bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dose Prescription and Delivery in Neonates With Congenital Heart Diseases Treated With Continuous Veno-Venous Hemofiltration
Authors: Ricci Zaccaria , Guzzi Francesco , Tuccinardi Germana , Di Chiara Luca , Clark William , Goldstein Stuart L. , Ronco Claudio 
Published: May 2017

Objectives:
Renal replacement therapy may be required for acute kidney injury treatment in neonates with complex cardiac conditions. Continuous veno-venous hemofiltration is applied safely in this population but no published recommendations for dose prescription in neonates currently exist. The aim of our study was to evaluate the effects of a relatively small dialysis dose on critically ill neonates.

Design:
Retrospective analysis of clinical charts.

Setting:
Pediatric Cardiac ICU.

Patients:
Ten critically ill neonates with severe acute kidney injury were analyzed. The primary indication for continuous veno-venous hemofiltration initiation was severe fluid overload with oligoanuria.

Interventions:
None.

Measurements and Main Results:
The median (range) age and weight were 3 days (1–12 d) and 2.6 kg (2.1–4.2 kg), respectively, whereas the median continuous veno-venous hemofiltration duration was 17 days (3–63 d). Median prescribed blood flow rate, replacement fluid rate, and net ultrafiltration rate were 12 mL/min (9–50 mL/min), 100 mL/hr (40–200 mL/hr), and 20 mL/hr (5–45 mL/hr), respectively. The median effluent-based continuous veno-venous hemofiltration dose was 35 mL/kg/hr (11–66 mL/kg/hr), whereas the median delivered daily Kt/V per session (24 hr) was 0.5 (0.01–1.8). However, for treatment sessions lasting less than or equal to 12 versus greater than or equal to 12 hours per session, the median prescribed effluent dose was 41 (11–66) and 32 (17–60) mL/kg/hr, respectively (p = 0.06), whereas the delivered creatinine daily Kt/V values were 0.3 (0.01–0.9) and 0.9 (0.5–1.8), respectively (p < 0.0001). An inverse correlation was found between delivered daily Kt/V and the blood concentration differences of both creatinine (r = –0.3; p = 0.0093) and urea (r = –0.3; p = 0.0028) measured at the end and the beginning of a 24-hour treatment. The decrease of creatinine concentration was significantly greater during 24-hour treatment sessions with a delivered daily Kt/V greater than 0.9 than during those with daily Kt/V less than 0.9.

Conclusions:
Based on these findings, we propose on a provisional basis the use of daily Kt/V as a measure of continuous renal replacement therapy adequacy for critically ill neonates.
Outcome of Pediatric Critical Care Medicine Abstracts Presented at North American Academic National Meetings*
Authors: Basu Sonali , Pollack Murray M. 
Published: May 2017

Objectives:
Pediatric critical care medicine abstracts presented at North American national academic meetings have not been followed up to determine their publication outcomes. Our objective was to determine the following: 1) the proportion of these presentations that are published in peer-reviewed journals within 5 years; 2) the impact of trainee status on time to and success of publication; and 3) the quality of the research as reflected in the publishing journal’s impact factor.

Design:
Four years of abstracts (2007–2011) were reviewed from the American Academy of Pediatrics, Pediatric Academic Societies, and Society of Critical Care Medicine national meetings. Pediatric critical care medicine abstracts were delineated by the meeting or identified by keyword search. Data included mode of presentation, trainee status of first author, publication status within 5 years based on a PubMed search, trainee position in the journal of publication authorship list, and the impact factor of journal of publication.

Measurements and Main Results:
We evaluated 267 pediatric critical care medicine abstracts, 85–94 from each meeting. Overall, 41% were published, with the highest rate in Pediatric Academic Societies abstracts (54% Pediatric Academic Societies, 38% Society of Critical Care Medicine, and 33% American Academy of Pediatrics; p = 0.011). Mean time to publication was 22 (± 3) months and did not differ by conference or presentation mode. Journal first authorship was retained in 84%. Journal impact factor was highest in Society of Critical Care Medicine abstracts (3.38 Society of Critical Care Medicine, 2.64 Pediatric Academic Societies, and 1.92 American Academy of Pediatrics; p = 0.006). First author trainee status was not associated with publication rate, time to publication, and impact factor. A total of 100% of trainees but only 79% of nontrainees who published retained first authorship.

