bluuebunny/crossref_metadata_2025_split huggingface dataset:
Functional Recovery in Critically Ill Children, the “WeeCover” Multicenter Study
Authors: Choong Karen , Fraser Douglas , Al-Harbi Samah , Borham Asm , Cameron Jill , Cameron Saoirse , Cheng Ji , Clark Heather , Doherty Tim , Fayed Nora , Gorter Jan-Willem , Herridge Margaret , Khetani Mary , Menon Kusum , Seabrook Jamie , Simpson Racquel , Thabane Lehana 
Published: February 2018

Objectives:
To evaluate functional outcomes and evaluate predictors of an unfavorable functional outcome in children following a critical illness.

Design:
Prospective observational longitudinal cohort study.

Setting:
Two tertiary care, Canadian PICUs: McMaster Children’s Hospital and London Health Sciences.

Patients:
Children 12 months to 17 years old, admitted to PICU for at least 48 hours with one or more organ dysfunction, were eligible. Patients not expected to survive, direct transfers from neonatal ICU and patients in whom long-term follow-up would not be able to be conducted, were excluded.

Interventions:
None.

Measurements and Main Results:
The primary endpoint was functional outcome up to 6 months post PICU discharge, measured using the Pediatric Evaluation of Disabilities Inventory Computer Adaptive Test. Secondary outcomes included predictors of unfavorable functional outcome, caregiver stress, health-related quality-of-life, and clinical outcomes such as mortality, length of stay, and PICU-acquired complications. One hundred eighty-two patients were enrolled; 78 children (43.6%) had functional limitations at baseline and 143 (81.5%) experienced functional deterioration following critical illness. Ninety-two (67.1%) demonstrated some functional recovery by 6 months. Higher baseline function and a neurologic insult at PICU admission were the most significant predictors of functional deterioration. Higher baseline function and increasing age were associated with slower functional recovery. Different factors affect the domains of functioning differently. Preexisting comorbidities and iatrogenic PICU-acquired morbidities were associated with persistent requirement for caregiver support (responsibility function) at 6 months. The degree of functional deterioration after critical illness was a significant predictor of increased hospital length of stay.

Conclusions:
This study provides new information regarding functional outcomes and the factors that influence meaningful aspects of functioning in critically ill children. Identifying patients at greatest risk and modifiable targets for improvement in PICU care guides us in developing strategies to improve functional outcomes and tailor to the rehabilitation needs of these patients and their families.
Sensory symptom profiles differ between trigeminal and thoracolumbar postherpetic neuralgia
Authors: Rehm Stefanie , Groβkopf Moritz , Kabelitz Maria , Keller Thomas , Freynhagen Rainer , Tölle Thomas R. , Baron Ralf 
Published: February 2018

Abstract

Introduction:
Animal experimental evidence suggests that mechanisms of pain generation and response to treatment differ between neuropathic pain in the cephalic and the extracephalic innervation territories.

Objectives:
The objective of the study was to examine whether in humans an identical peripheral painful neuropathy is associated with different pain qualities and sensory abnormalities in the face as compared with the thoracic region.

Methods:
We retrospectively analysed epidemiological and clinical data of 639 patients with postherpetic neuralgia (PHN) in the face and at the trunk who were collected within a cross-sectional cohort survey and compared the respective sensory symptom profiles captured with the painDETECT questionnaire.

Results:
Two hundred twenty-four patients suffered from trigeminal PHN and 415 from thoracolumbar PHN. There were no significant differences in sex-ratio, age, body mass index, and pain duration. Patients with trigeminal PHN were more often severely depressed. Anxiety and sleep scores were not different. The average pain intensity was slightly higher in thoracolumbar PHN than trigeminal PHN (visual analogue scale 5.0 vs 4.6). Postherpetic neuralgia in the thoracolumbar region showed significantly more intense burning sensations, allodynia, painful attacks, and significantly less prickling and numbness than PHN in the face.

