryngologists (20.4%). Under advancement and rotation flaps, the senior authors were plastic surgeons (40.5%, 38.9%), dermatologists (38.1%, 34.2%), and otolaryngologists (14.4%, 21.6%). Under transposition and interpolation flaps, the senior authors were plastic surgeons (47.3%, 39.4%), dermatologists (32.3%, 27.0%), and otolaryngologists (15.3%, 23.4%).

CONCLUSION
The primary specialties contributing to the cutaneous head and neck reconstructive literature are plastic surgery, dermatology, and otolaryngology.
Assessing Skin Biopsy Rates for Histologic Findings Indicative of Nonpathological Cutaneous Disease
Authors: Solomon James A. , Oswalt Michael , Nodzenski Michael , Glener Julie , Schaeffer Matthew R. , Cartee Todd V. , Maher Ian A. , Sobanko Joseph F. , Waldman Abigail , Yoo Simon S. , Lewis Suzanna , Barr Morgan , Marous Molly , Sledge Brigitte , Duke Jodi Kay , Armstrong April W. , Poon Emily , Veledar Emir , Dellavalle Robert P. , Alam Murad 
Published: March 2019

BACKGROUND
Recent increase in skin biopsies has been attributed to an epidemic of skin cancer. This may be avoidable, with potential savings.

OBJECTIVE
To determine whether the increase in skin biopsies is attributable to increasing frequency of biopsies associated with histology lacking pathological cutaneous disease. Pathological cutaneous disease was defined as (1) a malignancy, precancerous lesion, or lesion of uncertain behavior; or (2) disease symptomatic or associated with adverse quality of life impact.

PATIENTS AND METHODS
Retrospective cohort study, 2006 to 2013 of dermatology practice serving Florida and Ohio. Data were a consecutive sample of skin biopsies for diagnosis of dermatologic disease.

RESULTS
A total of 267,706 biopsies by an average of 52 providers per month from January 06 to December 13 were analyzed. Number of biopsies per visit increased 2% per year (RR: 1.02, CI: 1.00–1.04). Likelihood of biopsy associated with histology indicative of nonpathological cutaneous disease did not increase over time (OR: 0.99, CI: 0.95–1.03, p = .6302).

CONCLUSION
Rates of biopsies associated with nonpathological cutaneous disease is not increasing. Overall biopsy rates per visit have gradually increased; this seems attributable to greater rates of detection of pathological dermatologic disease.
Safety Profile of Sclerosing Agents: An Analysis From the World Health Organization Pharmacovigilance Database VigiBase
Authors: Roselli Audrey , Khouri Charles , Roustit Matthieu , Blaise Sophie , Cracowski Jean-Luc 
Published: March 2019

BACKGROUND
Several sclerosing agents are used to treat chronic venous diseases. Although they do not seem to differ in terms of efficacy, their safety profiles might differ.

OBJECTIVE
To compare the safety profile of sclerosing agents through an analysis of the World Health Organization pharmacovigilance database.

METHODS
The authors performed a disproportionality analysis using the proportional reporting ratio (PRR) method to compare pharmacovigilance signals between each sclerosing agent among 6 adverse event syndromes of interest: hypersensitivity reactions, arterial thromboembolic disorders, venous thromboembolic disorders, cardiac arrhythmias, visual/neurological disturbances, and skin ulcerations. The cutoff for signal detection was defined by a logPRR lower boundary 95% confidence interval (CI) ≥0 and number of cases n ≥3.

RESULTS
Of 1,227 Individual Case Safety Reports (ICSRs) identified, after removal of ICSRs with unselected indications, the authors selected 472 reports for the analysis. The authors found that polidocanol is associated with more reporting of venous embolic/thrombotic events (logPRR = 1.38 [95% CI 1.27–1.49]), ethanolamine with the higher pharmacovigilance disproportionality signal of cardiac arrhythmias (logPRR = 0.80 [95% CI 0.51–1.09]), and STS with more reporting of allergic reactions (logPRR = 1.79 [95% CI 1.59–1.98]).