Conclusions:
Less than half of pediatric critical care medicine research abstracts presented at North American national academic meetings culminate in articles. Pediatric Academic Societies had the highest publication success rate, and Society of Critical Care Medicine abstracts were published in journals with the highest impact factors. All trainees who were first authors retained that status in the journal publications.
Breast Implant–Associated Anaplastic Large Cell Lymphoma in Australia and New Zealand: High-Surface-Area Textured Implants Are Associated with Increased Risk
Authors: Loch-Wilkinson Anna , Beath Kenneth J. , Knight Robert John William , Wessels William Louis Fick , Magnusson Mark , Papadopoulos Tim , Connell Tony , Lofts Julian , Locke Michelle , Hopper Ingrid , Cooter Rodney , Vickery Karen , Joshi Preeti Avinash , Prince H. Miles , Deva Anand K. 
Published: May 2017

Background:
The association between breast implants and breast implant–associated anaplastic large cell lymphoma (ALCL) has been confirmed. Implant-related risk has been difficult to estimate to date due to incomplete datasets.

Methods:
All cases in Australia and New Zealand were identified and analyzed. Textured implants reported in this group were subjected to surface area analysis. Sales data from three leading breast implant manufacturers (i.e., Mentor, Allergan, and Silimed) dating back to 1999 were secured to estimate implant-specific risk.

Results:
Fifty-five cases of breast implant–associated ALCL were diagnosed in Australia and New Zealand between 2007 and 2016. The mean age of patients was 47.1 years and the mean time of implant exposure was 7.46 years. There were four deaths in the series related to mass and/or metastatic presentation. All patients were exposed to textured implants. Surface area analysis confirmed that higher surface area was associated with 64 of the 75 implants used (85.3 percent). Biocell salt loss textured (Allergan, Inamed, and McGhan) implants accounted for 58.7 percent of the implants used in this series. Comparative analysis showed the risk of developing breast implant–associated ALCL to be 14.11 times higher with Biocell textured implants and 10.84 higher with polyurethane (Silimed) textured implants compared with Siltex textured implants.

Conclusions:
This study has calculated implant-specific risk of breast implant–associated ALCL. Higher-surface-area textured implants have been shown to significantly increase the risk of breast implant–associated ALCL in Australia and New Zealand. The authors present a unifying hypothesis to explain these observations.
Dual Infection Contributes to Rapid Disease Progression in Men Who Have Sex With Men in China
Authors: Luan Hong , Han Xiaoxu , Yu Xiaoou , An Minghui , Zhang Hui , Zhao Bin , Xu Junjie , Chu Zhenxing , Shang Hong 
Published: May 2017

Background:
Considerable numbers of HIV-1–infected men who have sex with men (MSM) show a relatively rapid disease progression in China; however, the cause remains elusive. HIV-1 dual infection was reported to occur commonly among the MSM population, and its contribution to clinical prognosis remains controversial. We investigated the occurrence and impact on disease progression of dual infection in a prospective MSM cohort in China.

Methods:
Sixty-four HIV-1 early-infected participants were longitudinally followed up for 2 years. Deep sequencing was used as dual-infection screening. CD4+ T-cell counts and HIV-1 viral load were compared between coinfection and single-infection participants and pre- versus post-superinfection.

Results:
Eight coinfected participants and 10 superinfected participants were identified, including 9 participants with intersubtype and 9 with intrasubtype dual infections. The prevalence of coinfection was 13.1%, with a superinfection incidence of 15.6%. Coinfection participants showed lower CD4+ T-cell counts at 120 days after infection (P = 0.042) and a higher viral set point tendency (P = 0.053) as compared with single-infection participants. Kaplan–Meier analysis showed that the time for the viral load to increase to above 4 log10 copies per milliliter was shorter in coinfection participants than in single-infection participants (P < 0.001). After superinfection, the median CD4+ T-cell count decreased from 635 to 481 cells/μL (P = 0.027).

Conclusions:
The occurrence of dual infection among Chinese MSM is relatively high, and HIV-1 dual infection might contribute to rapid disease progression seen in the MSM population.
Addition of Etravirine Does Not Enhance the Initial Decline of HIV-1 RNA in Treatment-Experienced Patients Receiving Raltegravir
Authors: Flandre Philippe , Marcelin Anne-Geneviève , Calvez Vincent ,   on behalf of the ANRS AC11 Resistance Study Group
Published: May 2017

Objective:
The importance of an early reduction of HIV-1 RNA as a marker for positive longer term outcome is still under debate. We investigate whether antiretroviral-experienced patients receiving raltegravir plus etravirine have a higher early reduction of HIV-1 RNA compared with patients receiving raltegravir.

