bluuebunny/crossref_metadata_2025_split huggingface dataset:
Overview of pathophysiology and treatment of human lupus nephritis
Authors: Trotter Kimberly , Clark Marcus R. , Liarski Vladimir M. 
Published: June 2016

Purpose of reviewDespite recent developments and treatment successes, the outcome, and prognosis of patients with lupus nephritis (LuN) have not greatly changed since the 1980s. This review covers the application of new concepts to the understanding of renal inflammation and the study of new pharmacologic agents to improve patient outcomes.Recent findingsStudies have shown that the presence of anti-vimentin antibodies and T follicular helper cells in patient biopsies is associated with more severe interstitial inflammation, which has been tied to faster disease progression and onset of end-stage renal disease. Additionally, data regarding the role of serum IgE antidouble-stranded DNA antibodies in LuN by means of mediating IFN1 production by plasmacytoid dendritic cells are highlighted. Finally, a thorough review of completed and currently open clinical trials of therapeutic agents is provided.SummaryCurrent management of LuN is guided almost exclusively by glomerular involvement. Based on the data provided in this review, we argue that renal tubulointerstitial inflammation is no less important and represents an overlooked feature in the current clinical approach to patients. Tubulointerstitial inflammation is driven by both adaptive and innate immune mechanisms that are still poorly understood. Studying these pathogenic processes promises to reveal new therapeutic opportunities for those LuN patients with the worst prognosis.Video abstractAlternate video abstract introduction (see Video, Supplemental Digital Content 1, with introduction by two of the authors – VL and KT). Abstract Video: http://links.lww.com/COR/A35
Oblique Terminal Screw Placement: Does It Improve Fixation in Plate Osteosynthesis?
Authors: Waldrop Robert , Wood William , Cunningham Brian P. , McLemore Ryan , McLaren Alex 
Published: June 2016

Summary:
The technique of placing an oblique screw in the terminal hole of a plate to increase screw pullout strength is widely taught in the operating room. The origin of this technique is unclear; however, it may have been used simply as a means to identify radiographs and misinterpreted to have some biomechanical benefit. The objective of this study was to measure the structural effect of oblique terminal screw placement (OTSP) during plate osteosynthesis. Foam blocks and limited contact dynamic compression plates and screws were used along with a custom fixture device. The terminal screw was placed in either an oblique (30-degree angle outward) or perpendicular fashion. A load was applied perpendicular to the plate in cantilever bending until failure. The oblique screw construct was significantly weaker than the perpendicular screw construct (399N vs. 465N, P < 0.001), independent of the block of material used. Post hoc analysis showed that the screw angle (P < 0.001) was a significant determinant of the load required to cause screw pullout. OTSP led to a decrease in pullout strength compared with a perpendicular screw in a deformable foam medium similar in density to osteoporotic bone. In patients with poor bone quality, OTSP may create a suboptimal fracture fixation construct.
Individualized predictions of time to menopause using multiple measurements of antimüllerian hormone
Authors: Gohari Mahmood Reza , Ramezani Tehrani Fahime , Chenouri Shojaeddin , Solaymani-Dodaran Masoud , Azizi Fereidoun 
Published: June 2016

AbstractObjective:The ability of antimüllerian hormone (AMH) to predict age at menopause has been reported in several studies, and a decrease in AMH level has been found to increase the probability of menopause. The rate of decline varies among women, and there is also a variability of decline between women's cycles. As a result, individualized evaluation is required to accurately predict time of menopause. To this end, we have used the AMH trajectories of individual women to predict each one's age at menopause.Methods:From a cohort study, 266 women (ages 20-50 y) who had regular and predictable menstrual cycles at the initiation of the study were randomly selected from among 1,265 women for multiple AMH measurements. Participants were visited at approximately 3-year intervals and followed for an average of 6.5 years. Individual likelihood of menopause was predicted by fitting the shared random-effects joint model to the baseline covariates and the specific AMH trajectory of each woman.Results:In total, 23.7% of the women reached menopause during the follow-up period. The estimated mean (SD) AMH concentration at the time of menopause was 0.05 ng/mL (0.06 ng/mL), compared with 1.36 ng/mL (1.85 ng/mL) for those with a regular menstrual cycle at their last assessment. The decline rate in the AMH level varied among age groups, and age was a significant prognostic factor for AMH level (P < 0.001). Adjusting for age and body mass index, each woman had her own specific AMH trajectory. Lower AMH and older age had significant effects on the onset of menopause. Individualized prediction of time to menopause was obtained from the fitted model.Conclusions:Longitudinal measurements of AMH will enable physicians to individualize the prediction of menopause, thereby facilitating counseling on the timing of childbearing or medical management of health issues associated with menopause.
BIMANUAL PARS PLANA VITRECTOMY FOR REMOVAL OF A DISLOCATED DESCEMET-STRIPPING AUTOMATED ENDOTHELIAL KERATOPLASTY GRAFT FROM THE VITREOUS CAVITY
Authors: Xu Kunyong , Chin Eric K. , Carpel Emmett F. , Almeida David R. P. 
Published: June 2016

