bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improvement in Scoliosis Research Society-22R Pain Scores After Surgery for Adolescent Idiopathic Scoliosis
Authors: Djurasovic Mladen , Glassman Steven D. , Sucato Daniel J. , Lenke Lawrence G. , Crawford Charles H. , Carreon Leah Y. 
Published: November 2016

Study Design.
Longitudinal cohort.

Objective.
To investigate whether patients with painful adolescent idiopathic scoliosis experience pain relief with surgical treatment.

Summary of Background Data.
Adolescent idiopathic scoliosis (AIS) was previously thought to be a painless condition, but recent studies have shown that a significant proportion of patients have pain. Little information is available regarding pain relief with surgical treatment for AIS.

Methods.
Patients enrolled in a prospective database of surgically treated AIS were divided into two groups based on their preoperative Scoliosis Research Society (SRS)-22R pain domain score. Patients with a preoperative pain domain score of 4 or more (N = 1005) were classified as nonpainful. If the preoperative pain domain score was less than 4 (N = 505), they were classified as painful. Demographics, SRS total and domain scores, and changes with treatment were compared for the two groups.

Results.
The two groups had similar demographics and preoperative coronal curve magnitude. Patients with painful scoliosis experienced significant improvement in SRS-22R pain scores, from 3.29 preoperatively to 4.03 postoperatively (P < 0.000). Eighty-one percent of these patients reached the minimum clinically important difference threshold (0.20) for improvement in pain score. Painful scoliosis patients also had greater 2-year improvement in total and all domain scores than the nonpainful scoliosis patients (P < 0.000). Absolute values of SRS-22R total and domain scores were all greater at 2 years in the nonpainful group than the painful group.

Conclusion.
Patients with AIS with substantial back pain can be cautiously counseled to expect significant improvement in pain level with surgical correction of their deformity, even if curve progression is the primary indication for surgery. Although these patients achieve greater improvements in health-related quality of life compared with patients with mild or no pain, 2-year SRS-22R scores were still better in patients with mild or no pain preoperatively.

Level of Evidence: 2
Brincidofovir Is Not a Substrate for the Human Organic Anion Transporter 1: A Mechanistic Explanation for the Lack of Nephrotoxicity Observed in Clinical Studies
Authors: Tippin Timothy K. , Morrison Marion E. , Brundage Thomas M. , Momméja-Marin Hervé 
Published: November 2016

Background:
Brincidofovir (BCV) is an orally bioavailable lipid conjugate of cidofovir (CDV) with increased in vitro potency relative to CDV against all 5 families of double-stranded DNA viruses that cause human disease. After intravenous (IV) administration of CDV, the organic anion transporter 1 (OAT1) transports CDV from the blood into the renal proximal tubule epithelial cells with resulting dose-limiting nephrotoxicity.

Objective:
To study whether OAT1 transports BCV and to evaluate the pharmacokinetic and renal safety profile of oral BCV compared with IV CDV.

Methods:
The cellular uptake of BCV and its major metabolites was assessed in vitro. Renal function at baseline and during and after treatment in subjects in BCV clinical studies was examined.

Results:
In OAT1-expressing cells, uptake of BCV and its 2 major metabolites (CMX103 and CMX064) was the same as in mock-transfected control cells and was not inhibited by the OAT inhibitor probenecid. In human pharmacokinetic studies, BCV administration at therapeutic doses resulted in detection of CDV as a circulating metabolite; peak CDV plasma concentrations after oral BCV administration in humans were <1% of those observed after IV CDV administration at therapeutic doses. Analysis of renal function and adverse events from 3 BCV clinical studies in immunocompromised adult and pediatric subjects indicated little to no evidence of associated nephrotoxicity. Over 80% of subjects who switched from CDV or foscarnet to BCV experienced an improvement in renal function as measured by maximum on-treatment estimated glomerular filtration rate.