Design:
An observational study of treatment-experienced patients.

Methods:
The objective is to investigate 349 patients included in a raltegravir resistance study. The early outcome is defined as a reduction of HIV-1 RNA at week 8. The crude method defines all measurements below the limit of quantification to be equal to the limit of quantification provides biased estimates. Such a reduction is censored by the limit of quantification and is subject to selection bias in observational studies.

Results:
The crude method showed a significant higher reduction in HIV-1 RNA reduction in patients receiving raltegravir plus etravirine compared with patients receiving raltegravir (mean reduction of 2.1 versus 1.8 log10 copies/mL). However, survival methods adjusted for both censoring, due to the limit of quantification, and confounding factors lead to a nonsignificant difference between the 2 treatment groups (mean reduction of 2.8 versus 2.7 log10 copies/mL).

Conclusion:
Taking into account censoring and confounding factors, our study did not demonstrate a higher early reduction of HIV-1 RNA in patients receiving raltegravir with versus without etravirine.
Distribution of Behavioral Patterns Before Infection Among San Francisco Men Who Have Sex With Men Newly Infected With HIV in 2014
Authors: Chen Yea-Hung , McFarland Willi , Raymond Henry F. , Scott Hyman M. , Vittinghoff Eric , Porco Travis C. 
Published: May 2017

Background:
Despite continued reductions in the number of HIV cases reported among San Francisco men who have sex with men (MSM) and the HIV-prevention potential offered by pharmaceutical tools such as pre-exposure prophylaxis (PrEP), there are uncertainties, particularly given reported decreases in consistent condom use. A key uncertainty is what groups of MSM should be targeted. This study estimates the distribution of behavioral patterns before infection among San Francisco MSM newly infected with HIV in 2014.

Methods:
We used a novel modeling approach. The approach uses estimates from the National HIV Behavioral Surveillance System for MSM, the Medical Monitoring Project, 2 trials of PrEP, and a meta-analysis of per-act risks of HIV infection.

Results:
The modeling study suggests that 76% of newly HIV-infected MSM in 2014 were individuals with no discernible strategy in the 6 months before infection: that is, they had condomless receptive anal intercourse with one or more partners not perceived to be HIV uninfected. An estimated 7% of newly infected MSM were serosorters before infection.

Conclusions:
Prevention efforts in San Francisco must reach HIV-uninfected MSM with no discernible behavioral strategy, a group that constitutes 8% of HIV-uninfected MSM in the city. Our study suggests that if all HIV-uninfected, San Francisco MSM with no discernible strategy had been on PrEP in 2014, there would have been 70% fewer HIV infections among San Francisco MSM. Uncertainty analysis suggests that PrEP's impact may be maximized by encouraging PrEP persistence and concomitant reductions in sexual risk behaviors.
Impact of Perinatally Acquired HIV Disease Upon Longitudinal Changes in Memory and Executive Functioning
Authors: Malee Kathleen M. , Chernoff Miriam C. , Sirois Patricia A. , Williams Paige L. , Garvie Patricia A. , Kammerer Betsy L. , Harris Lynnette L. , Nozyce Molly L. , Yildirim Cenk , Nichols Sharon L. ,   for the Memory and Executive Functioning Study of the Pediatric HIV/AIDS Cohort Study
Published: May 2017

Background:
Little is known regarding effects of perinatally acquired HIV infection (PHIV) on longitudinal change in memory and executive functioning (EF) during adolescence despite the importance of these skills for independence in adulthood.

Methods:
PHIV (n = 144) and perinatally HIV-exposed uninfected youth (PHEU, n = 79), ages 12–17, completed standardized tests of memory and EF at baseline and 2 years later. Changes from baseline for each memory and EF outcome were compared between PHEU and PHIV youth with (PHIV/C, n = 39) and without (PHIV/non-C, n = 105) history of CDC class C (AIDS-defining) diagnoses. Among PHIV youth, associations of baseline and past disease severity with memory and EF performance at follow-up were evaluated using adjusted linear regression models.

