bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of Parasite Load Levels in Amniotic Fluid With Clinical Outcome in Congenital Toxoplasmosis
Authors: Yamamoto Lidia , Targa Lília S. , Sumita Laura M. , Shimokawa Paulo T. , Rodrigues Jonatas C. , Kanunfre Kelly A. , Okay Thelma S. 
Published: July 2017

OBJECTIVE:
To correlate neonatal and infant clinical outcome with parasite load in amniotic fluid (AF).

METHODS:
We conducted a retrospective cohort study of 122 children whose mothers had toxoplasmosis during pregnancy. The children were monitored from birth to 12 months old. Stored AF samples were obtained at maternal diagnosis and tested by quantitative polymerase chain reaction. Gestational age at maternal infection, quantitative polymerase chain reaction results, neonatal anti–Toxoplasma gondii immunoglobulin (Ig) M, and clinical outcome at 12 months were correlated.

RESULTS:
Maternal infection occurred in 18 of 122 (14.7%) and 104 of 122 (85.2%) women in the first and second trimesters, respectively. At birth, IgM was present in 107 of 122 (87.7%) neonates and 36 (29.5%) were symptomatic. Of these, half occurred in the first and the other half in the second trimester and 6 of 36 had severe infections (16.7% of symptomatic, 4.9% of total), all infected in the first trimester. Parasite load levels were highly variable (median 35 parasites/mL, range 2–30,473). Logistic regression correlated symptomatic infection with gestational age (odds ratio [OR] 0.47, CI 0.31–0.73) and parasite load (OR 2.04, CI 1.23–3.37), but not with positive IgM (OR 6.81, CI 0.86–53.9). Negative correlations were found between gestational age and parasite load (rs –0.780, CI −0.843 to −0.696), gestational age and symptoms (rs –0.664, CI −0.755 to −0.547), but not gestational age and IgM (rs −0.136, CI −0.311 to 0.048). Parasite load levels distributed by percentile showed that all symptomatic patients appeared from the 75th percentile and all severe infections from the 95th percentile. Load rankings showed doubled the OR for each 20 parasite/mL increment. Parasite load was associated with symptomatic infections (area under the curve 0.959, CI 0.908–0.987) as well as gestational age (area under the curve 0.918, CI 0.855–0.960) and both parameters combined (area under the curve 0.969, CI 0.920–0.992).

CONCLUSION:
Parasite load in AF is associated with the clinical outcome in congenital toxoplasmosis, irrespective of gestational age at maternal infection.
Secnidazole Treatment of Bacterial Vaginosis
Authors: Hillier Sharon L. , Nyirjesy Paul , Waldbaum Arthur S. , Schwebke Jane R. , Morgan Franklin G. , Adetoro Nikki A. , Braun Carol J. 
Published: July 2017

OBJECTIVE:
To evaluate secnidazole as a single oral dose treatment for bacterial vaginosis in a phase 2 randomized, double-blind, placebo-controlled study.

METHODS:
In a phase 2, randomized, double-blind, dose-ranging, placebo-controlled study, women with bacterial vaginosis who met all Amsel criteria (discharge; pH 4.7 or greater; 20% or greater clue cells; positive whiff test) were randomized one to one to one at 24 U.S. centers to 1 or 2 g secnidazole compared with placebo. The primary endpoint was clinical cure (normalization of discharge, amine odor, and clue cells) 21–30 days after treatment. Secondary endpoints included microbiologic cure, defined as a Nugent score of 0–3, and therapeutic cure, defined as meeting criteria for both clinical and microbiologic cure. The modified intent to treat was used for efficacy analyses and included all randomized patients who met the enrollment criteria. Assuming a clinical cure rate of 40% in the active groups and 15% in the placebo group, a sample size of 52 patients per group provided approximately 80% power to detect a significant difference between groups (.05 level [two-sided]) using a Cochran-Mantel-Haenszel test.