Conclusions:
The differences in sensory symptom profiles between facial PHN and truncal PHN might be associated with different pathophysiological mechanisms and different treatment response. Drugs that primarily act on sensitization processes in the peripheral nociceptive system may work better in thoracolumbar PHN than in trigeminal PHN. If new medications are tested in patients with PHN, it would therefore be of interest to include an analysis of the treatment results in regard to subgroups based on the localisation of pain in patients with PHN.
Clear Cell Sarcoma of the Tongue on MRI and PET/CT
Authors: Tordjman Mickael , Dubois Matthieu , de Malherbe Maxime , Denoux Yves , Gillebert Quentin 
Published: February 2018

Abstract

18F-FDG PET/CT and MRI were performed in a 44-year-old woman to characterize a mass of the anterior tongue. MR images showed a voluminous mass, well circumscribed and enhanced heterogeneously after gadolinium chelates injection. There was an intense uptake on PET/CT. Pathological examination and molecular analysis revealed the diagnosis of clear cell sarcoma of the tongue. We present a case of clear cell sarcoma of the tongue, which includes imaging features. It is an extremely rare tumor, with only 3 cases previously reported in the literature.
Superior Pituitary Border Analysis in Immunotherapy-Induced Hypophysitis
Authors: Pucar Darko , Boustani Anne Marie , Bronen Richard A. , Saperstein Lawrence 
Published: February 2018

Abstract
Immunotherapy-induced hypophysitis presents with headache, fatigue, and visual disturbances. The diagnosis is supported by imaging findings of pituitary swelling, enhancement, and hypermetabolism and established by low levels of pituitary hormones. A 64-year-old man with metastatic melanoma on nivolumab presented with a severe headache, initially attributed to sinus disease. Contrast CT was interpreted as minor sinus disease and no pituitary abnormality. Hypophysitis was eventually diagnosed and successfully treated based on PET and laboratory findings. Our retrospective analysis demonstrated abnormal convex superior pituitary border visible on contrast and noncontrast CT and PET. This feature may aid diagnosis in the challenging cases.
Detecting Intestinal Malrotation on Hepatobiliary Scintigraphy
Authors: Miner Lane T. , Tulchinsky Mark 
Published: February 2018

Abstract
Intestinal malrotation displays classic pattern of the small bowel activity on hepatobiliary scintigraphy that could lead to the diagnosis, but only if an interpreting physician looks for it. Presented are 2 cases, one demonstrates diagnostic findings during the first 60-minute phase, whereas the other reveals the diagnosis only on the later sincalide stimulation phase. The currently recommended structured reporting for hepatobiliary scintigraphy does not include examination of bowel activity pattern, which could result in a missed diagnosis. Including interrogation of the small bowel pattern into the structured reporting checklist would ensure consistent detection of this rare but most consequential diagnosis.
SPECT/CT MIBG Imaging Is Crucial in the Follow-up of the Patients With High-Risk Neuroblastoma
Authors: Liu Bin , Servaes Sabah , Zhuang Hongming 
Published: February 2018

Background
Planar whole-body imaging with 123I-radiolabeled metaiodobenzylguanidine (123I-MIBG) is routinely used in the follow-up evaluation of neuroblastoma. In recent years, SPECT with integrated low-dose CT (SPECT/CT) has become more accessible. We investigated how much SPECT/CT can have additional diagnostic value over planar imaging in detection of residual and recurrent neuroblastoma.

Methods
A total of 170 planar 123I-MIBG imaging scans with SPECT/CT follow-up scans performed in 147 patients with known high-risk neuroblastoma were retrospectively analyzed. Regions of increased 123I-MIBG uptake on planar images and the findings on SPECT/CT were compared.

Results
In 61% of the studies, the whole-body planar images and SPECT/CT images yielded the same result. In 39% of the time, however, SPECT/CT images provided additional information.

Conclusions
In the follow-up of patients with high-risk neuroblastoma, SPECT/CT can significantly improve planar imaging interpretation and impact patient management.
68Ga-DOTATATE PET/CT Reveals Epstein-Barr Virus–Associated Nasopharyngeal Carcinoma in a Case of Suspected Sphenoid Wing Meningioma
Authors: Unterrainer Marcus , Maihoefer Cornelius , Cyran Clemens C. , Bartenstein Peter , Niyazi Maximilian , Albert Nathalie Lisa 
Published: February 2018

Abstract
In this case of suspected sphenoid wing meningioma, 68Ga-DOTATATE PET/CT showed a somatostatin receptor (SSR)–expressing tumor with extension to the nasopharynx and SSR-expressing cervical lymph nodes. Subsequent biopsy from the nasopharynx revealed an Epstein-Barr virus (EBV)–associated, undifferentiated World Health Organization type 3 nasopharyngeal carcinoma (NPC), a potential clinical pitfall due to the reported high SSR expression of this tumor subtype. In consideration of the high target-to-background contrast, SSR ligands might be superior to 18F-FDG for EBV-associated NPC PET imaging, particularly at the skull base. Somatostatin receptor ligands might furthermore offer interesting theranostic possibilities for patients with advanced/extensive EBV-associated NPC.
177Lu–Prostate-Specific Membrane Antigen Super Scan and Good Response Even After 1 Cycle of Radioligand Therapy
Authors: Aryana Kamran , Zarehparvar moghadam Soroush , Salek Roham , Divband Ghasemali 
Published: February 2018

