bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bilateral cataracts as the first manifestation of type 1 diabetes mellitus
Authors: Wu Juan , Zeng Haixia , Xuan Rui , Lei Shuihong , Li Jing , Lai Xiaoyang , Liu Jianping 
Published: October 2018

Abstract

Rationale:
Cataracts can occur in children and adolescents with Type 1 Diabetes Mellitus who have poorly controlled glycemia. Here, we report a case of a 16-year-old female, who was diagnosed with bilateral cataracts, and genetic screening identified a mutation in the PRRC2A gene which is rarely reported. After surgery, retinopathy was found in this patient, combined with the published literature, we encourage that postoperative monitoring for retinal lesions during the follow-up visits should be conducted.

Patient concerns:
In this article, we present an adolescent diagnosed with bilateral cataracts, and developed retinopathy during the follow-up visits. Genetic screening identified a mutation in the PRRC2A gene.

Diagnoses:
The diagnoses of Diabetic cataracts, Type 1 diabetes and Diabetic retinopathy was made.

Interventions:
The patient underwent surgery in both eyes, and hypoglycemic treatment was provided.

Outcomes:
The surgery achieved satisfactory results, during the follow-up visits, her visual acuity was reported as 0.8 in the right eye and 1.0 in the left eye. Besides, her blood glucose was well controlled, and her glycated hemoglobin was reduced to 6.9% after three months of continuous treatment.

Lessons:
This case highlights the importance of genetic screening for detecting mutations in diabetes-related genes, and postoperative monitoring for retinal lesions during the follow-up visits.
Comparison of 3 assessment modes of acupuncture effect on patients with chronic prostatitis/chronic pelvic pain syndrome
Authors: Zhou Jing , Liu Yan , Li Chunbin , Liu Zhishun 
Published: October 2018

Abstract

Background:
Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common disorder. Some studies have indicated that acupuncture may ameliorate the symptoms of CP/CPPS. However, results are varied and range widely, perhaps due to different modes of assessment including timepoints, places of assessment, and especially subjective scales. We propose to determine the efficacy of acupuncture relative to sham acupuncture for patients with CP/CPPS, and compare different modes of assessment regarding the therapeutic effects of acupuncture.

Methods:
Sixty patients with CP/CPPS will be randomly assigned to receive either acupuncture or sham-acupuncture (30 patients, each). Treatment will be conducted 3 times/week, for 4 weeks. The coprimary outcomes will each be the change from baseline of the total NIH (National Institutes of Health) CPSI (Chronic Prostatitis Symptom Index) score associated with 3 modes of assessment: Mode 1, the scale recorded at the hospital within 10 minutes after the last session of 4 weeks of acupuncture treatment, in the company of the outcome assessors; Mode 2, the scale recorded the same day, but not at the hospital; and Mode 3, the scale recorded at the hospital 1 to 3 days after the last acupuncture session. The 3 key secondary outcomes include will be the 3 modes assessment of the changes from baseline of the NIH-CPSI total scores in the acupuncture group at week 4 after treatment. Analysis was by intention-to-treat, and multiplicity was controlled for with a step-down closed-testing procedure.

Discussion:
To our knowledge, previous studies did not include the details of assessment scales when determining the efficacy of acupuncture in CP/CPPS. Furthermore, it is not clear which mode was used to assess the effect. The answers provided by the proposed study may improve the reproducibility of acupuncture research and the reliability of results.
CT-guided special approaches of drainage for intraabdominal and pelvic abscesses
Authors: Zhao Ning , Li Qian , Cui Jing , Yang Zhiyong , Peng Tao 
Published: October 2018

Abstract

Background
To explore the safety and efficacy of several special approaches of drainage for deep inaccessible intraabdominal and pelvic abscesses.

Methods
By searching of our institutional database, the clinical and radiologic information of all patients with special approaches of abscesses drainage was collected, consisting of etiology, diameter of abscess, duration of drainage, major complications, rates of success, failure and death, and pre-procedure, intra-procedure and post-procedure computed tomography scans.

Results
A total of 124 patients are eligible for the criterion in our center between January 2010 and January 2018. The mean diameter of abscess was 5.6 cm (range 3.0–9.8 cm) and mean duration of drainage was 10.3 days (range 4–43 days). Pain was complained in 6 patients (4.8%) and hemorrhage was observed in one patient. Complete resolution of the abscess following drainage was observed in 115 patients (92.7%). A total of 9 patients (7.3%) failed to percutaneous abscess drainage and 3 patients died of catheter-unrelated diseases. Transintestinal afferent loop of drainage was firstly attempted in six patients and complete resolution of abscess was achieved in five patients.

