bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of the Short Face Pattern in Individuals of Bauru-Brazil
Authors: Bastos Douglas Rezende , de Castro Ferreira Conti Ana Cláudia , Filho Leopoldino Capelozza , de Almeida-Pedrin Renata Rodrigues , de Almeida Cardoso Maurício 
Published: February 2017

Aim:
This study aimed at assessing the prevalence and severity of short face pattern in ethnically different individuals.

Material and Methods:
The sample comprised 4,409 Brazilians (2,192 females and 2,217 males), with a mean age of 13 years, enrolled in secondary schools in the municipality of Bauru. The sample inclusion criteria involved subjects with vertically impaired facial relationship based on excessive lip compression, when standing at natural head position, with the lips at rest. Once short face syndrome had been identified, the individuals were classified into three severity subtypes: mild, moderate, and severe. The sample was then stratified by ethnic background as White (Caucasoid), Black (African descent), Brown (mixed Caucasian–African descent), Yellow (Asian descent), and Brazilian Indian (Native Brazilian descent), using the Brazilian Institute of Geography and Statistics classification. The chi-square test at the 5% significance level was used to compare frequency ratios of individuals with vertically impaired facial relationships and across different ethnicities, according to severity.

Results:
The prevalence of short face pattern was 3.15%, as 1.11%, 1.99%, and 0.02% considered mild, moderate and severe subtypes, respectively. The severe subtype was rare (0.02%) and found only in one White individual. The White group had the highest relative frequency (45.53%) of the moderate subtype, followed by Brown individuals (43.40%). In the mild subtype, Yellow (68.08%) and White (62.21%) individuals showed similar and higher relative frequency values.

Conclusion:
The prevalence of short face pattern was 3.15%, and White individuals had the highest prevalence.
Alveolar Bone Fracture: Pathognomonic Sign for Clinical Diagnosis
Authors: Gutmacher Zvi , Peled Eli , Norman Doron , Lin Shaul 
Published: February 2017

Aim:Dental injuries, especially luxation and avulsion, are common. Dental trauma can cause alveolar bone fracture that can lead to tooth loss and malocclusion. Single tooth alveolar bone fractures are difficult to identify unless it protrudes through the overlying mucosa and can be visualized. Pain, malocclusion, and tooth mobility provide signs of suspected alveolar bone fractures. Integrity of the proximate alveolar bone should be examined for fractures where avulsion, luxation, or other tooth trauma is detected. Any suggestion of alveolar fractures should be further investigated with an appropriate radiograph.Summary:This case report shows a pathognomonic sign that detects and diagnosis single tooth alveolar bone fractures,i.e., a localized hematoma crossing the attached gingiva from the free gingival margin to the vestibular mucosa. This should serve as a warning for localized alveolar bone fracture.A visualized hematoma and gentle, careful palpation may help detect covered fractures when the overlying mucosa is not perforated.
La Teoría de la Indiferencia de la Concausa en la jurisprudencia de la Sala Segunda de la Corte Suprema de Justicia
Authors: Herrera Vargas Norman Armando 
Published: February 2017

Este artículo pretende ofrecer a quienes operan el Derecho Laboral una herramienta que les permita dimensionar el hecho de que no todos los supuestos de personas trabajadoras que se vean afectadas por patologías degenerativas que en apariencia no guardan relación directa con sus trabajos, deben excluirse de la posibilidad de ampararse a través de las prestaciones que da la seguridad social, ya que bajo ciertas condiciones que deben acreditarse con una prueba médica especializada, el siniestro acaecido sí debe de ser calificado como una enfermedad del trabajo y por ende, como riesgo laboral, pues en nuestro medio hay un completo vacío temático y una falta de aplicación de la teoría de la indiferencia de la concausa en detrimento de la clase trabajadora.
The Association of Allergic Sensitization with Radiographic Sinus Opacification
Authors: Brook Christopher D. , Kuperstock Jacob E. , Rubin Samuel J. , Ryan Matthew W. , Platt Michael P. 
Published: February 2017

