bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Evaluation of PROMIS in Patients With Primary or Metastatic Spine Tumors
Authors: Bernstein David N. , Bakhsh Wajeeh , Papuga Mark Owen , Menga Emmanuel N. , Rubery Paul T. , Mesfin Addisu 
Published: November 2018

Study Design.
Retrospective evaluation of prospectively collected data.

Objective.
In spine tumor patients: i) to assess the correlation of Patient-reported Outcomes Measurement Information System (PROMIS) physical function (PF), pain interference (PI), and Depression scores with Oswestry Disability Index (ODI) and Neck Disability Index (NDI) scores; and ii) to assess ceiling and floor effects of PROMIS PF, PI, and Depression domains and the ODI/NDI.

Summary of Background Data.
There remains no widely used patient-reported outcome (PRO) instrument for spine tumor patients. PROMIS, a universal PRO tool, may add notable value to patient care. A paucity of work exists comparing PROMIS to legacy PRO tools in primary and metastatic spine tumor patients.

Methods.
Patients confirmed to have a primary or metastatic spine tumor were asked to complete PROMIS PF, PI, and Depression domains and either an ODI or NDI questionnaire between May 2015 and December 2017. Pearson correlation coefficients (r) were calculated. Ceiling and floor effects were determined. P < 0.05 was significant.

Results.
Eighty unique visits from 51 patients with spine tumors (44 metastatic/67 visits; 7 primary/13 visits) met our inclusion criteria. A strong correlation existed between PROMIS PI and the ODI/NDI in both primary and metastatic tumor patient subgroups (range, r = 0.75–0.86, P < 0.05). PROMIS PF and the ODI/NDI demonstrated a strong correlation among all patients (r = –0.75, P < 0.05) and in the metastatic disease subgroup (r = –0.78, P < 0.05). A strong correlation existed between PROMIS Depression and the ODI/NDI in the primary tumor subgroup (r = 0.79, P < 0.05). PROMIS Depression demonstrated the largest floor effect (13.6%); there were similar ceiling effects.

Conclusion.
PROMIS PF and PI domains correlate well with the ODI/NDI in spine tumor patients and have a similar ceiling effect but decreased floor effect. PROMIS Depression was not as well captured, except in the primary tumor subgroup.

Level of Evidence: 2
The Influence of Body Mass Index on Functional Outcomes, Satisfaction, and Return to Work After Single-level Minimally-invasive Transforaminal Lumbar Interbody Fusion
Authors: Goh Graham Seow-Hng , Liow Ming Han Lincoln , Yeo William , Ling Zhixing Marcus , Yue Wai Mun , Guo Chang Ming , Tan Seang Beng 
Published: November 2018

Study Design.
Retrospective study using prospectively collected registry data.

Objectives.
To evaluate the effect of obesity on patient-reported outcome measures of pain, disability, quality of life, satisfaction, and return to work after single-level minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF).

Summary of Background Data.
MIS-TLIF is an appealing alternative for obese patients with potentially lower complication risk. However, there is limited data investigating the influence of obesity on outcomes 5 years after MIS-TLIF.

Methods.
Prospectively collected registry data of 296 patients who underwent single-level MIS-TLIF at a single institution were reviewed. Patients had complete 2- and 5-year follow-up data. Patients were stratified into control (<25.0 kg/m2), overweight (25.0–29.9 kg/m2), and obese (≥30.0 kg/m2) groups. Outcomes assessed were visual analogue scale for back pain, leg pain, Oswestry Disability Index, Short-form 36, North American Spine Society score for neurogenic symptoms, return to work (RTW), return to function (RTF), satisfaction, and expectation fulfilment. Length of operation, length of stay, and comorbidities were recorded.

Results.
Among the patients, 156 (52.7%) had normal weight, 108 (36.5%) were overweight, and 32 (10.8%) were obese. There was no difference in length of operation or hospitalization (P > 0.05). All three groups had comparable preoperative scores at baseline (P > 0.05). At 5 years, the control group had significantly higher PCS compared with the overweight (P = 0.043) and obese groups (P = 0.007), although the change in scores was similar (P > 0.05). The rate of MCID attainment, RTW, RTF, expectation fulfilment, and satisfaction was comparable.

