bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vitamin D3 Supplementation Increases Fibroblast Growth Factor-23 in HIV-Infected Youths Treated with Tenofovir Disoproxil Fumarate
Authors: Havens Peter L , Hazra Rohan , Stephensen Charles B , Kiser Jennifer J , Flynn Patricia M , Wilson Craig M , Rutledge Brandy , Bethel James , Pan Cynthia G , Woodhouse Leslie R , Van Loan Marta D , Liu Nancy , Lujan-Zilbermann Jorge , Baker Alyne , Kapogiannis Bill G , Gordon Catherine M , Mulligan Kathleen ,   the Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN) 063 study team
Published: February 2014

Background Tenofovir (TDF) is associated with phosphaturia and elevated 1,25 dihydroxy vitamin D (1,25-OH(2)D). Fibroblast growth factor 23 (FGF23) causes phosphaturia and increases in response to elevated 1,25-OH(2)D. Vitamin D-binding protein (VDBP) binds to 1,25-OH(2)D, decreasing its biological activity, and is elevated in individuals with higher plasma tenofovir concentrations. We compared FGF23 and VDBP before and after vitamin D3 (VITD) supplementation in youths treated with combination antiretroviral therapy (cART) containing or not containing TDF. Methods A randomized controlled trial in HIV-positive youths aged 18–25 years enrolled participants based on cART treatment with TDF (TDF; n=118) or without TDF (no-TDF; n=85), and randomized within those groups to VITD (50,000 IU every 4 weeks) or placebo (PL). We measured FGF23 and VDBP and calculated free 1,25-OH(2)D at baseline and week 12, and compared changes by TDF treatment and VITD randomized group. Results At baseline, serum FGF23 concentration showed a quadratic relationship with 1,25-OH(2)D most pronounced in the TDF group. At week 12, total and free 1,25-OH(2)D increased in the VITD but not PL groups, independent of TDF use. FGF23 increased in the TDF group receiving VITD, but there was no FGF23 change in the no-TDF group receiving VITD or the PL groups. The adjusted mean change in FGF23 from baseline to week 12 was 7.7 pg/ml in the TDF/VITD group, compared with -1.7 (no-TDF/VITD, P=0.010), -1.3 (TDF/PL, P=0.006) and 1.1 (no-TDF/PL, P=0.035). Conclusions These results suggest that TDF-containing cART may alter the FGF23 response to vitamin D supplementation in HIV-infected youths. Clinical trials number: NCT00490412.
Intensive Short-Term Dynamic Psychotherapy in the Private Practice of Psychiatry
Authors: Wolff David M. 
Published: February 2014

CME Educational Objectives

1.
Understand the potential benefits of combined psychotherapy and medication management.

2.
Appreciate subtleties in conducting these two processes simultaneously.

3.
Develop a further understanding of the intensive short-term dynamic psychotherapy (ISTDP) model.

Intensive short-term dynamic psychotherapy (ISTDP) is based on the psychoanalytic theory of unconscious conflict but departs from standard psychodynamic therapy in a number of significant ways. This highly active form of treatment is designed to mobilize intense feelings, regulate anxiety, and overcome defense and resistance. It has a growing body of evidence of clinical effectiveness across a wide range of patients and has demonstrated significant cost savings.
1
This article explores unique elements of ISTDP, as well as practical issues that arise when ISTDP is introduced into a psychiatrist’s practice. It will offer examples of how ISTDP can positively impact an outpatient practice where psychotherapy and medications are integrated. ISTDP’s unique approach to assessment and diagnosis will be described and compared to the standard psychiatric evaluation. Additionally, the relationship between ISTDP and medication treatment is explored.
Emerging Evidence for Intensive Short-Term Dynamic Psychotherapy with Personality Disorders and Somatic Disorders
Authors: Town Joel M. , Driessen Ellen 
Published: February 2014

