bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ligation of Intersphincteric Fistula Tract for Fistula in Ano: Lessons Learned From a Decade of Experience
Authors: Malakorn Songphol , Sammour Tarik , Khomvilai Supakij , Chowchankit Irin , Gunarasa Shankar , Kanjanasilp Prapon , Thiptanakij Charnjiroj , Rojanasakul Arun 
Published: September 2017

BACKGROUND:
Ligation of intersphincteric fistula tract is a well-described sphincter-preserving technique for the management of fistula in ano. In 2007, we reported our early experience demonstrating a primary success rate of 94.4%. These findings have since been supported by several short-term studies, but long-term results and secondary cure rates after ligation of intersphincteric fistula tract failure remain unknown.

OBJECTIVE:
This study aims to report a 10-year experience of ligation of intersphincteric fistula tract with extended long-term follow-up.

DESIGN:
Retrospective analysis of single-center data from May 2006 to October 2010 was performed.

SETTINGS:
This study was conducted at a large tertiary hospital in Bangkok, Thailand.

PATIENTS:
All patients with primary or recurrent fistula in ano who underwent a ligation of intersphincteric fistula tract procedure were included. Patients with malignancy, incontinent patients, and patients with rectovaginal fistula were excluded.

MAIN OUTCOME MEASURES:
Healing as defined by the absence of symptoms with no visible external opening on clinical examination. Follow-up was continued until May 2016.

RESULTS:
In total, 251 patients were identified, with a primary healing rate of 87.65% at a median follow-up of 71 months. The healing rates for low transsphincteric, intersphincteric, high transsphincteric, semihorseshoe, and horseshoe fistulas were 92.1%, 85.2%, 60.0%, 89.0%, and 40.0%. Of the 42 patients who had an unhealed fistula after previous non-ligation of intersphincteric fistula tract surgery, 38 (90.48%) healed after the first attempt at ligation of intersphincteric fistula tract. There were 31 patients with unhealed fistulas after the first ligation of intersphincteric fistula tract. Of these, 3 healed spontaneously, and the rest underwent either repeat ligation of intersphincteric fistula tract, fistulotomy (if the recurrence was intersphincteric), or simple curettage (if no internal opening was found). Ultimately, only 2 of the original 251 patients remained unhealed, and there was no change in subjective continence status after surgery.

LIMITATIONS:
This study was limited by its retrospective design.

CONCLUSION:
Ligation of intersphincteric fistula tract is an effective technique for the treatment of fistula in ano, including recurrent or unhealed fistula after other procedures. See Video Abstract at http://links.lww.com/DCR/A387.
Adjuvant Chemotherapy After Preoperative Chemoradiation Improves Survival in Patients With Locally Advanced Rectal Cancer
Authors: Sun Zhifei , Gilmore Brian , Adam Mohamed A. , Kim Jina , Hsu Shiao-wen D. , Migaly John , Mantyh Christopher R. 
Published: September 2017

BACKGROUND:
Practice guidelines differ in their support of adjuvant chemotherapy use in patients who received preoperative chemoradiation for rectal cancer.

OBJECTIVE:
The purpose of this study was to evaluate the impact of adjuvant chemotherapy among patients with locally advanced rectal cancer who received neoadjuvant chemoradiation and surgery.

DESIGN:
This was a retrospective study. Multivariable Cox proportional hazard modeling was used to evaluate the adjusted survival differences.

SETTINGS:
Data were collected from the National Cancer Database.

PATIENTS:
Adults with pathologic stage II and III rectal adenocarcinoma who received neoadjuvant chemoradiation and surgery were included.

MAIN OUTCOME MEASURES:
Overall survival was measured.

RESULTS:
Among 12,696 patients included, 4023 (32%) received adjuvant chemotherapy. The use of adjuvant chemotherapy increased over the study period from 23% to 36%. Although older age and black race were associated with a lower likelihood of receiving adjuvant chemotherapy, patients with higher education level and stage III disease were more likely to receive adjuvant chemotherapy (all p < 0.05). At 7 years, overall survival was improved among patients who received adjuvant chemotherapy (60% vs. 55%; p < 0.001). After risk adjustment, the use of adjuvant chemotherapy was associated with improved survival (HR = 0.81 (95% CI, 0.72–0.91); p < 0.001). In the subgroup of patients with stage II disease, survival was also improved among patients who received adjuvant chemotherapy (68% vs 58% at 7 y; p < 0.001; HR = 0.70 (95% CI, 0.57–0.87); p = 0.002). Among patients with stage III disease, the use of adjuvant chemotherapy was associated with a smaller but persistent survival benefit (56% vs 51% at 7 y; p = 0.017; HR = 0.85 (95% CI, 0.74–0.98); p = 0.026).

