bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Response and Complications are not Associated with Drug Levels in Patients with Severe Ulcerative Colitis on IV Cyclosporine Induction Therapy
Authors: Patel Parita , Yarur Andres , Dalal Sushila , Sakuraba Atsuhi , Rubin David T , Hanauer Stephen B , Hanan Ira , Raffals Laura H , Cohen Russell D , Pekow Joel 
Published: March 2018

Abstract

Background
IV ciclosporin therapy is effective in steroid-refractory ulcerative colitis. The optimal drug level to achieve response and minimize complications during induction therapy is not known.

Aim
The primary aim was to evaluate if serum ciclosporin drug levels are associated with increased risk of colectomy within 90 days of hospitalization. Secondary aims were to determine if ciclosporin levels are associated with avoidance of colectomy at 7 and 30 days, if ciclosporin levels are associated with drug-related and postoperative complications, and if patient-specific factors are associated with response to ciclosporin.

Methods
We conducted a retrospective analysis of 81 hospitalized patients with steroid-refractory ulcerative colitis treated with ciclosporin. Risk factors for colectomy within 7, 30, and 90 days, medication-specific and postoperative complications were compared by first, mean, and peak ciclosporin level during IV induction therapy.

Results
There were 47 patients (58%) who underwent surgery. There were no differences between initial, mean, and peak ciclosporin levels among responders and nonresponders and treatment-related or postoperative complications. Responders within 90 days had lower C-reactive-protein levels (20mg/L vs. 38mg/L, P = 0.01), lower serum albumin concentrations (3.4g/dL vs. 3.7g/dL, P = 0.03), and higher rates of kidney injury (50% vs 17%, P = 0.002).

Conclusion
Initial, mean, and peak serum levels of ciclosporin did not correlate with response or toxicity. However, C-reactive-protein levels levels and kidney injury may be helpful in predicting clinical response to ciclosporin.
A201 PREVALENCE OF NONALCOHOLIC FATTY LIVER DISEASE IN A COHORT OF HEALTHY CHILDREN IN ONTARIO
Authors: Dhaliwal J , Chavhan G , Wales P , Mouzaki M 
Published: March 2018

Abstract

Aims
To determine the prevalence of hepatic steatosis in a cohort of previously healthy children and adolescents, with the use of abdominal computer tomography (CT).

Methods
Retrospective review of the Sickkids trauma database from (year 2004 to 2015). Inclusion criteria: previously healthy children ages 1-17yr having undergone an abdominal CT scan as a part of routine trauma assessment. Exclusion criteria: Involvement of spleen and/or liver in the injury, known metabolic condition, concurrent use of medications that could predispose to hepatic steatosis. Steatosis was defined as a liver spleen attenuation index (L/S AI) of &lt;0.8. Anthropometrics and baseline demographics were collected. Statistical analyses were performed using Graphpad Prism 7.

Results
A total of 143 children were included in the analyses with a mean (SD) age of 7.12(4.26) years. 88 children were male (7.10(4.24) years old). The mean (SD) weight z score was 0.48 (0.97). Fifteen percent of the 137 children with a weight z-score between -2 to 2 had evidence of hepatic steatosis on imaging (using liver/spleen index &lt;0.8). Twenty seven percent (6/22) of children with weight z-scores less than the 33rd percentile had L/S AI &lt;0.8. An inverse correlation between weight z-scores and L/S AI was found in children &gt;10 years (P&lt;0.016) (Fig 1); however there was no correlation in pre-pubertal children (P&lt;0.374).

Conclusions
Hepatic steatosis is highly prevalent in this cohort of healthy children in Ontario. Larger population based studies are needed to investigate the prevalence of hepatic steatosis in children across Canada.

Funding Agencies
None
E-cigarettes: A new hazard for children and adolescents
Authors: Richmond Sarah A , Pike Ian , Maguire Jonathon L , Macpherson Alison 
Published: March 2018