RESULTS:
Between May and September 2014, 215 patients were enrolled. In the intent-to-treat population, the clinical cure rate was 65.3% for the 2-g group, 49.3% for the 1-g group, and 19.4% for the placebo group. The modified intent-to-treat population included 188 women (median age 33 years; 32% with four or more bacterial vaginosis episodes in the previous year; 54% black) with baseline Nugent scores 4 or greater. Clinical, microbiologic, and therapeutic cure rates were 67.7%, 40.3%, and 40.3% for 2 g secnidazole and 51.6%, 23.4%, and 21.9% for 1 g secnidazole compared with 17.7%, 6.5%, and 6.5% for placebo, respectively (P<.05 for secnidazole compared with placebo; all endpoints). Both doses were well-tolerated.

CONCLUSION:
Oral granules containing 1 and 2 g secnidazole were superior to placebo in bacterial vaginosis treatment (P<.001 for both groups). These data support the development of secnidazole for bacterial vaginosis treatment.

CLINICAL TRIAL REGISTRATION:
ClinicalTrials.gov, NCT02147899.
Contraception After Delivery Among Publicly Insured Women in Texas
Authors: Potter Joseph E. , Coleman-Minahan Kate , White Kari , Powers Daniel A. , Dillaway Chloe , Stevenson Amanda J. , Hopkins Kristine , Grossman Daniel 
Published: July 2017

OBJECTIVE:
To assess women's preferences for contraception after delivery and to compare use with preferences.

METHODS:
In a prospective cohort study of women aged 18–44 years who wanted to delay childbearing for at least 2 years, we interviewed 1,700 participants from eight hospitals in Texas immediately postpartum and at 3 and 6 months after delivery. At 3 months, we assessed contraceptive preferences by asking what method women would like to be using at 6 months. We modeled preference for highly effective contraception and use given preference according to childbearing intentions using mixed-effects logistic regression testing for variability across hospitals and differences between those with and without immediate postpartum long-acting reversible contraception (LARC) provision.

RESULTS:
Approximately 80% completed both the 3- and 6-month interviews (1,367/1,700). Overall, preferences exceeded use for both—LARC: 40.8% (n=547) compared with 21.9% (n=293) and sterilization: 36.1% (n=484) compared with 17.5% (n=235). In the mixed-effects logistic regression models, several demographic variables were associated with a preference for LARC among women who wanted more children, but there was no significant variability across hospitals. For women who wanted more children and had a LARC preference, use of LARC was higher in the hospital that offered immediate postpartum provision (P<.035) as it was for U.S.-born women (odds ratio [OR] 2.08, 95% CI 1.17–3.69) and women with public prenatal care providers (OR 2.04, 95% CI 1.13–3.69). In the models for those who wanted no more children, there was no significant variability in preferences for long-acting or permanent methods across hospitals. However, use given preference varied across hospitals (P<.001) and was lower for black women (OR 0.26, 95% CI 0.12–0.55) and higher for U.S.-born women (OR 2.32, 95% CI 1.36–3.96), those 30 years of age and older (OR 1.82, 95% CI 1.07–3.09), and those with public prenatal care providers (OR 2.04, 95% CI 1.18–3.51).

CONCLUSION:
Limited use of long-acting and permanent contraceptive methods after delivery is associated with indicators of health care provider and system-level barriers. Expansion of immediate postpartum LARC provision as well as contraceptive coverage for undocumented women could reduce the gap between preference and use.
Readmission After Gynecologic Surgery
Authors: Cory Lori , Latif Nawar , Brensinger Colleen , Zhang Xiaochen , Giuntoli Robert L. , Burger Robert A. , Morgan Mark , Ko Emily 
Published: July 2017