LIMITATIONS:
The study was limited by its potential for selection bias and inability to compare specific chemotherapy regimens.

CONCLUSIONS:
The use of adjuvant chemotherapy among patients with rectal cancer who received preoperative chemoradiation conferred a survival benefit. This study emphasizes the importance of adjuvant chemotherapy in the management of rectal cancer and advocates for its increased use in the setting of neoadjuvant therapy. See Video Abstract at http://link.lww.com/DCR/A428.
Safety and Efficacy of a Noninvasive 1,060-nm Diode Laser for Fat Reduction of the Flanks
Authors: Katz Bruce , Doherty Sean 
Published: September 2017

BACKGROUND
Preliminary reports indicate a hyperthermic diode laser treatment could be a safe and effective method for noninvasive fat reduction using the 1,060-nm wavelength. This wavelength penetrates the skin to heat subcutaneous adipocytes causing cellular disruption, leaving extracellular lipids, and cellular debris to be evacuated naturally by the body.

OBJECTIVE
To evaluate the safety and effectiveness of this modality for noninvasive fat reduction of the flanks.

MATERIALS AND METHODS
Forty-nine subjects received single laser treatment to 1 flank. Ultrasound images were taken at baseline, follow-up at 6 and 12 weeks after treatment. High-resolution photographs were taken at baseline and 12 weeks after treatment and then evaluated by independent reviewers. Adverse events recorded at all visits. Subjects completed a satisfaction questionnaire at the conclusion of the trial.

RESULTS
Ultrasound images showed statistically significant (p < .001) average fat reduction of 2.6 ± 1.1 mm. Reviewers correctly ordered photographs 90.3% of the time. Ninety-six percentage of subjects rated that they were satisfied. Noted side effects were transient mild to moderate tenderness which subsided within 1 to 3 weeks; no serious adverse events were reported.

CONCLUSION
The hyperthermic 1,060-nm diode laser treatment used in this study was safe and effective for noninvasive fat reduction of the flank.
Multimodal Approach for Treating Horizontal Neck Wrinkles Using Intensity Focused Ultrasound, Cohesive Polydensified Matrix Hyaluronic Acid, and IncobotulinumtoxinA
Authors: Jeon Heedae , Kim Taeyoon , Kim Heesu , Cho Sung Bin 
Published: September 2017

BACKGROUND
For the restoration of horizontal neck wrinkles, multimodal approaches using neuromodulators, intensity focused ultrasound (IFU), and fine line fillers are recommended.

OBJECTIVE
To evaluate the efficacy and safety of a 1-day, multimodal approach for horizontal neck wrinkles.

METHODS
Twelve female patients with horizontal neck wrinkles were treated with a combined treatment of IFU, cohesive polydensified matrix hyaluronic acid (CPMHA), and incobotulinumtoxinA. Therapeutic outcomes were assessed on Day 0 and 1, 2, 3, and 6 months thereafter.

RESULTS
Horizontal neck wrinkles decreased significantly in length from a median at baseline of 269.75 mm (interquatile range [IQR], 235.35–302.94 mm) to 91.5 mm (IQR, 51.4–108.61 mm) at 1 month, 92.3 mm (IQR, 69.66–132.07 mm) at 2 months, 101.88 mm (IQR, 86–146.77 mm) at 3 months, and 109.48 mm (IQR, 85.06–148.17 mm) at 6 months after the combined treatment. The median global aesthetic improvement scale scores were 3.5 (IQR, 2–4) at 1 month, 3 (IQR, 3–3.5) at 2 months, 3 (IQR, 2–4) at 3 months, and 3 (IQR, 3–3) at 6 months. Post-treatment petechiae resolved completely within 7 days, and CPMHA-induced lumps disappeared within 1 month.