AbstractObjectivesElectronic cigarettes and fluid (e-cigarettes, e-fluid) are hazardous materials that when inhaled or ingested may pose significant health risks to children and adolescents. The objective of this work was to explore the spectrum of injury related to e-cigarette exposure among Canadian children and adolescents.MethodsA one-time survey was sent to all paediatricians in Canada. Information was collected on children and adolescents who presented with e-cigarette exposure (inhalation and ingestion cases) in the previous 12 months. Questions included the number of injuries and symptoms, in addition to age, sex, treatment setting, intentional e-cigarette use and how the products were accessed.ResultsA total of 520 surveys were completed and returned, identifying 220 cases. Symptoms related to inhalation were present in 135 cases (43 unintentional, 92 intentional) and in 85 ingestion cases (35 unintentional, 50 intentional). For inhalation cases, most were male, aged 15 to 19 years, who sought treatment for nausea/vomiting, cough, throat irritation or acute nicotine toxicity in an outpatient clinic/office. Most inhalation cases reported e-cigarette use 2 to 3 days/week, and e-cigarettes purchases from a mall kiosk/store. For ingestion cases, most were male, aged 1 to 4 years presenting to an emergency department with nausea/vomiting, cough or respiratory irritation. Younger cases accessed e-fluid at home, older cases purchased in a mall kiosk/store. E-fluid flavours reported consumed were fruit, candy, and tobacco.ConclusionsE-cigarettes, recently introduced into the North American market are hazardous to children and adolescents. Further investigation into the risks that e-cigarettes pose and ways to reduce exposure is needed to minimize injury.
Methotrexate
Authors: Malakouti Mona , Hoxie Dana , No Daniel J. , Jacob Sharon E. 
Published: March 2018

ABSTRACT
A drug is defined as a medicine or substance that causes a physiologic effect on the body. A drug can be administered by various routes including oral, intravenous, intramuscular, topical, transdermal, or subcutaneous. The purpose of this section is to focus on common drugs used in dermatology, the drugs’ mechanisms of action, their indications and function, and adverse effects. The focus of this article is methotrexate and its usefulness in treating psoriasis as well as its adverse effects.
Risk Factors Linking Esophageal Squamous Cell Carcinoma With Head and Neck Cancer or Gastric Cancer
Authors: Onochi Kengo , Shiga Hisashi , Takahashi So , Watanabe Noboru , Fukuda Sho , Ishioka Mitsuaki , Koizumi Shigeto , Matsuhasi Tamotsu , Jin Mario , Iijima Katsunori 
Published: March 2018

Goals:
To investigate retrospectively the risk factors for synchronous and metachronous cancers in the upper gastrointestinal tract in patients with superficial esophageal squamous cell carcinoma (ESCC).

Background:
In patients who have received endoscopic resection (ER) for ESCC, synchronous and metachronous cancers are frequently detected not only in the esophagus but also in the head and neck area and the stomach.

Study:
A total of 285 patients who received ER for superficial ESCC were enrolled in this analysis. These patients were periodically followed-up endoscopically. Cumulative occurrence rates of the metachronous second primary cancers were determined by Kaplan-Meier method. Risk factors for synchronous and metachronous cancers in the head and neck area and the stomach were determined by logistic regression analyses.

Results:
During a mean follow-up period of 76 months, the 5-year cumulative occurrence of metachronous esophageal, head and neck, and stomach cancer was 14.0%, 2.8%, and 4.1%, respectively. Although the presence of multiple lugol-voiding lesions in the esophagus was a significant risk factor for synchronous and metachronous head and neck cancers (odds ratio, 3.8; 95% confidence interval, 1.7-9.0), older age (>65 y) was a significant risk factor for synchronous and metachronous gastric cancer (odds ratio, 3.1; 95% confidence interval, 1.2-9.3).

Conclusions:
The risk factors for the cooccurrence of head and neck cancer and that of gastric cancer in patients with ESCC differ. This information will likely be useful for managing patients who have been treated with ER for ESCC and who possess carcinogenic potential throughout the upper gastrointestinal tract.
Surgical Management and Evaluation of the Craniofacial Growth and Morphology in Cleidocranial Dysplasia
Authors: Greene Stephen L. , Kau Chung How , Sittitavornwong Somsak , Powell Kathlyn , Childers Noel K. , MacDougall Mary , Lamani Ejvis 
Published: March 2018

