bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Histological Comparison of Two Human Acellular Dermal Matrix Products in Prosthetic-Based Breast Reconstruction
Authors: Moyer Hunter R. , Hart Alexandra M. , Yeager Jessica , Losken Albert 
Published: January 2018

Background:
Acellular dermal matrices (ADMs) are an integral component of breast reconstruction. The ideal matrix would be relatively immuno-inert, allow rapid vascularization, and be affordable. The purpose of this study was to histologically compare 2 commonly used ADM products.

Methods:
This is a prospective histological study of 17 patients (20 breasts) following prosthetic-based breast reconstruction with ADM: Alloderm (LifeCell Corp, Branchburg, N.J.) or Cortiva (RTI Surgical, Alachua Fla.). Biopsies were taken from the dermal matrix and natural capsules surrounding the expander/implant during secondary surgery [Range, 72—694 days (mean, 217 days)]. Biopsy specimens were prepared via hematoxylin and eosin, Masson's trichrome, elastin, and transforming growth factor (TGF)-1 stains. Quantitative analysis of staining was performed with ImageJ software. The clinical outcome of each patient is analyzed in relation to capsule architecture and ADM performance.

Results:
There were 7 breasts in the Alloderm group and 13 in the Cortiva group. Both groups had similar demographic, aesthetic results, and complication profiles. The TGF-1 staining demonstrated significantly lower levels in the Cortiva capsules (P = 0.0139). The percentage of elastin and collagen are similar in the Cortiva, Alloderm, and natural peri-implant capsules. The native capsules show a significantly greater number of blood vessels when compared with Cortiva and Alloderm (P = 0.0371 and P = 0.0347, respectively); however, there is no difference in vascular pattern between the 2 dermal matrices.

Discussion:
Postoperatively, Cortiva demonstrates equal vascularity with less TGF-1 activation compared with Alloderm. The clinical success and complication profile were similar between the Alloderm and Cortiva patients.
Combining Autologous and Prosthetic Techniques: The Breast Reconstruction Scale Principle
Authors: Taglialatela Scafati Salvatore , Cavaliere Annachiara , Aceto Bianca , Somma Francesco , Cremone Luigi 
Published: January 2018

Background:
The latissimus dorsi (LD) flap remains a good option for immediate or delayed breast reconstruction. The main limitation of this flap is the small volume provided. To improve the reconstructed breast volume, the LD flap is usually combined with a breast implant. Recently, fat grafting to the LD flap was described to maximize flap volume and obtain a totally autologous breast reconstruction. We report our experience with hybrid breast reconstruction using both breast implants and fat-enriched latissimus dorsi (FELD) flaps.

Methods:
Between 2013 and 2016, 74 patients underwent breast reconstruction with FELD flaps only or FELD flaps combined with a breast implant. The LD flap was harvested as previously described. Donor sites for fat harvesting were chosen according to each patient’s natural fat distribution. Fat was harvested, centrifuged, and injected into the LD flap. After fat grafting, breast sizers were employed to determine the final breast volume when the addition of an implant was indicated.

Results:
Good cosmetic outcomes were achieved in all cases, with a mean follow-up of 2.1 years. No patients had cancer reoccurrences. Four patients experienced a seroma of the LD donor site, 1 had a breast hematoma, and 1 developed Baker grade III capsular contracture. One year postoperatively, a clinically relevant area of fat necrosis was observed in 1 patient and was surgically treated. Additional fat grafting sessions were required in 3 cases.

Conclusion:
In elected cases, a FELD flap alone or in combination with a small implant is a valuable technique for breast reconstruction surgery.
Impact of relational coordination on staff and patient outcomes in outpatient surgical clinics
Authors: Gittell Jody Hoffer , Logan Caroline , Cronenwett Jack , Foster Tina C. , Freeman Richard , Godfrey Marjorie , Vidal Dale Collins 
Published: January 2018

Background:
Pressures are increasing for clinicians to provide high-quality, efficient care, leading to increased concerns about staff burnout.

