bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vascular Anomalies Caused by Abnormal Signaling within Endothelial Cells: Targets for Novel Therapies
Authors: Nguyen Ha-Long , Boon Laurence , Vikkula Miikka 
Published: September 2017

AbstractVascular anomalies arise as a consequence of improper development and maintenance of the vasculature. Our knowledge on the pathophysiological bases of vascular anomalies has skyrocketed during the past 5 years. It is becoming clear that common intracellular signaling pathways are often activated by mutations, causing endothelial cell dysfunction. These mutations cause hyperactivation of two major intracellular signaling pathways that may be controlled by inhibitors developed for cancer treatment. Although we do not know yet all the downstream effects, it has become evident that normalization of the abnormal signaling is an interesting target for therapy. This is a major paradigm change, as developmental malformations were considered to be inert to any molecular treatment.
Percutaneous Image-Guided Cryoablation in Vascular Anomalies
Authors: Shaikh Raja 
Published: September 2017

AbstractUnderstanding and management of vascular anomalies has always been intriguing. These disorders exhibit an expected pattern of clinical presentation and progression, and characteristic imaging findings. Significant progress in understanding and treating patients with vascular anomalies has been made in the past quarter century. Newer multidisciplinary domains for treating these disorders with medical drugs and less invasive image-guided or surgical procedures are constantly evolving. Vascular anomalies can exhibit aggressive tumor-like behavior resulting in recurrence or persistent symptoms after treatment. Thermal ablation has been widely used in tumor treatment. This has generated interest on using thermal ablation for treating vascular anomalies. Percutaneous image-guided cryoablation is increasingly used for this purpose as compared with other ablation technologies. Availability of small caliber cryoprobes and the ability to monitor the freeze zone in real time have made this an attractive option to interventional radiologists. These experiences are relatively new and limited. It is helpful to understand the emerging role of this technology in the treatment of vascular anomalies.
Applicability of Evoked Auditory Brainstem Responses with Complex Stimuli in Adults with Hearing Loss
Authors: Peixe Bruna , Silva Débora , Biaggio Eliara , Bruno Rúbia , Sanguebuche Taissane , Garcia Michele 
Published: September 2017

Introduction The use of the speech-evoked auditory brainstem response (ABR) shows how the brainstem operates up to the subcortex in a more complex manner than when the click-evoked ABR is used.
Objective To study the applicability of the speech-evoked ABR in adults with hearing loss.
Methods The sample was composed of a study group of 11 subjects, with ages ranging between 18 and 59 years, and auditory thresholds within normal standards, with loss of up to 65 dB at high frequencies or up to moderately severe symmetric sensorineural hearing loss. The sample underwent a basic audiological assessment, as well as speech-evoked ABR and click-evoked ABR, in which waves I, III and V, and V, A, C, D, E, F were respectively marked. The electrophysiological assessments were performed using the SmartEP device (Intelligent Hearing Systems, Miami, FL, US).
Results For the speech-evoked ABR, the reference values were used in the identification and analysis of the study group. Those values found for the study group were: V = 8.56; A = 10.97; C = 21.33; D = 29.51; E = 37.93; F = 46.96; and O = 55.97. In the comparison between groups, the study group presented an increase in latency only in wave C.
Conclusion The speech-evoked ABR can be performed in subjects with up to moderately severe hearing loss, and the test proved to be appropriate, because, unlike the click-evoked ABR, the former does not suffer influence of peripheral hearing loss.
Special Consideration for Intraosseous Arteriovenous Malformations
Authors: Park Kwang , Do Young 
Published: September 2017

AbstractIntraosseous arteriovenous malformations (AVMs) have been associated with distortion, hypertrophy, osteolytic skeletal changes, bleeding, leg length discrepancy, and pathologic fracture. Computed tomography or magnetic resonance imaging is helpful in the evaluation of the extent and depth of intraosseous AVMs and associated soft-tissue AVMs. Treatment approaches can differ, depending on the angiographic classification. Embolotherapy with ethanol, coils, or n-butyl cyanoacrylate is the primary treatment for symptomatic intraosseous AVMs, and the goal of treatment is symptom improvement with few complications.
Serial Microbiota Analysis after Fecal Microbiota Transplantation in a Child with Down's Syndrome
Authors: Meijer Lisethe , Vermont Clementien , Budding Andries , Mulder Chris , Meij Tim , Beurden Yvette 
Published: September 2017