Purpose:
To describe a bimanual vitrectomy technique for the removal of a descemet-stripping automated endothelial keratoplasty donor graft dislocated into the vitreous cavity.

Methods:
The surgical technique requires the use of a temporary keratoprosthesis and external chandelier illumination to overcome corneal edema and visualization of the dislocated donor graft, respectively. A bimanual pars plana vitrectomy approach is then performed with intraocular forceps and the vitrectomy handpiece for segmentation and removal of the dislocated graft. Penetrating keratoplasty is then performed to restore corneal clarity.

Results:
This surgical technique allows for the dislocated descemet-stripping automated endothelial keratoplasty donor graft to be removed from the vitreous cavity safely in an efficient manner.

Conclusion:
The technique of bimanual pars plana vitrectomy with a temporary keratoprosthesis and external chandelier illumination can successfully remove a descemet-stripping automated endothelial keratoplasty donor graft dislocated into the vitreous cavity without the need for a large wound for donor graft explantation.
Computer-Assisted Transcatheter Heart Valve Implantation in Valve-in-Valve Procedures
Authors: Soulami Réda Belhaj , Verhoye Jean-Philippe , Duc Hung Nguyen , Castro Miguel , Auffret Vincent , Anselmi Amedeo , Haigron Pascal , Ruggieri Vito Giovanni 
Published: June 2016

Objective Valve-in-valve (ViV) procedures are increasingly being considered as an alternative to redo surgery for the treatment of degenerated bioprosthetic heart valves in patients with excessive reoperative risk. The objective of our study was to evaluate the feasibility of computer guidance in transcatheter heart valve (THV) implantation during ViV procedures. Methods Preprocedural electrocardiogram-gated computed tomography–scan images were processed using semiautomatic segmentation of the degenerated bioprosthesis’ radiopaque landmarks and of the ascending aorta. Virtual three-dimensional (3D) reconstructions were created. A virtual plane was subsequently added to the 3D reconstructions, indicating the optimal landing plane of the THV inside the tissue valve. Within a hybrid operating theater, a 3D/2D registration was used to superimpose the 3D reconstructions, while dynamic tracking was allowed to maintain the superimposition onto the fluoroscopic images. The THV was afterward implanted according to the optimal landing plane. Projection of the ascending aorta and the coronary arteries was used to assess the risk of coronary ostia obstruction. Results Between January 2014 and October 2014, nine patients underwent aortic ViV procedures in our institution. Among those nine patients, five procedures were retrospectively evaluated as a validation step using the proposed method. The mean (SD) superimposition error was 1.1 (0.75) mm. Subsequently, two live cases were prospectively carried out using our approach, successfully implanting the THV inside the degenerated tissue valve. Conclusions Our study demonstrates the feasibility of a computer-guided implantation of THV in ViV procedures. Moreover, it suggests that augmented reality may increase the reliability of THV implantation inside degenerated bioprostheses through better reproducibility.
Etiology and Management of Allergic Eyelid Dermatitis
Authors: Chisholm Smith Ann M. , Couch Steven M. , Custer Philip L. 
Published: June 2016

Purpose:
Allergic dermatitis is a common but often misdiagnosed condition that can present with a variety of findings including inflammation, eyelid malposition, and tearing. This study was performed to identify likely etiologies, along with presenting findings and treatment strategies for allergic dermatitis.

Methods:
A retrospective review of clinical records was performed of patients diagnosed with allergic dermatitis in academic oculoplastics practices from 2002 to 2014. Initial consultation included review of medications and cosmeceuticals. Suspected allergens were discontinued and an ophthalmic steroid was applied. Persistent allergic dermatitis led to further medication changes or formal allergy testing in an effort to identify the causative agent.