Purpose:
This study asks whether staff well-being can be achieved in ways that are also beneficial for the patient’s experience of care. It explores whether relational coordination can contribute to both staff well-being and patient satisfaction in outpatient surgical clinics where time constraints paired with high needs for information transfer increase both the need for and the challenge of achieving timely and accurate communication.

Methodology/Approach:
We studied relational coordination among surgeons, nurses, residents, administrators, technicians, and secretaries in 11 outpatient surgical clinics. Data were combined from a staff and a patient survey to conduct a cross-sectional study. Data were analyzed using ordinary least squares and random effects regression models.

Results:
Relational coordination among all workgroups was significantly associated with staff outcomes, including job satisfaction, work engagement, and burnout. Relational coordination was also significantly associated with patients’ satisfaction with staff and their overall visit, though the association between relational coordination and patients’ satisfaction with their providers did not reach statistical significance.

Practice Implications:
Even when patient–staff interactions are relatively brief, as in outpatient settings, high levels of relational coordination among interdependent workgroups contribute to positive outcomes for both staff and patients, and low levels tend to have the opposite effect. Clinical leaders can increase the expectation of positive outcomes for both staff and their patients by implementing interventions to strengthen relational coordination.
Efficacy and Safety of Intensive Transcranial Magnetic Stimulation
Authors: Sverak Tomas , Ustohal Libor 
Published: January 2018

Abstract
Repetitive transcranial magnetic stimulation (rTMS) is customarily applied on a daily basis for prolonged periods of time for the treatment of psychiatric diseases. The process is demanding in terms of staff and patient time, and the onset of the effect is slow. Recently, intensive rTMS protocols have been introduced in which stimulation is applied to the same area more than once a day with a higher than standard number of pulses. This article reviews 16 articles to determine the safety and efficacy of such protocols. Intensive rTMS seems to be effective in various mental disorders. It appears to have, in general, the same adverse events as classic, long-term, daily rTMS, and it is largely well tolerated by the patients. One episode of depersonalization, one of increased suicidal thoughts, and two of induced mania were observed in the 16 studies reviewed. The advantages of intensive rTMS are in the possible acute effect of the stimulation and in the possible reduction in the time required to achieve remission in depression (and potentially other disorders). It remains uncertain whether intensive rTMS is more effective than sham stimulation or once-daily, long-term rTMS.
Dry Eye Assessment in Patients With Vitiligo
Authors: Erdur Sevil Karaman , Aydin Rukiye , Balevi Ali , Ozsutcu Mustafa , Kocabora Mehmet Selim 
Published: January 2018

Purpose:
To evaluate tear osmolarity and tear film parameters in patients with vitiligo.

Methods:
A total of 25 eyes of 25 patients with vitiligo with periocular involvement (group 1), 30 eyes of 30 patients with vitiligo without periocular involvement (group 2), and 20 eyes of 20 controls (group 3) were evaluated using the Ocular Surface Disease Index (OSDI) questionnaire, Schirmer I test, tear film breakup time, scoring of ocular surface fluorescein staining using a modified Oxford scale, and tear osmolarity.

Results:
Mean tear osmolarity was 332 ± 16.3 mOsm/L in group 1, 308.8 ± 19.5 mOsm/L in group 2, and 286.3 ± 23.4 mOsm/L in group 3 (P < 0.001). There was no significant difference in Schirmer I test results among the 3 groups (16.5 ± 3.2 mm in group 1, 16.3 ± 4.7 mm in group 2, and 17.4 ± 4.2 mm in group 3) (P = 0.175). Tear film breakup time measurements in groups 1 (9.8 ± 3.5 seconds) and 2 (10.1 ± 4.3 seconds) were significantly lower than those in group 3 (18.5 ± 4.0 seconds) (P < 0.001). There was no significant difference among the 3 groups on the Oxford scale (0.04 ± 0.70 in group 1, 0.03 ± 0.33 in group 2, and 0.03 ± 0.20 in group 3) (P = 0.865). The mean Ocular Surface Disease Index score was significantly higher in groups 1 and 2 than in group 3 (42.1 ± 16.5 in group 1, 39.9 ± 17.3 in group 2, and 12.3 ± 11.6 in group 3) (P < 0.001).