Background The relationship between allergic sensitization and radiographic sinus inflammation remains unclear. Objectives To determine whether specific allergen sensitization is correlated with sinonasal radiographic opacification. Methods Patients with chronic sinonasal symptoms were selected and included if they had allergy testing and a computed tomography (CT) of the paranasal sinuses. Data regarding demographic characteristics, in vitro allergy test results, and comorbidities were collected. CTs were reviewed, and an overall Lund-Mackay score (LMS) was calculated for each patient. A two-sample t-test was used to compare mean LMS between patients who were sensitized and patients who were not sensitized. A multiple linear regression model was used to determine whether a relationship existed among LMS and allergy results, asthma, nasal polyps, immunoglobulin E (IgE) level, medication usage, in-season versus out-of-season CTs, age, and sex. Significance was determined at an alpha level of 0.05. Results There were 437 patients included, of whom, 251 had positive specific allergen test results and 186 had negative test results. A total of 282 patients had allergic rhinitis symptoms without a documented diagnosis of sinusitis, and 155 carried a diagnosis of chronic rhinosinusitis. The mean LMS did not differ between patients who were sensitized and patients who were not sensitized (5.56 versus 5.28; p = 0.61). Linear regression demonstrated an increase in LMS in patients with asthma (p = 0.02), male sex (p < 0.01), elevated IgE (p < 0.01), a history of anaphylaxis (p = 0.03), and nasal polyps (p < 0.01). There was a statistically significant decrease in LMS in patients with an in-season CT (p = 0.02). Conclusions Patients with a positive specific in vitro allergen test result did not have higher overall rates of radiographic sinus inflammation. Asthma, male sex, polyps, elevated IgE, and a history of anaphylaxis were associated with higher LMS.
Endoscopic Sinus Surgery for Chronic Rhinosinusitis with Nasal Polyps: Clinical Outcome and Predictive Factors of Recurrence
Authors: Veloso-Teles Rafaela , Cerejeira Rui 
Published: February 2017

Background Chronic rhinosinusitis with nasal polyps (CRSwNP) is a highly prevalent disease of the nasal cavity and paranasal sinus, but its exact etiology is still unclear and remains a difficult-to-treat condition. Hypothesis Endoscopic sinus surgery (ESS) is an effective treatment for medically recalcitrant CRSwNP. There are independent variables that can predict surgical outcomes in patients with CRSwNP. Objectives To evaluate ESS efficacy in CRSwNP treatment and to establish prognostic factors for disease recurrence. Methods Eighty-five patients with CRSwNP submitted to ESS, and a minimum follow-up of 9 months was selected. Patient demographics, occupational organic exposure (e.g., cotton, fuel gas, wood dust) and inorganic dust exposure (e.g., bleach, metals, cement), comorbidities, previous nasal surgeries, pre- and postoperative symptoms, ear, nose and throat examination findings, computed tomography results, and medical and surgical treatment information were collected from medical records. Statistical analysis was performed. Results All rhinologic symptoms improved after surgery, in a statistically significant way, with the best recovery rate for nasal obstruction and the worst for hyposmia. The major and minor complications rates were 1.2 and 15.3%, respectively. Disease recurrence occurred in 31% of the patient, but only 7% required surgical reintervention. Multivariate logistic regression analysis identified occupational dust exposure (p = 0.001) and non-immunoglobulin E (IgE) mediated asthma (p = 0.012) as independent predictive variables in CRSwNP recurrence, unlike the other tested variables: age, sex, IgE-mediated asthma, allergic rhinitis, smoking habits, nasal polyps endoscopic grade, Lund-Mackay score, and postoperative topical corticoid use. The adjusted logistic model presented a good discriminatory capacity with a receiver operating characteristic area under the curve of 0.82 (95% confidence interval, 0.73-0.91; p < 0.001). Conclusion ESS proved to be an effective treatment in CRSwNP but with a considerable rate of recurrence. These results indicated an important correlation of occupational dust exposure and non-IgE-mediated asthma with disease recurrence.
Prozessketteneinflüsse auf die Wärmebehandlung*
Authors: Hoffmann F. , Kleff J. 
Published: February 2017

Kurzfassung
Das Ergebnis einer Wärmebehandlung wird durch den Ausgangszustand des Werkstoffs beeinflusst. Das hat zur Folge, dass unterschiedliche Fertigungsketten bei gleicher Endwärmebehandlung zu Unterschieden im Gefügezustand und zu einem unterschiedlichen Verzugsverhalten führen können. Dies beeinflusst somit sowohl die Eigenschaften als auch den eventuellen Aufwand bei einer End-Hartbearbeitung. Der Artikel zeigt Beispiele für Wechselwirkungen infolge von Fertigungseinflüssen anhand einer Fertigungskette für eine thermochemische Wärmebehandlung (Einsatzhärten und Nitrieren) auf.
Retrospective review of previous minor leak before major subarachnoid hemorrhage diagnosed by MRI as a predictor of occurrence of symptomatic delayed cerebral ischemia
Authors: Oda Shinri , Shimoda Masami , Hirayama Akihiro , Imai Masaaki , Komatsu Fuminari , Shigematsu Hideaki , Nishiyama Jun , Hotta Kazuko , Matsumae Mitsunori 
Published: February 2017

