bluuebunny/crossref_metadata_2025_split huggingface dataset:
Extended Endoscopic Approach for Resection of Craniopharyngiomas
Authors: Almeida João , Suppiah Suganth , Karekezi Claire , Marigil-Sanchez Miguel , Wong Jay , Vescan Allan , Gentili Fred , Zadeh Gelareh 
Published: January 2018

Objectives Extended endoscopic approaches are useful for resection of selected craniopharyngiomas. Midline, extraventricular, and predominantly cystic lesions are good candidates for endoscopic resection. In this video, we demonstrate the endoscopic endonasal resection of a large suprasellar craniopharyngioma and discuss the nuances of the surgical technique.
Design/Setting Surgical video of an extended endoscopic approach for resection of a suprasellar craniopharyngioma.
Results We report the case of a 56-year-old woman who presented with bitemporal hemianopsia and visual acuity deterioration secondary to a large suprasellar solid–cystic lesion. The patient underwent an extended endoscopic transtuberculum approach for resection of the lesion, which was diagnosed as a papillary craniopharyngioma. This video discusses the anatomy and surgical technique applied for endoscopic resection of such lesions.
Conclusion Endoscopic endonasal surgery is a useful technique for management of craniopharyngiomas. It is associated with good clinical outcomes in selected cases. Complications, such as postoperative CSF leak, may occur and should be carefully managed.The link to the video can be found at: https://youtu.be/EneOCiQE7yo.
Microsurgical Resection of Tuberculum Sellae Meningioma via Pterional Craniotomy with Extradural Anterior Clinoidectomy and Optic Unroofing
Authors: Dogan Ihsan , Ucer Melih , Başkaya Mustafa 
Published: January 2018

AbstractMicrosurgical treatment of suprasellar tumors, in particular tuberculum sellae meningiomas, poses significant challenge. These tumors are surrounded by vital neurovascular structures, such as optic apparatus, pituitary stalk, internal carotid artery and its branches, and anterior cerebral arteries. In large and complex cases, early identification and decompression of these structures may facilitate safer dissection and resection. Therefore, extradural anterior clinoidectomy with optic unroofing facilitates the internal carotid artery exposure and optic nerve decompression. In this video, we describe a 37-year-old female patient who presented with new onset of severe headaches. On visual examination, she was found to have bitemporal visual defects. MRI scan of the head showed a large, approximately 3 cm suprasellar tumor consistent with tuberculum sellae meningioma. She underwent surgical resection via pterional craniotomy with extradural anterior clinoidectomy and optic unroofing. Microsurgical gross total resection was achieved and histopathology was WHO grade II meningioma. She had an uneventful postoperative course and visual field examination improved significantly. In this video, surgical technique in performing extradural anterior clinoidectomy and optic unroofing and steps of microsurgical resection are demonstrated.The link to the video can be found at: https://youtu.be/oPZ8NTyvxJc.
Intracranial Calcification after Probable Disseminated Bacillus Calmette–Guérin Infection in a Child with Severe Combined Immunodeficiency
Authors: Eser Isil , Uyan Zeynep Seda , Kilic Suar Caki , Uyur Emek , Arisoy Emin Sami , Tezcan Gulsun , Aydogan Metin 
Published: January 2018

AbstractBacillus Calmette–Guérin (BCG) vaccine is administered to infants in countries with a high prevalence of tuberculosis. Severe combined immunodeficiency (SCID) is one of the most severe forms of primary immunodeficiency disease, rendering patients prone to disseminated BCG infection. Early intensive antimycobacterial treatment and bone marrow transplantation may be lifesaving in patients with BCG infection and SCID. The central nervous system is rarely involved in BCG infection. We report a case of disseminated BCG infection with diffuse intracranial calcification, including periventricular white matter, subcortical area, pons and cerebellar white matter after bone marrow transplantation.
Epidemiologie, Diagnostik und Therapie erwachsener Patienten mit nosokomialer Pneumonie – Update 2017
Authors: Dalhoff K. , Abele-Horn M. , Andreas S. , Deja M. , Ewig S. , Gastmeier P. , Gatermann S. , Gerlach H. , Grabein B. , Heußel C. , Höffken G. , Kolditz M. , Kramme E. , Kühl H. , Lange C. , Mayer K. , Nachtigall I. , Panning M. , Pletz M. , Rath P.-M. , Rohde G. , Rosseau S. , Schaaf B. , Schreiter D. , Schütte H. , Seifert H. , Spies C. , Welte T. ,   Unter Mitwirkung der folgenden Wissenschaftlichen Fachgesellschaften und Institutionen: Deutsche Gesellschaft für Chirurgie,   Deutsche Gesellschaft für Innere Medizin e. V.,   Deutsche Gesellschaft für Internistische Intensivmedizin und Notfallmedizin,   Deutsche Sepsis-Gesellschaft e. V.,   und Robert Koch-Institut
Published: January 2018