Conclusions:
This study showed that vitiligo is associated with tear hyperosmolarity and tear film dysfunction. Patients with vitiligo with periocular involvement may be more prone to dry eye than those without ocular involvement.
The first episode of spontaneous bacterial peritonitis is a threat event in children with end-stage liver disease
Authors: Vieira Sandra M.G. , Schwengber Fernando P. , Melere Melina , Ceza Marília R. , Souza Melina , Kieling Carlos O. 
Published: January 2018

Objective
Studies on native liver survival (NLS) after the first episode of spontaneous bacterial peritonitis (SBP) are rare. Our objective was to evaluate NLS in children up to 1 year after SBP.

Methods
A historical cohort study of 18 children followed after the first episode of SBP was conducted. NLS, in-hospital mortality, causes of death, and rate of multidrug-resistant organisms were reported.

Results
Biliary atresia was the most prevalent diagnosis (72.2%); all were Child–Pugh C, and the median age was 1.0 year. The probability of NLS was 77.8, 27.8, and 11.1% at 1, 3 and 6 months, respectively. At 9 months, no child had the native liver. In-hospital mortality was 38.9%, and the main causes of death were septic shock and acute-on-chronic liver failure. Escherichia coli was the predominant organism cultured. Multidrug-resistant organisms were not detected. The cumulative probability of NLS was 77.8% at 1 month, 27.8% at 3 months, and 11.1% at 6 months. At 9-month follow-up, none of children had their native liver. Ascites PMN count cell more than 1000 cells/mm3, positive ascites culture, and prolonged international normalized ratio reached a significant value as predictive factors of NLS and were selected for multivariate analysis. We did not identify independent predictors of survival.

Conclusion
Development of SBP was a late event in children and had a high effect on NLS.
The association of fatty pancreas with subclinical atherosclerosis in nonalcoholic fatty liver disease
Authors: Ozturk Kadir , Dogan Tolga , Celikkanat Serhat , Ozen Alptug , Demirci Hakan , Kurt Omer , Turker Turker , Yilmaz Yusuf , Uygun Ahmet 
Published: January 2018

Introduction
Ectopic fat accumulation in many tissues has been shown to be a risk factor for developing cardiovascular disease. No study to date has investigated whether fatty pancreas plays a role in the development of subclinical atherosclerosis. We aimed to assess the relationship between fatty pancreas and subclinical atherosclerosis in patients with biopsy-proven nonalcoholic fatty liver disease (NAFLD) and healthy controls.

Patients and methods
One hundred patients with biopsy-proven NAFLD and 38 healthy controls were included. Transabdominal ultrasonography examination was performed on all the cases with high-resolution ultrasonography (Acuson S3000) using 6 mHz convex probes. The measurements of carotid intima-media thickness (CIMT) and carotid-femoral pulse wave velocity (cf-PWV) were performed to investigate the relationship between fatty pancreas and atherosclerosis.

Results
The rate of newly diagnosed DM and prediabetes in the NAFLD patients was 6 and 21%, respectively. Most of the patients with NAFLD (97%) were found to have an increased echogenicity of the pancreas at ultrasound examination. Grade of fatty pancreas was correlated positively with cf-PWV levels (P<0.05), whereas no correlation was found with CIMT (P>0.05). The presence of fatty pancreas was associated significantly with higher CIMT and cf-PWV levels (P<0.05). The results for cf-PWV and CIMT did not remain significant after adjustment for confounding factors. Although the levels of cf-PWV and CIMT increased with increasing grade of fatty pancreas, there was no significant association.

Conclusion
We have shown for the first time that fatty pancreas is a contributing factor for the development of atherosclerosis in patients with NAFLD. This study also confirms the strong association between NAFLD and fatty pancreas.
Progression of Chronic Pancreatitis to Pancreatic Cancer
Authors: Rashid Sumaira , Singh Nidhi , Gupta Surabhi , Rashid Safoora , Nalika Nandini , Sachdev Vikas , Bal Chandra Sekhar , Datta Gupta Siddhartha , Chauhan Shyam S. , Saraya Anoop 
Published: January 2018

Objectives
Early detection of pancreatic ductal adenocarcinoma still remains a challenge. Patients with chronic pancreatitis (CP) have a markedly increased risk of pancreatic cancer. Mutations in oncogenes and/or tumor suppressor genes play a role in development of pancreatic ductal adenocarcinoma. This study assessed mutations in KRAS and p53 gene in blood as a screening tool for malignant transformation in CP patients.

