bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fresh Osteochondral Allograft Transplantation for Osteochondritis Dissecans of the Knee
Authors: Sadr Kamran N. , Pulido Pamela , McCauley Julie C. , Bugbee William 
Published: April 2014

Objectives: Osteochondritis dissecans (OCD) of the knee can be difficult to treat. Cartilage restoration techniques are often indicated when the lesion or fragment cannot be salvaged. Fresh osteochondral allograft (OCA) transplantation can restore both bone and cartilage defect as a treatment modality. We hypothesize that osteochondral allografting is a successful method for treating osteochondritis dissecans of the knee. Methods: Between 1983 and 2010, 164 patients (181 knees) underwent OCA for OCD of the femoral condyle(s) (type III or IV). Minimum two-year follow-up was available on 149 patients (165 knees). Median age was 25 years (range, 14 to 55) and 73% were male. Mean allograft size was 7.2 cm2(range, 2 to 23 cm2). Evaluation included frequency and type of reoperations, modified Merle d’Aubigné-Postel (18-point) scale, International Knee Documentation Committee (IKDC) pain and function scores, and Knee Society function (KS-F) score. Clinical failure was defined as revision OCA or conversion to arthroplasty. Graft survivorship was determined. Results: Median follow-up time was 7.7 years (range, 2 to 28.4 years). 78% had more than 5-year follow-up. Fifty-one of 165 knees (31%) had reoperations, of which 21 (13%) were classified as allograft failures (13 OCA revisions, 5 UKA, and 3 TKA). OCA survivorship was 93% at 5 years, 87% at 10 years, and 77% at 20 years. Of the 144 knees whose grafts were still in situ, 91% were rated good/excellent, 8% were rated fair, and 1% was rated poor. Mean modified Merle d’Aubigné-Postel (18-point) scale was 17, mean IKDC pain and function scores were 2 and 8, and mean KS-F score was 93. 88% of patients reported satisfaction. Conclusion: Osteochondral allograft transplantation was an effective treatment for osteochondritis dissecans of the knee, with significant improvement in pain and function scores and high patient satisfaction. Graft survivorship was 87% at 10 years.
Meniscal Allograft Transplantation Reoperation Rates, Operative Findings, and Survival Analysis: A Review of 200 Consecutive Transplants at Minimum Two-year Follow-up
Authors: McCormick Francis , Harris Joshua David , Frank Rachel M. , Hussey Kristen Elizabeth , Wilson Hillary , Gupta Anil Kumar , Abrams Geoffrey D. , Bach Bernard R. , Cole Brian J. 
Published: April 2014

Objectives: Reoperation rates for meniscal allograft surgery (MAT) are high with a 70% survival rate at 10 years. The indications and findings for secondary surgery are not well characterized. The purpose of this study is to quantify the percentage of transplants requiring a re-operation, to characterize the operative findings, perform a survival analysis, and perform a case-control analysis if an early return to surgery is predictive of failure. Methods: A retrospective review of prospectively collected data from a single-surgeon was performed. Inclusion period was 2003-2011.. The number of patients returning to the OR and the findings at surgery were recorded. A meniscal transplant survival curve, the duration between transplantation and return to OR, and an odds-ratio of risk for failure for those requiring a re-operation in the perioperative period were calculated. Results: Two hundred patients underwent a MAT during the study period. 38% were isolated; 62% had concomitant procedures. Sixty-four (32%) patients returned to the operating room, of which 38 (59%) were for a meniscal? debridement. The mean duration to secondary surgery was 21 months, with 73% within 2 years. One hundred seventy-two (86%) patients were evaluated at a mean 59 months (Range 24-118 months). Eight went on to require a revision MAT or total knee replacement (4.7%). Patients requiring secondary surgery within two years had an 8.4 odds-ratio for future failure (95% CI 1.6-43.4 p.007). Conclusion: In the largest consecutive series reported in the literature, meniscal allograft transplantation (MAT) has a 95% success rate a mean of approximately five years. There is a 32% reoperation rate, with meniscal debridement the most common secondary surgical treatment.
Biomechanical Consequences of a Complete Radial Tear Adjacent to the Medial Meniscus Posterior Root Attachment Site
Authors: LaPrade Robert F. , Padalecki Jeffrey Ryan , Jansson Kyle , Smith Sean , Dornan Grant , Pierce Casey , Wijdicks Coen A. 
Published: April 2014