Abstract
A 76-year-old man with castration-resistant prostate cancer and widespread skeletal metastases underwent 2 cycles of 177Lu–prostate-specific membrane antigen (PSMA) 617 therapy in our department. Whole-body 177Lu-PSMA scan after the first cycle showed diffuse skeletal PSMA-avid lesions, whereas no PSMA uptake was evident in the kidneys with minimal PSMA uptake by salivary glands (super scan). After 6 weeks, he received the second dose of 177Lu-PSMA and whole-body scan after the treatment showed remarkable resolution of skeletal metastases and normal PSMA uptake by the kidneys and salivary glands. To our best knowledge, this is the first case report of 177Lu-PSMA super scan.
Prostate-Specific Membrane Antigen PET/CT Incidental Finding of a Schwannoma
Authors: Dias André H. , Bouchelouche Kirsten 
Published: February 2018

Abstract
We describe a case of a 73-year-old man with newly diagnosed prostate cancer referred to 68Ga-PSMA PET/CT for staging. A focal uptake of PSMA was visualized in the prostate compatible with primary prostate cancer. Outside the prostate, a PSMA-avid paravertebral soft tissue mass was observed. Further investigation with MRI of the same region showed signs compatible with schwannoma. This case shows the importance of including schwannoma in the differential diagnostic evaluation of patients with 68Ga-PSMA–positive foci in paravertebral locations, as schwannomas may show avid PSMA uptake and may potentially lead to an incorrect diagnosis of metastasis.
Pancreatic Malignancy or Not?
Authors: Parihar Ashwin Singh , Singh Harmandeep , Kumar Rajender , Gupta Vikas , Singh Harpreet , Mittal Bhagwant Rai 
Published: February 2018

Abstract
Immunoglobulin G4–related disease is an autoimmune entity with multisystem involvement. 18F-FDG PET/CT can provide important information about disease extent and severity and also aid in treatment response evaluation. We report a case of a 57-year-old woman presenting with abdominal discomfort, belching, and loss of weight in whom 18F-FDG PET/CT provided valuable information in diagnosis and monitoring treatment response.
68Ga–Prostate-Specific Membrane Antigen Expression in Neurocysticercosis Lesions in a Patient With Prostate Carcinoma
Authors: Vadi Shelvin Kumar , Kumar Rajender , Singh Harmandeep , Singh Shrawan Kumar , Mittal Bhagwant Rai 
Published: February 2018

Abstract

68Ga–prostate-specific membrane antigen (PSMA) ligand is a well-known tracer used in prostate cancer. Nevertheless, there are reports of unusual 68Ga-PSMA uptake in variety of benign lesions. We report a case of prostate cancer in which 68Ga-PSMA PET/CT revealed tracer avidity in the enhancing walls of cystic lesions in the brain consistent with the features of neurocysticercosis. The uptake of 68Ga-PSMA in neurocysticercosis is not known and may be attributed to angiogenesis occurring at the periphery of these lesions.
SPECT/CT With the PSMA Ligand 99mTc-MIP-1404 for Whole-Body Primary Staging of Patients With Prostate Cancer
Authors: Schmidkonz Christian , Cordes Michael , Beck Michael , Goetz Theresa Ida , Schmidt Daniela , Prante Olaf , Bäuerle Tobias , Uder Michael , Wullich Bernd , Goebell Peter , Kuwert Torsten , Ritt Philipp 
Published: February 2018

Background

99mTc-MIP-1404 (Progenics Pharmaceuticals, Inc, New York, NY) is a novel ligand binding to prostate-specific membrane antigen suitable for SPECT. There are, as yet, no data concerning its use in whole-body primary staging and its interobserver variability in patients with prostate cancer (PC) prior to therapy.

Methods
A search of our clinical database from April 2013 to May 2017 yielded 93 patients with histologically confirmed cancer in whom 99mTc-MIP-1404 SPECT/CT had been performed for primary whole-body staging before therapy. Whole-body planar and SPECT/CT images of the lower abdomen and thorax had been obtained 3 to 4 hours postinjection of 706 ± 72 MBq 99mTc-MIP-1404. Images were visually analyzed for extent and location of abnormal uptake by 2 experienced nuclear physicians. Interobserver agreement for detection of primary tumor and metastatic lesions was assessed. In addition, SUVs of prostate-specific membrane antigen–positive regions of the prostate were determined in all patients, and from these, a variable reflecting total tumor load in the prostate gland was calculated (TUprostate). Follow-up reports of subsequent therapeutic interventions were available in 52 (56%) of all patients with a median follow-up of 18 months.