CME Educational Objectives

1.
Review the outcome evidence of prior meta-analytic reviews of intensive short-term dynamic psychotherapy (ISTDP).

2.
Provide an additional meta-analysis of ISTDP for the treatment of personality and somatic disorders.

3.
Suggest areas for future study in the use of psychodynamic psychotherapy for personality and somatic disorders.

The literature reviewing studies of psychodynamic psychotherapy clearly demonstrates evidence for the efficacy of both short-term and long-term models.
1–3
Meta-analytic reviews synthesizing effects across different psychodynamic psychotherapy formats have been conducted for common mental disorders,
1
depression,
4,5
depression in the setting of personality disorder,
6
personality disorders,
7
and somatic disorders.
8
Psychodynamic psychotherapy demonstrates superiority to control condition,
1,9
and no significant difference to other formal psychotherapies, including cognitive behavioral therapies.
4,5,7,9,10
Building upon a recently published systematic review and meta-analysis,
11
the aim of this article is to further examine the evidence for a contemporary psychodynamic psychotherapy treatment protocol,
12,13
intensive short-term dynamic psychotherapy (ISTDP), in the treatment of personality and somatic disorders.
Residency Training in Intensive Short-Term Dynamic Psychotherapy: Methods and Cost-Effectiveness
Authors: Abbass Allan , Kisely Steve , Rasic Daniel , Katzman Jeffrey W. 
Published: February 2014

CME Educational Objectives

1.
Understand the role of training in psychodynamic psychotherapy in psychiatry residency training programs.

2.
Learn a potential model for training residents in a short-term model of psychodynamic psychotherapy.

3.
Review the efficacy and cost-savings data in a study training residents in this model.

Whereas psychiatry grows as a field through contributions from neuroscience, genetics, psychopharmacology, and diagnostic specificity, psychiatrists continue to value the importance of psychodynamic assessment and intervention. This is reflected in the current Royal College of Physicians and Surgeons of Canada
1
and American College of Graduate Medical Education (ACGME) guidelines in psychiatry,
2
requiring the demonstration of competency in psychodynamic psychotherapy. This has been further underscored through the roll out of the Next Accreditation System,
3
requiring faculty in psychiatry training programs to delineate the achievement of resident milestones in the area of psychodynamic psychotherapy.
Resilience in the Face of Chronic Illness and Family Caregiving in Middle and Later Life
Authors: Fortinsky Richard H. , Tennen Howard , Steffens David C. 
Published: February 2014

CME Educational Objectives

1.
Understand the role of perceived personal control and accommodative strategies in adults coping with common challenges of old age.

2.
Describe the effect of positive affect on resilience in older adults.

3.
Discuss a proposed model that links conceptualizations of resilience with intervention strategies among older adults faced with chronic illness, disability, and family caregiving responsibilities.

In the context of aging, resilience — the process of positive adaptation in response to threatening life circumstances, including chronic illness, disability, and providing personal and other types of care to older relatives in middle and later life — involves effective coping;
1
the ability to ‘bounce back;’
2
and rapid recovery, sustainability of purpose, and personal growth
3
while facing adversity. Although the idea of growth through adversity is appealing and has generated considerable interest, the research methods required to capture growth have lagged behind theoretical formulations, leaving this aspect of resilience more speculative.
4
Resilience has been studied as an aspect of personality, and the concept of resilience has been applied to organizations, neighborhoods, and communities.
A 6-Month-Old Boy with Persistent Pruritic Eruption
Authors: Kruse Lacey , Chamlin Sarah L. 
Published: February 2014

A previously healthy 6-month-old boy presented to the pediatric dermatology clinic for evaluation of a persistent, pruritic eruption. This eruption involved the scalp, extremities, and inguinal creases and was intensely pruritic. The patient had been previously treated with multiple topical corticosteroids and antifungals, all with minimal improvement. He born at full term and was otherwise well and thriving. Review of systems was negative.
Examination revealed erythematous to yellow scaly, greasy plaques, some with underlying purpuric papules in the frontal, temporal, and vertex of the scalp, post-auricular regions, and the conchae of both ears. There were also scattered papules and purpura noted in the inguinal creases, and hyperkeratotic yellow papules on the extensor extremities. He had no abnormal lymphadenopathy or hepatosplenomegaly. The remainder of his examination was normal. A diagnostic skin biopsy was performed.