Conclusions:
The lack of BCV uptake through OAT1, together with lower CDV concentrations after oral BCV compared with IV CDV administration, likely explains the superior renal safety profile observed in immunocompromised subjects receiving BCV compared with CDV.
Efficacy of Autologous Platelet-rich Plasma Glue in Weight Loss Sequelae Surgery and Breast Reduction: A Prospective Study
Authors: Hersant Barbara , SidAhmed-Mezi Mounia , Lapadula Simone , Niddam Jeremy , Bouhassira Jonathan , Meningaud Jean Paul 
Published: November 2016

Background:
Seroma and hematoma formations are the most common complications after plastic surgery. The aim of this study was to assess the efficacy of autologous platelet-rich plasma (A-PRP) glue to reduce postoperative wound complications and improve surgical outcomes.

Methods:
Fifty-four patients were included in this study. They underwent breast reduction surgery, abdominoplasty, or limb lifting with A-PRP glue application on the entire surface of the subcutaneous tissue at the time of suture. Retrospective data were used for the control group. The primary endpoint was the incidence of postoperative seroma or hematoma. The secondary endpoint was the Patient and Observer Scar Assessment Scale score.

Results:
Demographics and clinical characteristics were not statistically different between the A-PRP glue group and the control group regarding age, sex ratio, and body mass index. After abdominoplasty, 37.5% of patients (3/8) in the control group experienced seroma and hematoma complications versus 12.5% of patients (2/16) in the A-PRP glue group (P = 0.55 and P = 0.25, respectively). After limb lifting, 50% of patients experienced postoperative complications in the control group versus no patient in the A-PRP glue group (P = 0.03*; * indicates that the P value is significant). After breast reduction, no patient experienced complication in the A-PRP glue group versus 25% of patients in the control group who experienced hematoma (P = 0.04*). The scar quality assessed 12 months after surgery showed no statistical differences between the groups.

Conclusions:
A-PRP glue seems effective to prevent seroma formation after limb lifting and hematoma formation after breast reduction. Wound-healing quality did not seem to be improved.
Hybrid practices as a means to implement quality improvement: A comparative qualitative study in a Dutch and Swedish hospital
Authors: Quartz-Topp Julia , Sanne Johan M. , Pöstges Heide 
Published: November 2016

Background:
Managers and scholars commonly perceive resistance from professionals as hampering the implementation of quality improvement (QI) and refer to the incompatibility of clinical and managerial approaches to QI as a reason. Yet a growing body of research indicates that, in practice, these two approaches rather blend into hybrid practices that embody different types of QI-related knowledge and values. This opens up a new perspective on implementation challenges that moves attention away from resistance against managerial QI toward difficulties for clinicians to draw together different types of knowledge and values within their clinical work. So far, little is known about how managers can support clinicians to generate hybrid QI practices.

Purpose:
The aim of this study was to deepen our understanding of how managers can support the generation of hybrid practices that help clinicians to integrate QI into their everyday work.

Methodology/Approach:
We draw on comparative qualitative research including 21 semistructured interviews, documentary analysis, and participant observation that we conducted in one Dutch and one Swedish hospital over a period of 8 months in 2011/2012.

Results:
Hospital managers designed hybrid forums, tools, and professional roles in order to facilitate the integration of different QI practices, knowledge, and values. This integration generated new hybrid practices and an infrastructure for QI that has potential to support clinicians in their efforts to align different demands.

Practice Implications:
New opportunities to implement QI emerge when we change the implementation problem from clinical resistance to the need of support for clinicians to develop hybrid QI practices. Hospital managers then have to intentionally organize for the generation of hybrid practices by designing, for example, hybrid forums, tools, and professional roles that integrate different knowledge and values in a nonhierarchical way.
Team-based primary care: The medical assistant perspective
Authors: Sheridan Bethany , Chien Alyna T. , Peters Antoinette S. , Rosenthal Meredith B. , Brooks Joanna Veazey , Singer Sara J. 
Published: November 2016

Background:
Team-based care has the potential to improve primary care quality and efficiency. In this model, medical assistants (MAs) take a more central role in patient care and population health management. MAs’ traditionally low status may give them a unique view on changing organizational dynamics and teamwork. However, little empirical work exists on how team-based organizational designs affect the experiences of low-status health care workers like MAs.

Purposes:
The aim of this study was to describe how team-based primary care affects the experiences of MAs. A secondary aim was to explore variation in these experiences.