Results:
Participants were primarily black (79%); 16% were Hispanic; 55% were female. Mean memory and EF scores at follow-up generally fell in the low-average to average range. Pairwise comparison of adjusted mean change from baseline to follow-up revealed significantly greater change for PHIV/non-C compared with PHEU youth in only one verbal recognition task, with a difference in mean changes for PHIV/non-C versus PHEU of −0.99 (95% CI: −1.80 to −0.19; P = 0.02). Among youth with PHIV, better immunologic status at baseline was positively associated with follow-up measures of verbal recall and recognition and cognitive inhibition/flexibility. Past AIDS-defining diagnoses and higher peak viral load were associated with lower performance across multiple EF tasks at follow-up.

Conclusions:
Youth with PHIV demonstrated stable memory and EF during a 2-year period of adolescence, allowing cautious optimism regarding long-term outcomes.
Computed Tomography in the Diagnosis of Classical Trigeminal Neuralgia
Authors: Baliazin Victor A. , Baliazina Elena V. , Aksenov Daniil P. 
Published: May 2017

Objective
This study aims to characterize the pathogenesis of neurovascular conflict in trigeminal neuralgia (TN) with the goal of producing a reliable diagnostic method.

Methods
Data were obtained during microvascular decompression surgery. The normal relationship between the superior cerebellar artery (SCA) and the trigeminal nerve root also was characterized in postmortem cases. Furthermore, SCA was imaged with high-resolution computed tomography angiography.

Results
Our results indicate that contact between SCA and the trigeminal nerve root is present in both TN and non-TN cases, but in patients with TN, the apex of SCA loop was always at the bottom of the upper edge of the trigeminal root forming the state of neurovascular conflict. High-resolution angiography supported the intraoperative results.

Conclusions
These findings indicate a clear difference between neurovascular contact and conflict and point to the use of high-resolution computed tomography visualization of the position of SCA loop apex relative to the trigeminal nerve root as a primary diagnostic method.
Application and Indication of Carcinoembryonic Antigen Triggered 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Scanning in the Detection of Relapse of Colorectal Cancer Patients After Curative Therapy
Authors: Yu Xiaozhou , Zhu Lei , Dai Dong , Song Xiuyu , Chen Wei , Zhu Yanjia , Li Xiaofeng , Xu Wengui 
Published: May 2017

Objective
This study aimed to explore the characteristics of patients with colorectal cancer (CRC) following curative therapy that may benefit from fluorine-18-2-uoro-2-deoxy-d-glucose positron emission tomography/computed tomography (18F-FDG PET/CT) scanning, evaluate the application of carcinoembryonic antigen (CEA)–triggered 18F-FDG PET/CT scanning, and provide referential indicators.

Methods
This retrospective study included 56 CRC patients who received a PET/CT scan as a primary examination because of rising CEA levels after curative therapy and who had not received any other radiological examinations previously.

Results
The rate of recurrence or metastasis was 75.0% by PET/CT scan but was 69.6% with follow-up treatment. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were 94.9%, 70.6%, 87.5%, 88.1%, and 85.7%, respectively. TNM (tumor, node, metastasis) stage, body mass index, and CEA level were significant prognostic factors.

Conclusions
Positron emission tomography/CT can be selectively applied as a primary examination in CRC patients with asymptomatic elevation of CEA. High CEA levels, increased body mass index, and advanced TNM staging are risk factors for relapse.
Vessel-Masked Perfusion Magnetic Resonance Imaging With Histogram Analysis Improves Diagnostic Accuracy for the Grading of Glioma
Authors: Arisawa Atsuko , Watanabe Yoshiyuki , Tanaka Hisashi , Takahashi Hiroto , Matsuo Chisato , Fujiwara Takuya , Fujimoto Yasunori , Yamamoto Kouji , Tomiyama Noriyuki 
Published: May 2017

Objective
Dynamic susceptibility contrast magnetic resonance imaging is widely used to assess glioma grade; histogram analyses are used for precise tumor perfusion evaluations. We evaluated the effect of vessel contamination in normalized cerebral blood volume (nCBV) to differentiate high- and low-grade gliomas.

Methods
Thirty-four patients with gliomas underwent dynamic susceptibility contrast magnetic resonance imaging. Both traditional and vessel-masked nCBV maps were constructed. Histogram analyses of whole tumors and statistical comparisons were performed to compare traditional and vessel-masked images.