ZusammenfassungDie nosokomiale Pneumonie bleibt eine häufige Komplikation von Krankenhausaufenthalten. Die meisten Daten liegen zur beatmungsassoziierten Pneumonie vor, aber auch auf Normalstationen ist vermehrt mit dieser Erkrankung zu rechnen. Problematisch ist die Zunahme von Infektionen mit multiresistenten Erregern (MRE). Diese erschwert die adäquate Initialtherapie und kann zu unkritischem Einsatz von Breitspektrumantibiotika führen.Das vorliegende Update der S3-Leitlinie von 2012 wurde von einer interdisziplinären Arbeitsgruppe auf der Basis einer systematischen Literaturrecherche erarbeitet. Die Empfehlungen zu Diagnostik und Therapie wurden nach dem GRADE-System abgefasst. Graduierung und Empfehlungsstärke entsprechen der Methodik der Nationalen Versorgungsleitlinien.Die Leitlinie besteht aus zwei Teilen. Der allgemeine Teil vermittelt einen aktuellen Überblick zu Epidemiologie, Erregerspektrum und Therapieoptionen der nosokomialen Pneumonie. Handlungsorientierte Empfehlungen zu Diagnostik und Therapie werden im zweiten Teil abgegeben. Neu in diesem Update sind detailliertere Empfehlungen zur bildgebenden Diagnostik, zur Diagnostik nosokomialer Virusinfektionen sowie zur prolongierten Applikation von Antiinfektiva. Die Angaben zur Bedeutung von Risikofaktoren für Infektionen mit MRE und die Empfehlungen zum Einsatz einer antibakteriellen Kombinationstherapie bei derartigen Infektionen wurden angepasst. Strukturierte Deeskalationskonzepte und eine konsequente Begrenzung der Therapiedauer zur Verminderung des Selektionsdrucks werden besonders betont.
A novel method of endoscopic-assisted esophageal clearance in advanced achalasia
Authors: Tanaka Shinwa , Kawara Fumiaki , Toyonaga Takashi , Bechara Robert , Hoshi Namiko , Abe Hirofumi , Ohara Yoshiko , Ishida Tsukasa , Morita Yoshinori , Umegaki Eiji 
Published: January 2018

Abstract
Background and study aims In order to perform peroral endoscopic myotomy (POEM) safely, retained liquid and food debris must be removed before the procedure is started. We developed a novel technique using a super-slim gastroscope, and a gastric tube to remove retained food debris in achalasia patients. In this study, the safety and efficacy of this novel technique were investigated
Patients and methods Eleven patients with achalasia were enrolled in this study and underwent this novel method for esophageal clearance.
Results All patients had complete clearance of the retained food debris using this method. The median procedure time (range) was 13 (6 – 30) minutes. There were no serious adverse events (AEs) and one minor AE of mucosal erythema due to mucosal suctioning.
Conclusion This novel method for esophageal clearance is safe and effective in achalasia patients with large amounts of retained food debris.
German Guideline for Idiopathic Pulmonary Fibrosis – Update on Pharmacological Therapies 2017
Authors: Behr Jürgen , Günther Andreas , Bonella Francesco , Geißler Klaus , Koschel Dirk , Kreuter Michael , Prasse Antje , Schönfeld Nicolas , Sitter Helmut , Müller-Quernheim Joachim , Costabel Ulrich 
Published: January 2018