To read more and to earn CME credit for reading this article, access the full text by going to
Healio.com/Pediatrics
and searching: doi: 10.3928/00904481-20131223-10.
A 1-Year-Old Boy with Persistent, Generalized Eruption
Authors: Mir Adnan , Chamlin Sarah L. 
Published: February 2014

A healthy 1-year-old boy born at full term after an uncomplicated pregnancy presented to the dermatology clinic for a widespread eruption with gradual onset since 3 months of age. He was otherwise well, afebrile, feeding well, and gaining weight appropriately. The child was overall asymptomatic, though some of his lesions occasionally became red and pruritic. His mother noticed that after mild illnesses, he was more prone to these flares. She denied flushing, vomiting, diarrhea, respiratory distress, and irritability. He was meeting all developmental milestones and started walking at 11 months of age. The remainder of his review of systems was unremarkable, and family history was noncontributory.
Physical exam revealed a well-appearing, well-nourished, playful, and interactive toddler. There were innumerable discrete and coalescing pink-brown macules and papules concentrated on the trunk and extending onto the proximal upper and lower extremities bilaterally, as well as the neck and lower face. Stroking the lesions quickly led to development of erythematous edematous wheals. There was no hepatosplenomegaly, and the lymph node exam was unremarkable.

To read more and to earn CME credit for reading this article, access the full text by going to
Healio.com/Pediatrics
and searching: doi: 10.3928/00904481-20131223-11.
A 20-Day-Old Boy with a Blue Skin Lesion
Authors: Asztalos Lori , Gray Jayla , Chamlin Sarah L. 
Published: February 2014

A 20-day-old boy presented for evaluation of a blue nodule on the right shoulder that had been present since birth. The mother noted no changes in the size of the lesion since birth, and no bleeding or ulceration was noted. The patient’s past medical history was unremarkable. He was a full-term baby born at 39 weeks gestation via a normal, spontaneous vaginal delivery. The pregnancy was uncomplicated. The mother had no history of maternal hypertension and had no history of chorionic villus sampling or amniocentesis. The patient was not taking any medications and had no known allergies.
Physical exam revealed a well-developed, well-nourished male in no apparent distress. A full skin exam revealed a 1.8 cm × 2 cm discrete, blue-purple vascular nodule with coarse surface telangiectasias and a surrounding rim of pallor on the right shoulder. There was no bleeding or breakdown noted. There was no lymphadenopathy present.

To read more and to earn CME credit for reading this article, access the full text by going to
Healio.com/Pediatrics
and searching: doi: 10.3928/00904481-20131223-13.
An 8-Month-Old Girl with an Enlarging Lesion on Her Face
Authors: Reserva Jeave , Chamlin Sarah L. 
Published: February 2014

An otherwise healthy 8-month-old girl presented to the pediatric dermatology clinic for evaluation of an enlarging lesion on her right cheek. The child’s mother first noticed this “bump” a month prior to presentation and denied any inciting event. The lesion had increased in size since it was first noted but was not symptomatic. No bleeding was noted. Perinatal history and review of systems were unremarkable.
On physical examination, a solitary, well-demarcated, 3-mm yellow erythematous papule with central erosion was noted on the right upper cheek. No other lesions were identified. Lymph node examination was unremarkable. Clinical observation was recommended, with excision if significant enlargement or atypical features developed. Two months later, the lesion remained asymptomatic but had grown to 9 mm in size. The central erosion persisted, but no bleeding occurred.

To read more and to earn CME credit for reading this article, access the full text by going to
Healio.com/Pediatrics
and searching: doi: 10.3928/00904481-20131223-14.
A 7-Week-Old Boy with Violaceous Patches and Skin Nodules
Authors: Whittington Adam , Kenner-Bell Brandi 
Published: February 2014