CONCLUSION
The safety profile of sclerosing agents significantly differs and should guide benefit-risk ratio assessment of such agents.
Direct Oral Anticoagulants in Octogenarians With Atrial Fibrillation: It Is Never Too Late
Authors: Russo Vincenzo , Carbone Andreina , Rago Anna , Golino Paolo , Nigro Gerardo 
Published: March 2019

Abstract:
Atrial fibrillation is the most common arrhythmia in clinical practice, and age is one of the strongest predictors/risk factors for ischemic stroke in patients with atrial fibrillation. Elderly patients, in particular patients aged 80 years and older, are at higher risk of both ischemic and bleeding events compared with younger patients. Vitamin K antagonists (VKAs) reduce the risk of ischemic stroke, especially in the elderly, but increase the bleeding risk. In addition, frequent international normalized ratio monitoring is needed to ensure the optimal level of anticoagulation. Furthermore, VKAs have multiple drug and food interactions. Direct oral anticoagulants (DOACs) have recently emerged as alternatives to VKAs and are gradually increasing their popularity mainly because of their fewer drug and food interactions and ease of use. Their effectiveness and safety have been well-established in the general population, but the benefit in the very elderly (≥80 years old) is still unclear. Data about the safety and the effectiveness of DOACs in patients older than 75 years are available in literature, but the evidences of the use of DOACs in patients aged 80 years and older are lacking. This review aims to give light to the differences, in terms of benefits and safety, of the DOACs in this subset of patients.
Allopurinol Administration for the Prevention of Contrast-Induced Nephropathy: A Network Meta-analysis With Trial Sequential Analysis
Authors: Bellos Ioannis , Iliopoulos Dimitrios C. , Perrea Despina N. 
Published: March 2019

Abstract:
Contrast-induced nephropathy represents a major source of morbidity in patients undergoing coronary angiography. Various preventive measures have been proposed, although the optimal one remains still unknown. The aim of the present meta-analysis is to accumulate current literature knowledge and evaluate the renoprotective effects of allopurinol administration before contrast medium exposure. To achieve this, MEDLINE, Scopus, Cochrane Central Register of Controlled Trials, Clinicaltrials.gov, and Google Scholar databases were searched from inception to November 8, 2018. Statistical meta-analysis was conducted with Review Manager 5.3, TSA 0.9.5.5 and R-3.4.3. Six studies were included with a total of 918 patients. Quantitative synthesis revealed that allopurinol leads to significantly reduced incidence of contrast-induced nephropathy compared with hydration alone [odds ratio: 0.29, 95% confidence interval: (0.09–0.90)]. Trial sequential analysis suggested that Z-curve crossed the O'Brien–Fleming significance boundaries, although required information size was not reached. Network meta-analysis indicated that allopurinol had the highest probability (81.2%) to rank as the most effective intervention compared with hydration and N-acetyl cysteine; however, significant overlap with the rest treatments was noted. In conclusion, the present meta-analysis suggests that allopurinol may represent a promising measure for the prevention of acute kidney injury after coronary angiography. Future large-scale randomized controlled trials should verify this finding, while combinations of allopurinol with other novel interventions should be evaluated to define the most effective strategy to be implemented in the clinical setting.
Individualized luteal phase support
Authors: Lawrenz Barbara , Coughlan Carol , Fatemi Human M. 
Published: March 2019

Purpose of review
The aim of this review is to summarize the different aspects of luteal phase deficiency in IVF treatment and the possibilities of individualized luteal phase support.

Recent findings
After the application of human chorionic gonadotrophin (hCG) for final oocyte maturation, the vaginal route for progesterone administration is sufficient to maintain an adequate luteal phase support. New data point toward the possibility of oral medication; however, those data have yet to be confirmed in larger studies. Luteolysis after gonadotropinrealzing hormone (GnRH) agonist trigger is patient specific and not always severe. According to the progesterone level, individualized low dosages of hCG can be applied as luteal phase support without the risk of ovarian hyperstimulation syndrome (OHSS) development.

Summary
It is the task of the reproductive medicine specialist to individualize luteal phase support according to the patient's specific characteristics, needs and desires and the type of treatment performed. The greatest indication for individualization of the luteal phase is following GnRH agonist trigger in high responder patients in order to tailor luteal phase support to the patient-specific pattern of luteolysis and minimize the risk of causing OHSS with unnecessary high hCG dosages.