AbstractIdiopathic pulmonary fibrosis (IPF) is a severe and often fatal disease with a median survival of 2 – 4 years after diagnosis. Since the publication of the German IPF guideline in 2013 new treatment trials have been published, necessitating an update of the pharmacological therapy of IPF. Different from the previous guideline, the GRADE system was discarded and replaced by the Oxford evidence classification system which allows a more differentiated judgement. The following pharmacological therapies were rated not suitable for the treatment of IPF patients (recommendation A; evidence 1-b): triple therapy with prednisolone, azathioprine and acetyl-cysteine; imatinib; ambrisentan; bosentan; macitentan. A less clear but still negative recommendation (B, 1-b) was attributed to the treatment of IPF with the phosphodiesterase-5-inhibitor sildenafil and acetyl-cysteine monotherapy. In contrast to the international guideline antacid therapy as a general treatment for IPF was rated negative, based on conflicting results of recent analyses (recommendation C; evidence 4). An unanimous positive recommendation was granted for the antifibrotic drugs nintedanib and pirfenidone for the treatment of IPF (A, 1-a). For some open questions in the management of IPF patients for which firm evidence is lacking the guideline also offers recommendations based on expert consensus.
Underwater endoscopic mucosal resection: a new endoscopic method for resection of rectal neuroendocrine tumor grade 1 (carcinoid) ≤ 10 mm in diameter
Authors: Yamashina Takeshi , Tumura Takehiko , Maruo Takanori , Matsumae Takayuki , Yoshida Hiroyuki , Tanke Gensho , Taki Mio , Fukuhara Manabu , Kimura Yoshito , Sakamoto Azusa , Henmi Shinichiro , Sawai Yugo , Saito Sumio , Nishijima Norihiro , Nasu Akihiro , Komekado Hideyuki , Asada Masanori , Kita Ryuichi , Kimura Toru , Osaki Yukio 
Published: January 2018

Abstract
Background and study aims Rectal neuroendocrine tumors grade 1 (NET G1; carcinoid) ≤ 10 mm in diameter often extend into the submucosa, making their complete histological resection difficult using endoscopic techniques. Endoscopic submucosal resection with a ligation device (ESMR-L) and endoscopic submucosal dissection (ESD) are commonly used to overcome these difficulties. We also previously reported that underwater endoscopic mucosal resection (UEMR) could facilitate resection of rectal NET G1. This study aimed to evaluate the safety and efficacy of UEMR for removing rectal NET G1 ≤ 10 mm in diameter. 6 consecutive patients with rectal NET G1 ≤ 10 mm in diameter underwent UEMR at our hospital. The rate of en bloc resection was 100 %, and the rate of R0 resection was 83 %. The median procedure time was 8 min (range 5 – 12 min). No perforations or delayed bleeding occurred in this study. In conclusion, UEMR allows the safe and reliable resection of rectal NET G1 ≤ 10 mm in diameter with comparable results to ESMR-L or ESD, including high en bloc and R0 resection rates with no increase in significant adverse events. A multicenter trial is required to confirm the validity of the present results.
Covert hepatic encephalopathy leads to distinct alterations in the emotional state, independently of MELD-Score
Authors: Greinert Robin , Ripoll Cristina , Zipprich Alexander 
Published: January 2018

Abstract
Background and aims Covert hepatic encephalopathy impairs many aspects of quality of life, although its impact on the emotional state has not been evaluated. This study aims to evaluate the impact of covert hepatic encephalopathy on the emotional state and which factors are associated with changes in the emotional state in patients with cirrhosis.
Methods This single-center study included all patients with cirrhosis who underwent the portosystemic encephalopathy syndrome (PSE) test, critical flicker frequency, and emotional state assessment with the Eigenschaftswörterliste 60-S in 2011. Covert hepatic encephalopathy was defined by abnormal PSE. Parametric and non-parametric tests were used according to variable distribution.
Results One hundred seventeen patients with cirrhosis were included (median age: 59 [interquartile range: 48 – 67], 32 % female, 74 % alcohol-associated). Seventy patients had covert hepatic encephalopathy (60 %) with a higher MELD (16 [interquartile range: 13 – 21], p = 0.001) and a higher Child-Pugh score (p = 0.003) compared to patients without encephalopathy. Patients with covert encephalopathy felt reduced mental activity (p = 0.004), lower general well-being (p = 0.001), and reduced extraversion (p = 0.021). The scores in the negative domains such as general lethargy (p = 0.031) and anxiousness/depressiveness (p = 0.033) were higher in patients with covert hepatic encephalopathy. There was no correlation between MELD and the emotional state. Patients with 2 pathological tests (critical flicker frequency and PSE) showed the most distinct alterations in the emotional state in the group of patients with covert hepatic encephalopathy.
Conclusions Patients with covert hepatic encephalopathy have an alteration of the emotional state, which is more marked in patients with 2 pathological tests. Interestingly, MELD had no impact on the emotional state.
Development of an external-to-internal convertible endoscopic biliary drainage device – a preliminary prospective feasibility study
Authors: Mori Akihiro , Ito Shun , Yumura Takayuki , Hachiya Hiroki , Sawada Masashi , Hayashi Shintaro , Ohashi Noritsugu 
Published: January 2018