Conclusion.
Nonobese patients had better physical well-being in the mid-term, although obese patients experienced a comparable improvement in clinical scores. Obesity had no impact on patients’ ability to RTW or RTF. Equivalent proportions of patients were satisfied and had their expectations fulfilled up to 5 years after MIS-TLIF.

Level of Evidence: 3
The Anatomic Characteristics of the Retroperitoneal Oblique Corridor to the L1-S1 Intervertebral Disc Spaces
Authors: Wang Kai , Zhang Can , Wu Hao , Chen Zan , Chou Dean , Jian Fengzeng 
Published: November 2018

Study Design.
This is a cross-sectional study.

Objective.
To investigate the oblique corridor to the L1-S1 intervertebral disc space between the psoas muscle and the great vessels in cadaveric specimens bilaterally and the location of genitofemoral nerve and the diaphragmatic crura relative to the oblique corridor.

Summary of Background Data.
Although use of oblique lumbar interbody fusion is rapidly expanding, the morphometric data related to the procedure are limited.

Methods.
Twelve fresh-frozen full-torso cadaveric specimens were dissected to examine the oblique corridor to access the L1-S1 space in a static state and with mild retraction of the psoas. The level at which the genitofemoral nerve pierces from the psoas major and the diaphragmatic crura originate from the lumbar vertebral body was also investigated.

Results.
The mean width of oblique corridor in the static state and with mild psoas retraction, respectively, were as follows: on the right side: (L1–2) 13.33 and 16.75 mm; (L2–3) 15.42 and 21.42 mm; (L3–4) 16.58 and 22.67 mm; (L4–5) 12.75 and 21.17 mm; (L5–S1) 5.92 and 12.00 mm; on the left side: (L1–2) 16.75 and 19.67 mm; (L2–3) 18.50 and 25.33 mm; (L3–4) 20.58 and 28.00 mm; (L4-5) 18.17 and 26.08 mm; and (L5-S1) 5.83 and 12.00 mm. The level at which the genitofemoral nerve pierces from the psoas major was between L2 and L4. The diaphragmatic crura originates from L1 to L3.

Conclusion.
The oblique corridor allows access to the L1-L5 discs from both sides, but it is larger on the left side. The corridor between the iliac vessels and the psoas for L5-S1 is difficult to be applied clinically. Mild psoas retraction can moderately enlarge the oblique corridor. The genitofemoral nerve and diaphragmatic crura may be encountered in this approach and should be carefully observed.

Level of Evidence: 5
Late-Onset Nevus Comedonicus With Follicular Epidermolytic Hyperkeratosis—Case Report and Review of the Literature
Authors: Zanniello Ramona , Pilloni Luca , Conti Brunella , Faa Gavino , Rongioletti Franco 
Published: November 2018

Abstract:
Nevus comedonicus is a rare cutaneous follicular hamartoma, characterized by the clustering of papules with firm, blackened horny buffers. It is usually present at birth or during childhood, although few cases of late-onset disease have been described. We present a case of postmenopausal-onset nevus comedonicus in a 55-year-old white woman without relevant medical history. Skin biopsy showed the typical features of several cyst-dilated follicular structures occupied by keratotic material and the peculiar finding of epidermolytic hyperkeratosis of the follicular epithelial walls. A brief review of the clinical and histological features of other similar cases published in the literature is performed.
A Pilot Project Using Pediatricians as Initial Diagnosticians in Multidisciplinary Autism Evaluations for Young Children
Authors: Ahlers Kaitlyn , Gabrielsen Terisa P. , Ellzey Allison , Brady Anna , Litchford April , Fox Jason , Nguyen Quang-Tuyen , Carbone Paul S. 
Published: November 2018

ABSTRACT:

Objectives:
Wait times for autism spectrum disorder (ASD) evaluations are long, thereby delaying access to ASD-specific services. We asked how our traditional care model (requiring all patients to see psychologists for ASD diagnostic decisions) compared to an alternative model that better utilizes the available clinicians, including initial evaluation by speech, audiology, and pediatrics (trained in Level 2 autism screening tools). Pediatricians could diagnose immediately if certain about diagnosis but could refer uncertain cases to psychology. Accuracy and time to diagnosis, charges, and parent satisfaction were our main outcome measures.