Results:
Sixty-one patients were identified; average age was 66 years old (range: 33–94), and 45 of the patients were women (74%). Average follow up was 7 months (range: 1–60 months). Reasons for referral included epiphora (31.2%), ectropion (24.6%), blepharitis/dermatitis (18.0%), and “droopy” eyelid (14.8%). Presenting symptoms included irritation (77.1%) and tearing (50.8%). Average duration of symptoms was 16.5 months (range: 2 days–8 years). The 3 most common etiologies were eye drops (54.2%), creams/lotions (24.6%), and cosmetics (13.1%). Rubbing/manipulation was also thought to be a significant factor in 30% of the patients. Overall, the initial treatment regimen led to at least partial resolution in 88% of patients and 66% experienced complete resolution. Patients resistant to therapy were referred for patch testing. At follow up, 98% of patients had improvement in their symptoms and 90% of patients had complete resolution of their symptoms.

Conclusions:
Allergic eyelid dermatitis is commonly related to eye drops and topical cosmetics or skin care products. Identification and elimination of causative agents is the mainstay of management. Topical corticosteroids often facilitate resolution of the associated inflammation. Therapy resistant patients may benefit from formal allergy testing.
Variables Associated With Inpatient and Outpatient Resource Utilization Among Medicare Beneficiaries With Nonalcoholic Fatty Liver Disease With or Without Cirrhosis
Authors: Sayiner Mehmet , Otgonsuren Munkhzul , Cable Rebecca , Younossi Issah , Afendy Mariam , Golabi Pegah , Henry Linda , Younossi Zobair M. 
Published: June 2016

Background:
Nonalcoholic fatty liver disease (NAFLD) is one of the leading causes of chronic liver disease worldwide with tremendous clinical burden. The economic burden of NAFLD is not well studied.

Goal:
To assess the economic burden of NAFLD.

Study:
Medicare beneficiaries (January 1, 2010 to December 31, 2010) with NAFLD diagnosis by International Classification of Diseases, Ninth Revision codes in the absence of other liver diseases were selected. Inpatient and outpatient resource utilization parameters were total charges and total provider payments. NAFLD patients with compensated cirrhosis (CC) were compared with decompensated cirrhosis (DC).

Results:
A total of 976 inpatients and 4742 outpatients with NAFLD were included—87% were white, 36% male, 30% had cardiovascular disease (CVD) or metabolic syndrome conditions, and 12% had cirrhosis. For inpatients, median total hospital charge was $36,289. NAFLD patients with cirrhosis had higher charges and payments than noncirrhotic NAFLD patients ($61,151 vs. $33,863 and $18,804 vs. $10,146, P<0.001). Compared with CC, NAFLD patients with DC had higher charges and payments (P<0.02). For outpatients, median total charge was $9,011. NAFLD patients with cirrhosis had higher charges and payments than noncirrhotic NAFLD patients ($12,049 vs. $8,830 and $2,586 vs. $1,734, P<0.001). Compared with CC, DC patients had higher total charges ($15,187 vs. $10,379, P=0.04). In multivariate analysis, variables associated with increased inpatient resource utilization were inpatient mortality, DC, and CVD; for outpatients, having CVD, obesity, and hypertension (all P<0.001).

Conclusions:
NAFLD is associated with significant economic burden to Medicare. Presence of cirrhosis and CVD are associated with increased resource utilization.
Altered Underlying Renal Tubular Function in Patients With Chronic Hepatitis B Receiving Nucleos(t)ide Analogs in a Real-World Setting
Authors: Rodríguez-Nóvoa Sonia , García-Samaniego Javier , Prieto Martín , Calleja José L. , Pascasio Juan M. , Delgado Blanco Manuel , Crespo Javier , Buti María , Bonet Vidal Maria L. , Arenas Ruiz Tapiador Juan , Fernández-Rodríguez Conrado , Solá Ricard , Fraga Enrique , González Diéguez Luisa , Núñez Oscar , Praga Manuel , del Pino-Montes Javier , Romero-Gómez Manuel , Morillas Rosa , Diago Moisés , Castro Ángeles 
Published: June 2016

Background:
Cases of renal tubular dysfunction have been reported in patients with hepatitis B and in patients with human immunodeficiency virus who are undergoing tenofovir treatment. However, little is known about the impact on tubular function in patients with chronic hepatitis B (CHB) under long-term use of entecavir (ETV) and tenofovir disoproxil fumarate (TDF). We evaluated markers of renal tubular function and bone turnover in patients with CHB treated with ETV or TDF.