Methodology/Approach:
In late 2014, the authors interviewed 30 MAs from nine primary care practices transitioning to team-based care. Interviews addressed job responsibilities, teamwork, implementation, job satisfaction, and learning. Data were analyzed using a thematic networks approach. Interviews also included closed-ended questions about workload and job satisfaction.

Results:
Most MAs reported both a higher workload (73%) and a greater job satisfaction (86%) under team-based primary care. Interview data surfaced four mechanisms for these results, which suggested more fulfilling work and greater respect for the MA role: (a) relationships with colleagues, (b) involvement with patients, (c) sense of control, and (d) sense of efficacy. Facilitators and barriers to these positive changes also emerged.

Conclusion:
Team-based care can provide low-status health care workers with more fulfilling work and strengthen relationships across status lines. The extent of this positive impact may depend on supporting factors at the organization, team, and individual worker levels.

Practice Implications:
To maximize the benefits of team-based care, primary care leaders should recognize the larger role that MAs play under this model and support them as increasingly valuable team members. Contingent on organizational conditions, practices may find MAs who are willing to manage the increased workload that often accompanies team-based care.
Telavancin for MRSA Endocarditis
Authors: Majumdar Rohit , Crum-Cianflone Nancy F. 
Published: November 2016

Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) endocarditis refractory to standard therapies is an increasingly prevalent clinical entity. Telavancin is a newly developed lipoglycopeptide with potent activity against MRSA, but few data exist regarding its potential role for MRSA endocarditis. We report a case of MRSA persistent bacteremia and endocarditis successfully treated with telavancin after failing standard agents due to multiple adverse effects. Additionally, we summarize the patient characteristics, clinical courses, and outcomes of all 15 published cases of MRSA endocarditis treated with telavancin in the peer-reviewed literature. These cases demonstrate telavancin's potential role in the treatment of MRSA invasive endovascular infections in the setting of refractory disease.
History of the Endolymphatic Sac: From Anatomy to Surgery
Authors: Corrales C. Eduardo , Mudry Albert 
Published: November 2016

Objectives:
To evaluate the historical descriptive origins of the anatomy of endolymphatic sac (ELS), its initial dilation description, its association with tumors, and lastly its surgical implication.

Methods:
A collection of historical and contemporary references, and selected textbooks were compiled spanning the 18th century to present day with specific focus on the description of the ELS, ELS dilation, and ELS tumors (ELSTs).

Results:
Domenico Cotugno describes the ELS in 1760. Carl Hasse introduces the term endolymphatic sac (saccus endolymphaticus) in 1873, which has remained in use till today. Carlo Mondini, in 1791, describes ELS dilation. Georges Portmann proposes opening the ELS for the treatment of Ménière's disease (MD) in 1926. In 1984, the first reported case of an ELST is described with pathology consisting of an adenoma. Four years later, in 1988, the first report is published suggesting ELSTs in direct association to von Hippel-Lindau disease.

Conclusion:
Domenico Cotugno is precise in describing the ELS in 1760. A timeline of important events relating to the ELS is presented. These include ELS dilation, surgical opening of the ELS for Meniere's, and ELSTs relating to von Hippel-Lindau disease.
Cochlear Implantation in Ménière's Disease With and Without Labyrinthectomy
Authors: Mukherjee Payal , Eykamp Kate , Brown Daniel , Curthoys Ian , Flanagan Sean , Biggs Nigel , McNeill Celene , Gibson William 
Published: November 2016

Objective:
To investigate outcomes of cochlear implantation (CI) in patients with Ménière's disease (MD) with and without surgical labyrinthectomy.

Study Design:
Retrospective study.

Setting:
Multiple tertiary referral centers.

Subjects:
Thirty one ears from 27 patients (17 men, 10 women, aged 42–84) with CI in ipsilateral MD ear.

Intervention:
CI in ears with intact labyrinths (Group 1), CI with simultaneous surgical labyrinthectomy (Group 2), and CI sequential to surgical labyrinthectomy (Group 3).

Main Outcome Measure:
Within-subject improvement on Bamford Kowal Bench test or City University of New York open set sentence tests.