AbstractFecal microbiota transplantation (FMT) is a very effective treatment for recurrent Clostridium difficile infection (CDI) in adults. However, there is a paucity of data on FMT in children and associated microbiome changes in this particular group. We describe a child with Down's syndrome and intracranial malignancy, who received FMT for recurrent CDI. Detailed microbiota analysis before and after FMT, and pre- and post-recurrence, linked to microbial communities in the donor feces showed that the patient developed a unique microbiota profile after FMT which was very stable over time despite CDI recurrence and subsequent fidaxomicin therapy. Bacteroidetes were stably acquired from donor feces, while Firmicutes, Actinobacteria, Fusobacteria, Verrucomicrobia, and Proteobacteria were unique to the patient. The diversity of microbiota of the patient increased from a Shannon diversity index of 2.08 pre-FMT to 3.12 post-FMT. Our findings underscore that patients with Down's syndrome may well tolerate and benefit from FMT even in a severely immunocompromised state.
Anatomic Variability of the Morphometric Parameters of the Fourth Ventricle of the Brain
Authors: Zhuravlova Iuliia , Kornieieva Maryna , Rodrigues Erik 
Published: September 2017

Objectives The defining of the normal parameters of spacious relations and symmetry of the ventricular system of the brain depending on the gender and age is currently one of the topical research problems of clinical anatomy. The present research aims to identify the correlation between the morphometric parameters of the fourth ventricle of the brain and the shape of the skull in middle aged people.
Design This is a prospective cohort study.
Setting This study was set at the Trinity School of Medicine.
Participants A total of 118 normal computed tomography scans of the head of people aged from 21 to 86 years (mean age—48.6 years ± 17.57) were selected for the study.
Main Outcome Measures The anteroposterior, transverse diameters, and height of the fourth ventricle were measured and compared in dolichocranial, mesocranial, and brachycranial individuals.
Results The study has shown the presence of a statistically significant difference between morphometric parameters of the fourth ventricle of the brain in dolichocranial, mesocranial, and brachycranial individuals.
Conclusion The morphometric parameters of the fourth ventricle of the brain, such as height, anteroposterior, and transverse diameters, depend on the individual anatomic variability of the skull shape and gender.
Innovative Strategies for the Management of a Massive Neonatal Rhabdomyoma
Authors: Prabhu N. , Osifodunrin N. , Murphy D. , Butler S. , Hunter L. 
Published: September 2017

AbstractRhabdomyomas are histologically benign tumors known to be associated with tuberous sclerosis. The natural history predicts the majority of tumors to be asymptomatic and regress within the first year of life. We describe a neonate presenting on day 1 of life with cardiovascular collapse secondary to a massive rhabdomyoma. Surgical resection was excluded due to the extensive nature of the lesion and oral sirolimus, a mammalian target of rapamycin inhibitor, was commenced to promote tumor regression. The patient developed intractable arrhythmias requiring extracorporeal life support during therapy.
Total Hip Arthroplasty in an Inveterate Femoral Neck Fracture in a Patient with Congenital Insensitivity to Pain with Anhidrosis
Authors: Dagnino Augusto , Ursino Nicola , Ripamonti Carlo , Fiorentini Carlo , Scelsi Michele , D'Ambrosi Riccardo , Portinaro Nicola 
Published: September 2017

AbstractCongenital insensitivity to pain with anhidrosis (CIPA) is an extremely rare disorder characterized by autonomic and sensory nerves malfunction with insensitivity to both deep and superficial painful stimuli, inability to sweat and produce tears, and mild to moderate mental retardation with self-mutilating behavior. Related consequences of inveterate musculoskeletal injuries represent a major issue for these patients, since pain cannot act as a protection mechanism. For the same reason, the patients are at risk during postoperative rehabilitation, which should be taken into account when selecting an orthopaedic implant. To our knowledge, only one case of total hip arthroplasty has been reported in the literature to date. A 21-year-old Caucasian male patient affected with CIPA arrived at our attention complaining about a functional limitation of the left hip. No history of trauma was reported. The X-rays showed an inveterate femoral neck fracture with a severe necrosis and resorption of the femoral head. We decided to perform a total hip arthroplasty with a cemented stem and a cemented dual mobility cup. The postoperative course and rehabilitation were satisfactory, with excellent clinical results, measured with the Harris Hip Score at 1 year.
Aplicación clínica de la técnica percutánea en la tenosinovitis estenosante de los flexores de la mano
Authors: Brotat M. , Pérez C. , Medrano B. , Flórez L. , Ferrero M.Á. , Moreno M.F. 
Published: September 2017