Objectives: Complete radial tears near the medial meniscus posterior root attachment site disrupt the circumferential integrity of the meniscus ( similar to a posterior root avulsion). These tears can compromise the circumferential integrity and have been reported in biomechanical studies to simulate the meniscectomized state. The purpose of the study was to quantify the tibiofemoral contact load and contact area changes that occur in cadaveric knees from complete posterior horn radial tears and subsequent repairs of the medial meniscus adjacent to the posterior root attachment site. Methods: Six non-paired fresh-frozen human cadaveric knees each underwent 45 different testing conditions: 9 medial meniscus conditions (intact, root avulsion, root repair, serial radial tear and in-situ repair at 3, 6, and 9 mm from the root attachment site) at 5 flexion angles (0°, 30°, 45°, 60° and 90°); under a 1000-N axial load. Tekscan sensors were used to measure contact area and pressure in the medial and lateral compartments. Results: The medial meniscus root avulsion and all radial tear conditions resulted in significantly decreased contact area and increased mean contact pressure compared with the intact state for knee flexion angles beyond 0° (P < .05). Medial Compartment Contact Area Individual comparisons of meniscus conditions for results at 30°, 45°, 60° and 90° of flexion demonstrated the following. At each angle, the root avulsion and 3, 6 and 9 mm radial tears resulted in a significant reduction (range 33%-45% decrease) in medial compartment contact area. Medial Compartment Contact PressureIndividual comparisons of meniscus conditions were performed at 30°, 45°, 60° and 90° of flexion. At each angle, the root avulsion and all radial tears resulted in a significant increase in average contact pressure (range 46%-110%) when compared to the intact meniscus. Root Repair and In-situ Repairs The root repair and in-situ repairs restored contact area and pressure to levels statistically indistinguishable from the intact meniscus, and increased contact area and decreased contact pressure when compared to the corresponding tear conditions (Figure). Conclusion: Posterior horn radial tears adjacent to the medial meniscus root that extend to the meniscocapsular junction can lead to derangement of the loading profiles of the medial compartment that are similar to a root avulsion. Repair of these radial tears with an in-situ pullout technique restored joint mechanics to the intact state. Clinical Relevance Complete radial tears of the posterior horn of the medial meniscus, are biomechanically equivalent to root avulsions and could potentially lead to medial compartment arthrosis. An in-situ repair offers an alternative treatment to meniscectomy and can reestablish the posterior anchor point, thus improving load distribution in the medial compartment.
Results of Non-operative and Operative Management Of Apophyseal Avulsion Fractures of the Hip and Pelvis in Adolescent Athletes
Authors: Heyworth Benton E. , Bonner Bryant , Suppan Catherine A. , Kocher Mininder S. , Yen Yi-Meng , Micheli Lyle J. 
Published: April 2014

Objectives: Apophyseal avulsion fractures of the hip and pelvis occur almost exclusively in the adolescent population, with greater numbers being seen recently as the popularity and intensity of youth sports increases. Limited evidence exists detailing the demographics or distribution of these fractures by injury site. The goal of the current study was to present a comprehensive perspective on 437 of these fractures, including the indications and clinical course of 25 cases that underwent surgical intervention. Methods: All cases of an apophyseal avulsion fracture of the hip or pelvis between the years of 1981-2012 at a tertiary care pediatric center underwent radiographic and chart review, including operative details for that sub-population. Demographic data was analyzed, along with radiographic displacement, healing times, and return to sports for both groups. Results: 413 patients underwent definitive non-operative treatment, 72% of which were male. The mean age was 14.5 years. The anatomic site of injury was well-distributed: AIIS 29%, ASIS 27%, ischial tuberosity 17%, lesser trochanter 15%, and iliac crest 11%. Half of all injuries occurred during one of three different athletic activities (soccer 26%, track 13%, baseball/softball 11%), with a wide range of sports in the overall cohort. In the 287 nonop cases with adequate follow up data to confirm mean radiographic union and time of return to sports (RTS), healing occurred at 2.7 months and RTS at 2.8 months respectively. The mean age of the cohort of 25 patients who ultimately required operative treatment was 15.7 years, with 72% of cases being initially treated with nonoperative measures. The ischial tuberosity was the most common (64%) anatomic site with others including AIIS 16%, iliac crest 16%, and ASIS 4%. Excision of the apophyseal fragment was the intervention pursued for 48% of cases, with the mean time to union of 4.8 months in 11 cases which underwent fixation and had adequate follow up data. Conclusion: In over 400 cases of apophyseal avulsion fractures in an adolescent population, 94% were successfully treated nonoperatively, with mean times of healing and return to sports under 3 months. Most cases requiring surgery failed primary conservative care, many of which underwent fragment excision, rather than fixation, due to the chronic nature of their preoperative period. Better understanding of the rare indications for early fixation and functional outcome measures of both nonoperative and operative management of these injuries is warranted, particularly given their increasing frequency paralleling a rise in overuse and youth sports injuries.
Clinical Outcomes Following the Latarjet Procedure in Contact and Collision Athletes
Authors: Privitera David M. , Siegel Elana J. , Higgins Laurence D. 
Published: April 2014