Patients and Methods:
A multicenter, cross-sectional study was performed on markers of renal tubular function and bone turnover in hepatitis B virus–monoinfected patients on long-term treatment with Entecavir or Tenofovir (the MENTE study). The analyzed parameters were: retinol-binding protein/creatinine, neutrophil gelatinase-associated lipocalin/creatinine, excretion of phosphates, uric acid excretion, glomerular filtrate, protein/creatinine, albumin/creatinine, serum creatinine, phosphate, CTX, P1NP, vitamin D, and parathormone.

Results:
A total of 280 patients (ETV: 89, TDF: 69, control: 122) were included in this study. The TDF group was associated with altered levels of retinol-binding protein (RBP)/creatinine (TDF 25% vs. 7% ETV and control; P<0.001). Protein/creatinine, uric acid excretion, P1NP1, and parathormone were higher in the TDF group. The proportion of patients with serum phosphate <2.5 mg/dL was higher in both the ETV and the TDF groups compared with the control. The multivariate analysis showed that the use of TDF was independently associated with a higher risk of altered excretion of RBP/creatinine (4.4; interquartile range: 1.4 to 14; P=0.013).

Conclusions:
We found an independent association between TDF use and altered RBP excretion. This finding indicates subclinical tubular damage. Because tubular dysfunction can precede the decline of renal function, close monitoring of RBP levels in patients with CHB on nucleos(t)ide analog treatment must be performed for early detection of TDF-related renal toxicity. In this study, these differences in tubular function were not associated with concomitant changes in markers of bone turnover.
Management of Patients With Pancreatic Cysts
Authors: Kowalski Thomas , Siddiqui Ali , Loren David , Mertz Howard R. , Mallat Damien , Haddad Nadim , Malhotra Nidhi , Sadowski Brett , Lybik Mark J. , Patel Sandeep N. , Okoh Emuejevoke , Rosenkranz Laura , Karasik Michael , Golioto Michael , Linder Jeffrey , Catalano Marc F. , Al-Haddad Mohammad A. 
Published: June 2016

Goals:To examine the utility of integrated molecular pathology (IMP) in managing surveillance of pancreatic cysts based on outcomes and analysis of false negatives (FNs) from a previously published cohort (n=492).Background:In endoscopic ultrasound with fine-needle aspiration (EUS-FNA) of cyst fluid lacking malignant cytology, IMP demonstrated better risk stratification for malignancy at approximately 3 years’ follow-up than International Consensus Guideline (Fukuoka) 2012 management recommendations in such cases.Study:Patient outcomes and clinical features of Fukuoka and IMP FN cases were reviewed. Practical guidance for appropriate surveillance intervals and surgery decisions using IMP were derived from follow-up data, considering EUS-FNA sampling limitations and high-risk clinical circumstances observed. Surveillance intervals for patients based on IMP predictive value were compared with those of Fukuoka.Results:Outcomes at follow-up for IMP low-risk diagnoses supported surveillance every 2 to 3 years, independent of cyst size, when EUS-FNA sampling limitations or high-risk clinical circumstances were absent. In 10 of 11 patients with FN IMP diagnoses (2% of cohort), EUS-FNA sampling limitations existed; Fukuoka identified high risk in 9 of 11 cases. In 4 of 6 FN cases by Fukuoka (1% of cohort), IMP identified high risk. Overall, 55% of cases had possible sampling limitations and 37% had high-risk clinical circumstances. Outcomes support more cautious management in such cases when using IMP.Conclusions:Adjunct use of IMP can provide evidence for relaxed surveillance of patients with benign cysts that meet Fukuoka criteria for closer observation or surgery. Although infrequent, FN results with IMP can be associated with EUS-FNA sampling limitations or high-risk clinical circumstances.
Treatment of Pulmonary Exacerbations Improves Short But Not Long‐Term Growth Trajectory in Children With Cystic Fibrosis
Authors: Loong Christine , Breton Jessica , Yang Connie L. 
Published: June 2016