Methods:
Data were gathered through record extraction (n = 244) and parent questionnaire (n = 57). We compared time to diagnosis, charges, and parent satisfaction between traditional and alternative models. Agreement between pediatrician and psychologist diagnoses was examined for a subset (n = 18).

Results:
The alternative model's time to diagnosis was 44% faster (85 vs 152 d) and 33% less costly overall. Diagnostic agreement was 93% for children with ASD diagnoses and 100% for children without ASD diagnoses. Pediatricians expressed higher diagnostic certainty about children with higher levels of ASD symptoms. Parents reported no differences in high satisfaction with experiences, family-centered care, and shared decision making.

Conclusion:
Efficient use of available clinicians with additional training in Level 2 autism screening resulted in improvements in time to diagnosis and reduced charges for families. Coordination of multidisciplinary teams makes this possible, with strategic sequencing of patients through workflow. Flexibility was key to not only allowing pediatricians to refer uncertain cases to psychology for diagnosis but also allowing for diagnosis by a pediatrician when symptomatic presentation clearly met diagnostic criteria.
Diagnostic Uncertainty in a Complex Young Man: Autism Versus Psychosis
Authors: Fogler Jason , Kuhn Jocelyn , Prock Lisa , Radesky Jenny , Gonzalez-Heydrich Joseph 
Published: November 2018

CASE:
James is a 7½-year-old boy born in Vietnam to a mother with mental illness. Little is known about his early history; he spent the first 6 months of his life in an orphanage, followed by foster care and a disrupted adoption. He moved to the U.S. at age 1½ and joined his current adoptive family at age 4 years. Shortly thereafter, James' psychiatric nurse practitioner diagnosed him with attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). Pragmatic language and syntax deficits were also noted from an early age.
James is now exhibiting anxiety, perseverative beliefs, and regression in his toileting. He began “talking to himself in his room” and using neologisms. A school-based evaluation resulted in educational diagnoses of ADHD and ASD based on social disconnectedness and invading others' personal space. James' parents felt “something else was going on” and sought a second opinion with a multidisciplinary team (consisting of a pediatric psychologist and a developmental pediatrician). Considering James' history, previous assessments, and their assessment battery (Behavior Assessment System for Children, Behavior Rating Inventory of Executive Function, and Autism Diagnostic Observation Schedule, and Rorschach Inkblot Test), the team characterized his current symptoms as an emerging psychotic disorder.
Several consultations occurred over the next 9 months of the school term. First, clinicians in the psychiatry department confirmed symptoms of functional decline, cognitive disorganization, and hallucinations, which were attributed to post-traumatic stress rather than a psychotic disorder. Second, adding to the diagnostic uncertainty, when James started an atypical antipsychotic medication and was under good symptom control, the school team believed that ADHD—not psychosis—best accounted for his presentation. There was significant contention between the medical team and consulting school psychologist regarding the extent to which data from the parental history and Rorschach should be considered in formulating the patient's diagnosis.
Two-and-a-half years later, James was weaned off risperidone to manage a new side effect of tics. He subsequently manifested significant paranoia with reactive aggression toward peers for imagined slights and insults that he could “swear he heard.” A different school-contracted psychologist's re-evaluation corroborated the diagnosis of schizophrenia based on the several years of unfolding clinical observations. Acting from the supposition that early-onset psychosis was too rare and too stigmatizing a condition to apply to a “kid who's just having trouble paying attention,” the first school psychologist remained adamant that ADHD and ASD were the most appropriate diagnoses, and James would be ill-served “pumped full of neuroleptics.”
He returns now to the original Developmental Behavioral Pediatric consulting team. What would you do to try to bridge this impasse?
Increased Risk of Inflammatory Bowel Disease in Families with Tonsillectomy
Authors: Bager Peter , Gørtz Sanne , Feenstra Bjarke , Nyboe Andersen Nynne , Jess Tine , Frisch Morten , Melbye Mads 
Published: November 2018

Background:
The possible etiologic link between tonsillectomy and inflammatory bowel diseases remains unclear. To investigate the hereditary component, we assessed the risk of inflammatory bowel disease after own tonsillectomy as well as after tonsillectomy among family members.

