bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Fentanyl Nasal Packing Treatment on Patients With Acute Postoperative Pain After Nasal Operation: A Randomized Double-Blind Controlled Trial
Authors: Kim Kwan-Sub , Yeo Nam-Kyung , Kim Seong-Su , Park Woong-Sub , Kwak Su-Hyun , Cho Sang-Hyeon , Sung Gyu-Wan , Kim Hae-Sook , Yi Sang-Wook , Cho Hae Jun 
Published: March 2018

Purpose: Nasal packing is an option for bleeding control after endoscopic sinus surgery and septoplasty. Although new packing materials have been developed, patients still suffer from pain and require additional analgesics treatments. In this study, a prospective, randomized, and double-blind controlled trial was designed to evaluate the effect of fentanyl-soaked packing on pain after endoscopic sinus surgery and septoplasty. Methods: One hundred fifty-two patients who underwent nasal surgeries due to chronic rhinosinusitis or nasal septal deviation were enrolled in this study. At the end of operation, 50 mcg fentanyl-soaked biodegradable synthetic polyurethane foams packing Nasopore or Merocel were applied to a group of 79 patients, and saline-soaked ones were applied to another group of 73 patients. To evaluate the influence of fentanyl on postoperative nasal pain, patients’ conditions were assessed via means of Numeric Rating Scale, patient satisfaction, and Ramsay Sedation Scale. In addition, symptoms of headache or sore throat and any signs of cardiopulmonary-relevant indicators were monitored. Results: The fentanyl group had significantly decreased Numeric Rating Scale and increased patient satisfaction in every operation type for the majority of postoperative time periods ( P < .05) with reduced postoperative headache and sore throat compared to the control group. The fentanyl group showed a higher score on Ramsay Sedation Scale than the control group ( P < .05 in group including endoscopic sinus surgery). There were no significant differences in cardiopulmonary-relevant indicators between the 2 groups ( P > .05). Conclusion: Fentanyl group showed significantly reduced postoperative pain without serious adverse effects. We suggest that topical fentanyl application to nasal packs can be a useful method to reduce pain during the early postoperative period after endoscopic sinus surgery and septoplasty.
High-Density Otologic Camps in Regions of Sparse Expertise
Authors: Girma Bizuayehu , Bitew Asnake , Kiros Nega , Redleaf Miriam 
Published: March 2018

Aims/Purpose: When 2 models of otologic surgery instruction in Ethiopia are compared, high-density otologic surgery campaigns are more effective for accelerated skills transfer in areas of sparse expertise than the standard outpatient clinic/OR model. Methods: A continuously operating otolaryngology/head and neck surgery department in a large public hospital is compared with a nonprofit specialty hospital where outpatients are selected for weeklong surgical campaigns. The number and variety of otologic visits and operations in each setting, presence of expert supervision, and resident-trainees’ surgical progress were tallied. Results: The public hospital saw 84 otologic operations in 1 full year. Meanwhile, the ear specialty surgical campaign site saw 185 otologic operations in 6 surgical campaign weeks. All operations at both sites were performed primarily by trainees. Experienced otologists supervised 40% of operations at the public hospital and 100% at the surgical campaign site. At the end of the year, none of the 10 resident-trainees in the public hospital were able to perform a simple underlay tympanoplasty, compared to 6 of 12 resident-trainees in the campaign setting. Conclusions: Where otologic expertise is sparse, otologic surgical campaigns allow the most effective use of resources—patient pathology, medical facilities, trainee attendance, and imported instructors.
Changes in the Practice Patterns and Demographics of Ontario Dermatologists
Authors: Micieli Robert , Alhusayen Raed 
Published: March 2018