Abstract
Cleidocranial dysplasia (CCD, MIM 119600) is a rare autosomal dominant disorder affecting bone, cartilage, craniofacial growth, and tooth formation leading to supernumerary teeth. Few reports delineate the genotype–phenotype correlations related to the variations in craniofacial morphology and patterning of the dentition and the complexity of treating patient's malocclusion. Successful management of the craniofacial deformities in patients with CCD requires a multidisciplinary team of healthcare specialists. Approximately 70% of patients are due to point mutations in RUNX2 and <20% due to copy number variations with the remainder unidentified. There is no literature to date, describing the orthognathic management of CCD patients with deletion in one of the RUNX2 alleles. The purpose of this study was to evaluate the craniofacial morphology and dental patterning in a 14-year-old Caucasian female with CCD resulting from a novel microdeletion of RUNX2 in 1 allele. The CCD patient with RUNX2 haploinsufficiency due to microdeletion had decreased craniofacial bone and ankyloses in the permanent dentition. An altered extraction protocol of supernumerary teeth was followed in this patient. Craniofacial growth and morphologic analysis demonstrated atypical skull shape, persistent metopic suture, and decreased mandibular size.
Does Pediatric Obstructive Sleep Apnea Syndrome Cause Systemic Microvascular Dysfunction?
Authors: Koçak Hasan Emre , Acipayam Ayşe Şermin Filiz , Acipayam Harun , Erdoğan Bilgen Çakil , Elbistanli Mustafa Suphi , Kaya Kamil Hakan 
Published: March 2018

Abstract
The aim of this study was to evaluate whether pediatric obstructive sleep apnea syndrome (OSAS) secondary to adenoid hypertrophy causes systemic microvascular dysfunction. This is a prospective single-blinded case–control study. As the patient group, 81 patients diagnosed to have OSAS secondary to adenoid hypertrophy at our hospital between January 2016 and May 2016; as the control group, 26 healthy pediatric volunteers who presented to the hospital for health screening were included in this study. Three groups of OSAS patients were defined as mild, moderate, and severe respectively, according to the lateral nasopharynx x-ray. Patients with comorbid diseases were excluded from the study. For microvascular dysfunction, videocapillaroscopic evaluation was performed at the nailfold and capillary density (CD) and postocclusive reactive hyperemia (PORH) values were measured and statistical analysis between the groups was performed. The duration of complaints in all patients with OSAS was at least 6 months and <1 year. CD measurement in the control group and mild, moderate, and severe OSAS group was 94.1 ± 7.9, 96.9 ± 11, 94.7 ± 8.4, and 93.7 ± 9.4, respectively, with no significant difference between the groups (P > 0.05). PORH measurement in the control group and mild, moderate, and severe OSAS group was 95.6 ± 8.6, 97.9 ± 10.1, 96 ± 8.7, and 93.9 ± 9.3, respectively, with no significant difference between the groups (P > 0.05). OSAS secondary to adenoid hypertrophy in pediatric patients was demonstrated to cause no dysfunction in microvascular circulation and carried no cardiovascular risk in the early period.
Influence of Backscatter Radiation on Cranial Bone Fixation Devices
Authors: Sakamoto Yoshiaki , Koike Naoyoshi , Takei Hideyuki , Ohno Mari , Shigematsu Naoyuki , Kishi Kazuo 
Published: March 2018

Abstract
Postoperative radiation can cause ulcer formation, leading to the denudation of skin over alloplastic materials. The influence of backscatter radiation from fixation devices has not been investigated. The aim of this study is to evaluate backscatter dose variations for different cranial bone fixation devices in an experimental model designed to simulate postoperative radiotherapy. The authors assessed the radiation backscatter doses associated with resorbable (PLLA-PGA) and titanium plates. The samples were irradiated with 6 and 10 MV photon beams from a linear accelerator. Measurements were obtained using an ionization chamber and radiochromic films cut from the same batch. As a result, the backscatter radiation of water and PLLA-PGA proportionally decreased as the depth increased. However, the backscatter radiation of the titanium plate increased just above the plate. This depth lies in the region of the scalp. Each material showed a dose of radioactivity that was higher at 10 MV than that at 6 MV. These devices showed a significant difference, which suggested that these materials amplified the dose compared with water at 6 MV. In conclusion, it is supposed that PLLA-PGA should be used to fix the cranium to decrease the potential for radiation ulcers.
Comparing the Efficacy of Peritonsillar Injection of Tramadol With Honey in Controlling Post-Tonsillectomy Pain in Adults
Authors: Hatami Maryam , Mirjalili Mahdieh , Ayatollahi Vida , Vaziribozorg Sedighe , Zand Vahid 
Published: March 2018

Introduction:
The authors investigated the effect of honey on post-tonsillectomy pain and compare its efficacy with tramadol.