Conclusion
Special approaches, including transgluteal, presacral space, transhepatic, multiplane reconstruction (MPR)-assisted oblique approach and transintestinal afferent loop approach for those deep inaccessible intraabdominal and pelvic abscesses are safe and feasible.
Subtrochanteric femoral shortening osteotomy concomitantly performed with revision total hip arthroplasty
Authors: Takeda Yu , Fukunishi Shigeo , Nishio Shoji , Fujihara Yuki , Yoshiya Shinichi 
Published: October 2018

Abstract

Rationale:
Total hip arthroplasty (THA) concomitant with subtrochanteric femoral shortening osteotomy for Crowe type IV dysplastic hip has been reported. However, the combination of subtrochanteric femoral osteotomy and revision THA has only been mentioned in one case report.

Patient concerns:
A 67-year-old female had a history of congenital dislocation of both hips.

Diagnoses:
Right hip was diagnosed the aseptic loosening of THA with extremely high replacement of the acetabular component.

Interventions:
Revision THA concomitant with subtrochanteric femoral shortening osteotomy using a cement stem was performed. Before the revision surgery, primary THA with subtrochanteric shortening osteotomy was performed on the opposite side. Regarding leg length, the actual leg length of the affected side was 9 mm longer, and the subjective leg length discrepancy was 45 mm shorter in the affected limb due to pelvic obliquity. Subtrochanteric osteotomy was performed with an amount of osteotomy equal to the amount of distal translation of the hip center to the original acetabulum.

Outcomes:
As a result, pelvic obliquity improved, and the subjective leg length discrepancy disappeared after revision surgery.

Lessons:
The combination of subtrochanteric femoral shortening osteotomy with revision THA resulted in a satisfactory outcome.
Clinical and Genetic Study of Children With Peutz‐Jeghers Syndrome Identifies a High Frequency of STK11 De Novo Mutation
Authors: Zhao Hong‐Mei , Yang Yong‐Jia , Duan Jia‐Qi , Ouyang Hong‐Juan , Liu Li , Yi Li‐Chun , Xiao Zheng‐Hui , Zheng Yu , Peng Lv , Attard Thomas M. , Li Ding‐You , You Jie‐Yu 
Published: October 2018

ABSTRACTObjectives:The present study aims to identify the genotype‐phenotype correlation in children with Peutz‐Jeghers Syndrome (PJS) through the analysis of STK11 gene mutations in the context of clinical and pathological characteristics.Method:In this observational cohort study, the clinical characteristics of 18 families diagnosed with pediatric PJS were collected. Genomic DNA from the peripheral blood of affected children and their family members was collected. The coding region of STK11 was amplified by PCR and screened for mutation by Sanger sequencing. The families that were negative for STK11 mutation were further assessed by multiplex ligation‐dependent probe amplification (MLPA).Result:Initial presentation in affected children was at 1.6 to 14.2 years and included anemia in 8 patients whereas 6 presented for screening by virtue of family history. All patients underwent endoscopy, colonoscopy, and polypectomy. Polyps were distributed throughout the gastrointestinal (GI) tract, including the small intestine, stomach, colon, and rectum.In the 18 pediatric PJS families, STK11 mutations were detected in 8 families by Sanger sequencing, and large deletions were detected in 3 by MLPA, respectively. Nine of the 11 STK11 mutations were de novo, 3 were novel (c.419T>C:p.L140P, c.314T>G:p.L105X), and (c.488_489insACGG p.L164fs).Conclusions:Although the main clinical features of pediatric PJS were similar to those of PJS cases in adults, a high frequency of STK11 de novo mutations were encountered in our population of patients with PJS.
Where Do People Go for Gonorrhea and Chlamydia Tests: A Cross-Sectional View of the Central Indiana Population, 2003–2014
Authors: Batteiger Teresa A. , Dixon Brian E. , Wang Jane , Zhang Zuoyi , Tao Guoyu , Tong Yan , Tu Wanzhu , Hoover Sarah A. , Arno Janet N. 
Published: October 2018

Background
Despite major efforts to control their spread, reported sexually transmitted infections (STI) are increasing. Using data from a mid-sized Midwest metropolitan area, we examined the settings in which individuals are tested for gonorrhea and chlamydia in relation to demographics and test result to determine where interventions may best be focused.