OBJECTIVE:To compare 30-day postsurgical readmission rates and associated risk factors for readmission among women undergoing gynecologic surgery for benign and malignant conditions.METHODS:In a retrospective cohort study, we identified patients after surgery for benign and malignant gynecologic conditions in the National Surgical Quality Improvement Program database between January 1, 2011, and December 31, 2012. Data collected included surgical factors, perioperative characteristics, surgical complications, and 30-day readmissions. The primary study outcome was readmission rates after gynecologic surgery for benign and oncologic conditions. Secondary study outcomes were risk factors associated with readmission among gynecologic surgeries performed for benign and oncologic conditions.RESULTS:Approximately 3% (1,444/46,718) compared with 8.2% (623/7,641) of patients who underwent gynecologic surgery for benign and malignant indications, respectively, were readmitted (P<.01). Compared with patients with benign surgical indications, those with uterine cancer (readmission rate 6.6%; odds ratio [OR] 2.21, 95% CI 1.95–2.51), ovarian cancer (readmission rate 10.9%; OR 3.82, 95% CI 3.29–4.45), and cervical cancer (readmission rate 10.1%; OR 3.51, 95% CI 2.71–4.53) were more likely to be readmitted. In multivariable models, independent risk factors for readmission for gynecologic cancer surgery included worse preoperative conditions (OR 1.49, 95% CI 1.17–1.90) and major complications (OR 17.84, 95% CI 14.19–22.43). In comparison, independent risk factors for readmission after surgery for benign indications included comorbid conditions (OR 1.36, 95% CI 1.18–1.57), operative time (15–59 minutes: referent; 60 minutes or greater: 1.37, 95% CI 1.14–1.63) and major complications (OR 53.91, 95% CI 46.98–61.85).CONCLUSION:Among gynecologic surgeries, those performed for oncologic indications were associated with readmission rates 2.8 times that of surgeries performed for benign indications. In adjusted models, worse preoperative conditions and surgical complications remained independent risk factors associated with the higher rate of readmission among patients with gynecologic cancer.
Extensile Fasciotomy for Compartment Syndrome of the Forearm and Hand
Authors: Turkula Stefan C. , Fuller David A. 
Published: July 2017

Purpose:
The purpose of this video is to demonstrate the technique of an extensile fasciotomy of the forearm and hand.

Methods:
A patient presented to our hospital with a rapidly progressing infection of the right upper extremity and clinical signs and symptoms of compartment syndrome. The patient was immediately taken to the operating room for decompressive fasciotomy, debridement, drainage, and irrigation of what cultures subsequently revealed to be a virulent streptococcal infection. Important anatomical structures are identified in the video as the compartments of the forearm and hand are decompressed through volar and dorsal incisions. In the conclusion of the video, the skin is loosely approximated over the elbow and wrist flexion creases, and a bulky gauze dressing is applied including a plaster splint.

Results:
The video is 6 minutes, 20-second duration in time, and 558,180,000 bytes in size.

Conclusions:
This video successfully demonstrates the anatomical approach and technique of an extensile forearm and hand fasciotomy for compartment syndrome related to a rapidly progressing infection.
Use of Volar Plate for Indirect Coronal Plane Reduction in an Intraarticular Distal Radius Fracture
Authors: Senehi Rebecca , Luo Tyani D. , Marquez-Lara Alejandro , Aneja Arun , Beard Hoyt R. , Carroll Eben A. 
Published: July 2017

Summary:
Management of intraarticular distal radius fractures requires precise reconstruction of the articular surface to optimize outcomes. Treatment goals also include restoration of alignment, rotation, and angulation in both the coronal and sagittal planes of the metaphyseal component of these fractures. Surgical management with open reduction and internal fixation with a volar plate is often the preferred method of open treatment. However, a variety of different techniques have been described, and the preferred technique may be determined on an individual basis by the fracture characteristics, patient-dependent factors, or surgeon experience.
Immunohistochemical Demonstration of Parvovirus B19 Viral Protein 2 in Periflexural Exanthema in an Adult, Supporting Antibody-Dependent Enhancement as Means of Endothelial Uptake of the Virus
Authors: Santonja Carlos , Pielasinski Úrsula , Polo Jorge , Kutzner Heinz , Requena Luis 
Published: July 2017

Abstract:
Human parvovirus B19 (B19V) causes a number of skin exanthemas and has been related to both cutaneous and systemic diseases. Tropism of the virus for the rapidly proliferating erythroid progenitor cells in the bone marrow and fetal liver explains the pathogenesis of anemia and fetal hydrops. The cutaneous lesions of erythema infectiosum and other B19V-related exanthemas have been attributed to the deposition of immune complexes in the skin. We report on the immunohistochemical detection of B19V protein in the cytoplasm of dermal endothelial cells in a case of periflexural exanthema in a 28-year-old woman. An antibody-dependent enhancement mechanism of entry has been suggested for B19V in myocardial endothelial cells and could also be involved in B19V-related exanthemas.
Circulating osteoprotegerin in postmenopausal osteoporotic women: marker of impaired glucose regulation or impaired bone metabolism
Authors: Mashavi Margarita , Menaged Miriam , Shargorodsky Marina 
Published: July 2017

Abstract

Objective:
Osteoprotegerin (OPG) is closely related to insulin resistance and bone remodeling. However, no studies have examined the role of OPG in postmenopausal women with coexistent impaired glucose and bone regulation. The present study investigated the relationship of OPG to glucose homeostasis and insulin resistance in postmenopausal osteoporotic women with different types of glucose tolerance.