OBJECTIVEThis study attempted to determine whether a previous minor leak correlated with the occurrence of symptomatic delayed cerebral ischemia (sDCI).METHODSThe authors retrospectively evaluated sDCI-related clinical features and findings from MRI, including T1-weighted imaging (T1WI)–FLAIR mismatch at the time of admission, in 151 patients admitted with subarachnoid hemorrhage (SAH) within 48 hours of ictus.RESULTSThe overall incidence of sDCI was 23% (35 of 151 patients). In all subjects, multivariate analysis revealed that World Federation of Neurosurgical Societies Grades II–V, age 70 years or older, presence of rebleeding after admission, a previous minor leak before the major SAH attack as diagnosed by T1WI-FLAIR mismatch, acute infarction on diffusion-weighted imaging, and CT SAH score were significantly associated with occurrence of sDCI. In patients with no previous minor leak before major SAH as diagnosed by T1WI-FLAIR mismatch, the incidence of sDCI was only 7% (7 of 97 patients).CONCLUSIONSA previous minor leak before major SAH as diagnosed by T1WI-FLAIR mismatch represents an important sDCI-related factor. When the analysis was restricted to patients with true acute SAH without a previous minor leak diagnosed by T1WI-FLAIR mismatch, the incidence of sDCI was extremely low.
Minimally invasive scoliosis surgery assisted by O-arm navigation for Lenke Type 5C adolescent idiopathic scoliosis: a comparison with standard open approach spinal instrumentation
Authors: Zhu Weiguo , Sun Weixiang , Xu Leilei , Sun Xu , Liu Zhen , Qiu Yong , Zhu Zezhang 
Published: February 2017

OBJECTIVE
Recently, minimally invasive scoliosis surgery (MISS) was introduced for the correction of adult scoliosis. Multiple benefits including a good deformity correction rate and fewer complications have been demonstrated. However, few studies have reported on the use of MISS for the management of adolescent idiopathic scoliosis (AIS). The purpose of this study was to investigate the outcome of posterior MISS assisted by O-arm navigation for the correction of Lenke Type 5C AIS.

METHODS
The authors searched a database for all patients with AIS who had been treated with either MISS or PSF between November 2012 and January 2014. Levels of fusion, density of implants, operation time, and estimated blood loss (EBL) were recorded. Coronal and sagittal parameters were evaluated before surgery, immediately after surgery, and at the last follow-up. The accuracy of pedicle screw placement was assessed according to postoperative axial CT images in both groups. The 22-item Scoliosis Research Society questionnaire (SRS-22) results and complications were collected during follow-up.

RESULTS
The authors retrospectively reviewed the records of 45 patients with Lenke Type 5C AIS, 15 who underwent posterior MISS under O-arm navigation and 30 who underwent posterior spinal fusion (PSF). The 2 treatment groups were matched in terms of baseline characteristics. Comparison of radiographic parameters revealed no obvious difference between the 2 groups immediately after surgery or at the final follow-up; however, the MISS patients had significantly less EBL (p < 0.001) and longer operation times (p = 0.002). The evaluation of pain and self-image using the SRS-22 showed significantly higher scores in the MISS group (p = 0.013 and 0.046, respectively) than in the PSF group. Postoperative CT showed high accuracy in pedicle placement in both groups. No deep wound infection, pseudarthrosis, additional surgery, implant failure, or neurological complications were recorded in either group.