CONCLUSION
The present data demonstrated that the multimodal, combined treatment used in the present study provides satisfactory and long-lasting therapeutic outcomes by targeting different pathogenetic factors of horizontal neck wrinkles.
Mechanism of Proliferation of Cultured Human Corneal Endothelial Cells
Authors: Joko Takeshi , Shiraishi Atsushi , Kobayashi Takeshi , Ohashi Yuichi , Higashiyama Shigeki 
Published: September 2017

Abstract:
Because human corneal endothelial cells (HCECs) do not proliferate once the endothelial monolayer has formed, corneal wound healing is believed to be mediated by cell enlargement or migration, rather than by proliferation. However, the cellular mechanisms involved in wound healing by HCECs have not been fully determined. In this review, we focus on the effects of promyelocytic leukemia zinc finger (PLZF), a DNA-binding transcription factor, and transforming growth factor (TGF)-β2 on the proliferation and migration of cultured HCECs. Involvement of the mitogen-activated protein kinase (MAPK) signaling pathway in the migration of HCECs was also investigated. Expression of PLZF mRNA decreased as cell–cell contact was disrupted and returned to the original level as cell–cell contact was re-formed. Assessment with a real-time cell electronic sensing system revealed that proliferation of cultured HCECs was inhibited after infection with Ad-PLZF and exposure to TGF-β2. Migration of cultured HCECs was increased by TGF-β2 through p38 MAPK activation. We conclude that PLZF expression in cultured HCECs is closely related to the formation of cell–cell contact and that TGF-β2 suppresses proliferation of cultured HCECs, while promoting their migration through p38 MAPK activation.
Streptococcus pneumoniae Serotyping by a Single Polymerase Chain Reaction–Based Multiplex Assay
Authors: Shokri Moghadam Mohammad , Talebi Malihe , Masjedian Faramarz , Irajian Gholamreza , Pourshafie Mohammad Reza 
Published: September 2017

Background

Streptococcus pneumoniae is a prominent pathogen in children younger than 5 years as well as elderly people. Capsular serotyping of S. pneumoniae is necessary to develop the new vaccines and prevent invasive and noninvasive infections by S. pneumoniae. In this study, we used 2-step multiplex polymerase chain reaction (mPCR) that contained primers to detect PCV13 (13-valent pneumococcal conjugated vaccine) and non-PCV13 serotypes in different clinical and normal flora samples.

Methods
A total of 100 S. pneumoniae isolates were obtained between 2013 and 2015 in Tehran, Iran. The sources of isolates were clinical and normal flora. Clinical isolates were eye infection (26%), blood (19%), sputum (18%), sinusitis and cerebrospinal fluid (9% each), trachea (7%), pleural aspirate (3%), otitis (3%), and urine, bronchoalveolar lavage, and abscess (2% each). Moreover, 43 normal flora isolates were collected from healthy individuals. The strain isolates were tested for antimicrobial susceptibility and serotyped by mPCR.

Results
The highest rate of resistance was seen for trimethoprim-sulfamethoxazole (96%) followed by tetracycline (77%), erythromycin (64%), clindamycin (56%), chloramphenicol (44%), and penicillin (26%). All isolates were susceptible to imipenem, ceftriaxone, vancomycin, linezolid, gemifloxacin, levofloxacin, moxifloxacin, and ofloxacin. By using mPCR, 91 and 7 isolates were typed in the first and second reactions, respectively. Two isolates were identified as nontypeable. The most frequent serotypes in 98 typeable serotypes were 23F (n = 21 [22%]), 14 (n = 19 [20%]), 3 (n = 13 [13%]), and 19F (n = 13 [13%]).

Conclusions
Our multiplex assay is a precise and reliable method that can be used instead of the Quellung reaction for S. pneumoniae serotyping studies.
Prion Disease
Authors: Lodhi Sameed Khalid , Mirza Maira , Khawaja Ayaz Mahmood 
Published: September 2017

Abstract
Since the discovery of Prion Proteins (PrPs) in 1982, a new model for an “infectious agent” has been proposed that is substantially different from our understanding of disease transmission by other microorganisms. Prion proteins have been implicated in many different diseases. Various transmission modes have been discovered, including consumption of infected meat, blood transfusion, medical devices used in neurosurgery and corneal transplantation, environmental routes (such as soil), and airborne routes. Familial and sporadic instances of the disease have also been recognized, such as fatal familial insomnia. Prion disease harbors long incubation periods, and subclinical infectious states have been discovered in asymptomatic individuals owing to lymphoreticular accumulation of PrPs. The uniformly fatal outcome after symptom onset secondary to prion disease has prompted rigorous research and attempts at development of prophylactic immunomodulatory techniques, gene therapy, and clinical trials investigating various medications such as doxycycline, quinacrine, pentosan polysulfate, and flupirtine to improve the survival and outcome in patients. In this article, we extensively review the background of PrPs and Creutzfeldt-Jakob disease, the various transmission methods, and recent developments into discovering a treatment for Creutzfeldt-Jakob disease.
Disseminated Mycobacterium Haemophilum Infection Masquerading as Erythema Nodosum and Avascular Necrosis in an Immunocompromised Host
Authors: Sainato Rebecca J. , Smith Benjamin R. , Parekh Dina S. , Flores Michelle S. , Logemann Nicholas F. , Chung Ellen M. , Eberly Matthew D. , Stagliano David R. , Malloy Allison M.W. 
Published: September 2017