A 7-week-old boy presented to the pediatric dermatology clinic for evaluation of diffuse blue lesions on the skin. The mother first noticed a bluish lesion on the left thigh at 6 to 7 weeks of age. The child quickly developed several similar lesions and deeper nodules on the head, arms, and trunk. He had a history of ankyloglossia and subsequent uncomplicated repair, as well as a sister with neonatal anemia. He was otherwise well and thriving. Review of systems was unremarkable. His birth involved an uncomplicated delivery, with negative maternal serology. There was no history of maternal infection or recent exposure to infection.
Physical exam revealed a well-appearing, non-dysmorphic, vigorous infant. Skin exam was notable for numerous dusky erythematous and violaceous-blue patches and nodules on the anterior scalp, bilateral arms, legs, face, and trunk — including the diaper area. Lesions ranged in size from 1 to 3 cm. The nodules were firm and non-tender. The remainder of his physical examination was normal without abnormal lymphadenopathy or hepatosplenomegaly noted. No mucosal lesions were noted. A biopsy was performed on a thigh lesion.

To read more and to earn CME credit for reading this article, access the full text by going to
Healio.com/Pediatrics
and searching: doi: 10.3928/00904481-20131223-15.
A 6-Week-Old Boy with Annular Skin Lesions
Authors: Hasbún Trinidad , Chamlin Sarah L. 
Published: February 2014

A 6-week-old, otherwise healthy boy presented to the dermatology clinic for evaluation of an eruption involving his scalp, face, and trunk. The truncal lesions had been present for several weeks, and the facial and scalp lesions were noticed 5 days prior to presentation. The eruption was asymptomatic without scratching or discomfort noted by his mother.
Past medical history was remarkable for preterm delivery due to maternal hypertension during pregnancy. The infant was thriving and gaining weight appropriately. There was no family history of cutaneous or autoimmune disease. No one in the family had a recent tinea infection.

On physical exam, he was a well-appearing, vigorous infant. There were multiple erythematous papules and annular plaques involving his left pre-auricular and post-auricular areas, scalp, upper chest, and right abdominal wall (

Figures
1
and
2

). No other cutaneous or mucus membrane lesions were noted. His cardiac, lung, and abdominal exams were normal.

To read more and to earn CME credit for reading this article, access the full text by going to
Healio.com/Pediatrics
and searching: doi: 10.3928/00904481-20131223-08.
Fifteen-year Survivor of Renal Cell Carcinoma After Metastasectomies for Multiple Bone Metastases
Authors: Kato Satoshi , Murakami Hideki , Takeuchi Akihiko , Demura Satoru , Yoshioka Katsuhito , Kawahara Norio , Tomita Katsuro , Tsuchiya Hiroyuki 
Published: February 2014

This article describes a patient with multiple metastases from renal cell carcinoma who survived and maintained an ambulatory status for 15 years with no recurrence in the spine after en bloc resection of solitary spinal metastasis. Skeletal metastasis from renal cell carcinoma is common, second only to lung metastasis. Surgery plays an important role in the treatment of the metastasis because of its resistance to chemotherapy and radiotherapy.
A 60-year-old man had T1N2M1 renal cell carcinoma in the right kidney and synchronous bone metastases at T12 vertebral body and the right humerus. The patient underwent right nephrectomy and en bloc resection of T12 metastasis at the same time using a retroperitoneal approach. He also underwent curetted total excision of metastasis in the right humerus. He underwent radiotherapy and an additional 7 tumor excision surgeries in the right humerus due to repeated tumor recurrences and a pulmonary metastasectomy in the right lung. Thirteen years after initial surgery, he underwent right forequarter amputation due to tumor recurrence and surgical site infection. Fifteen years after initial surgery, he is still alive with no evidence of disease. He has been ambulatory with no tumor recurrence in the spine for 15 years. En bloc resection of solitary spinal metastasis allowed the patient to be ambulatory without recurrence. This contrasts with curetted total excision of bone metastasis in the humerus that resulted in repeated recurrences and surgeries and loss of the arm.
Discoid Medial Meniscus Completely Coalesced With the Anterior Cruciate Ligament
Authors: Joshi Deepak , Jain Vineet , Goyal Ankit , Bahl Vibhu , Chaudhary Deepak 
Published: February 2014