Background: Changes in the practice patterns and demographics of Canadian dermatologists remain largely unknown and would be helpful in assessing the future practice of dermatology across Canada. Objective: To assess changes in the population of Ontario dermatologists over time and the factors that influence their practice patterns, caseload, and the procedures they perform. Methods: A retrospective population-based analysis was performed using comprehensive administrative data on Ontario Health Insurance Plan insured dermatology visits and procedures from April 1, 2009, to March 31, 2015. Results: The number of dermatologists practicing in Ontario per 100 000 people increased from 1.52 (2009) to 1.62 (2014). During this period, the proportion of female dermatologists increased from 40% to 47%, and the proportion of male dermatologists decreased from 60% to 53%. The mean number of patient visits per dermatologist decreased from 6323 (2009) to 5877 (2014). Females saw a decrease from 4818 to 4181 visits, and males remained constant at 7274 to 7265 visits. Middle career dermatologists had more patient visits compared to those in their early or late career. A rural practice was associated with more patient visits compared to an urban one. The proportion of dermatologists providing nonemergency in-hospital patient services declined. The number of biopsies and malignant excisions performed increased. Conclusions: The number of dermatologists at the population level increased and the number of patient visits per dermatologist decreased. Career stage, physician sex, and practice location all affect the practice of dermatology. Future studies to assess underlying factors for these observations would be of value.
The Successful Treatment of Elephantiasis Nostras Verrucosa With Ablative Carbon Dioxide Laser
Authors: Robinson Caitlin G. , Lee Kory R. , Thomas Valencia D. 
Published: March 2018

Background and Objective: Elephantiasis nostras verrucosa (ENV) is a disfiguring skin condition that is difficult to treat. Existing treatment modalities serve to improve cosmesis or treat symptoms. Herein, we report a case of ENV with lymphocutaneous fistula successfully treated with ablative carbon dioxide laser. Study Design/Patients and Methods: A 57-year-old woman with biopsy-proven ENV with lymphocutaneous fistula was treated with ablative carbon dioxide laser to the symptomatic area of her right thigh in 3 treatment sessions over 6 months. Results: The patient had resolution of lymphocutaneous drainage as well as 90% improvement in the appearance of ENV lesions at the 1-month follow-up visit. Conclusion: Ablative carbon dioxide laser may provide cosmetic, symptomatic, and medical benefit for patients with localized ENV.
Carotid Pseudoaneurysm After Eversion Endarterectomy: A Case Report and Review of the Literature
Authors: Varetto Gianfranco , Trevisan Alessandra , Barile Giovanni , Gibello Lorenzo , Spalla Flavia , Frola Edoardo , Pennica Daniele , Rispoli Pietro 
Published: March 2018

Background: Pseudoaneurysm (PA) after carotid endarterectomy (CEA) is a rare and potentially life-threatening complication, with an incidence lower than 1%. Most of the cases described report PAs after carotid patch angioplasty and are associated with infection, often caused by Staphylococci. The management of PAs can be surgical, endovascular, or hybrid. Methods: We herein present the case of an infected carotid PA 27 days after an eversion CEA. We performed a common to internal carotid bypass with the interposition of great saphenous vein (GSV) associated with specific polyantibiotic therapy for 4 weeks. We searched the PubMed database for reviews and cases reports for patients who developed carotid PA after primary repair CEA in the period between 1969 and 2017. Results: We identified 21 cases of primary closure post-CEA PAs in the literature. In almost 60% of patients, infection was detected. Open surgery was performed in all the cases; in 1 case, an hybrid approach was preferred. In 52% of cases, a vein graft/patch or primary closure was chosen; in 3 cases, ligation was preferred, and in 1 case, a polyester graft was used. Conclusion: In our experience and with the evidence observed in the literature, open surgery with GSV interposition is the safest treatment in infected carotid PAs. The endovascular approach must be performed only in proven noninfectious cases. A bridge technique with the insertion of a stent followed by open surgery repair can be an option in emergency cases.
Mechanosensing Piezo channels in tissue homeostasis including their role in lungs
Authors: Zhong Ming , Komarova Yulia , Rehman Jalees , Malik Asrar B. 
Published: March 2018

Piezo channels are deemed to constitute one of the most important family of mechanosensing ion channels since their discovery in 2010. With recent advances in identifying their topological structure and the discovery of the agonist Yoda1 as well as the specific inhibitor GsMTx4, it is now possible to study the mechanisms by which Piezo channels are involved in physiological and pathophysiological processes. During embryonic cardiovascular development, Piezo1 senses shear stress and promotes vasculature growth. In adult mice, Piezo1 mediates the release of nitric oxide and ATP from endothelial cells to regulate blood pressure. Piezo channels also play a crucial role in cell differentiation and tissue homeostasis by exquisite mechanical force sensing.Piezo channels are also abundantly expressed in lung tissues. As the lung is exposed to complex pulmonary hemodynamics and respiratory mechanics, cells in the lung, such as microvascular endothelial cells, bear mechanical forces from blood flow shear, pulsatile strain, static pressure, and cyclic stretch due to respiratory movement. These mechanical stimuli are involved in a serial of physiological function and pathophysiological processes of the lung, many of which Piezo channels may be the key player. Mutation of genes encoding Piezo channels are also associated with hereditary human diseases, thus highlighting the critical role of Piezo channels in both tissue homeostasis and disease.
Journalists covering the refugee and migration crisis are affected by moral injury not PTSD
Authors: Feinstein Anthony , Pavisian Bennis , Storm Hannah 
Published: March 2018