Results:
Majority of ears achieved excellent open-set speech recognition by 12 months post-CI, irrespective of intervention group. Preoperative details including patient age and sex, implant, MD and previous intervention, and audiological test results did not significantly affect outcomes. Patients with MD undergoing CI only may experience vestibular dysfunction which may cause long-term concerns. Incidental finding was noted of eight ears with fluctuating symptoms in ipsilateral ear during 12-month period post-CI, with five of eight ears showing objective fluctuating impedances and mapping.

Conclusion:
CI in MD can yield good hearing outcomes in all three groups and this is possible even after a long delay after labyrinthectomy. Bilateral MD patients are complex and prospective quality of life (QoL) measures would be beneficial in being better able to manage the vestibular outcomes as well as the audiological ones.
The Use of Nesiritide in Children With Congenital Heart Disease
Authors: Bronicki Ronald A. , Domico Michele , Checchia Paul A. , Kennedy Curtis E. , Akcan-Arikan Ayse 
Published: November 2016

Objective:
We evaluated the use of nesiritide in children with critical congenital heart disease, pulmonary congestion, and inadequate urine output despite conventional diuretic therapy.

Design:
We conducted a retrospective analysis of 26 consecutive patients, comprising 37 infusions occurring during separate hospitalizations. Hemodynamic variables, urine output, and serum creatinine levels were monitored prior to and throughout the duration of therapy with nesiritide. In addition, the stage of acute kidney injury was determined prior to and throughout the duration of the therapy using a standardized definition of acute kidney injury—The Kidney Disease: Improving Global Outcomes criteria.

Setting:
Cardiac ICU.

Patients:
Pediatric patients with critical congenital heart disease, pulmonary congestion, and inadequate urinary output despite diuretic therapy.

Intervention:
Nesiritide infusion.

Measurements and Main Results:
The use of nesiritide was associated with a significant decrease in the central venous pressure and heart rate with a trend toward a significant increase in urine output. During the course of therapy with nesiritide, the serum creatinine and stage of acute kidney injury decreased significantly. The decrease in stage of acute kidney injury became significant by day 4 (p = 0.006) and became more significant with time (last day of therapy compared with baseline; p < 0.001). During 12 of the 37 infusions, the stage of acute kidney injury decreased by two or more (p < 0.001).

Conclusions:
Nesiritide had a favorable impact on hemodynamics and urine output in children with critical congenital heart disease and pulmonary congestion, and there was no worsening of renal function.
Differences in Risk Behavior and Demographic Factors Between Men Who Have Sex With Men With Acute and Nonacute Human Immunodeficiency Virus Infection in a Community-Based Testing Program in Los Angeles
Authors: Joseph Davey Dvora , Beymer Matthew , Roberts Chelsea P. , Bolan Robert K. , Klausner Jeffrey D. 
Published: November 2016

Introduction:
High viremia combined with HIV-infection status unawareness and increased sexual risk behavior contributes to a disproportionate amount of new HIV infections.

Methods:
From August 2011 to July 2015, the Los Angeles Lesbian, Gay, Bisexual, and Transgender Center conducted 66,546 HIV tests. We compared factors, including the presence of concomitant sexually transmitted infections, number of recent sex partners and reported condomless anal intercourse between men who have sex with men (MSM) diagnosed with an acute HIV infection and a nonacute HIV infection using multivariable logistic regression.

Results:
Of 1082 unique MSM who tested HIV-infected for the first time, 165 (15%) had an acute infection and 917 had a nonacute infection. HIV rapid antibody testing was 84.8% sensitive for detecting HIV infection (95% confidence interval (CI): 82.9% to 87.1%). Median HIV viral load among acutely infected MSM was 842,000 copies per milliliter (interquartile range = 98,200–4,897,318). MSM with acute infection had twice the number of sex partners in the prior 30 days (median = 2) and prior 3 months (median = 4) before diagnosis compared with those diagnosed with nonacute infection (P ≤ 0.0001). The odds of acute HIV infection were increased with the numbers of recent sex partners after controlling for age and race/ethnicity (adjusted odds ratio (aOR) >5 partners in past 30 days = 2.74; 95% CI: 1.46 to 5.14; aOR >10 partners in past 3 months = 2.41; 95% CI: 1.36 to 4.25). Non-African American MSM had almost double the odds of being diagnosed with an acute HIV infection compared with African American MSM (aOR = 1.97; 95% CI: 1.10 to 3.52).