Objectives: Although there are several reports of clinical outcomes after the Latarjet procedure for recurrent anterior glenohumeral instability, the literature is sparse for these Latarjet outcomes in the strictly contact or collision-type sport athletes who have significant glenoid deficiency and/or failed previous stabilization surgery. The purpose of this study was to evaluate the clinical and functional results of these contact or collision athletes who underwent a Latarjet for symptomatic instability with glenoid bone loss or failed stabilization surgery, using modern instability outcome measures. Study Design: Case series, Level of evidence, 4. Methods: Sixty-one consecutive contact and/or collision athletes (64 shoulders) treated with an open Latarjet procedure for recurrent anterior glenohumeral instability with significant glenoid bony deficiency and/or failed prior stabilization were retrospectively identified from two surgeons’ practices. Thirty-nine patients and 42 shoulders (66%) were evaluated at a mean follow-up of 46 months (range: 24-95), whose an average age of surgery of 25.9 years (range: 16-47). Primary outcome measures were the Western Ontario Shoulder Instability Index (WOSI), American Shoulder and Elbow Society Questionnaire (ASES), Visual Analogue Scale, and return to sporting activity. IRB approval was granted for this study. Results: Thirty-seven of forty-two shoulders (88%) were perceived as stable to these athletes. Two patients experienced subluxation events at 18 and 24 months after their Latarjet procedures. These 2 patients underwent further surgery including an arthroscopic debridement with biceps tenodesis and the other a revision stabilization Eden-Hybinette procedure, performed at 22 and 29 months after their Latarjets, respectively. One additional patient underwent surgery for hardware removal with arthroscopic debridement, with no reports of concomitant instability. Average WOSI and ASES scores for 42 shoulders were 76.5% (range: 6.4-100%, +/- 24.4) and 89.9 (range: 21.7-100, +/- 17.3). The average VAS score was 1.1. Fifty-four percent (21/39) of the athletes returned to their preoperative sports level, 18% (7/39) decreased their activity level in the same sport, 13% (5/39) changed sports and 15% (6/39) decreased level and changed sport, or stopped sports altogether. Conclusion: At a minimum of 2 year follow-up, 72 % of contact/collision athletes returned to their original sport, whereas 28% had to change their sport type after their Latarjet, or stop sporting activities altogether. Failure by subluxation occurred in 4.8% of shoulders (at an average of 21 months); 88% reported their shoulder as feeling stable with average WOSI and ASES scores of 76.5% and 89.9 respectively. In this challenging group of patients, the Latarjet procedure successfully restores stability in 88% of cases; 72% return to their pre-operative sport type.
Biomarkers of terminal complement activation confirm the diagnosis of aHUS and differentiate aHUS from TTP
Authors: Cataland Spero R. , Holers V. Michael , Geyer Susan , Yang Shangbin , Wu Haifeng M. 
Published: April 2014

Key PointsBiomarkers of complement activation can confirm the diagnosis of aHUS. Complement biomarkers may be useful to differentiate aHUS from TTP.
TNT003, an inhibitor of the serine protease C1s, prevents complement activation induced by cold agglutinins
Authors: Shi Ju , Rose Eileen L. , Singh Andrew , Hussain Sami , Stagliano Nancy E. , Parry Graham C. , Panicker Sandip 
Published: April 2014