Methods
This was a cohort, single-center study including 294 CP patients. DNA was isolated from plasma of CP patients, and KRAS mutations were identified using polymerase chain reaction–restriction fragment length polymorphism. Patients with positive KRAS mutation were screened for malignancy using positron emission tomography or endoscopic ultrasound. Mutations in p53 gene were analyzed by sequencing. Tissue samples from CP and pancreatic cancer patients were also tested for mutations in KRAS and p53 genes.

Results
The plasma samples of 64 CP patients were positive for KRAS mutation, and 4 had mutation in p53 gene also. No patient positive for KRAS mutation and/or p53 mutation was found to have malignant transformation.

Conclusion
Detection of KRAS or p53 mutation in plasma is not an effective screening tool for pancreatic cancer because accumulation of multiple mutations is required for malignant transformation in the pancreas.
Patient Perception and Satisfaction Questionnaire for Microtia Reconstruction: A New Clinical Tool to Improve Patient Outcome
Authors: Cui Chunxiao , Li Yiyuan , Zhang Ruhong , Zhang Qun , Xu Zhicheng , Chiu Ernest S. , Xu Feng , Li Datao , Li Tianya , Chen Wei 
Published: January 2018

Background:
Patients’ satisfaction is an increasingly important indicator for successful ear reconstruction surgeries. However, there is no scientifically sound patient-based outcome instrument in this field. This study aims at developing a patient-reported outcome measure for microtia reconstruction for investigating patients’ satisfaction and perception of reconstructed ear and clinical researches.

Methods:
The development of questionnaire included 3 stages. Traditional psychometric tests were used for analysis. At first stage, a preliminary version of the questionnaire was developed using qualitative methods, including interviews with 10 patients. At second stage, the questionnaire was field tested by survey of 76 patients. Redundant items were deleted; acceptability, reliability, and responsiveness were examined. At third stage, survey was conducted to another 94 patients with the shortened questionnaire to further evaluate the acceptability, reliability, and validity.

Results:
A questionnaire of 12 items for microtia reconstruction was developed. Results demonstrated the instrument satisfied the current criteria. The acceptability (missing data <1%, largest endorsement frequencies <60%), reliability (Cronbach alphas >0.80, item-total correlations >0.7, interitem correlation <0.8), validity (scale intercorrelations r = 0.59, low correlations with age and sex) of the questionnaire.

Conclusions:
The questionnaire is an acceptable, reliable, and validated outcome measure for evaluation of ear reconstruction esthetic outcomes in microtia patients. It could be used for further comparison studies and effectiveness studies.
Surgical Treatment of Synovial Chondromatosis in the Inferior Compartment of the Temporomandibular Joint With Articular Disc Involvement
Authors: Leite Pablo Cornelius Comelli , Tolentino Elen de Souza , Yamashita Amanda Lury , Iwaki Lilian Cristina Vessoni , Iwaki Filho Liogi 
Published: January 2018

Abstract
The authors report an unusual case of painful synovial chondromatosis originated in the inferior compartment of the temporomandibular joint (TMJ) with articular disc involvement in a 56-year-old woman with complaint of severe pain in the right preauricular region. Magnetic resonance images showed advanced destruction of the right articular disc anteriorly displaced, condylar erosion, and distinct nodules within an extremely expanded inferior joint compartment with large amount of fluid, as well as a large TMJ effusion. A scintigraphy showed elevated bone uptake in the right TMJ, demonstrating intense bone remodeling activity in the region. After a right internal maxillary artery embolization, the patient underwent open surgery. The intraoperative procedures, including articular disc removal, condylar remodeling, and replacement of the articular disc, are described in detail. Synovial chondromatosis of the TMJ is a rare disease, especially when it affects the inferior compartment and the articular disc. Initial diagnosis is challenging and imaging techniques (magnetic resonance imaging and scintigraphy) play an important role in identifying signs, making accurate diagnosis, and offering additional information not available with conventional imaging, such as TMJ inflammation or remodeling. In these patients, open surgery may be considered a definitive treatment, since the postoperative recurrence rate is very low.
Unusual Craniofacial Distraction
Authors: Greig Aina V.H. , Cutting Court B. , Levine Jamie , Grayson Barry , McCarthy Joseph G. 
Published: January 2018