Methods
A deidentified and integrated registry, containing records from all patients tested for an STI from 2003 to 2014, was created by combining data from a large health information exchange and the reporting district's STI Program located in Indianapolis, IN. Individual characteristics and visit settings where gonorrhea and chlamydia testing was performed were analyzed.

Results
We identified 298,946 individuals with 1,062,369 visits where testing occurred at least once between the ages of 13 and 44 years. Females were tested significantly more often than males and received testing more often in outpatient clinics whereas males were most often tested in the STI clinic. Individuals who used both STI and non-STI settings were more likely to have a positive test at an STI or emergency department visit (6.4–20.8%) than outpatient or inpatient setting (0.0–11.3%) (P < 0.0001). Test visits increased over the study period particularly in emergency departments, which showed a substantial increase in the number of positive test visits.

Conclusions
The most frequent testing sites remain STI clinics for men and outpatient clinics for women. Yet, emergency departments (ED) are increasingly a source of testing and morbidity. This makes them a valuable target for public health interventions that could improve care and population health.
Renal Replacement Therapy Modalities in Critically Ill Children*
Authors: Beltramo Fernando , DiCarlo Joseph , Gruber Joshua B. , Taylor Thom , Totapally Balagangadhar R. 
Published: October 2018

Objectives:
The objective of this study is to describe the relative frequency of use of continuous renal replacement therapy, intermittent hemodialysis, and peritoneal dialysis and to analyze characteristics and outcomes of critically ill children receiving renal replacement therapies admitted to PICUs that participate in the Virtual PICU (VPS LLC, Los Angeles, CA) registry.

Design:
Retrospective, database analysis.

Setting:
PICUs that participate in the Virtual PICU (VPS LLC) registry.

Patients:
Critically ill children admitted to PICUs that participate in the Virtual PICU (VPS LLC) registry and received renal replacement therapy from January 1, 2009, to December 31, 2015.

Interventions:
None.

Measurements and Main Results:
A total of 7,109 cases (53% males) received renal replacement therapy during the study period. The median age was 72.3 months (interquartile range, 8.4–170 mo) and median length of stay was 8.7 days (interquartile range, 3.3–21.2 d). Caucasians comprised 42% of the cohort and blacks and Hispanics were 16% each. Continuous renal replacement therapy was used in 46.5%, hemodialysis in 35.5% and peritoneal dialysis in 18%. Of the 7,109 cases, 1,852 (26%) were postoperative cases (68% cardiac surgical) and 981 (14%) had a diagnosis of cancer. Conventional mechanical ventilation was used in 64%, high-frequency oscillatory ventilation in 12%, noninvasive ventilation in 24%, and extracorporeal membrane oxygenation in 5.8%. The overall mortality was 22.3%. Patients who died were younger 40.8 months (interquartile range, 1.5–159.4 mo) versus 79.9 months (interquartile range, 12.6–171.7 mo), had a longer length of stay 15 days (interquartile range, 7–33 d) versus 7 days (interquartile range, 3–18 d) and higher Pediatric Index of Mortality 2 score –2.84 (interquartile range, –3.5 to –1.7) versus –4.2 (interquartile range, –4.7 to –3.0) (p < 0.05). On multivariate logistic regression analysis, higher mortality was associated with the presence of cancer (32.7%), previous ICU admission (32%), requiring mechanical ventilation (33.7%), receiving high-frequency oscillatory ventilation (67%), or extracorporeal membrane oxygenation (58.4%), admission following cardiac surgical procedure (29.4%), and receiving continuous renal replacement therapy (38.8%), and lower mortality was associated with hemodialysis (9.8%), and peritoneal dialysis (12.3%) (p < 0.0001).

Conclusions:
Continuous renal replacement therapy is an increasingly prevalent renal replacement therapy modality used in critically ill children admitted to an ICU. Higher mortality rate with the use of continuous renal replacement therapy should be interpreted with caution.
Surgical Safety Checklists in Children’s Surgery: Surgeons’ Attitudes and Review of the Literature
Authors: Roybal Jessica , Tsao KuoJen , Rangel Shawn , Ottosen Madelene , Skarda David , Berman Loren 
Published: October 2018

Introduction:
Surgical safety checklists (SSCs) aim to create a safe operating room environment for surgical patients. Provider attitudes toward checklists affect their ability to prevent harm. Pediatric surgeons’ perceptions surrounding SSCs, and their role in improving patient safety, are unknown.