Objective To explore the emotional health of journalists covering the migrations of refugees across Europe. Design Descriptive. A secure website was established and participants were given their unique identifying number and password to access the site. Setting Newsrooms and in the field. Participants Responses were received from 80 (70.2%) of 114 journalists from nine news organisations. Main outcome measures Symptoms of PTSD (Impact of Events Scale-revised), depression (Beck Depression Inventory-Revised) and moral injury (Moral Injury Events Scale-revised). Results Symptoms of PTSD were not prominent, but those pertaining to moral injury and guilt were. Moral injury was associated with being a parent ( p = .031), working alone ( p = .02), a recent increase in workload ( p = .017), a belief that organisational support is lacking ( p = .046) and poor control over resources needed to report the story ( p = .027). A significant association was found between guilt and moral injury ( p = .01) with guilt more likely to occur in journalists who reported covering the migrant story close to home ( p = .011) and who divulged stepping outside their role as a journalist to assist migrants ( p = .014). Effect sizes ( d) ranged from .47 to .71. Conclusions On one level, the relatively low scores on conventional psychometric measures of PTSD and depression are reassuring. However, our data confirm that moral injury is a different construct from DSM-defined trauma response syndromes, one that potentially comes with its own set of long-term maladaptive behaviours and adjustment problems.
Juvenile hyposomatotropism in a Somali cat presenting with seizures due to intermittent hypoglycaemia
Authors: König Maya Laura , Henke Diana , Adamik Katja , Pérez Vera Cristina 
Published: March 2018

Case summary A 3-month-old intact male Somali cat was evaluated for a history of seizures, hypoglycaemia and mental dullness 4 weeks after being bitten in the head by a dog. The cat’s body size and weight were approximately half that of his littermates and its haircoat was woolly, with fewer guard hairs. Multiple hypoglycaemic episodes were documented over a period of 4 weeks, which resolved rapidly after correction of the hypoglycaemia. Juvenile hyposomatotropism was presumptively diagnosed by demonstrating low circulating levels of insulin-like growth factor 1 and after exclusion of other endocrine and non-endocrine causes of small stature and hypoglycaemia. The cat’s intermittent hypoglycaemia resolved spontaneously within 1 month and the cat never showed any more neurological signs. Nevertheless, the physical retardation and the coat abnormalities remained unchanged. A year later, the cat was diagnosed with chronic kidney disease IRIS stage 2. Relevance and novel information Hyposomatotropism is an extremely rare feline endocrinopathy. This is the second case reported in the veterinary literature, and the only one to describe hypoglycaemic events associated with growth hormone deficiency. Although hypoglycaemia is one of the most common disease manifestations in children with pituitary dwarfism, this has not yet been reported in veterinary medicine.
Energy Absorption Contribution and Strength in Female Athletes at Return to Sport After Anterior Cruciate Ligament Reconstruction: Comparison With Healthy Controls
Authors: Boo Marie E. , Garrison J. Craig , Hannon Joseph P. , Creed Kalyssa M. , Goto Shiho , Grondin Angellyn N. , Bothwell James M. 
Published: March 2018