Abstract
A retrospective Institutional Review Board-approved review was performed at the Institute of Reconstructive Plastic Surgery, NYU Langone Medical Center, of patients undergoing craniofacial distraction osteogenesis procedures using the rigid external distractor device between 2000 and 2010. Three particularly challenging cases were identified and are presented here.
Facing a New Face: An Interpretative Phenomenological Analysis of the Experiences of a Blind Face Transplant Patient and His Partner
Authors: Hendrickx Hannelore , Blondeel Phillip N. , Van Parys Hanna , Roche Nathalie A. , Peeters Patrick C. , Vermeersch Hubert F. , Rogiers Xavier , Van Lierde Kristiane , Lemmens Gilbert M. D. 
Published: January 2018

Abstract
Increasing evidence points to good functional, aesthetic, and psychosocial outcomes after face transplantation. However, research investigating how patients and their families subjectively experience the transplantation process is lacking thus far. This study aims to investigate the personal experiences of a blind face transplant patient and his partner. In-depth interviews exploring different experiences were conducted with both partners separately 20 months after face transplantation. The interviews were analyzed using interpretative phenomenological analysis. Seven themes were identified in both interviews: coping with the facial trauma, motivation for the face transplantation, outcomes of the face transplantation, acceptance of the new face, gratitude toward the donor family, relation to the medical team, and dealing with the media. Two further themes were only mentioned by the patient (coping with complications and coping with blindness) and one theme only by the partner (loss of choices). The results of this study increase our understanding of the transplantation process as experienced by a face transplant recipient and his partner. They may help to better inform professionals to optimize transplantation procedures or supportive interventions.
No Gains in Long-term Survival After Liver Transplantation Over the Past Three Decades
Authors: Rana Abbas , Ackah Ruth L. , Webb Gwilym J. , Halazun Karim J. , Vierling John M. , Liu Hao , Wu Meng-Fen , Yoeli Dor , Kueht Michael , Mindikoglu Ayse L. , Sussman Norman L. , Galván Nhu T. , Cotton Ronald T. , O’Mahony Christine A. , Goss John A. 
Published: January 2018

Objective:
The aim of this study was to assess improvements in long-term survival after liver transplant by analyzing outcomes in transplant recipients who survived beyond 1 year.

Summary of Background Data:
Gains in short-term survival following liver transplantation have been gratifying. One-year survival in 1986 was 66% improved to over 92% in 2015. However, little is known about why long-term has not seen similar success.

Methods:
We analyzed 111,568 recipients from 1987 to 2016 using the Kaplan-Meier method for time-to-event analysis and multivariable Cox regression.

Results:
There were no significant gains in unadjusted long-term outcomes among 1-year survivors over the past 30 years. Only the time periods of 1987 to 1990 [hazard ratio (HR) 1.35, confidence interval CI) 1.28–1.42] and 1991 to 1995 (HR 1.17, CI 1.13–1.21) had a minor increase in risk compared with the period 2011 to 2016. Cause of death analysis suggests malignancy after transplantation is a growing problem and preventing recurrent hepatitis C with direct-acting antivirals (DDAs) may only have a limited impact. Furthermore, rejection leading to graft failure and death had a rare occurrence (1.7% of long-term deaths) especially when compared with the sequelae of long-term immunosuppression: malignancy (16.4%), nonrejection graft failure (9.8%), and infection (10.5%) (P < 0.001).

Conclusion:
In stark contrast to short-term survival, there have been no appreciable improvements in long-term survival following liver transplantation among 1-year survivors. Long-term sequelae of immunosuppression, including malignancy and infection, are the most common causes of death. This study highlights the need for better long-term immunosuppression management.