bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Two Posterior Three-Point Fixation Techniques for Treating Reducible Atlantoaxial Dislocation
Authors: Zhao Wenlong , Wu Yaming , Hu Wei , Ni Bin , Guo Qunfeng , Chen Jinshui , Guo Xiang 
Published: June 2018

Study Design.
Retrospective comparative study.

Objective.
To compare the outcomes of C1–C2 transarticular screw combined with C1 laminar hook (TAS+C1H) and C1–C2 transarticular screw combined with modified Gallie technique (TAS+G) for treating reducible atlantoaxial dislocation (AAD).

Summary of Background Data.
Both TAS+C1H and TAS+G fixation were 3-point fixation techniques for AAD. TAS+C1H technique was comparable to TAS+G technique in biomechanics. However, it is unknown whether it can achieve same outcomes as TAS+G technique.

Methods.
Data of the 63 patients who underwent TAS+C1H or TAS+G fixation and fusion because of AAD were retrospectively reviewed. Bone fusion time was recorded. The outcomes evaluated by visual analog scale score for neck pain (VASSNP), Nurick scale, neck stiffness (none/mild/severe), patient satisfaction, and Neck Disability Index (NDI) were compared between two groups.

Results.
At the final follow-up, bone graft fusion rates were 100% in both groups (P > 0.05). Nurick scales were significantly improved in both groups (P < 0.05), but with no significant differences between groups (P > 0.05). There were no significant differences between two groups in VASSNP, neck stiffness, patient satisfaction, or NDI (all P > 0.05). There were no complications related to the surgical approach and instrumentation in either group.

Conclusion.
Both TAS+C1H and TAS+G fixation were effective in the treatment of reducible AAD. TAS+C1H was safer than TAS+G because it could potentially reduce the risk of spinal cord and venous plexus injury associated with sublaminar cables.

Level of Evidence: 3
Comparison of Postoperative Outcomes Between Primary MIS TLIF and MIS TLIF With Revision Decompression
Authors: Khechen Benjamin , Haws Brittany E. , Patel Dil V. , Narain Ankur S. , Hijji Fady Y. , Guntin Jordan A. , Cardinal Kaitlyn L. , Iyer Sravisht , Singh Kern 
Published: June 2018

Study Design.
Retrospective cohort.

Objective.
To compare postoperative improvements in surgical and patient-reported outcomes (PROs) between patients undergoing minimally invasive laminectomy and minimally invasive transforaminal lumbar interbody fusion (MIS TLIF) as a primary procedure to patients undergoing MIS laminectomy and TLIF as a revision to primary lumbar decompression (LD).

Summary of Background Data.
MIS TLIF and LD have demonstrated to be effective surgical options for lumbar degenerative disease. However, some patients undergoing LD experience recurrent symptoms and eventually require a revision decompression with fusion.

Methods.
A prospectively maintained surgical database of patients who underwent a primary or revision one-level MIS TLIF for degenerative spinal pathology between 2014 and 2016 was reviewed. Consecutive patients undergoing primary MIS TLIF and revision lumbar discectomy and/or laminectomy were matched in a one-to-one fashion to primary MIS TLIF patients who had not undergone a previous LD by age and preoperative diagnosis. Differences in patient demographic, comorbidity, and perioperative characteristics between procedure groups were assessed using Pearson chi-squared analysis and Student t test for categorical and continuous variables, respectively. Improvements in PROs from preoperative values were compared between primary and revision cohorts using Student t tests. Pearson chi-squared analysis was used to compare rates of minimum clinically important difference achievement between procedure groups. Statistical significant was set at P < 0.05.

Results.
A total of 52 patients were included in this analysis. Twenty-six underwent primary MIS laminectomy and TLIF and 26 underwent MIS TLIF with a revision decompression. No differences in baseline or perioperative variables were observed. Revision and primary MIS TLIF patients experienced similar improvements in PROs at all postoperative time points.

Conclusion.
The results of the present study demonstrate patients undergoing primary MIS TLIF with LD as a revision to a primary decompression experienced similar postoperative improvements in PROs as compared to primary MIS TLIF patients. This indicates a primary decompression does not compromise clinical outcomes in patients undergoing MIS TLIF. As such, patients should not be precluded from undergoing MIS TLIF based on the history of a previous LD.