Methods:
In all, 114 postmenopausal osteoporotic women were divided into three groups according to glucose tolerance status: 51 with normal glucose tolerance (NGT, group 1), 31 with impaired glucose tolerance (IGT, group 2), and 32 with type 2 diabetes mellitus (DM, group 3). Study participants were evaluated for metabolic parameters, OPG, Homeostasis Model Assessment of Insulin Resistance (HOMA-IR), and bone mineral density parameters.

Results:
The OPG levels differed significantly across groups and increased from group 1 to group 3 in a continuous fashion (analysis of variance, P < 0.0001). In post-hoc analysis, OPG was significantly lower in osteoporotic women with NGT, than participants with IGT and DM (P < 0.05 and P < 0.0001, respectively). OPG was positively associated with HOMA-IR (P < 0.0001). No association between serum OPG levels and measures of BMD was observed. In a multiple regression analysis, OPG emerged as an independent predictor of HOMA-IR even after controlling for age, body mass index, and creatinine.

Conclusions:
OPG is significantly higher in postmenopausal osteoporotic women with impaired glucose regulation (IGT and DM) than women with NGT. OPG was independently associated with insulin resistance assessed by HOMA-IR. Thus, measurement of OPG may potentially be considered as a prediabetic state screening in postmenopausal osteoporotic women.
Perimenopausal arthralgia in the shoulder
Authors: Yoon Seunghyun , Lee Doo-hyung , Bang Junyoung 
Published: July 2017

Abstract

Objective:
To evaluate perimenopausal arthralgia in the shoulder and treatment thereof.

Methods:
Participants with perimenopausal (n = 197) or premenopausal (n = 113) shoulder arthralgia were included in the study. The prevalences of synovitis, adhesive capsulitis, rotator cuff disorder, arthritis, and other pathologies in the two groups were compared. Participants diagnosed with synovitis were treated with oral prednisolone for 9 to 12 weeks.

Results:
The most common diagnosis in the perimenopausal and premenopausal groups was adhesive capsulitis (35.4% and 31.8%, respectively), but the difference in prevalence between the two groups was not significant (P = 0.532). The second most common diagnosis in the perimenopausal group was shoulder synovitis (25.1%), the prevalence of which was significantly higher than that in the premenopausal group (6.2%; P < 0.001). An improvement after treatment with oral prednisolone was reported by 92.9% of the 56 participants diagnosed with shoulder synovitis.

Conclusions:
In this study, we evaluated the relationship between menopause and shoulder arthralgia, specifically synovitis. These findings can help clinicians correctly diagnose and treat shoulder arthralgia in perimenopausal women.
Tensor Fasciae Suralis Muscle: Report of a Symptomatic Case With Emphasis on Imaging Findings
Authors: Tsifountoudis Ioannis , Kalaitzoglou Ioannis , Papacostas Emmanuel , Malliaropoulos Nikos 
Published: July 2017

Abstract:
We report a case of a symptomatic tensor fasciae suralis (TFS) muscle in an elite jumper, with a very rare tear in its origin. The TFS muscle must be recognized and differentiated from other pathologic entities in the popliteal region. The magnetic resonance imaging (MRI) and ultrasound (US) can reliably identify this variant and its pathology.
EUS-guided Gastrojejunostomy Versus Laparoscopic Gastrojejunostomy
Authors: Perez-Miranda Manuel , Tyberg Amy , Poletto Daniel , Toscano Ernesto , Gaidhane Monica , Desai Amit P. , Kumta Nikhil A. , Fayad Lea , Nieto Jose , Barthet Marc , Shah Raj , Brauer Brian C. , Sharaiha Reem Z. , Kahaleh Michel 
Published: July 2017

Introduction:
Endoscopic ultrasound–guided gastrojejunostomy (EUS-GJ) with placement of a lumen-apposing metal stent is a minimally invasive and efficacious procedure for gastric outlet obstruction (GOO) patients not amenable to surgery. Laparoscopic gastrojejunostomy (Lap-GJ) has traditionally been the standard of care. No direct comparison between EUS-GJ and Lap-GJ has been described. Our aim was to compare the clinical outcomes, success rate, and adverse events (AE) of EUS-GJ with Lap-GJ.