Methods:
A nationwide Danish cohort of 7,045,288 individuals was established and linked to comprehensive national registers with data on kinship, tonsillectomy surgery, and diagnosis of inflammatory bowel disease from all health sectors. We used Poisson regression models to estimate hospital contact rate ratios (RR) for Crohn’s disease and ulcerative colitis, with 95% confidence intervals (CI), between individuals with or without tonsillectomy, as well as between individuals with or without tonsillectomized relatives.

Results:
During 189 million person-years of follow-up between 1977 and 2014, 276,673 individuals were tonsillectomized, 22,015 developed Crohn’s disease, and 49,550 developed ulcerative colitis. Rates of inflammatory bowel disease were elevated up to 20 years after own tonsillectomy (Crohn’s disease: RR 1.52 [95% CI = 1.43, 1.61]; ulcerative colitis: RR 1.24 [95% CI = 1.18, 1.29]). RRs for Crohn’s disease was 1.22 (95% CI = 1.17, 1.27) after first-degree relatives’ tonsillectomy, 1.14 (95% CI = 1.08, 1.19) after second-degree relatives’ tonsillectomy, and 1.08 (95% CI = 1.01, 1.15) after third-degree relatives’ tonsillectomy. Corresponding RRs for ulcerative colitis were 1.10 (95% CI = 1.07, 1.13), 1.05 (95% CI = 1.01, 1.08), and 1.03 (95% CI = 0.98, 1.09).

Conclusions:
Even individuals with tonsillectomized family members were at increased risk of inflammatory bowel disease. These findings call into question a direct influence of tonsillectomy on gastrointestinal inflammation and point instead toward shared hereditary or environmental factors. See video abstract at, http://links.lww.com/EDE/B464.
Accuracy of Self-reported Abnormal Pap Smears Among Reproductive-age African-American Women
Authors: Moore Kristen R. , Baird Donna D. 
Published: November 2018

Background:
Self-reported history of abnormal Pap smear is used in large public health surveys. However, literature on the accuracy of this reporting is limited. We sought to assess the validity of self-reported abnormal Pap history in a community-based sample of African-American women 24–37 years of age in the Detroit, MI, recruited from 2010 to 2012.

Methods:
We compared self-reported data on 2-year history of abnormal Pap smear to medical Pap record data (the gold standard) obtained from eligible participants. Sensitivity and specificity were evaluated to summarize the accuracy of the self-reported data. We also explored the sensitivity by severity of abnormality.

Results:
We identified 345 participants with 480 eligible Pap records. Thirty-five percent of abnormal Pap results were not identified by self-report (sensitivity/specificity: 65%/91%; kappa = 0.54). The sensitivity of reporting an abnormal Pap tended to be higher for those with a more severe abnormality.

Conclusions:
A large proportion of abnormal Pap smears were not identified by self-report in this sample of African-American women. Public health studies utilizing self-reported abnormal Pap information should be interpreted with caution.
Gland Suspension Improves Breast Augmentation Outcomes
Authors: Andjelkov Katarina , Sijan-Miskovic Nina , Colic Milan , Colic Miodrag , Lalic Anja , Llull Ramon 
Published: November 2018

Background:
While dual plane breast augmentation successfully addresses low ptosis grades, concomitant hypomastia and greater ptosis often requires combined immediate or staged mastopexy with extended incisions beyond those required for breast augmentation. In an attempt at offering a minimal scar in a single procedure, we evaluated the benefit of a gland suspension maneuver in addition to a dual plane dissection and implant placement to improve breast contour, avoid postoperative ptosis, and thus reduce staged reintervention procedures.

Methods:
A consecutive group of 73 patients presenting ptotic hypomastia were jointly categorized and underwent implant placement, dual plane dissection level 3, and gland suspension maneuver. An age, implant volume, ptosis degree matched historical cohort was used as control (no gland suspension). All subjects were followed longer than 1 year postoperatively. Outcome analysis included reintervention rates and objective geodesic changes using objective morphometric parameters as measured by 3D scan analysis.

Results:
When experimental and control cohorts were segregated according to ptosis grade, gland suspension maneuver was associated to a lower frequency of subsequent ancillary mastopexy procedures (reintervention rate) for all ptosis grades except ptosis grade III. When gland suspension was compared with ptosis equivalent control groups, gland suspension was associated to a higher upper pole volume increment and higher pole convexity and lower pole morphometry.