Abstract
Background and study aims Endoscopic nasobiliary drainage (ENBD) for a malignant stricture in the bile duct has some advantages over endoscopic biliary stenting (EBS). However, ENBD may cause nasopharyngeal discomfort. We developed an external-to-internal convertible endoscopic biliary drainage (ETI-EBD) device that enables both internal and external drainage to occur during a single endoscopy.
Patients and methods This device consists of three parts, comprising a 5-Fr ENBD tube (250 cm) (ENBD-t), an 8.5-Fr EBS tube (7 cm) (EBS-t), and an 8-Fr pusher tube for EBS (230 cm) (P-t). The EBS-t is mounted over the ENBD-t at the distal end of the ENBD-t. The P-t is also placed over the ENBD-t. After an endoscopic sphincterotomy, the EBS-t of the device is inserted into the papilla, then the duodenal endoscope is withdrawn, leaving the device in place. After ENBD, only the ENBD-t was withdrawn from the P-t. At this point, the EBS-t was isolated and left without endoscopy or radiography.
Results ETI-EBD was successfully placed in all consecutive 21 patients (100 %). The release of EBS-t from ENBD-t wit was successfully completed in 19 patients (90.5 %). There were 4 patients with kink of P-t when exchanging this device from the mouth to the nose. It was difficult for 2 patients to withdraw the ENBD-t because of poor lubrication performance. There were no significant complications associated with the use of the device.
Conclusion This device allows for both external and internal biliary drainage with a single endoscopy.
Non-surgical management of Boerhaave’s syndrome: a case series study and review of the literature
Authors: Aloreidi Khalil , Patel Bhavesh , Ridgway Tim , Yeager Terry , Atiq Muslim 
Published: January 2018

Abstract
Background and study aims Boerhaave’s syndrome (BS) is a life-threatening condition with morbidity and mortality rates as high as 50 % in some reports. Until recently, surgical intervention has been the mainstay of management plans. With advances in therapeutic endoscopy, however, there has been increasing interest in non-surgical options including endoscopic esophageal stenting.
Patients and methods We reviewed the medical records of all patients diagnosed with BS and managed with endoscopic interventions between November 2011 and November 2016. The following variables were collected: patient demographics, clinical presentations, locations of esophageal perforation, primary interventions, complications, and outcomes.
Results Six patients were found to be diagnosed with BS during the study period. The median age at presentation was 55. There were 4 males and 2 females. The most common site of perforation was in the distal esophagus. The most common presenting symptom was chest pain (67 %) following an episode of vomiting or retching. Four patients (66.7 %) developed septic shock. Endoscopic treatment with a fully covered esophageal stent was the primary intervention in all patients (100 %). Interventional radiology was consulted in all cases for fluid drainage and chest tube placements. Clinical resolution of the BS was achieved in all patients (100 %) without any subsequent surgical interventions. There were no deaths within the study group, and the average follow-up duration was 2 years.
Conclusion Endoscopic treatment seems to be an effective management strategy in patients with BS. We also noted satisfactory results in patients presenting with sepsis, presumably due to urgent, interventional radiology-guided fluid drainage.
Use of anticoagulant or antiplatelet agents is not related to epistaxis in patients undergoing transnasal endoscopy
Authors: Kobayashi Yoshiya , Komazawa Yoshinori , Yuki Mika , Ishitobi Hitomi , Nagaoka Makoto , Takahashi Yoshiko , Nakashima Sayaka , Shizuku Toshihiro , Kinoshita Yoshikazu 
Published: January 2018

Abstract
Background and study aims Unsedated transnasal endoscopy (uTNE) has become accepted as a safe and tolerable method for upper gastrointestinal tact examinations. Epistaxis is 1 of the major complications of TNE, though its risk factors have not been elucidated. Generally, patients administered an anticoagulant or antiplatelet drug are considered to have an increased risk of epistaxis during TNE. Here, we investigated risk factors of epistaxis in patients undergoing uTNE, with focus on those who received antithrombotic agents.
Patients and methods We enrolled 6860 patients (average age 55.6 ± 12.97 years; 3405 males, 3455 females) who underwent uTNE and received the same preparations for the procedure. Epistaxis was evaluated using endoscopic images obtained while withdrawing the scope through the nostril. We also noted current use of medications including anticoagulant or antiplatelet agents prior to the endoscopic examination.
Results Epistaxis occurred in 3.6 % of the enrolled patients (245/6860), and that rate was significantly higher in younger patients (average age 49.31 ± 11.8 years for epistaxis group vs. 55.83 ± 13.0 years for no epistaxis group, P < 0.01) as well as females (4.78 % vs. 2.35 %, P < 0.01). The odds ratio for occurrence of epistaxis was 2.31 (95 %CI: 1.746 – 3.167) in the younger patients and 2.02 (95 % CI: 1.542 – 2.659) in females. In contrast, there was no significant difference for rate of epistaxis between patients with and without treatment with an antithrombotic agent (3.0 % vs. 3.6 %).
Conclusions The rate of epistaxis was higher in younger and female patients. Importantly, that rate was not significantly increased in patients who were administered an antithrombotic agent.
Getting More Than You Paid For: Unauthorized “Natural” Substances in Herbal Food Supplements on EU Market
Authors: Zovko Končić Marijana 
Published: January 2018