Introducción: La tenosinovitis estenosante de los flexores de la mano es una patología que conduce al bloqueo de la polea de flexión proximal del dedo. Aunque el tratamiento inicial es conservador, si éste no es efectivo, está indicado el tratamiento quirúrgico mediante liberación abierta o percutánea.Material y método: Estudio descriptivo retrospectivo de 116 pacientes intervenidos de dedo en resorte en el HCUV (enero 2005- diciembre 2007), seguimiento medio 36 meses. Análisis de datos con el 91% de los pacientes (105 pacientes) con un total de 182 dedos afectos realizando comparación de ambas técnicas.Resultados: Edad media varones 53.70 años y la de las mujeres 53.95. El 34% de las manos intervenidas no presentan otras patologías asociadas. Primer dedo más afectado, seguido del tercero y cuarto. Se realizó técnica percutánea en el 42% de los pacientes, abierta en el 53% y ambas en el 5% del total. Destacan los problemas con la cicatriz en la tenolisis abierta. Técnica percutánea permite reincorporación a la vida laboral 8 días antes.Discusión: La liberación percutánea de la polea AI es una alternativa a la liberación abierta por su bajo coste y por permitir una rápida reincorporación del paciente a su vida laboral. Gracias a estudios experimentales en cadáver, se obtienen referencias topográficas que aportan mayor seguridad, permitiendo ampliar el uso de esta técnica que ha demostrado grandes ventajas en el ámbito socio-económico y laboral.
Artroplastia total de muñeca. Resultados funcionales, complicaciones y factores predictivos de la evolución
Authors: Aragó A. , Moreno B. , López M. , de la Sotilla J.M. , Alcázar L. , Calvo M. Á. 
Published: September 2017

Objetivo: El objetivo de este estudio es presentar los resultados a corto plazo de la artroplastia total de muñeca y estudiar los factores que determinan su evolución.Material y método: Se han revisado retrospectivamente 15 pacientes intervenidos mediante prótesis total de muñeca Tipo Universal2® (KMI, Carlsbad, California). Se han estudiado los factores epidemiológicos, las radiografías, la movilidad y la fuerza prequirúrgica y postquirúrgica. Se han evaluado a los pacientes mediante el cuestionario DASH y la escala visual analógica, EVA. Se han utilizado diversos test estadísticos para el estudio de la predicción de la evolución. Se han descrito las complicaciones y las reintervenciones.Resultados: Los pacientes han presentado una disminución del dolor estadísticamente significativa. No hemos obtenido diferencias estadísticamente significativas de ninguno de los valores para prever la evolución. Seis de los casos requirieron ser reintervenidos debido a complicaciones como pinzamiento, “impingement” cubital, neuropatía del nervio cubital y luxación del primer compartimento extensor.Conclusiones: La artroplastia total de muñeca es una alternativa en el tratamiento de la artrosis radiocarpiana avanzada en pacientes que quieren preservar cierta movilidad en la muñeca. Las complicaciones han surgido debido a que se trata de una exigente técnica quirúrgica, y disminuyen con la curva de aprendizaje. No se han encontrado factores predictivos de su evolución.
Síndrome del canal radial: nueva técnica de liberación endoscópica
Authors: Gonzalez J. 
Published: September 2017

El objetivo de este trabajo es presentar una nueva técnica endoscópica para la liberación de la rama motora del nervio radial en el síndrome del canal radial.El síndrome del canal radial es la neuropatía compresiva de la rama motora del nervio radial que, muy a menudo, requiere la liberación quirúrgica mediante la apertura completa de las estructuras que producen la compresión.Las vías de abordaje convencionales son amplias, requieren disecciones agresivas y laboriosas. El pequeño tamaño del nervio y su posición profunda entre vientres musculares hace que, fácilmente, pueda ser dañado durante su disección si la visualización no es correcta en todo momento.Presentamos una nueva técnica que combina el marcaje preoperatorio de la posición del nervio mediante ecografía y liberación mediante técnica endoscópica.Esta técnica permite un abordaje quirúrgico mucho menor, una mejor visualización del nervio en todo su recorrido y de las estructuras anatómicas durante la disección.Se presenta una serie de 22 intervenciones en 20 pacientes intervenidos entre 2010 y 2014. En 14 casos los resultados fueron excelentes, 5 buenos y 3 regulares. Las complicaciones fueron en un caso una lesión parcial del nervio durante la cirugía y 4 casos de paresia a la extensión de los dedos que se recuperaron completamente en todos los casos entre las 3 y 6 semanas.
Esomeprazol-induzierter kutaner Lupus erythematodes
Authors: Gliem Nina , Broekaert Sigrid , Seitz Cornelia , Schön Michael , Ellenrieder Volker 
Published: September 2017