Discoid meniscus is an abnormality of the knee in which the meniscus is discoid rather than semilunar in shape. Medial discoid menisci are rare, and no specific associated symptoms suggest this condition. Several medial meniscus anomalies, including discoid variants, have been reported in the literature. This article describes a rare case of medial discoid meniscus completely coalesced with the anterior cruciate ligament (ACL).
A 22-year-old man presented with intermittent right knee pain of 6 months’ duration. Physical examination revealed mild wasting of the quadriceps with medial joint line tenderness but no effusion. Radiographically, hypoplasia of the lateral tibial spine, increased medial joint space, and increased concavity of the medial tibial condyle were noted in both knees. Arthroscopic examination revealed a complete discoid medial meniscus that was contiguous with the ACL. On probing, a horizontal tear in the medial meniscus was noted. A meniscectomy was performed, and deep longitudinal furrows with exposed subchondral bone were noted underlying the posteromedial tibial condyle. At the patient’s 6-month follow-up visit, he had no knee symptoms and had returned to his daily activities, which included jogging.
Discoid medial meniscus is a rare anomaly, and this case represents only the second reported in the literature of discoid medial meniscus completely coalesced with ACL. This case supports the theory that the ACL and menisci can be differentiated from 1 mesenchyme.
Proximal Humeral Nonunion Treated With an Intramedullary Tantalum Cylinder
Authors: Georgiadis Gregory M. , Georgiadis Andrew G. 
Published: February 2014

Nonunion is uncommon after proximal humerus fracture surgery. There is no agreement about preferred method of treatment. Traditional approaches have included laterally based locking plates, autogenous grafting, and endosteal support to provide improved biomechanical stability. Open reduction and internal fixation (ORIF) of proximal humeral nonunion has been performed with various methods, including blade plates and bone grafting, as well as intramedullary support with autologous or allogenic grafts. Both malunion and nonunion have occurred after ORIF with locking plates. Endosteal support in the form of a fibular allograft incorporated into the locking plate construct can increase mechanical stability in selected cases.
An ideal implant for proximal humeral nonunion provides medial column mechanical support and osteoconductive and osteoinductive properties. Porous intramedullary tantalum metal may play a role in nonunion surgery as an alternative to fibular allograft because of its versatility of use and salutary biological effects. It offers many material advantages for use in nonunion surgery. Tantalum is extensively porous (75%–80%), has a stiffness close to that of native bone, and offers the possibility of being a carrier for osteoinductive materials. It may also be suitable for patients who refuse allograft material. This article describes a 65-year-old woman with recalcitrant proximal humeral nonunion who was successfully treated with revision ORIF with intramedullary tantalum cylinder augmentation with a lateral-based locking plate and autogenous cancellous bone grafting. At 5-year follow-up, she had excellent motion and clinical and radiographic union.
Identical Osteochondritis Dissecans Lesions of the Knee in Sets of Monozygotic Twins
Authors: Gans Itai , Sarkissian Eric J. , Grant Struan F.A. , Ganley Theodore J. 
Published: February 2014

Osteochondritis dissecans (OCD) is a focal, idiopathic alteration of subchondral bone structure with the risk for secondary damage to adjacent articular cartilage and the development of premature osteoarthritis. The exact etiology of OCD is unknown, although repetitive microtrauma and vascular insufficiency have been previously described. A genetic predisposition has been suggested, but the existing evidence is sparse. There are multiple case reports of twins and siblings with OCD and a few large family series in the literature, promoting the theory that OCD may have a genetic component to its etiology.
This article describes 2 sets of monozygotic twins presenting concurrently with OCD of their dominant knees, offering further support for a genetic component to the etiology of OCD. Interestingly, in both sets of twins, 1 was left-handed and 1 was right-handed. Both sets of twins had simultaneous presentations and clinical courses, lending support to a genetic element to OCD. The development of the OCD lesion in the dominant knee of each patient suggests an environmental influence, perhaps due to repetitive microtrauma and overuse.
Recently, a genome-wide linkage study identified a prime candidate locus for OCD. However, despite the suggested association, genetic and developmental factors in the development of OCD remain relatively unstudied. The authors believe monozygotic twins provide an excellent clinical opportunity for future examination of the role of familial inheritance in the etiology of OCD.