CONCLUSIONS
Minimally invasive scoliosis surgery is an effective and safe alternative to open surgery for patients with Lenke Type 5C AIS. Compared with results of the open approach, the outcomes of MISS are promising, with reduced morbidity. Before the routine use of MISS, however, long-term data are needed.
Risk factors for surgical site infection following nonshunt pediatric neurosurgery: a review of 9296 procedures from a national database and comparison with a single-center experience
Authors: Sherrod Brandon A. , Arynchyna Anastasia A. , Johnston James M. , Rozzelle Curtis J. , Blount Jeffrey P. , Oakes W. Jerry , Rocque Brandon G. 
Published: February 2017

OBJECTIVE
Surgical site infection (SSI) following CSF shunt operations has been well studied, yet risk factors for nonshunt pediatric neurosurgery are less well understood. The purpose of this study was to determine SSI rates and risk factors following nonshunt pediatric neurosurgery using a nationwide patient cohort and an institutional data set specifically for better understanding SSI.

METHODS
The authors reviewed the American College of Surgeons National Surgical Quality Improvement Program–Pediatric (ACS NSQIP-P) database for the years 2012–2014, including all neurosurgical procedures performed on pediatric patients except CSF shunts and hematoma evacuations. SSI included deep (intracranial abscesses, meningitis, osteomyelitis, and ventriculitis) and superficial wound infections. The authors performed univariate analyses of SSI association with procedure, demographic, comorbidity, operative, and hospital variables, with subsequent multivariate logistic regression analysis to determine independent risk factors for SSI within 30 days of the index procedure. A similar analysis was performed using a detailed institutional infection database from Children's of Alabama (COA).

RESULTS
A total of 9296 nonshunt procedures were identified in NSQIP-P with an overall 30-day SSI rate of 2.7%. The 30-day SSI rate in the COA institutional database was similar (3.3% of 1103 procedures, p = 0.325). Postoperative time to SSI in NSQIP-P and COA was 14.6 ± 6.8 days and 14.8 ± 7.3 days, respectively (mean ± SD). Myelomeningocele (4.3% in NSQIP-P, 6.3% in COA), spine (3.5%, 4.9%), and epilepsy (3.4%, 3.1%) procedure categories had the highest SSI rates by procedure category in both NSQIP-P and COA. Independent SSI risk factors in NSQIP-P included postoperative pneumonia (OR 4.761, 95% CI 1.269–17.857, p = 0.021), immune disease/immunosuppressant use (OR 3.671, 95% CI 1.371–9.827, p = 0.010), cerebral palsy (OR 2.835, 95% CI 1.463–5.494, p = 0.002), emergency operation (OR 1.843, 95% CI 1.011–3.360, p = 0.046), spine procedures (OR 1.673, 95% CI 1.036–2.702, p = 0.035), acquired CNS abnormality (OR 1.620, 95% CI 1.085–2.420, p = 0.018), and female sex (OR 1.475, 95% CI 1.062–2.049, p = 0.021). The only COA factor independently associated with SSI in the COA database included clean-contaminated wound classification (OR 3.887, 95% CI 1.354–11.153, p = 0.012), with public insurance (OR 1.966, 95% CI 0.957–4.041, p = 0.066) and spine procedures (OR 1.982, 95% CI 0.955–4.114, p = 0.066) approaching significance. Both NSQIP-P and COA multivariate model C-statistics were > 0.7.

CONCLUSIONS
The NSQIP-P SSI rates, but not risk factors, were similar to data from a single center.
Subdural hematoma as a major determinant of short-term outcomes in traumatic brain injury
Authors: Lee Jonathan J. , Segar David J. , Morrison John F. , Mangham William M. , Lee Shane , Asaad Wael F. 
Published: February 2017

OBJECTIVEEarly radiographic findings in patients with traumatic brain injury (TBI) have been studied in hopes of better predicting injury severity and outcome. However, prior attempts have generally not considered the various types of intracranial hemorrhage in isolation and have typically not excluded patients with potentially confounding extracranial injuries. Therefore, the authors examined the associations of various radiographic findings with short-term outcome to assess the potential utility of these findings in future prognostic models.METHODSThe authors retrospectively identified 1716 patients who had experienced TBI without major extracranial injuries, and categorized them into the following TBI subtypes: subdural hematoma (SDH), traumatic subarachnoid hemorrhage, intraparenchymal hemorrhage (which included intraventricular hemorrhage), and epidural hematoma. They specifically considered isolated forms of hemorrhage, in which only 1 subtype was present.RESULTSIn general, the presence of an isolated SDH was more likely to result in worse outcomes than the presence of other isolated forms of traumatic intracranial hemorrhage. Discharge to home was less likely and perihospital mortality rates were generally higher in patients with SDH. These findings were not simply related to age and were not fully captured by the admission Glasgow Coma Scale (GCS) score. The presence of SDH had a much higher sensitivity for poor outcome than the presence of other TBI subtypes, and was more sensitive for these poor outcomes than having a low GCS score (3–8).CONCLUSIONSIn these ways, SDH was the most important finding associated with poor outcome, and the authors show that consideration of SDH, specifically, can augment age and GCS score in classification and prognostic models for TBI.
Image guidance based on MRI for spinal interstitial laser thermotherapy: technical aspects and accuracy
Authors: Tatsui Claudio E. , Nascimento Clarissa N. G. , Suki Dima , Amini Behrang , Li Jing , Ghia Amol J. , Thomas Jonathan G. , Stafford R. Jason , Rhines Laurence D. , Cata Juan P. , Kumar Ashok J. , Rao Ganesh 
Published: February 2017