ZusammenfassungProtonenpumpeninhibitoren gehören zu den weltweit am häufigsten verwendeten Arzneimitteln. Sie gelten als weitgehend sicher und nebenwirkungsarm. Wir berichten über eine 69-jährige Patientin, bei der 2 Monate nach Einleitung einer Therapie mit Esomeprazol anuläre erythematöse Plaques überwiegend an lichtexponierten Körperstellen auftraten. Anhand des klinischen Bildes, dem histologischen Befund eines Hautbioptats und dem Nachweis von Anti-Ro/SSA-Antikörpern wurde die Diagnose eines subakut kutanen Lupus erythematodes gestellt. Insbesondere der zeitliche Zusammenhang mit dem Beginn der Protonenpumpeninhibitor-Therapie begründete den hochgradigen Verdacht auf eine medikamenteninduzierte Genese. Nach Absetzen von Esomeprazol waren die charakteristischen Hautveränderungen ohne spezifische Therapie nahezu vollständig rückläufig, was die anfängliche Verdachtsdiagnose erhärtete. Beim Auftreten typischer Hautveränderungen in lichtexponierten Arealen im zeitlichen Zusammenhang mit der Einnahme von PPI sollte daher immer auch an die Möglichkeit eines medikamenteninduzierten kutanen Lupus erythematodes gedacht werden. Aufgrund der häufigen Rezidive nach erneuter Exposition sollte eine erneute Therapie mit PPI vermieden werden.
Development of an Incremental Sit-to-Stand Exercise for Aerobic Fitness Evaluation
Authors: Nakamura Keisuke , Nagasawa Yuya , Sawaki Shoji , Yokokawa Yoshiharu , Ohira Masayoshi 
Published: September 2017

AbstractIncremental sit-to-stand exercise (ISTS) is an incremental exercise test using external signals to control the sit-to-stand rate in a given time frame. This study aimed to investigate the concurrent validity and reproducibility of the ISTS in aerobic fitness evaluation among healthy elderly women. Sixteen elderly women performed the ISTS and cycle ergometer test at 3-day to 2-week intervals, and six of the participants performed the ISTS twice. Peak oxygen uptake (VO2), peak heart rate and completion time on the ISTS and cycle ergometer test were determined. Measured peak VO2 on the cycle ergometer test was significantly related to the peak VO2 (r=0.80, P<0.05) and the completion time (r=0.65, P<0.05) on the ISTS. The intraclass correlation coefficients were 0.96 for peak VO2 values and 0.91 for the completion time values during the two ISTSs. In conclusion, the ISTS is a valid, reproducible and safe test for aerobic fitness evaluation in healthy elderly women.
Glaskörperersatz in der Ablatiochirurgie – warum wir eine ganz neue Tamponadestrategie brauchen!
Authors: Szurman Peter 
Published: September 2017

ZusammenfassungDas wichtigste Konzept zur Behandlung der Netzhautablösung ist die Pars-plana-Vitrektomie in Kombination mit Endotamponaden (Luft, Gase, Silikonöle). Trotz zahlreicher technischer Innovationen und modernsten Tamponadematerialien scheinen die Grundprobleme der Ablatiochirurgie aber nicht gelöst zu sein: Seit Jahrzehnten ist die primäre Erfolgsrate nicht zufriedenstellend, es gibt keine gute Strategie bei Mehrlochsituationen und die Problematik der proliferativen Vitreoretinopathie oder der persistierenden Hypotonie ist nicht gelöst. Insbesondere die Geschichte der Tamponaden ist voller Mythen und Missverständnisse. Trotz immer neuer Materialentwicklungen haben diese bei genauer Betrachtung nur wenig Einfluss auf die Erfolgsrate gehabt. Zunehmend zeigt sich, dass der Wert der Tamponade deutlich überschätzt wird. Der Grund dafür ist ein konzeptuell falscher Ansatz: Denn alle verfügbaren Tamponaden sind hydrophob und üben ihre tamponierenden Eigenschaften über Auftriebsvektor und Oberflächenspannung aus. Dies beschränkt sie auf die hydraulische Tamponadefunktion in nur einer Richtung und erlaubt keine vollständige Füllung des Glaskörperraums. Der hydrophobe Charakter des Tamponadematerials birgt damit grundsätzliche Nachteile, die beispielsweise die PVR-Entwicklung oder erneute Lochbildung eher fördern als hemmen. Deshalb ist eine Neubewertung des Stellenwerts von Tamponaden nötig. Die Lösung könnte ein radikaler Strategiewechsel weg von hydrophoben hin zu hydrophilen Tamponaden mit Hydrogelen sein. Diese bilden die natürliche und recht komplexe Funktion des juvenilen, gesunden Glaskörpers viel besser ab als Gase oder Öle.
Epidemiology of Overuse Injuries in Youth Team Sports: A 3-year Prospective Study
Authors: Leppänen Mari , Pasanen Kati , Kannus Pekka , Vasankari Tommi , Kujala Urho , Heinonen Ari , Parkkari Jari 
Published: September 2017