Methods:
This clinical trial was performed on 60 patients with American Society of Anesthesia I and II aged between 18 and 55 years and underwent tonsillectomy. Induction of anesthesia was carried out using 2 mg/kg propofol and 0.5 atracurium following 1.5 μg/kg fentanyl administration. Group B was given tramadol at dose of 2 mg/kg and with volume of 4 mL and Group A was given normal saline with the same volume 2 mL of medications were injected using needle (25) into tonsil bed and anterior old of each tonsil by an anesthesiologist. Three minutes after injection, the surgery was performed by the same ENT residents for all patients. In the recovery room Group B received antibiotics and oral acetaminophen. Group A was given antibiotics, oral acetaminophen, and honey dissolved in 40 mL warm water every 6 hours from when the patient was fully awake. Patients in Group A were told to eat honey 3 times a day 7 days postoperatively. Pain was scored using Numeric Rating Scale at the time points of 2, 6, 12, and 24 hours as well as 3 and 7 days postoperatively. Moreover, the healing status and epithelialization degree of tonsillar bed were considered on 1 and 7 days after the surgery by ENT specialist.

Results:
The mean of pain score was significantly higher in Group A within 24 hours postoperatively as compared with Group B (P < 0.01). The mean of pain score was lower in Group B after 3 and 7 days but this difference was not statistically significant (P > 0.05). Considering restoration status and epithelialization degree of tonsillar bed on the 1st and 7th days, there was no statistically significant difference between 2 groups; however, tonsillar bed healing process was better in Group B on the 7th day.

Conclusion:
The current investigation confirmed the positive impact of tramadol on post-tonsillectomy pain relief in adults. The authors also found that honey can be used as a complementary treatment along with acetaminophen and other analgesics for reducing post-tonsillectomy pain. Considering honey impact on wound healing and its anti-inflammatory effect, it is suggested for relieving complications after surgery.
Ruptured Pseudoaneurysm of the Maxillary Artery and Its Branches Following Le Fort I Osteotomy: Evidence-Based Guidelines
Authors: Bykowski Michael R. , Hill Amber , Garland Catherine , Tobler William , Losee Joseph E. , Goldstein Jesse A. 
Published: March 2018

Background:
Although rare, pseudoaneurysms (PA) can develop following Le Fort I osteotomy and lead to life-threatening hemorrhage. However, the typical presentation of a PA following a Le Fort I osteotomy is not well characterized. Evidence-based guidelines are not currently available for evaluation of PA following Le Fort I osteotomy.

Methods:
A case report is presented of a 27-year-old man who underwent Le Fort I advancement and subsequently developed a bleeding PA. A comprehensive search of journal articles was performed using the MEDLINE/PubMed database between 1964 and April 2016. Keywords and phrases used were “(osteotomy OR craniofacial OR orthognathic) AND (pseudoaneurysm OR aneurysm OR epistaxis).” Preferred Reporting Items for Systematic Reviews and Meta- Analyses (PRISMA) guidelines were followed.

Results:
The literature search yielded 13 reports of 18 patients. All 18 patients underwent Le Fort I osteotomy and subsequently developed a delayed postoperative bleeding PA. All studies were level IV or V evidence. Twenty-eight percent (N = 5) of the cases documented “excessive” intraoperative bleeding or more than 500 mL of estimated blood loss. The average time for the first bleeding episode and time until final bleed was 17.3 ± 14.3 days (range: 3–62 days) and 27.8 ± 21.2 days following surgery (range: 6–77 days), respectively. Sixty-seven percent (N = 12) had multiple episodes of bleeding. The duration between the bleeding events averaged 10.6 (± 7.9 days) with a range of 1 to 35 days. Bleeding PA's were treated with image-guided embolization (15/18 patients; 83.3%) or ligation or clamping (3/18 patients; 16.7%).

Conclusion:
In the setting of recurrent and/or delayed postoperative epistaxis following Le Fort I osteotomy, surgeons should maintain a high clinical suspicion for PA. Ruptured PA's are often preceded by multiple episodes of progressively worsening epistaxis. Based on the presented case report and pooled data from the literature, angiography is recommended to evaluate for PA in the setting of recurrent epistaxis following Le Fort I osteotomy, especially within the first 4 weeks following surgery.
Impairments in sensory-motor gating and information processing in a mouse model of Ehmt1 haploinsufficiency
Authors: Davis Brittany A. , David François , O’Regan Ciara , Adam Manal A. , Harwood Adrian J. , Crunelli Vincenzo , Isles Anthony R. 
Published: March 2018