Abstract

Mycobacterium haemophilum is likely an underrecognized cause of infection among patients with deficits in their cell-mediated immunity. Despite its name, which translates to “blood loving,” it remains unclear whether hyperferritinemic patients are also at higher risk of this infection. We present a 24-year-old woman with disseminated M. haemophilum infection who has hyperferritinemia and T-cell acute lymphoblastic leukemia in remission and was initially misdiagnosed as having erythema nodosum and avascular necrosis. This report highlights the clinical and histological similarities of M. haemophilum and erythema nodosum, discusses some diagnostic peculiarities, and also reviews similar cases within the literature.
Underlying Chronic Disease, Medication Use, History of Running Injuries and Being a More Experienced Runner Are Independent Factors Associated With Exercise-Associated Muscle Cramping: A Cross-Sectional Study in 15778 Distance Runners
Authors: Schwellnus Martin P. , Swanevelder Sonja , Jordaan Esme , Derman Wayne , Van Rensburg Dina C. Janse 
Published: September 2017

Background:
Exercise-associated muscle cramping (EAMC) is a significant medical complication in distance runners, yet factors associated with EAMC are poorly documented.

Objective:
To document risk factors associated with EAMC in runners.

Design:
Cross-sectional study.

Setting:
Two ocean races (21.1 km, and 56 km).

Participants:
Fifteen thousand seven hundred seventy-eight race entrants.

Methods:
Participants completed a prerace medical history screening tool including: training, cardiovascular disease (CVD), risk factors for, and symptoms of CVD, history of diseases affecting major organ systems, cancer, allergies, medication use, and running injury. Runners were grouped as having a history of EAMC (hEAMC group = 2997) and a control group (Control = 12 781).

Results:
Independent factors associated with a higher prevalence ratio (PR) of hEAMC were any risk factor for CVD (PR = 1.16; P = 0.0002), symptoms of CVD (PR = 2.38; P < 0.0001), respiratory disease (PR = 1.33; P < 0.0001), gastrointestinal disease (PR = 1.86; P < 0.0001), nervous system or psychiatric disease (PR = 1.51; P < 0.0001), kidney or bladder disease, (PR = 1.60; P < 0.0001), haematological or immune disease (PR = 1.54; P = 0.0048), cancer (PR = 1.34; P = 0.0031), allergies (PR = 1.37; P < 0.0001), regular medication use (PR = 1.80; P < 0.0001), statin use (PR = 1.26; P = 0.0127), medication use during racing (PR = 1.88; P < 0.0001), running injury (PR = 1.66; P < 0.0001), muscle injury (PR = 1.82; P < 0.0001), tendon injury (PR = 1.62; P < 0.0001), and runners in the experienced category (PR = 1.22; P < 0.0001).

Conclusion:
Novel risk factors associated with EAMC in distance runners were underlying chronic disease, medication use, a history of running injuries, and experienced runners. These factors must be identified as possible associations, and therefore be considered in the diagnosis and treatment of EAMC.
Children and Adolescent Hodgkin Lymphoma in Argentina: Long-term Results After Combined ABVD and Restricted Radiotherapy
Authors: Zubizarreta Pedro A. , Alfaro Elizabeth , Guitter Myriam , Sanchez La Rosa Cristian , Galluzzo María L. , Millán Natalia , Fiandrino Fernando , Felice María S. 
Published: September 2017

Objective:
Prospective analysis of clinical characteristics and long-term treatment results of a pediatric cohort with Hodgkin lymphoma (HL) treated in a single institution with ABVD and restricted radiotherapy (RT).