ABSTRACTObjectives:The present study sought to determine the long‐term growth consequences after a pulmonary exacerbation in children with cystic fibrosis (CF).Methods:Retrospective cohort study of pediatric patients with CF with a hospital admission for a pulmonary exacerbation. Logistic regression used to determine risk factors for failure to recover baseline body mass index (BMI) percentile.Results:Of 72 patients, 43% failed to recover their baseline BMI percentile 12 months after discharge and these patients also had a lower forced expiratory volume in 1 second at follow‐up. A greater decrease in weight percentile from baseline to admission was the only risk factor identified (odds ratio 0.83, P = 0.0015).Conclusions:Greater decrease in weight percentile from baseline to admission predicts failure to recover BMI percentile 1 year after a pulmonary exacerbation. Children with CF with poor growth preceding a pulmonary exacerbation continue to be at risk for long‐term nutritional failure despite treatment for pulmonary exacerbation.
Total Pancreatectomy With Islet Autotransplantation Resolves Pain in Young Children With Severe Chronic Pancreatitis
Authors: Bellin Melena D. , Forlenza Gregory P. , Majumder Kaustav , Berger Megan , Freeman Martin L. , Beilman Gregory J. , Dunn Ty B. , Pruett Timothy L. , Murati Michael , Wilhelm Joshua J. , Cook Marie , Sutherland David E.R. , Schwarzenberg Sarah J. , Chinnakotla Srinath 
Published: June 2016

ABSTRACTObjectives:Fear of diabetes and major surgery may prohibit referral of young children severely affected by pancreatitis for total pancreatectomy with islet autotransplant (TPIAT). We evaluated outcomes in our youngest TPIAT recipients, 3 to 8 years of age at surgery.Methods:Medical records were reviewed for 17 children (9 girls) ages 8 years or younger undergoing TPIAT from 2000 to 2014. Most (14/17) had genetic risk factors for pancreatitis. Since 2006, TPIAT recipients were followed prospectively with health questionnaires including assessments of pain and narcotic use, and scheduled hemoglobin A1c (HbA1c) and mixed‐meal tolerance tests (6 mL/kg Boost HP) before surgery, and at regular intervals after. Patients are 1 to 11 years post‐TPIAT (median 2.2 years). Data are reported as median (25th, 75th percentile).Results:All had relief of pain, with all 17 patients off narcotics at most recent follow‐up. Hospitalization rates decreased from 5.0 hospitalization episodes per person‐year of follow‐up before TPIAT, to 0.35 episodes per person‐year of follow‐up after TPIAT. Fourteen (82%) discontinued insulin, higher than the observed insulin independence rate of 41% in 399 patients older than 8 years of age undergoing TPIAT over the same interval (P = 0.004). Median post‐TPIAT HbA1c was 5.9% (5.6%, 6.3%), and within patient post‐TPIAT mean HbA1c was ⩽6.5% for all but 2 patients.Conclusions:Young children with severe refractory chronic pancreatitis may be good candidates for TPIAT, with high rates of pain relief and insulin independence, and excellent glycemic control in the majority.
Effective Use of Computed Tomography for Detection of Press-Through-Package Sheet Ingestion in a Pediatric Patient
Authors: Takeuchi Ichiro , Ito Tomoya , Ito Yurie , Uematsu Satoko , Misato Migita , Oono Michinobu , Tsuji Satoshi , Sakai Hirokazu 
Published: June 2016

Abstract
Press-through-package sheet (PTPS) ingestion can cause perforation of gastrointestinal tract. Such incidents, which require immediate medical attention, are often observed in elderly people. In this report, we describe the case of a 12-year-old patient who ingested PTPS. The patient, who has attention-deficit/hyperactivity disorder, presented with abdominal pain at our hospital. While it was not revealed by a chest x-ray, computed tomography scan showed a PTPS lodged in his lower esophagus. The ingested PTPS was removed by endoscopy without complications. Press-through-package sheets ingestion can occur in pediatric patients, and computed tomography scan is useful in the diagnosis.
Implementing Safe Practices in Administering Pro re nata Medications in a Rural Hospital
Authors: Hogan Kerry-Anne , Lapenskie Julie , Leclair Joanne , Thick Naomi , Gazarin Mohamed , Webster Penny , Devin Brian 
Published: June 2016

Abstract
Developing and implementing a policy for safe pro re nata medications practices became a priority when 1 nurse questioned a regularly occurring double-range narcotic order. This article describes how double-range medications can compromise patient safety and how a small rural hospital with minimal resources was able to develop an interdisciplinary practice standard to ensure safe medication practices.