Results
Mean values of all the histogram metrics were lower in vessel-masked images than in traditional images. Receiver operating characteristic curve analyses for every histogram metric showed a higher area under the curve for vessel-masked images than for traditional images. The integrated discrimination improvement showed that the vessel-masked images were superior to the traditional images significantly for predicting the glioma grading.

Conclusions
Vessel-masked nCBV maps can prevent overestimations of CBV measurements and can improve diagnostic accuracy for glioma grading.
Maximum Arterial Contrast Concentrations With Computed Tomography and Left Ventriculography: Implications for Contrast Nephrotoxicity Risk
Authors: Gutierrez Nicholas M. , Newhouse Jeffrey H. 
Published: May 2017

Purpose
Contrast nephropathy occurs more frequently after cardiac angiography, which usually includes left ventriculography via direct left ventricular injection, than after contrast-enhanced computed tomography (CT), despite the usually higher intravenous contrast dose used for CT. To determine whether maximum renal arterial contrast concentration is higher after left ventriculography, we assessed this parameter for both procedures.

Materials and Methods
Contrast concentration in abdominal aortic blood during contrast-enhanced CT was measured by performing CT densitometry of aortic blood before contrast, and in the arterial phase, in 100 adults undergoing abdominal CT. Densities were converted to contrast concentrations by scanning water phantoms containing 20 graded concentrations of contrast and comparing their densities to patient data. Because it was impossible to perform CT densitometry during cardiac angiography, aortic contrast concentrations were calculated from standard contrast doses and injection rates with the range of clinically encountered cardiac output rates, assuming ultimate steady state for blood/contrast mixing and normal data distribution.

Results
Maximum aortic (and hence renal arterial) concentrations were significantly higher (range, 6.68%–15.90%) after ventriculography than after CT (1.22%–5.80%). Because ventricular injection times are much shorter than published initial-appearance-to-maximum-concentration times after intravenous administration, the rate of change of contrast concentration is also higher after ventriculography than after CT.

Conclusion
Higher maximum renal arterial contrast concentration may be responsible for the greater risk of nephropathy after cardiac angiography than after doses for CT. The faster rate of change of renal arterial contrast concentration after ventriculography may also increase the likelihood of renal toxicity.

Clinical Relevance/Application
Maximum renal arterial contrast concentration, and/or the rapidity of change of this parameter, may be partly responsible for the risk of nephropathy. Controlling these factors might permit reduction of nephropathy risk; they also suggest avenues of research into the pathophysiology of contrast nephropathy.
Interreader Reliability and Clinical Validity of a Magnetic Resonance Imaging Grading System for Cervical Foraminal Stenosis
Authors: Lee Jung Eun , Park Hee Jin , Lee So Yeon , Lee Yong Taek , Kim Yong Bum , Lee Kyu Hong , Shin Hyunchul , Kwon Young Joon 
Published: May 2017

Objective
Park system is a magnetic resonance imaging (MRI) grading system for cervical neural foraminal stenosis (CNFS) and consists of 4 grades (0–3) based on the foraminal shape of 45-degree T2-weighted oblique sagittal images. The objective of this study was to evaluate the interreader reliability of the Park system among radiologists, residents, and clinicians. This study also assessed the correlations between radiologic and clinical findings.

Material and Methods
A total of 289 patients (men:women = 155:134, mean age = 50 years) who underwent oblique sagittal MRI of the cervical spine at our hospital were included. According to the MR grading system suggested by Park et al (Br J Radiol 2013;86:20120515), 2 radiologists, 2 trainees, and 2 clinicians measured CNFS grade at the most narrow point. A neurosurgeon assessed the associated clinical manifestations. κ statistics were used to analyze the interreader agreement among the radiologists and clinicians. The clinical correlations between grade and positive clinical manifestations were assessed with R using nonparametric correlation analysis (Spearman correlation).

Results
The overall interreader agreements between radiologists, between trainees, between clinicians, and between radiologists and clinicians were almost perfect (κ = 0.80–0.96). There were moderate correlations between grade and clinical manifestations in each group (R = 0.562–0.669). There were moderate to relatively high correlations between grade and neurologic manifestations based on cervical level (R = 0.570–0.715) (all P < 0.05).

Conclusions
Regardless of reader experience, there was substantial to almost perfect interreader reliability with the Park system for CNFS based on oblique sagittal MRI.