Methods:
American Pediatric Surgical Association members conducted an online survey to evaluate the use of and attitudes toward SSCs. The survey measured surgeons’ perceptions of checklists, including the components that make them effective and barriers to participation. To better evaluate the available data on SSCs, the authors performed a systematic literature review on the use of SSCs with a focus on pediatric studies.

Results:
Of the 353 survey respondents, 93.6% use SSCs and 62.6% would want one used in their own child’s operation, but only 54.7% felt that checklists improve patient safety. Reasons for checklist skepticism included the length of the checklist process, a distraction from thoughtful patient care, and lack of data supporting use. Literature review shows that checklists improve communication, promote teamwork, and identify errors, but do not necessarily decrease morbidity. Staff perception is a major barrier to implementation.

Conclusions:
Almost all pediatric surgeons participate in SSCs at their institutions, but many question their benefit. Better pediatric surgeon engagement in checklist use is needed to change the safety culture, improve operating room communication, and prevent harm.
Sexual Risk Compensation in a Pre-exposure Prophylaxis Demonstration Study Among Individuals at Risk of HIV
Authors: Milam Joel , Jain Sonia , Dubé Michael P. , Daar Eric S. , Sun Xiaoying , Corado Katya , Ellorin Eric , Blumenthal Jill , Haubrich Richard , Moore David J. , Morris Sheldon R. ,   the CCTG Team
Published: October 2018

Background:
A public health concern regarding HIV pre-exposure prophylaxis (PrEP) is sexual risk compensation (ie, increased unsafe sex among PrEP users that may undermine prevention efforts).

Methods:
This demonstration study (NCT#01761643; initiated in 2013) included 398 men who have sex with men who initiated PrEP and were followed over 48 weeks at 4 sites in Southern California. Wilcoxon signed-rank tests compared previous 30-day number of sex partners and condomless insertive anal sex and receptive anal sex (CIAS and CRAS, respectively) acts at weeks 4, 12, 24, 36, and 48 to baseline. At 2 sites, PrEP users were also compared with a lagged, comparison group of 99 men who have sex with men who did not receive PrEP over 24 weeks using linear regression models, adjusting for age, race/ethnicity, education, and respective baseline scores. Logistic regression compared week 24 sexually transmitted infection (STI) rates.

Results:
Over 48 weeks in the PrEP group, there were significant decreases in the number of unknown HIV status sex partners and increases in CRAS at all study visits; there was no consistent change in number of HIV+ sex partners or CIAS. Among participants at 2 sites, there were no significant differences between PrEP and non-PrEP users in change in number of partners, CIAS, CRAS, or STI rates at week 24.

Conclusions:
Among early adopters of PrEP, there is some evidence for sexual risk compensation. Results support current guidelines of regular STI screening and behavioral risk reduction and adherence counseling with the provision of PrEP.
In Their Own Words: Caregiver and Patient Perspectives on Stressors, Resources, and Recommendations in Craniofacial Microsomia Care
Authors: Johns Alexis L. , Luquetti Daniela V. , Brajcich Michelle R. , Heike Carrie L. , Stock Nicola M. 
Published: October 2018

Abstract
This study describes stressors, resources, and recommendations related to craniofacial microsomia (CFM) care from the perspective of caregivers of children with CFM and adults with CFM to inform improved quality of healthcare delivery. A mixed method design was used with fixed-response and open-ended questions from an online survey in English. The survey included demographics, CFM phenotypic information, and items about CFM-related experiences across settings. Themes were identified by qualitative analysis of responses to open-ended questions. Respondents (n = 51) included caregivers (n = 42; 90% mothers) and adults with CFM (n = 9; 78% female), who had a mean age of 45 ± 6 years. Most children were male (71%) with an average age of 7 ± 4 years. Respondents were primarily white (80%), non-Hispanic (89%), from the United States (82%), had a college degree (80%), and had private health insurance (80%). Reflecting the high rate of microtia (84%) in the sample, themes centered on the impact of hearing difficulties across settings with related language concerns. Negative social experiences were frequently described and school needs outlined. Multiple medical stressors were identified and corresponding suggestions included: providers need to be better informed about CFM, treatment coordination among specialists, and preference for a family-centered approach with reassurance, empathy, and clear communication. Advice offered to others with CFM included positive coping strategies. Overall, caregivers’ and patients’ responses reflected the complexity of CFM treatment. Incorporating these perspectives into routine CFM care has the potential to reduce family distress while improving their healthcare.
Distraction Sugosteogenesis: Its Biologic Bases and Therapeutic Principles
Authors: Castro-Núñez Jaime 
Published: October 2018