AbstractAs the population in the industrialized world develops preference for what is perceived as a natural and holistic way of disease treatment, the popularity and the number of food supplements on the market, including herbal ones, is experiencing an unprecedented rise. However, unlike herbal medicinal products, intended for treating or preventing disease, current legislation classifies food supplements as products intended for achieving nutritional or physiological effect and to supplement the normal diet. Accordingly, most food supplements are not to be associated with specific health claims. However, either due to the subtle suggestions by the producers or the wishful thinking of the consumers, certain pharmacological effects from food supplements are often expected. Medicinal plants included in food supplements usually do not produce dramatic and instant pharmacological effects. Therefore, in order to meet the expectation of their customers, some producers have turned to the illicit and dangerous practice of adulterating their products with synthetic adulterants, including naturally occurring molecules, having the desired activity. Such practice is prevalent in, although not limited to, food supplements intended for use as weight-loss aids, as well as for sport performance and libido enhancement. The review is focusing on naturally occurring alkaloids, phenylethanolamines, and their semi-synthetic derivatives in food supplements in the European Union as reported by the Rapid Alert System for Food and Feed. Their desired and undesired pharmacological effects, as well as the methods for their detection and quantification in food supplements, will be reviewed.
Electron mean-free-path filtering in Dirac material for improved thermoelectric performance
Authors: Liu Te-Huan , Zhou Jiawei , Li Mingda , Ding Zhiwei , Song Qichen , Liao Bolin , Fu Liang , Chen Gang 
Published: January 2018

SignificanceUsing ab initio simulations, we uncover the electron mean-free-path (MFP) spectrum in Dirac material and specifically show how the thermoelectric efficiency can greatly benefit from a distinct, monotonically decreasing trend of electron MFPs arising from the linear energy-momentum dispersion implied by the Dirac band topology. In the past, it was generally assumed that for the nanostructuring approach to be effective, one should design nanostructures to have characteristic length larger than the electron MFP but smaller than the phonon MFP to reduce thermal conductivity. Our results show that enhancement in thermoelectric performance can be achieved in Dirac materials even when they are smaller than the electron MFP by selectively filtering out long-MFP electrons that are harmful to the Seebeck coefficient.
Human ectoparasites and the spread of plague in Europe during the Second Pandemic
Authors: Dean Katharine R. , Krauer Fabienne , Walløe Lars , Lingjærde Ole Christian , Bramanti Barbara , Stenseth Nils Chr. , Schmid Boris V. 
Published: January 2018

SignificancePlague is infamous as the cause of the Black Death (1347–1353) and later Second Pandemic (14th to 19th centuries CE), when devastating epidemics occurred throughout Europe, the Middle East, and North Africa. Despite the historical significance of the disease, the mechanisms underlying the spread of plague in Europe are poorly understood. While it is commonly assumed that rats and their fleas spread plague during the Second Pandemic, there is little historical and archaeological support for such a claim. Here, we show that human ectoparasites, like body lice and human fleas, might be more likely than rats to have caused the rapidly developing epidemics in pre-Industrial Europe. Such an alternative transmission route explains many of the notable epidemiological differences between historical and modern plague epidemics.
HELLS and CDCA7 comprise a bipartite nucleosome remodeling complex defective in ICF syndrome
Authors: Jenness Christopher , Giunta Simona , Müller Manuel M. , Kimura Hiroshi , Muir Tom W. , Funabiki Hironori 
Published: January 2018

Significance
The molecular basis of immunodeficiency–centromeric instability–facial anomalies (ICF) syndrome is poorly understood. ICF is caused by mutations in HELLS, CDCA7, or the DNA methyltransferase DNMT3b. While these mutations all cause DNA methylation defects, little is known about the molecular function of CDCA7. It has been speculated that HELLS, which belongs to the SNF2 family ATPase, facilitates DNA methylation by DNMT3b through nucleosome remodeling, but HELLS on its own fails to exhibit such an activity. Here, starting from a comparative proteomic analysis of chromatin proteins in frog egg extracts, we demonstrated that CDCA7 is required for HELLS to associate with chromatin and exert nucleosome remodeling activity. Our finding delineates the molecular pathway involving CDCA7, HELLS, and DNMT3b.