Results
In 90 (97%) of 93 patients, prostate uptake above background was detected as correlate of the histologically diagnosed PC. Forty-eight lymph node and 29 bone metastases were detected in 16 and 9 patients, respectively. In addition, 3 patients had disseminated bone metastases. No distant organ metastases were found. Interobserver agreement was high for the overall scan result (97%), as well as for the detection of the primary tumor (97%), of lymph node metastases (97%), and of bone metastases (99%). Recurrence of PC occurred in 5 patients in whom follow-up was available (10%). TUprostate was significantly higher in patients with Gleason scores of 8 or greater compared with patients with Gleason scores of 7 or less and at prostate-specific antigen (PSA) serum levels of 10 ng/mL or greater compared with PSA serum levels of 10 ng/mL or less. TUprostate of greater than 26 in the primary tumor predicted the occurrence of lymph node or bone metastases with a sensitivity of 82% and specificity of 76%.

Conclusions
MIP-1404 SPECT/CT has a high accuracy and low interobserver variability in the diagnosis of PC and allows detection of lymph node and bone metastases in a significant proportion of as yet untreated PC patients. TUprostate is correlated with Gleason score and PSA serum concentration and allows prediction of the occurrence of lymph node and bone metastases with moderate accuracy at primary staging.
Incidental Detection of Synchronous Lung Melanoma on 18F-FDG PET/CT in a Patient With Parotid Gland Myoepithelial Carcinoma
Authors: Parihar Ashwin Singh , GA Abhiram , Sood Karan , Seam Rajeev Kumar , Kaushal Vijay , Sood Ashwani , Kakkar Nandita , Mittal Bhagwant Rai 
Published: February 2018

Abstract
The detection of synchronous or metachronous malignancies is on the rise with the advent of whole-body 18F-FDG PET/CT. It has shown its utility in detecting second primary carcinoma in patients undergoing imaging for evaluation of primary carcinoma, influencing the management and overall survival. Primary malignant melanoma of the lung is an extremely rare entity, accounting for 0.01% of all lung tumors. It is an even rare occurrence as a synchronous malignancy. We present the case of a 33-year-old woman with primary parotid myoepithelial carcinoma and incidental detection of second primary malignant melanoma of lung during 18F-FDG PET/CT imaging.
False-Positive 18F-FDG PET/CT Due to Filgrastim That Induced Extramedullary Liver Hematopoiesis in a Burkitt Lymphoma
Authors: Maffione Anna Margherita , Rampin Lucia , Rossella Paolini , Pecori Sara , Colletti Patrick M. , Rubello Domenico 
Published: February 2018

Abstract
We report a case of Burkitt lymphoma with largely extranodal disease localizations at staging. Chemotherapy was given, thus obtaining a complete metabolic response in all previous disease sites as shown at a control PET, however associated to the appearance of new focal uptake areas in the liver; these findings were confirmed at US and MRI. Chemotherapy determined also neutropenia that was treated by filgrastim, followed by a prompt and important medullary response. Liver biopsy revealed extramedullary hematopoiesis, probably filgrastim induced. Filgrastim administration may cause false-positive findings in the liver at FDG PET.
Cognitive Aids Do Not Prompt Initiation of Cardiopulmonary Resuscitation in Simulated Pediatric Cardiopulmonary Arrests
Authors: Nelson McMillan Kristen , Rosen Michael A. , Shilkofski Nicole A. , Bradshaw Jamie Haggerty , Saliski Mary , Hunt Elizabeth A. 
Published: February 2018

Introduction
Although American Heart Association guidelines exist for proper management of cardiopulmonary arrest (CPA), in-hospital cardiopulmonary resuscitation (CPR) may be of poor quality and is not performed in all indicated situations. Cognitive aids have been created to assist in rapid, accurate recall of guidelines for pediatric CPA management.

Methods
Pediatric residents participated in individual mock codes for two years. Using a high-fidelity simulator, each resident participated in a standardized scenario that required management of both pulseless ventricular tachycardia and pulseless electrical activity. The primary study objective was to calculate the proportion of residents (a) who were not performing CPR on a simulated “pulseless” patient when cognitive aid use was first initiated and (b) who subsequently initiated CPR after cognitive aid use.