OBJECTIVEImage guidance for spinal procedures is based on 3D-fluoroscopy or CT, which provide poor visualization of soft tissues, including the spinal cord. To overcome this limitation, the authors developed a method to register intraoperative MRI (iMRI) of the spine into a neuronavigation system, allowing excellent visualization of the spinal cord. This novel technique improved the accuracy in the deployment of laser interstitial thermal therapy probes for the treatment of metastatic spinal cord compression.METHODSPatients were positioned prone on the MRI table under general anesthesia. Fiducial markers were applied on the skin of the back, and a plastic cradle was used to support the MRI coil. T2-weighted MRI sequences of the region of interest were exported to a standard navigation system. A reference array was sutured to the skin, and surface matching of the fiducial markers was performed. A navigated Jamshidi needle was advanced until contact was made with the dorsal elements; its position was confirmed with intraoperative fluoroscopy prior to advancement into a target in the epidural space. A screenshot of its final position was saved, and then the Jamshidi needle was exchanged for an MRI-compatible access cannula. MRI of the exact axial plane of each access cannula was obtained and compared with the corresponding screenshot saved during positioning. The discrepancy in millimeters between the trajectories was measured to evaluate accuracy of the image guidanceRESULTSThirteen individuals underwent implantation of 47 laser probes. The median absolute value of the discrepancy between the location predicted by the navigation system and the actual position of the access cannulas was 0.7 mm (range 0–3.2 mm). No injury or adverse event occurred during the procedures.CONCLUSIONSThis study demonstrates the feasibility of image guidance based on MRI to perform laser interstitial thermotherapy of spinal metastasis. The authors' method permits excellent visualization of the spinal cord, improving safety and workflow during laser ablations in the epidural space. The results can be extrapolated to other indications, including biopsies or drainage of fluid collections near the spinal cord.
Clinical presentation and treatment outcomes of spinal epidural arteriovenous fistulas
Authors: Nasr Deena M. , Brinjikji Waleed , Clarke Michelle J. , Lanzino Giuseppe 
Published: February 2017

OBJECTIVESpinal epidural arteriovenous fistulas (SEDAVFs) constitute a rare but treatable cause of vascular myelopathy and are a different subtype from the more common Type I spinal dural AVFs. The purpose of this study was to review a consecutive series of SEDAVFs from a single institution and report on the clinical presentations, functional status, and treatment outcomes.METHODSThe authors identified all SEDAVFs treated at their institution from 2005 to 2015. SEDAVFs were defined as spinal AVFs in which the fistulous connection occurred in the epidural venous plexus. The clinical presentation, functional status, immediate treatment outcomes, and long-term neurological outcomes were analyzed.RESULTSTwenty-four patients with SEDAVFs were included in this study. The patients' mean age at presentation was 66.9 years. The most common presenting symptoms were pain and numbness (22 patients, 91.7%), followed by lower-extremity weakness (21 patients, 87.5%). The mean duration of symptoms prior to diagnosis was 11.8 months. Eighteen patients (75.0%) were treated with endovascular therapy alone, 4 (16.7) with surgery, and 2 (8.3%) with a combination of techniques. There was 1 major treatment-related complication (4.2%). Fifteen patients (62.5%) had improvement in disability, and 12 patients (54.5%) had improvement in sensory symptoms.CONCLUSIONSSEDAVFs often present with lower-extremity motor dysfunction and sensory symptoms. With the availability of newer liquid embolic agents, these lesions can be effectively treated with endovascular techniques. Surgery is also effective at treating these lesions, especially in situations where endovascular embolization fails or is not safe and in patients presenting with mass effect from compressive varices.