Conclusion:
The addition of gland suspension to implant dual plane breast augmentation appears to be a clinically beneficial maneuver with measurable contour impact and appears to avoid subsequent mastopexy procedures, except for high ptosis grade candidates.
RIDGE-SHAPED MACULA IN YOUNG MYOPIC PATIENTS AND ITS DIFFERENTIATION FROM TYPICAL DOME-SHAPED MACULA IN ELDERLY MYOPIC PATIENTS
Authors: Xu Xian , Fang Yuxin , Jonas Jost B. , Du Ran , Shinohara Kosei , Tanaka Noriko , Yokoi Tae , Onishi Yuka , Uramoto Kengo , Kamoi Koju , Yoshida Takeshi , Ohno-Matsui Kyoko 
Published: November 2018

Purpose:To assess and compare clinical features of a ridge-shaped macula (defined as macular elevation only in one meridian across the fovea) in individuals younger than 20 years with those of a dome-shaped macula (DSM) in patients aged 20+ years.Methods:The retrospective observational case series study included 185 highly myopic eyes of 100 consecutive patients younger than 20 years, who were compared with highly myopic patients with DSMs, aged 20+ years and examined in previous studies.Results:Seventeen (9.2%) eyes of the highly myopic young patients showed macular elevations all of which ran only in the horizontal direction across the vertical optical coherence tomographic section fulfilled the definition of a ridge and did not show any staphylomas or any macular Bruch membrane defects. By contrast, in the older patients with DSMs, the DSMs were significantly higher and had a narrower base than the ridges in the young patients, and showed macular Bruch membrane defects in their vicinity, with the axial length being significantly longer, the myopic maculopathy more severe, and the subfoveal choroid thinner.Conclusion:Macular elevations detected in children and adolescents are usually ridge-shaped maculas and do not have the characteristics of DSMs. In comparison with DSMs, ridge-shaped maculas do not show a spatial association with macular Bruch membrane defects or posterior staphylomas and have a wider basis and smoother elevation slope. As a hypothesis, ridge-shaped maculas may be due to a folding of Bruch membrane at the posterior pole, potentially caused by an asymmetrical enlargement of Bruch membrane in the equatorial region.
The association between endogenous opioid function and morphine responsiveness: a moderating role for endocannabinoids
Authors: Bruehl Stephen , Burns John W. , Morgan Amanda , Koltyn Kelli , Gupta Rajnish , Buvanendran Asokumar , Edwards David , Chont Melissa , Kingsley Philip J. , Marnett Larry , Stone Amanda , Patel Sachin 
Published: November 2018

Abstract
We sought to replicate previous findings that low endogenous opioid (EO) function predicts greater morphine analgesia and extended these findings by examining whether circulating endocannabinoids and related lipids moderate EO-related predictive effects. Individuals with chronic low-back pain (n = 46) provided blood samples for endocannabinoid analyses, then underwent separate identical laboratory sessions under 3 drug conditions: saline placebo, intravenous (i.v.) naloxone (opioid antagonist; 12-mg total), and i.v. morphine (0.09-mg/kg total). During each session, participants rated low-back pain intensity, evoked heat pain intensity, and nonpain subjective effects 4 times in sequence after incremental drug dosing. Mean morphine effects (morphine-placebo difference) and opioid blockade effects (naloxone-placebo difference; to index EO function) for each primary outcome (low-back pain intensity, evoked heat pain intensity, and nonpain subjective effects) were derived by averaging across the 4 incremental doses. The association between EO function and morphine-induced back pain relief was significantly moderated by endocannabinoids [2-arachidonoylglycerol (2-AG) and N-arachidonoylethanolamine (AEA)]. Lower EO function predicted greater morphine analgesia only for those with relatively lower endocannabinoids. Endocannabinoids also significantly moderated EO effects on morphine-related changes in visual analog scale–evoked pain intensity (2-AG), drug liking (AEA and 2-AG), and desire to take again (AEA and 2-AG). In the absence of significant interactions, lower EO function predicted significantly greater morphine analgesia (as in past work) and euphoria. Results indicate that EO effects on analgesic and subjective responses to opioid medications are greatest when endocannabinoid levels are low. These findings may help guide development of mechanism-based predictors for personalized pain medicine algorithms.