ABSTRACTRegulators of chromatin dynamics and transcription are increasingly implicated in the aetiology of neurodevelopmental disorders (NDDs). Haploinsufficiency of EHMT1, encoding a histone methyl-transferase, is associated with several NDDs, including Kleefstra syndrome, developmental delay and autism spectrum disorder. Using a mouse model of Ehmt1 haploinsufficiency (Ehmt1D6Cre/+), we examined a number of brain and behavioural endophenotypes of relevance to NDDs. Specifically, we show that Ehmt1D6Cre/+ mice have deficits in information processing, evidenced by abnormal sensory-motor gating, a complete absence of object recognition memory and a reduced magnitude of auditory evoked potentials in both paired-pulse inhibition and mismatch negativity (MMN). The electrophysiological experiments show that differences in magnitude response to auditory stimulus were associated with marked reductions in total and evoked beta- and gamma-band oscillatory activity, as well as significant reductions in phase synchronisation. The pattern of electrophysiological deficits in Ehmt1D6Cre/+ matches those seen in control mice following administration of the selective NMDA-R antagonist, ketamine. This, coupled with reduction of Grin1 mRNA expression in Ehmt1D6Cre/+ hippocampus, suggests that Ehmt1 haploinsufficiency may lead to disruption in NMDA-R. Taken together, these data indicate that reduced Ehmt1 dosage during forebrain development leads to abnormal circuitry formation, which in turn results in profound information processing deficits. Such information processing deficits are likely paramount to our understanding of the cognitive and neurological dysfunctions shared across the NDDs associated with EHMT1 haploinsufficiency.
Crossbrowse: A versatile genome browser for visualizing comparative experimental data
Authors: Shenker Sol , Lai Eric 
Published: March 2018

AbstractThe recent beyond-exponential growth in diverse collections of deep sequencing datasets creates enormous opportunities for discovery, concomitant with new challenges for displaying and interpreting these data. Notably, the availability of scores of whole genome sequences in multiple species clades enables comparative studies of functional elements. However, current genome browsers do not permit effective visualization of multigenome experimental data. Here, we present CrossBrowse, a standalone desktop application for displaying and browsing cross-species genomic datasets. We utilize data standards and graphic representation of popular browsers, and incorporate an intuitive graphical visualization of genome synteny that facilitates and drives human interrogation of comparative data. Our platform permits users with minimal informatics capacity to select arbitrary sets of genomes for display, upload and configure multiple datasets, and interact with vertebrate-sized genomic datasets in real-time. We illustrate the utility of CrossBrowse with interrogation of comparative invertebrate and mammalian datasets that provide insights into diverse aspects of transcriptional and post-transcriptional regulation. Of note, we show examplars of both preservation and divergence of functional elements that cannot be inferred from sequence alignments alone. Moreover, we demonstrate how inspection of primary data using CrossBrowse exposes an artifact in a typical strategy for assigning species-specific functional elements, and drives the implementation of an improved computational strategy. We anticipate that CrossBrowse will greatly foster user-based discovery within multispecies genomic datasets, and inform their bioinformatic interpretation.
Sexual selection and inbreeding: two efficient ways to limit the accumulation of deleterious mutations
Authors: Noël E. , Fruitet E. , Lelaurin D. , Bonel N. , Ségard A. , Sarda V. , Jarne P. , David P. 
Published: March 2018

AbstractTheory and empirical data showed that two processes can boost selection against deleterious mutations, thus facilitating the purging of the mutation load: inbreeding, by exposing recessive deleterious alleles to selection in homozygous form, and sexual selection, by enhancing the relative reproductive success of males with small mutation loads. These processes tend to be mutually exclusive because sexual selection is reduced under mating systems that promote inbreeding, such as self-fertilization in hermaphrodites. We estimated the relative efficiency of inbreeding and sexual selection at purging the genetic load, using 50 generations of experimental evolution, in a hermaphroditic snail (Physa acuta). To this end, we generated lines that were exposed to various intensities of inbreeding, sexual selection (on the male function) and nonsexual selection (on the female function). We measured how these regimes affected the mutation load, quantified through the survival of outcrossed and selfed juveniles. We found that juvenile survival strongly decreased in outbred lines with reduced male selection, but not when female selection was relaxed, showing that male-specific sexual selection does purge deleterious mutations. However, in lines exposed to inbreeding, where sexual selection was also relaxed, survival did not decrease, and even increased for self-fertilized juveniles, showing that purging through inbreeding can compensate for the absence of sexual selection. Our results point to the further question of whether a mixed strategy combining the advantages of both mechanisms of genetic purging could be evolutionary stable.