Key Points
Cold agglutinin–driven classical pathway activity terminates prior to the initiation of the terminal cascade in CAD patient blood. By inhibiting cold agglutinin–mediated complement deposition on the cellular membrane, TNT003 prevents RBCs from being phagocytosed.
mtDNA haplogroup and single nucleotide polymorphisms structure human microbiome communities
Authors: Ma Jun , Coarfa Cristian , Qin Xiang , Bonnen Penelope E , Milosavljevic Aleksandar , Versalovic James , Aagaard Kjersti 
Published: April 2014

Abstract

Background
Although our microbial community and genomes (the human microbiome) outnumber our genome by several orders of magnitude, to what extent the human host genetic complement informs the microbiota composition is not clear. The Human Microbiome Project (HMP) Consortium established a unique population-scale framework with which to characterize the relationship of microbial community structure with their human hosts. A wide variety of taxa and metabolic pathways have been shown to be differentially distributed by virtue of race/ethnicity in the HMP. Given that mtDNA haplogroups are the maternally derived ancestral genomic markers and mitochondria’s role as the generator for cellular ATP, characterizing the relationship between human mtDNA genomic variants and microbiome profiles becomes of potential marked biologic and clinical interest.

Results
We leveraged sequencing data from the HMP to investigate the association between microbiome community structures with its own host mtDNA variants. 15 haplogroups and 631 mtDNA nucleotide polymorphisms (mean sequencing depth of 280X on the mitochondria genome) from 89 individuals participating in the HMP were accurately identified. 16S rRNA (V3-V5 region) sequencing generated microbiome taxonomy profiles and whole genome shotgun sequencing generated metabolic profiles from various body sites were treated as traits to conduct association analysis between haplogroups and host clinical metadata through linear regression. The mtSNPs of individuals with European haplogroups were associated with microbiome profiles using PLINK quantitative trait associations with permutation and adjusted for multiple comparisons. We observe that among 139 stool and 59 vaginal posterior fornix samples, several haplogroups show significant association with specific microbiota (q-value < 0.05) as well as their aggregate community structure (Chi-square with Monte Carlo, p < 0.005), which confirmed and expanded previous research on the association of race and ethnicity with microbiome profile. Our results further indicate that mtDNA variations may render different microbiome profiles, possibly through an inflammatory response to different levels of reactive oxygen species activity.

Conclusions
These data provide initial evidence for the association between host ancestral genome with the structure of its microbiome.
Study of Helicobacter pylori genotype status in cows, sheep, goats and human beings
Authors: Momtaz Hassan , Dabiri Hossein , Souod Negar , Gholami Mohsen 
Published: April 2014

AbstractBackgroundHelicobacter pyloriis one of the most controversial bacteria in the world causing diverse gastrointestinal diseases. The transmission way of this bacterium still remains unknown. The possibility of zoonotic transmission ofH. pylorihas been suggested, but is not proven in nonprimate reservoirs. In the current survey, we investigate the presence ofH. pyloriin cow, sheep and goat stomach, determine the bacterium virulence factors and finally compare the humanH. pylorivirulence factors and animals in order to examine whetherH. pylorimight be transmitted from these animals to human beings.MethodsThis cross- sectional study was performed on 800 gastric biopsy specimens of cows, sheep, goats and human beings. The PCR assays was performed to detection ofH. pylori,vacAandcagAgenes. The PCR products of Ruminant’s samples with positiveH. pyloriwere subjected to DNA sequencing analysis. Statistical tests were applied for data analysis.ResultsOverall 6 (3%) cows, 32 (16%) sheep and 164 (82%) human beings specimens were confirmed to beH. pyloripositive; however we were not able to detect this bacterium in all 200 goat samples. ThevacA s1a/m1awas the predominantH. pylorigenotype in all three kinds of studied population. There was 3.4–8.4% variability and 92.9-98.5% homology between sheep and human samples.ConclusionsConsidering the high sequence homology among DNA ofH. pyloriisolated from sheep and human, our data suggest that sheep may act as a reservoir forH. pyloriand in the some extent share the ancestral host for the bacteria with human.
Novel mutations of PKD genes in the Czech population with autosomal dominant polycystic kidney disease
Authors: Obeidova Lena , Elisakova Veronika , Stekrova Jitka , Reiterova Jana , Merta Miroslav , Tesar Vladimir , Losan Frantisek , Kohoutova Milada 
Published: April 2014

AbstractBackgroundAutosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary renal disorder caused by mutation in either one of two genes,PKD1andPKD2. High structural and sequence complexity ofPKDgenes makes the mutational diagnostics of ADPKD challenging. The present study is the first detailed analysis of bothPKDgenes in a cohort of Czech patients with ADPKD using High Resolution Melting analysis (HRM) and Multiplex Ligation-dependent Probe Amplification (MLPA).MethodsThe mutational analysis ofPKDgenes was performed in a set of 56 unrelated patients. For mutational screening of thePKD1gene, the long-range PCR (LR-PCR) strategy followed by nested PCR was used. Resulting PCR fragments were analyzed by HRM; the positive cases were reanalyzed and confirmed by direct sequencing. Negative samples were further examined for sequence changes in thePKD2gene by the method of HRM and for large rearrangements of bothPKD1andPKD2genes by MLPA.ResultsScreening of thePKD1gene revealed 36 different likely pathogenic germline sequence changes in 37 unrelated families/individuals. Twenty-five of these sequence changes were described for the first time. Moreover, a novel large deletion was found within thePKD1gene in one patient. Via the mutational analysis of thePKD2gene, two additional likely pathogenic mutations were detected.ConclusionsProbable pathogenic mutation was detected in 71% of screened patients. Determination ofPKDmutations and their type and localization within corresponding genes could help to assess clinical prognosis of ADPKD patients and has major benefit for prenatal and/or presymptomatic or preimplantational diagnostics in affected families as well.
Hardy personality and burnout syndrome among nursing students in three Brazilian universities—an analytic study
Authors: da Silva Rodrigo Marques , Goulart Carolina Tonini , Lopes Luis Felipe Dias , Serrano Patrícia Maria , Costa Ana Lucia Siqueira , de Azevedo Guido Laura 
Published: March 2014

Abstract

Background
Nursing students may exhibit the characteristics of resistance to stress, such as hardiness, which can reduce the risk of burnout. However, we found only one published study about these phenomena among nursing students. Thus, we investigated the association between hardiness and burnout in such students.

Methods
An analytic, cross-sectional study was conducted among 570 nursing students from three Brazilian universities. Data were collected relating to sociodemographic characteristics, hardiness, and burnout, which we analyzed using inferential statistics.

Results
We observed that 64.04% of nursing students in the sample had a high level of emotional exhaustion, 35.79% had a high level of cynicism, and 87.72% had a low level of professional efficacy: these are dimensions of burnout. We also found that 48.77% had a high level of control, 61.40% a high level of commitment, and 35.44% a high level of challenge: these are dimensions of hardiness. Only 24.74% of the students experienced burnout, and 21.93% met the criteria for a hardy personality. There was a statistically significant difference between the frequency of hardiness and burnout (p = 0.033), with 68.00% of hardy students not exhibiting burnout.

Conclusions
Although nursing students live with educational stressors, burnout was not preponderant in our sample students; this may be linked to hardiness. Thus, given its benefits to student life and health, we recommend the development of strategies to promote hardiness among nursing students.
Acute urticaria as a side effect of the Mirena® (levonorgestrel-releasing intrauterine system): a case report
Authors: Chen Xiangjuan , Wu Xueqing , Zhu Haiyan 
Published: April 2014

Abstract

Background
The levonorgestrel intrauterine system, Mirena®, is widely used for contraception and the treatment of idiopathic menorrhagia. Here, we reported one case of acute urticaria following Mirena® implantation to increase the awareness of possible adverse side effects associated with Mirena®.

Case presentation
The case presented is a 27-year-old Chinese woman who received Mirena® implantation for her adenomyosis and menorrhagia. The operation was successful and the patient did not experience any discomfort during the operation. However, she developed acute urticaria on her entire body accompanied with pruritic, slight left lower quadrant pain, and slight dizziness two hours after the operation. The patient was recommended to have the Mirena® removed immediately, and she took 10 mg oral methylprednisolone and 5 mg desloratadine tablet daily for five days. Her urticaria resolved and did not recur.

Conclusion
The patient’s acute urticaria seems to have been associated with the Mirena® levonorgestrel intrauterine system implantation, since she had no history of allergic reactions to materials used during the operation such as plastic, metal, alcohol, medications, and povidone-iodine.