Methods:
Patients with GOO from 4 academic centers in 3 countries were included. Technical success was defined as successful creation of a gastrojejunostomy. Clinical success was defined as the ability to tolerate a diet postprocedure.

Results:
Data were collected on 54 patients. A total of 25 patients underwent EUS-GJ (male n=11, mean age 63.9 y) and 29 patients underwent Lap-GJ (male n=22, mean age 75.8 y). Technical success was achieved in 29 (100%) Lap-GJ group patients and 23 (88%) in the EUS-GJ group (P=0.11). AEs occurred in 41% (n=12) of patients in the Lap-GJ group and 12% (n=3) in the EUS-GJ group (P=0.0386). According to the Clavien-Dindo Classification, the Lap-GJ group AEs were grade I (n=4), grade II (n=5), grade III (n=2), and grade V (n=1); the EUS-GJ AEs were grade II (n=2) and grade V (n=1).

Conclusions:
Although the EUS-GJ group contained more complex patients, efficacy was similar between the groups. AEs were significantly lower in the EUS-GJ group. EUS-GJ is a safe and efficacious, minimally invasive option for patients with GOO.
Current body composition measurement techniques
Authors: Lemos Thaisa , Gallagher Dympna 
Published: July 2017

Purpose of review
The current article reviews the most innovative and precise, available methods for quantification of in-vivo human body composition.

Recent findings
Body composition measurement methods are continuously being perfected. Ongoing efforts involve multisegmental and multifrequency bioelectrical impedance analysis, quantitative magnetic resonance for total body water, fat, and lean tissue measurements, imaging to further define ectopic fat depots. Available techniques allow for the measurement of fat, fat-free mass, bone mineral content, total body water, extracellular water, total adipose tissue and its subdepots (visceral, subcutaneous, and intermuscular), skeletal muscle, select organs, and ectopic fat depots.

Summary
There is an ongoing need for methods that yield information on metabolic and biological functions. Based on the wide range of measurable properties, analytical methods and known body composition models, clinicians, and scientists can quantify a number of body components and with longitudinal assessment, can track changes in health and disease with implications for understanding efficacy of nutritional and clinical interventions, diagnosis, prevention, and treatment in clinical settings. With the greater need to understand precursors of health risk beginning prior to conception, a gap exists in appropriate in-vivo measurement methods with application beginning during gestation, that is, fetal development.
Effects of Berberine on Acute Necrotizing Pancreatitis and Associated Lung Injury
Authors: Choi Sun-Bok , Bae Gi-Sang , Jo Il-Joo , Song Ho-Joon , Park Sung-Joo 
Published: July 2017

Objectives
We set out to examine whether berberine (BBR) might affect the severity of pancreatitis and pancreatitis-associated lung injury in choline-deficient ethionine-supplemented (CDE) diet–induced severe acute pancreatitis.

Methods
Severe acute pancreatitis was induced by feeding a CDE diet for 3 days. Berberine was administered intraperitoneally during CDE diet. Mice were killed on days 1, 2, and 3 after the onset of CDE diet. The severity of pancreatitis was assessed by evaluating changes to the pancreas and lung and survival rate. Blood, pancreas, and lung were harvested for further examination. Furthermore, the regulating mechanisms of BBR were evaluated on the pancreas.

Results
Administration of BBR significantly inhibited histological damage to the pancreas and lung and decreased serum level of amylase and lipase, myeloperoxidase activity, cytokine production, and the mortality rate. Furthermore, administration of BBR inhibited activation of nuclear factor kappa B, c-Jun N-terminal kinases, and p38 in the pancreas during CDE diet.

Conclusions
These findings suggest that BBR attenuates the severity of pancreatitis by inhibiting activation of nuclear factor kappa B, c-Jun N-terminal kinase, and p38 and that BBR could be used as a beneficial agent to regulate AP.