Patients and Methods:
Between September 2000 and December 2015, 165 new consecutive assessable patients with HL were registered at our institution. Lymphocyte predominant nodular HL was excluded. Low risk (LR) patients were stage I and IIA (no bulky disease, <4 involved ganglionar areas and no lung hilar nodes), high risk (HR) was assigned to stage IV and any other stage with bulky mediastinum. The rest of the cohort was treated as intermediate risk (IR). Chemotherapy for LR and IR patients was 4 and 6 courses of ABVD regimen, respectively. These subsets received Low-dose involved field radiotherapy only in case of partial remission at the end of chemotherapy (21 Gy in initially involved areas, plus 14 Gy boost on residual disease). The HR group was treated with 6 courses of ABVD followed always with 21 Gy involved field radiotherapy if complete remission (CR) was achieved. A boost of 14 Gy was added to residual disease in case of partial remission.

Results:
Median age was 10.6 years (range, 2.7 to 17 y). Males: 117 (71%); females: 48 (29%). Eighteen (11%) patients were stage I, 76 (46%) stage II, 35 (21%) stage III, and 35 (21%) stage IV. Forty-nine (30%) patients were assigned to LR, 49 (30%) to IR, and 67 (40%) to HR. Forty-three patients (26%) had “bulky” mediastinum involvement. One hundred thirty (79%) patients achieved CR after chemotherapy and 161 (98%) after RT. Four patients (all HR), did not respond to initial therapy and died of disease. One patient died in first CR due to adenovirus infection on previously therapy-related damaged lungs. Seventeen (10%) patients relapsed and 13 of them remained in second CR after further therapy. Seventy-six (46%) patients could be spared from RT and cured of disease (88% of LR patients and 67% of IR patients). With a median follow-up of 5 years, event free and overall survival were 0.84 (SE: 0.03) and 0.95 (SE: 0.02), respectively. Overall survival according to risk group was 1 for LR, 0.93 for IR, and 0.85 for HR. Acute toxicity and late effects due to therapy were not significant.

Conclusions:
The strategy of avoiding RT for LR and IR patients that responded completely to ABVD chemotherapy achieved very good results. For the HR group, the combination of 6 cycles of ABVD and Low-dose involved field radiotherapy was efficacious with similar good results. Nearly half of the patients could be cured without RT.
Factors Affecting Suicide Method Lethality Among Suicide Attempters in the Korea National Suicide Survey
Authors: Yeum Tae-Sung , Kim Bora , Kim Eun Young , Kim Se Hyun , Ha Kyooseob , Ahn Yong Min 
Published: September 2017

Abstract
This is the first national survey study in South Korea investigating the relationship between suicide lethality and the clinical information of suicide attempters. An interview questionnaire was used to assess their sociodemographic factors, medical and psychiatric information, and two suicide scales, the Columbia–Suicide Severity Rating Scale and the Suicide Intent Scale. Suicide methods were categorized as low and high lethality; low lethality covered drug overdose or self-cutting behavior, and high lethality covered all other methods. High and low lethality suicide method groups were significantly different in demographic, medical, and psychiatric factors. The two scale score distributions differed significantly across two groups, and the difference was also valid for the subcategory analyses of the Suicide Intent Scale. Multiple factors such as older age, male sex, no previous psychiatric history, and previous suicide attempt, as well as high suicide intent by means of suicide scale, affect selection of suicide method of high lethality.
Dentoalveolar Effects of Early Orthodontic Treatment in Patients With Cleft Lip and Palate
Authors: Cassi Diana , Di Blasio Alberto , Gandolfinini Mauro , Magnifico Marisabel , Pellegrino Francesca , Piancino Maria Grazia 
Published: September 2017

Abstract
No agreement exists on the most appropriate timing of orthodontic treatment in patients with cleft lip and palate. The aim of this study is to investigate the effect of early orthodontic treatment on development of the dental arches and alveolar bone.
A dental casts analysis was performed on 28 children with cleft lip and palate before orthodontic treatment (T0; mean age, 6.5 ± 1.7) and at the end of active treatment (T1; mean age, 9.2 ± 2.1 years). The considered variables were: intercanine and intermolar distances; dental arch relationships, evaluated according to the modified Huddart/Bodenham system.
The study group was divided into 2 samples according to the age at T0: Group A (age < 6 years) and Group B (age ≥ 6 years). A statistical comparison of the treatment effects between the 2 samples was performed.
Patients in Group A exhibited a greater increase of intercanine distance (8 mm versus 2.7 mm; P<0.001), intermolar distance (7.2 mm versus 5 mm; P = 0.06), and Huddart/Bodenham score (7.1 versus 3; P < 0.05) when compared with patients in Group B.
Early orthodontic treatment strongly improved the dental arch relationship, since subjects starting the therapy before the age of 6 had a better response in terms of anterior maxillary expansion.