Level of Evidence: 3
Three Methods of Pelvic Fixation for Scoliosis in Children With Cerebral Palsy
Authors: Abousamra Oussama , Sullivan Brian T. , Samdani Amer F. , Yaszay Burt , Cahill Patrick J. , Newton Peter O. , Sponseller Paul D. 
Published: June 2018

Study Design.
A retrospective review.

Objective.
The aim of this study was to assess correction of pelvic obliquity in children with cerebral palsy (CP) scoliosis postoperatively and 5 years after posterior spinal fusion with pelvic fixation using unit rods, sacral-alar-iliac (SAI) screws, or iliac screws.

Summary of Background Data.
There are multiple options for pelvic fixation in children with scoliosis secondary to CP. The long-term differences in outcomes between these fixation methods are still unclear.

Methods.
A multicenter review identified records of 70 children with CP who underwent posterior spinal fusion for scoliosis using unit rods (n = 9), SAI screws (n = 19), or iliac screws (n = 42). Patients younger than 18 years with 5-year follow-up were included. Pelvic obliquity and major coronal curve measurements were compared using preoperative, (first erect) postoperative, and 5-year follow-up radiographs. Implant-related complications were noted. Alpha = 0.05.

Results.
For all groups, there was a significant difference between preoperative and postoperative pelvic obliquity that was maintained at 5 years. At 5-year follow-up, pelvic obliquity was significantly higher in the IS group (12°) compared with the unit rod group (4°, P = 0.001) and SAI screw group (6°) (P = 0.006). Implant-related complications were as follows: unit rod group, one patient (reoperation); SAI screw group, none; iliac screw group, six patients, including three cases of loss of connection between the rod and the iliac screw, two prominent screws, and one loose screw.

Conclusion.
Correction of pelvic obliquity for children with CP-related scoliosis was achieved postoperatively using unit rods, SAI screws, and iliac screws. Implant-related complications and reoperations were most common in the iliac screw group. At 5-year follow-up, the iliac screw group had loss of major curve correction and less correction of pelvic obliquity than the unit rod and SAI screw groups.

Level of Evidence: 3
Fragility Fracture Risk in Elderly Patients With Cervical Myelopathy
Authors: Horowitz Jason A. , Puvanesarajah Varun , Jain Amit , Raad Micheal , Gjolaj Joseph P. , Shen Francis H. , Hassanzadeh Hamid 
Published: June 2018

Study Design.
Retrospective review.

Objective.
To identify and compare the incidences of fragility fractures amongst three elderly populations: the general population, patients with surgically treated cervical spondylotic myelopathy (CSM), and patients with CSM not surgically treated.

Summary of Background Data.
CSM is a common disease in the elderly. Progression of myelopathic symptoms, including gait imbalance, can be a source of morbidity as it can lead to increased falls.

Methods.
Records of elderly patients with Medicare insurance from 2005 to 2014 were retrospectively reviewed. Three mutually exclusive populations of patients were identified for analysis, including a cohort of patients with a diagnosis of CSM who were not treated with surgery; a cohort of patients with CSM who were treated with surgery; and a group of control patients who had never been treated with cervical spine surgery nor were diagnosed with CSM. Incidence of fractures of the distal radius, proximal humerus, proximal femur, and lumbar spine were assessed and compared between cohorts, adjusted by age, sex, osteoporosis, dementia, cerebrovascular disease, and Charlson Comorbidity Index.

Results.
A total of 891,864 patients were identified, of which 60,332 had a diagnosis of CSM and 24,439 underwent cervical spine surgery. Compared to general population controls, the 12-month adjusted odds of experiencing at least one fragility fracture were 1.59 times higher in patients with CSM who were not treated with surgery (P < 0.001). The analogous odds ratio was 1.34 (P < 0.001) at 3 years. Compared to nonsurgically treated patients with CSM, the odds of experiencing at least one fragility fracture were reduced to 0.89 in surgically treated patients (P = 0.008).

Conclusion.
Fragility fractures are a significant source of morbidity and mortality in elderly patients. CSM is associated with increased rates of fragility fractures, although surgical management of CSM may be protective against risk of fragility fracture.