AbstractProspective studies on overuse injuries and their impact on athletic training among youth team sports are scarce. The purpose of this study was to investigate the incidence, severity and player related risk factors of overuse injuries among young (12–20 years) basketball and floorball players. A total of 387 players participated in a 3-year prospective study. Each player completed a baseline questionnaire regarding their background information. Overuse injuries that prevented players to fully or partly participate in their regular training were collected. In all, 204 overuse injuries were registered (injury incidence 1.51 injuries/1 000 h of exposure; 95% CI 1.35–1.78). Most of the injuries involved the knee (35%) and lower back (21%), and were classified as severe (44%). Injury incidence was 1.51 (95% CI 1.2–1.82) and 1.61 (95% CI 1.32–1.91) in basketball and floorball, respectively. Incidence was significantly higher among female compared with male players (incidence rate ratio 1.58; 95% CI 1.20–2.09). Previous injury and playing at adult level were the strongest factors associated with occurrence of an overuse injury. In conclusion, overuse injuries of the knee and low back are relatively common in youth basketball and floorball. Effective prevention strategies as well as training load monitoring is needed in youth team sports.
Tuberkulose
Authors: Blaas Stefan 
Published: September 2017

Was ist neu?
Epidemiologie Bedingt durch die Zunahme der Migration ist es 2015 in Deutschland zu einem deutlichen Anstieg von Tuberkulosefällen gekommen. Die resistente Tuberkulose nimmt weltweit zu.
Neue Leitlinie Die Leitlinie zur Behandlung der Tuberkulose bei Erwachsenen wurde im Sommer 2017 aktualisiert. Für Kinder wird eine eigene Leitlinie für 2017 erwartet.
Fremdsprachige Patienteninformationen finden sich z. B. unter http://www.explaintb.org.
Resistente Tuberkulose Zur Behandlung der multiresistenten Tuberkulose (MDR-TB) gibt es neue WHO-Empfehlungen. Darin wird unter bestimmten Voraussetzungen ein verkürztes Therapieregime vorgeschlagen. Dieses wird für Deutschland aufgrund der hierzulande zu erwartenden Resistenzen nicht empfohlen.
Long-term quality of life after peroral endoscopic myotomy remains compromised in patients with achalasia type III
Authors: Hernández Mondragón Oscar , González Martinez Marina , Blancas Valencia Juan , Hernandez Reyes Maria , Solórzano Pineda Omar , Blanco Velasco Gerardo 
Published: September 2017

Abstract
Background and study aims Peroral endoscopic myotomy (POEM) is an excellent endoscopic treatment for achalasia. Clinical and manometric parameters are used for evaluation and follow-up. However, clinical success does not guarantee high quality of life (QoL) scores, generating doubts about their direct relationship. We aimed to evaluate QoL scores before and after POEM at medium and long term, to evaluate differences between achalasia subtypes and find which factors related to low QoL scores.
Patients and methods Achalasia-confirmed patients undergoing POEM between February 2012 and November 2016. and completing at least 1 year of follow-up, were included. Assessment before and at 1, 6, 12, 24, 36 and 48 months after POEM employed manometry, barium series, Eckardt score, and the AE-18 health-related QoL scale. Demographic, clinical, and procedure characteristics were documented, with comparisons between subgroups. Multiple logistic regression analysis was done.
Results 65 of 88 patients were included (38 women, 27 men; median age 47 years, interquartile range [IQR] 20 – 81), and 50 (76.9 %) completed 4 years of follow-up. Eckardt score improved (median, preprocedure 10 vs. post-procedure 2; P = 0.002) and this persisted. There was initial improvement in median integrated relaxation pressure (IRP) (29.4 mmHg [16 – 55] vs. 10.3 mmHg [3 – 18]; P = 0.000) and median QoL scores (40 vs. 68 at 1 month; P = 0.002); however IRP increased and QoL scores decreased. Men with confirmed type III achalasia had low QoL scores.
Conclusions All patients had significant clinical improvement after POEM, with medium- to long-term persistence. Though quality of life and IRP initially improved, they deteriorated in the long term. Male sex and type III achalasia seem to be associated with low QoL scores.