Results
One hundred thirty-two (83.5%) of 158 pediatric residents participated, and of 125 videos available for review, 107 residents (85.6%) used a cognitive aid. Mean (SD) time to cognitive aid use was 106 (100) seconds after the mannequin became pulseless. Most common immediate actions prompted by cognitive aid use were the following: defibrillation, 43 (40%) of 107; and adrenaline (epinephrine) administration, 28 (26%) of 107. Most alarmingly, 58 (54%) of 107 were not performing CPR on the pulseless patient when cognitive aid use was initiated and only two (3.4%) of 58 were subsequently prompted to initiate chest compressions.

Discussion
Cognitive aids in use during this study did not prompt timely initiation of CPR, potentially contributing to delays and errors in CPA management. Failure of these aids to prompt CPR initiation represents a “missed opportunity” to enhance performance of this vital skill.
CSF Beta-amyloid 1–42 Concentration Predicts Delirium Following Elective Arthroplasty Surgery in an Observational Cohort Study
Authors: Cunningham Emma L. , McGuinness Bernadette , McAuley Daniel F. , Toombs Jamie , Mawhinney Tim , O’Brien Seamus , Beverland David , Schott Jonathan M. , Lunn Michael P. , Zetterberg Henrik , Passmore Anthony P. 
Published: February 2018

Objective:
To test the hypothesis that APOE ε4 status and cerebrospinal fluid (CSF) Aβ42, T-tau and P-tau would independently predict the risk of postoperative delirium.

Background:
Delirium following surgery is common and associated with adverse outcomes. Age and cognitive impairment are consistent risk factors for postoperative delirium.

Methods:
This observational cohort study recruited 282 participants aged 65 years or older, without a diagnosis of dementia, admitted for primary elective hip or knee arthroplasty. Cognitive tests were undertaken preoperatively, blood and CSF were sampled at the time of spinal anesthesia, and participants were assessed daily postoperatively for delirium.

Results:
Increasing age (P = 0.04), preoperative comorbidity (P = 0.03), type of surgery (P = 0.05), intravenous opioid usage (P = 0.04), and low CSF Aβ42 (P < 0.01) were independent predictors of postoperative delirium.

Conclusions:
This study is the first to show an independent association between CSF Aβ42 and delirium incidence in an elective surgical population, suggesting that postoperative delirium may indicate incipient Alzheimer disease.
Immunomodulatory effects of plasma products on monocyte function in vitro
Authors: Shah Sanjna , Coppolino Katirina , Menocha Somaang , Beceiro Susana , Nateri Jyotsna , Spinella Philip C. , Nicol Kathleen , Hall Mark W. , Muszynski Jennifer A. 
Published: February 2018

BACKGROUND
Restoration of a balanced innate immune response is paramount to recovery from critical injury. Plasma transfusion may modulate innate immune responses; however, little is known about the immunomodulatory potential of various plasma products. We conducted in vitro experiments to determine the effects of fresh frozen plasma, thawed plasma, solvent/detergent plasma, and an investigational spray-dried solvent/detergent plasma product on monocyte function.

METHODS
Monocytes were isolated from healthy adult volunteers and cocultured with aliquots of autologous plasma (control), fresh frozen plasma, thawed plasma, solvent/detergent treated plasma, or spray-dried solvent/detergent plasma. Monocyte function was assessed by cytokine production with and without lipopolysaccharide (LPS) stimulation, and flow cytometric assessment of HLA-DR cell surface expression.

RESULTS
Monocyte cytokine production was not significantly altered after exposure to fresh frozen plasma or thawed plasma. In the absence of LPS, spray-dried solvent/detergent plasma exposure resulted in markedly increased IL-8 production compared to other plasma groups and controls (p = 0.01, analysis of variance [ANOVA]). Likewise, spray-dried SD plasma exposure resulted in higher LPS-induced IL-8, TNFα, and IL-1β production compared with autologous plasma controls (p < 0.0001; p < 0.0001, p = 0.002, respectively; ANOVA). LPS-induced IL-8 and TNFα production was lowest after exposure to solvent/detergent plasma (p < 0.0001, ANOVA).

CONCLUSION
Exposure to spray-dried solvent/detergent plasma resulted in marked augmentation of monocyte inflammatory cytokine production. Solvent/detergent plasma exposure resulted in the lowest cytokine production, suggesting lower immunomodulatory potential. Further work is needed to determine how these in vitro findings may translate to the bedside.