Level of Evidence: 3
Management of the Critically Ill Adult Chimeric Antigen Receptor-T Cell Therapy Patient: A Critical Care Perspective
Authors: Gutierrez Cristina , McEvoy Colleen , Mead Elena , Stephens R. Scott , Munshi Laveena , Detsky Michael E. , Pastores Stephen M. , Nates Joseph L. 
Published: June 2018

Objectives:
Chimeric antigen receptor T-cell therapy, a type of immune effector therapy for cancer, has demonstrated encouraging results in clinical trials for the treatment of patients with refractory hematologic malignancies. Nevertheless, there are toxicities specific to these treatments that, if not recognized and treated appropriately, can lead to multiple organ failure and death. This article is a comprehensive review of the available literature and provides, from a critical care perspective, recommendations by experienced intensivists in the care of critically ill adult chimeric antigen receptor T-cell patients.

Data Sources:
PubMed and Medline search of articles published from 2006 to date.

Study Selection:
Clinical studies, reviews, or guidelines were selected and reviewed by the authors.

Data Extraction:
Not available.

Data Synthesis:
Not available.

Conclusions:
Until modifications in chimeric antigen receptor T-cell therapy decrease their toxicities, the intensivist will play a leading role in the management of critically ill chimeric antigen receptor T-cell patients. As this novel immunotherapeutic approach becomes widely available, all critical care clinicians need to be familiar with the recognition and management of complications associated with this treatment.
Experiences of Population Monitoring Using Whole-Body Counters in Response to the Fukushima Nuclear Accident
Authors: Kurihara Osamu , Li Chunsheng , Lopez Maria Antonia , Kim Eunjoo , Tani Kotaro , Nakano Takashi , Takada Chie , Momose Takumaro , Akashi Makoto 
Published: June 2018

Abstract
Whole-body counter measurements of residents of Fukushima Prefecture have been extensively performed after the Fukushima Dai-ichi Nuclear Power Plant accident in March 2011. These measurements have demonstrated that the levels of internal contamination with radioactive cesium (134Cs and 137Cs) in the residents are very low. This article provides an overview of and lessons learned from these whole-body counter measurements with emphasis on the technical problems encountered, and it discusses the effective use of whole-body counters for assessing the internal thyroid doses of individuals when direct measurements of 131I in the thyroid are difficult or impossible to implement for the total affected population in a short time after a nuclear reactor accident. The application of this dose reconstruction method requires determining the intake ratio of 131I to cesium isotopes at appropriate times and considers the short biological half-lives of cesium isotopes, in particular for children.
Efficacy of hypnosis on pain, wound-healing, anxiety, and stress in children with acute burn injuries: a randomized controlled trial
Authors: Chester Stephen J. , Tyack Zephanie , De Young Alexandra , Kipping Belinda , Griffin Bronwyn , Stockton Kellie , Ware Robert S. , Zhang Xi , Kimble Roy M. 
Published: June 2018

Abstract
No randomized controlled trial has investigated the efficacy of hypnosis for reducing pain and improving wound-healing in children with burns. This randomized controlled trial aimed to investigate whether hypnosis decreases pain, anxiety, and stress and accelerates wound-healing in children undergoing burn wound procedures. Children (4-16 years) with acute burns presenting for their first dressing change were randomly assigned to a Hypnosis Group who received hypnosis plus standard care or a Standard Care Group who received standard pharmacological and nonpharmacological intervention. Repeated measures of pain intensity, anxiety, stress, and wound-healing were taken at dressing changes until ≥95% wound re-epithelialization. Data for 62 children were analyzed on an intent-to-treat basis using Generalized Estimating Equations (n = 35 Standard Care Group; n = 27 Hypnosis Group). An effect on the primary outcomes of pain and wound healing was not supported {self-reported pain intensity largest Mean Difference [MD] = −0.85 (95% confidence interval [CI]: −1.91 to 0.22), P = 0.12; MD for re-epithelialization = −0.46 [95% CI: −4.27 to 3.35], P = 0.81}. Some support was found for an effect on the secondary outcomes of preprocedural anxiety (MD = −0.80 [95% CI: −1.50 to −0.10], P = 0.03 before the second dressing change) and heart rate as a measure of stress (MD = −15.20 [−27.20 to −3.20], P = 0.01 and MD = −15.39 [−28.25 to −2.53], P = 0.02 before and after the third dressing change). Hypnosis may be effective for decreasing preprocedural anxiety and heart rate in children undergoing repeated pediatric wound care procedures but not for reducing pain intensity or accelerating wound healing.
Involvement of lysophosphatidic acid–induced astrocyte activation underlying the maintenance of partial sciatic nerve injury–induced neuropathic pain
Authors: Ueda Hiroshi , Neyama Hiroyuki , Nagai Jun , Matsushita Yosuke , Tsukahara Tamotsu , Tsukahara Ryoko 
Published: June 2018