Background: Female patients are more likely to suffer a second anterior cruciate ligament (ACL) injury after ACL reconstruction (ACLR) and return to sport (RTS) compared with healthy female controls. Few studies have examined the energy absorption contribution (EAC) that could lead to this subsequent injury. Hypothesis: The ACLR group would demonstrate an altered EAC between joints (hip, knee, and ankle) but no difference in quadriceps, hip abduction, or hip external rotation (ER) strength at the time of RTS. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 34 female participants (ACLR: n = 17; control: n = 17) were enrolled in the study and matched for age and activity level. Jump landing performance for the initial 50 milliseconds of landing of a lateral-vertical jump was assessed using a 10-camera 3-dimensional motion capture system and 2 force plates. Isokinetic quadriceps strength was measured using a Biodex machine, and hip abduction and ER isometric strength were measured using a handheld dynamometer. All values were normalized to the participant’s height and weight. A 1-way multivariate analysis of variance was used to assess between-group differences in the EAC at the hip, knee, and ankle. Two 1-way analyses of variance were used to independently examine quadriceps, hip abduction, and hip ER strength between the groups. Results: Significant differences in the EAC were found between the groups for the involved hip ( P = .002), uninvolved hip ( P = .005), and involved ankle ( P = .023). There were no between-group differences in the EAC for the involved or uninvolved knee or the uninvolved ankle. Patients who underwent ACLR demonstrated significantly decreased quadriceps strength on the involved limb ( P = .02) and decreased hip ER strength on both the involved ( P = .005) and uninvolved limbs ( P = .002). No significant strength differences were found between the groups for the uninvolved quadriceps or for involved or uninvolved hip abduction. Conclusion: At RTS, patients who underwent ACLR utilized a greater hip EAC bilaterally and a decreased involved ankle EAC during a lateral-vertical jump. Furthermore, quadriceps strength on the involved limb and hip ER strength of bilateral lower extremities remained decreased. This could place greater stress on the ACL graft and ultimately lead to an increased injury risk.
Do Age and Weightbearing Radiographs Affect Lateral Joint Space and Fibular Height Measurements in Patients With Discoid Lateral Meniscus?
Authors: Milewski Matthew D. , Krochak Ryan , Duarte Andrew J. , Marchese Joseph W. , Kostyun Regina O. , Pace J. Lee , Broom Alexander M. , Solomito Matthew J. 
Published: March 2018

Background: Several radiographic parameters have been associated with a discoid lateral meniscus. However, limited information is available regarding the radiographic findings of a discoid meniscus in the pediatric population. Purpose: To determine the effect of age and weightbearing (WB) on radiographic parameters associated with discoid lateral menisci in pediatric patients. Study Design: Cohort study (diagnosis); Level of evidence, 3. Methods: Radiographs of pediatric patients with arthroscopically confirmed lateral discoid menisci were compared with age-, side-, and sex-matched individuals with confirmed normal menisci. Radiographic parameters of lateral joint space width (LJSW) and fibular head height (FHH) were measured by 3 physicians. Results: Significant differences were found between the discoid and control groups when LJSW ( P = .002) and FHH ( P < .001) were compared. Interrater reliability was good for LJSW (intraclass correlation coefficient [ICC], 0.635) and excellent for FHH (ICC, 0.759). WB radiographs were noted to have better interrater reliability compared with non-WB radiographs for LJSW (ICC, 0.729 vs 0.514, respectively) but had reduced interrater reliability for FHH (ICC, 0.625 vs 0.868, respectively). Subgroup analysis with age stratification indicated that FHH was significantly decreased (indicative of a high fibular head) in the discoid group for all age groups ( P < .001 for <10 years and 10-14 years; P = .030 for >14 years); however, LJSW was significantly different only in patients older than 14 years. Conclusion: Increased LJSW and FHH were associated with discoid lateral menisci and showed satisfactory interrater reliability. Radiographic evaluation for potential discoid meniscus in pediatric and adolescent patients may be improved by use of fibular height to indicate the presence of a discoid lateral meniscus across age groups, while lateral joint space may be more reliable for older patients.
Therapeutic plasma exchange for the treatment of systemic sclerosis: A comprehensive review and analysis
Authors: Harris Edward S , Meiselman Herbert J , Moriarty Patrick M , Metzger Allan , Malkovsky Miroslav 
Published: March 2018