Conclusions:
MSM with acute HIV infection had nearly twice as many sex partners in the past 30 days and 3 months compared with MSM with newly diagnosed nonacute HIV infection. Those diagnosed with acute HIV infection had decreased odds of being African American MSM.
Higher Cystatin C Levels Are Associated With Neurocognitive Impairment in Older HIV+ Adults
Authors: Sakoda Marissa E. , Fazeli Pariya L. , Ellis Ronald J. , Jeste Dilip V. , Grant Igor , Letendre Scott L. , Moore David J. 
Published: November 2016

Objective:
The study aims to determine whether cystatin C is associated with HIV disease and HIV-associated neurocognitive impairment (NCI).

Methods:
Participants included 124 (HIV+ n = 77; HIV− n = 47) older adults (age ≥ 50 years) examined at the University of California, San Diego HIV Neurobehavioral Research Program. Cystatin C, a biomarker of kidney functioning that has been linked to poor health outcomes, was measured in blood. Participants completed a comprehensive neurocognitive assessment that was used to define both global and domain NCI.

Results:
The HIV+ group had significantly higher cystatin C concentrations than the HIV− group (d = 0.79 P < 0.001). Among HIV+ participants, those with NCI had higher cystatin C concentrations than those without NCI (d = 0.42, P = 0.055), particularly among participants taking tenofovir (d = 0.78, P = 0.004). A receiver–operator characteristic curve identified that cystatin C levels ≥0.75 mg/L were associated with NCI in the HIV+ group. Using this binary variable and including relevant covariates, multivariate modeling confirmed that NCI was associated with higher cystatin C levels (OR = 3.0; P = 0.03).

Conclusions:
Our results confirm that HIV+ older adults have higher cystatin C than HIV− older adults and further identify that cystatin C may be associated with NCI in this population, particularly if they use tenofovir. This blood biomarker may be a useful clinical tool to identify older HIV+ persons at greater risk for cognitive decline.
Semen Bacterial Concentrations and HIV-1 RNA Shedding Among HIV-1–Seropositive Kenyan Men
Authors: Korhonen Christine J. , Srinivasan Sujatha , Huang Dandi , Ko Daisy L. , Sanders Eduard J. , Peshu Norbert M. , Krieger John N. , Muller Charles H. , Coombs Robert W. , Fredricks David N. , Graham Susan M. 
Published: November 2016

Introduction:
HIV-1 is transmitted through semen from men to their sexual partners. Genital infections can increase HIV-1 RNA shedding in semen, but shedding also occurs in the absence of typical pathogens. We hypothesized that higher bacterial concentrations in semen would be associated with higher HIV-1 RNA levels.

Methods:
We analyzed semen samples from 42 HIV-1–seropositive Kenyan men using quantitative polymerase chain reaction (PCR) to assess bacterial concentrations and real-time PCR to measure HIV-1 RNA levels. Generalized estimation equations were used to evaluate associations between these 2 measures. Broad-range 16S rRNA gene PCR with pyrosequencing was performed on a subset of 13 samples to assess bacterial community composition.

Results:
Bacteria were detected in 96.6% of 88 samples by quantitative PCR. Semen bacterial concentration and HIV-1 RNA levels were correlated 0.30 (P = 0.01). The association between bacterial concentration and HIV-1 RNA detection was not significant after adjustment for antiretroviral therapy (ART) (adjusted odds ratio: 1.27, 95% CI: 0.84 to 1.91). Factors associated with semen bacterial concentration included insertive anal sex (adjusted beta 0.92, 95% CI: 0.12 to 1.73) and ART use (adjusted beta: −0.77, 95% CI: −1.50 to 0.04). Among 13 samples with pyrosequencing data, Corynebacterium spp., Staphylococcus spp., and Streptococcus spp. were most frequently detected.

Conclusion:
Most of these HIV-1–infected men had bacteria in their semen. ART use was associated with undetectable semen HIV-1 RNA and lower semen bacterial concentrations, whereas insertive anal sex was associated with higher bacterial concentrations. Additional studies evaluating the relationship between semen bacteria, inflammation, mucosal immunity, and HIV-1 shedding are needed to understand implications for HIV-1 transmission.