Abstract
We have previously demonstrated that lysophosphatidic acid (LPA) plays key roles in the initial mechanisms for neuropathic pain (NeuP) development. Here, we examined whether LPA receptor mechanisms and LPA production are related to the glial activation at a late stage after partial sciatic nerve ligation (pSNL) by use of microglial inhibitor, Mac1-saporin or astrocyte inhibitor, and l-α-aminoadipate (l-AA). Although single intrathecal injection of LPA1/3 antagonist, Ki-16425 did not affect the pain threshold at day 7 after the spinal cord injury, repeated treatments of each compound gradually reversed the basal pain threshold to the control level. The intrathecal administration of a microglia inhibitor, Mac-1-saporin reversed the late hyperalgesia and LPA production at day 14 after the pSNL, whereas l-AA inhibited the hyperalgesia, but had no effect on LPA production. The involvement of LPA receptors in astrocyte activation in vivo was evidenced by the findings that Ki-16425 treatments abolished the upregulation of CXCL1 in activated astrocytes in the spinal dorsal horn of mice at day 14 after the pSNL, and that Ki-16425 reversed the LPA-induced upregulation of several chemokine gene expressions in primary cultured astrocytes. Finally, we found that significant hyperalgesia was observed with intrathecal administration of primary cultured astrocytes, which had been stimulated by LPA in a Ki-16425–reversible manner. All these findings suggest that LPA production and LPA1/3 receptor activation through differential glial mechanisms play key roles in the maintenance as well as initiation mechanisms in NeuP.
Location-specific responses to nociceptive input support the purposeful nature of motor adaptation to pain
Authors: Gallina Alessio , Salomoni Sauro E. , Hall Leanne M. , Tucker Kylie , Garland S. Jayne , Hodges Paul W. 
Published: June 2018

Abstract
Movement is changed in pain, but the mechanisms remain unclear. Key questions are unresolved such as whether activation can be inhomogeneously distributed within a muscle in a manner that is specific to the location of noxious input. This study addressed this question using high-density electromyography (EMG) to study regional redistribution of muscle activation within the vasti muscles and changes in knee extension force direction in response to noxious stimulation applied to muscular and nonmuscular tissues around the knee. Fourteen participants performed a low-force knee extension contraction at baseline, during, and after pain induced in 4 locations (infrapatellar fat pad, vastus lateralis, distal vastus medialis, or proximal vastus medialis). The knee extension force direction was estimated from a 3-dimensional load cell positioned just above the ankle. Regional muscle activation was estimated from amplitude of high-density surface EMG signals from vastus medialis and lateralis. Pain-induced spatial variations of activation were identified as the position of the 5 channels that showed the largest decrease (or smallest increase) in amplitude from baseline to pain or after pain. Knee extension force was produced more medially during pain after infrapatellar pad injection only (P = 0.01). Preferential reduction of activation of the distal region of vastus medialis was observed when distal vastus medialis (P < 0.001) or vastus lateralis (P < 0.05) was injected. Both adaptations persisted after pain resolution. These results support the hypothesis that specific adaptation depends on the location of a noxious stimulus and imply that recovery of pain is not necessarily concomitant with return of the EMG to prepain patterns.
Influence of neuropathic pain on nicotinic acetylcholine receptor plasticity and behavioral responses to nicotine in rats
Authors: Brunori Gloria , Schoch Jennifer , Mercatelli Daniela , Ozawa Akihiko , Toll Lawrence , Cippitelli Andrea 
Published: June 2018