Background: Therapeutic plasma exchange has been tried as a treatment approach for systemic sclerosis since 1978 based on the rationale that some circulating factor is involved in disease pathogenesis, for example, autoantibodies or immune complexes, and that removing the potential pathogenic factors could lead to symptom improvement. Based on our impression that clinicians and researchers are largely unaware that a large volume of research has been published about the use of therapeutic plasma exchange as a treatment for systemic sclerosis, we conducted a comprehensive review and analysis of all published research on this topic. Results: We identified 46 relevant articles that met our search criteria, involving a total of 572 patients. Of these, 19 were case studies; the rest ranged from small observational studies to prospective randomized clinical trials. In all but two studies, most patients receiving therapeutic plasma exchange showed improvements in both clinical symptoms and laboratory markers, including significant improvement in Raynaud’s symptoms and healing of digital ulceration after three to four weekly treatments. The beneficial effects from even a short course of therapeutic plasma exchange treatments were long-lasting, typically 6 months or longer. Therapeutic plasma exchange was very well tolerated. Adverse events were rare and, in almost all cases, mild and transitory. Conclusion: These results suggest that long-term therapeutic plasma exchange may offer a low-risk way to control and in some cases reverse systemic sclerosis symptoms. The mechanism for the clinical improvements seen from therapeutic plasma exchange in systemic sclerosis patients is unclear. Therefore, additional studies of therapeutic plasma exchange effects in systemic sclerosis appear to be highly desirable.
Hepcidin agonists as therapeutic tools
Authors: Casu Carla , Nemeth Elizabeta , Rivella Stefano 
Published: March 2018

Abstract
Hepcidin agonists are a new class of compounds that regulate blood iron levels, limit iron absorption, and could improve the treatment of hemochromatosis, β-thalassemia, polycythemia vera, and other disorders in which disrupted iron homeostasis causes or contributes to disease. Hepcidin agonists also have the potential to prevent severe complications of siderophilic infections in patients with iron overload or chronic liver disease. This review highlights the preclinical studies that support the development of hepcidin agonists for the treatment of these disorders.
Structures of human plasma β–factor XIIa cocrystallized with potent inhibitors
Authors: Dementiev Alexey , Silva Abel , Yee Calvin , Li Zhe , Flavin Michael T. , Sham Hing , Partridge James R. 
Published: March 2018

Key PointsThe first crystal structure of human plasma β-FXIIa in its active state is presented. The conformational lability of FXIIa is discussed. These novel structural data provide molecular insight into β-FXIIa interaction with its substrates and inhibitors.
Genetic regulation ofIL1RL1methylation and IL1RL1-a protein levels in asthma
Authors: Dijk F. Nicole , Xu Chengjian , Melén Erik , Carsin Anne-Elie , Kumar Asish , Nolte Ilja M. , Gruzieva Olena , Pershagen Goran , Grotenboer Neomi S. , Savenije Olga E.M. , Antó Josep Maria , Lavi Iris , Dobaño Carlota , Bousquet Jean , van der Vlies Pieter , van der Valk Ralf J.P. , de Jongste Johan C. , Nawijn Martijn C. , Guerra Stefano , Postma Dirkje S. , Koppelman Gerard H. 
Published: March 2018

Interleukin-1 receptor–like 1(IL1RL1) is an important asthma gene. (Epi)genetic regulation ofIL1RL1protein expression has not been established. We assessed the association betweenIL1RL1single nucleotide polymorphisms (SNPs),IL1RL1methylation and serum IL1RL1-a protein levels, and aimed to identify causal pathways in asthma.Associations ofIL1RL1SNPs with asthma were determined in the Dutch Asthma Genome-wide Association Study cohort and three European birth cohorts, BAMSE (Children/Barn, Allergy, Milieu, Stockholm, an Epidemiological survey), INMA (Infancia y Medio Ambiente) and PIAMA (Prevention and Incidence of Asthma and Mite Allergy), participating in the Mechanisms of the Development of Allergy study. We performed blood DNAIL1RL1methylation quantitative trait locus (QTL) analysis (n=496) and (epi)genome-wide protein QTL analysis on serum IL1RL1-a levels (n=1462). We investigated the association ofIL1RL1CpG methylation with asthma (n=632) and IL1RL1-a levels (n=548), with subsequent causal inference testing. Finally, we determined the association of IL1RL1-a levels with asthma and its clinical characteristics (n=1101).IL1RL1asthma-risk SNPs strongly associated withIL1RL1methylation (rs1420101; p=3.7×10−16) and serum IL1RL1-a levels (p=2.8×10−56).IL1RL1methylation was not associated with asthma or IL1RL1-a levels. IL1RL1-a levels negatively correlated with blood eosinophil counts, whereas there was no association between IL1RL1-a levels and asthma.In conclusion, asthma-associatedIL1RL1SNPs strongly regulateIL1RL1methylation and serum IL1RL1-a levels, yet neither theseIL1RL1-methylation CpG sites nor IL1RL1-a levels are associated with asthma.