Purpose:
Recently, the terms sugosteogenesis and distraction sugosteogenesis have been introduced to the scientific literature. While the former describes a biologic phenomenon, the latter refers to the clinical technique which relies on the accelerated normal bone healing process that takes place at the osseous walls surrounding a cystic cavity when active negative pressure is applied. The purpose of this study is to provide the biologic bases and the therapeutic principles of this emerging technique. Employing well-stablished biologic principles, clinical evidence from analogous techniques, emerging experimental data, and circumstantial evidence, this study presents the possible mechanism of action of the evacuator for odontogenic cysts (Evocyst), a closed, vacuum-like drain system intended to treat cystic conditions using negative pressure.

Methods:
A review of the literature was done. Keywords for the Medline search were: marsupialization, decompression, odontogenic cysts, effects of negative pressure on bone, and negative pressure wound therapy. In addition, relevant publications from the reference list of the retrieved studies were considered. The matches were evaluated for relevance and analyzed accordingly. Clinical reports used to illustrate the concept of distraction sugosteogenesis were performed following the Declaration of Helsinki on medical protocol and ethics.

Results:
Currently, the standard of care to manage odontogenic cystic lesions includes marsupialization, enucleation and curettage, decompression, and surgical resection. However, there is a need for an alternative option in which the entity could be treated while promoting bone formation. With large odontogenic cystic conditions treated in a short period of time, distraction sugosteogenesis appears to be a choice.

Conclusion:
The application of negative pressure to osseous cells produces a stretching that creates mechanical cues that trigger signaling pathways, promotes fluid flow, and enhances angiogenesis. All of them, combined, may explain sugosteogenesis. The clinical application of such parameters may explain the good clinical results obtained with the Evocyst.
Assessment of Vertical Triangular Spreader Graft Technique for Reconstruction of Middle Vault and Internal Nasal Valve Angle
Authors: Kocak Omer Faruk , Düzenli Ufuk 
Published: October 2018

Background:
Rhinoplasty is a surgical procedure to smooth out the nasal deformities and to fix nasal breathing problems. Spreader grafts and flaps are used to prevent some complications such as middle vault collapse, narrowing the internal nasal valve and inverted V deformity. To obtain more stable middle vault, spreader grafts and flaps could be used together. Many researchers have tried different graft and flap techniques to reach more successful aesthetic and functional results. In this research, we investigated effects of triangular graft on the internal nasal valve angle, nasal breathing, and aesthetic outcomes when it used together with sprader flap.

Methods:
In this prospective study, 3 different groups were formed as: the spreader flap group (group 1); the spreader flap with the rectangular spreader graft group (group 2); and the spreader flap with the triangular spreader graft group (group 3). Preoperative nasal obstruction symptom evaluation (NOSE) scale was used to evaluate nasal breathing and visual analog scale (VAS) was used to evaluate aesthetic appearance. And also, measurement of the internal nasal valve angle was performed for each patients. These evaluations were repeated at postoperative 3rd month. Preoperative and postoperative comparisons between study groups were performed.

Results:
There were 12 patients in group 1, 14 patients in group 2, and 10 patients in group 3. In each group, statistically significant decrease in NOSE scores (P < 0.05) and statistical significant increase in VAS scores (P < 0.05) were observed. And also, increased internal nasal valve angle after surgery was detected in all groups (P < 0.05). Postoperative NOSE and VAS scores were found similar in 3 different groups (P > 0.05). On the contrary, the internal nasal valve angles were found statistically significant increased in group 3 according to other groups (P < 0.05).

Conclusion:
The results of this prospective study presented that the use of triangular spreader graft with spreader flap was an appropriate technique to obtain successful aesthetic and functional outcomes with widening the internal nasal valve angle.