Abstract
Tobacco smoking is particularly evident in individuals experiencing chronic pain. This complex relationship is poorly understood at both molecular and behavioral levels. Here, we describe experiments aimed at understanding whether a chronic pain state induces neuroadaptations into the brain or peripheral nerves that involve nicotinic acetylcholine receptors (nAChRs) and whether these neuroadaptations directly lead to increased vulnerability to nicotine addiction or to the development of coping strategies to relieve pain symptoms. We found that ligation of the rat L5 spinal nerve led to a dramatic downregulation in the mRNA expression levels of all nAChR subunits examined in dorsal root ganglia and a time-dependent downregulation of discrete subunits, particularly in the cingulate cortex and the amygdala. Spinal nerve ligation and sham-operated rats showed minor or no changes in patterns of acquisition and motivation for nicotine taking. Spinal nerve ligation rats also showed similar vulnerability to nicotine seeking as sham animals when reinstatement was induced by nicotine-associated cues, but failed to reinstate lever pressing when relapse was induced by nicotine priming. Spinal nerve ligation and sham rats were equally sensitive to nicotine-induced anxiety-like behavior and antinociception; however, nicotine produced a potent and long-lasting antiallodynic effect in spinal nerve ligation rats. These results demonstrate that chronic pain leads to plasticity of nAChRs that do not directly facilitate nicotine addictive behaviors. Instead, nicotine potently decreases allodynia, an effect that could lead to increased nicotine consumption in chronic pain subjects.
Chronic itch impairs mood and HPA axis function in mice: modulation by CRFR1 antagonist
Authors: Zhao Xin , Yu Chao , Ye Feng , Wang Yan-Gui , Mei Qi-Yong , Ma Qing , Cui Wu-Geng , Zhou Wen-Hua 
Published: June 2018

Abstract
Chronic itch is clinically correlated with the development of mood disorders such as anxiety and depression. Nonetheless, whether this relevance exists in rodents is unknown, and evidence demonstrating chronic itch can affect mood is lacking. The aim of this study is to characterize the affective consequences of chronic itch, and explore potential mechanisms and interventional strategy. We subjected mice to chronic itch by repetitive cutaneous treatment with acetone and diethylether followed by water (AEW) that models “dry skin.” After 3 to 4 weeks AEW treatment, the mice developed behavioral phenotypes of anxiety and depression assessed by a battery of behavioral paradigms, such as light–dark box and forced swim test. These behavioral symptoms of mood disturbance were independent of cutaneous barrier disruption, but correlated well with the degree of the irritating itch sensation. Although AEW mice showed normal circadian hypothalamic-pituitary-adrenal (HPA) axis activity, their neuroendocrine functionality was dampened, including impaired endocrine stress responsivity, altered neuroendocrine–immune interaction, and blunted corticosterone response to both dexamethasone and CRF. Parameters of HPA functionality at the level of mRNA transcripts are altered in stress-related brain regions of AEW mice, implying an overdrive of central CRF system. Remarkably, chronic treatment of AEW mice with antalarmin, a CRFR1 antagonist, ameliorated both their mood impairment and stress axis dysfunction. This is the first evidence revealing mood impairment, HPA axis dysfunction, and potential therapeutic efficacy by CRFR1 antagonist in mice with chronic itch, thus providing a preclinical model to investigate the affective consequence of chronic itch and the underlying mechanisms.
Low- and high-threshold primary afferent inputs to spinal lamina III antenna-type neurons
Authors: Fernandes Elisabete C. , Santos Ines C. , Kokai Eva , Luz Liliana L. , Szucs Peter , Safronov Boris V. 
Published: June 2018

Abstract
The dorsal horn of the spinal cord (laminae I-VI) processes diverse modalities of nociceptive and nonnociceptive sensory information. Antenna-type neurons with cell bodies located in lamina III and large dendritic trees extending from the superficial lamina I to deep lamina IV are best shaped for the integration of a wide variety of inputs arising from primary afferent fibers and intrinsic spinal circuitries. Although the somatodendritic morphology, the hallmark of antenna neurons, has been well studied, little is still known about the axon structure and basic physiological properties of these cells. Here, we did whole-cell recordings in a rat (P9-P12) spinal cord preparation with attached dorsal roots to examine the axon course, intrinsic firing properties, and primary afferent inputs of antenna cells. Nine antenna cells were identified from a large sample of biocytin-filled lamina III neurons (n = 46). Axon of antenna cells showed intensive branching in laminae III-IV and, in half of the cases, issued dorsally directed collaterals reaching lamina I. Antenna cells exhibited tonic and rhythmic firing patterns; single spikes were followed by hyperpolarization or depolarization. The neurons received monosynaptic inputs from the low-threshold Aβ afferents, Aδ afferents, as well as from the high-threshold Aδ, and C afferents. When selectively activated, C-fiber-driven monosynaptic and polysynaptic excitatory postsynaptic potentials were sufficiently strong to evoke firing in the neurons. Thus, lamina III antenna neurons integrate low-threshold and nociceptive high-threshold primary afferent inputs and can function as wide dynamic range neurons able to directly connect deep dorsal horn with the major nociceptive projection area lamina I.