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Mark J Gordon, Joseph G Christenbury, Christine L Bokman, Daniel B Rootman, Robert A Goldberg
PURPOSE: This study aims to understand the degree to which ptosis is recognizable to a layperson. METHODS: Fifteen color drawings of a gender-neutral human face were created. Six faces exhibited right-sided ptosis (decreased margin reflex distance 1 and lengthened tarsal platform show) of 0.5 mm, 1 mm, 1.5 mm, 2 mm, 2.5 mm, and 3 mm, respectively. Six more faces exhibited left-sided ptosis of the same amounts. The 12 ptotic faces and 3 symmetrical faces were randomly placed on three 11-inch by 14-inch sheets of paper with 5 faces on each page...
June 13, 2018: Annals of Plastic Surgery
Ingrid M Ganske, Joseph M Firriolo, Laura C Nuzzi, Oren Ganor, Thomas E Hamilton, C Jason Smithers, Russell W Jennings, Joseph Upton, Brian I Labow, Amir H Taghinia
BACKGROUND: A variety of surgical techniques exist to manage long-gap esophageal atresia (LGEA), including gastric pull-up (GPU), colonic interposition (CI), jejunal interposition (JI), and distraction lengthening. Salvage reconstruction for late failure of any conduit type is a complex surgical problem fraught with technical difficulty and significant risk. Jejunal interposition can be used as a salvage procedure in the management of LGEA. However, the opposing requirements of conduit length and adequate perfusion make the procedure technically challenging...
June 13, 2018: Annals of Plastic Surgery
Liang Xu, Yong Qiu, Zhonghui Chen, Benlong Shi, Xi Chen, Song Li, Changzhi Du, Zezhang Zhu, Xu Sun
OBJECTIVE This study aimed to evaluate the correction results of traditional dual growing rods (DGRs) on axial rotation using CT scans and to further explore the relationships between axial and torso deformities in patients with early-onset scoliosis (EOS). METHODS Patients with EOS who were treated with traditional DGRs between January 2006 and December 2014 were retrospectively reviewed. Plain radiographs were used to assess the degree of coronal and sagittal deformity. The apical vertebral rotation (AVR) and rib hump (RH) were measured on CT scans at the apical vertebra...
June 15, 2018: Journal of Neurosurgery. Pediatrics
Thierry Deltombe, Maxime Gilliaux, François Peret, Mie Leeuwerck, Delphine Wautier, Philippe Hanson, Thierry Gustin
BACKGROUND: Neuro-orthopaedic surgery is recognized as an effective treatment to improve walking capacity in case of spastic equinovarus foot. However, the effect of surgery on the 3 domains of the International Classification of Functioning, Disability and Health (ICF) has never been studied. AIM: To assess the efficacy of the neuro-orthopaedic surgery for spastic equinovarus foot after stroke based on a goal-centered approach and on the 3 domains of the International Classification of Functioning, Disability and Health (ICF)...
June 14, 2018: European Journal of Physical and Rehabilitation Medicine
Li Luo, Yumeng Zhang, Fang Qing, Hongwei Ding, Yingkang Shi, Huili Guo
BACKGROUND: Many hospitals in China experience large volumes of emergency department (ED) radiology patients, thereby lengthening the wait times for non-emergency radiology patients. We examine whether an emergency reservation policy which deals with stochastic arrivals of ED patients can shorten wait times, and what effect it has on patient and hospital related metrics. METHODS: In this study, operations research models are used to develop an emergency reservation policy...
June 15, 2018: BMC Health Services Research
Rosario Maugeri, Luigi Basile, Carlo Gulì, Aurelia Banco, Giovanna Giordano, Antonella Giugno, Francesca Graziano, Roberto Giuseppe Giammalva, Domenico Gerardo Iacopino
BACKGROUND:  Lumbar spinal stenosis (LSS) is a narrowing of the spinal canal due to spinal degeneration, and its main clinical symptom is neurogenic claudication. Surgical treatment is pursued for patients who do not improve with conservative care. Patients with symptomatic LSS who also have significant medical comorbidities, although clearly in need of intervention, are unattractive candidates for traditional open lumbar decompressive procedures. Thus it is important to explore minimally invasive surgical techniques to treat select patients with LSS...
June 14, 2018: Journal of Neurological Surgery. Part A, Central European Neurosurgery
Ashley E Mason, Frederick M Hecht, Jennifer J Daubenmier, David A Sbarra, Jue Lin, Patricia J Moran, Samantha G Schleicher, Michael Acree, Aric A Prather, Elissa S Epel
OBJECTIVE: To determine, within a weight-loss clinical trial for obesity, the impact of intervention arm, weight change, and weight-loss maintenance on telomere length (TL). METHODS: Adults (N=194) with a BMI between 30 and 45 were randomized to a 5.5-month weight-loss program with (n=100) or without (n=94) mindfulness training and identical diet-exercise guidelines. We assessed TL at baseline and 3, 6, and 12 months post-baseline in immune cell populations (primarily in peripheral blood mononuclear cells [PBMCs], but also in granulocytes and T and B lymphocytes)...
June 12, 2018: Psychosomatic Medicine
Peng Zhu, Zhenong Jin, Qianlai Zhuang, Philippe Ciais, Carl Bernacchi, Xuhui Wang, David Makowski, David Lobell
A better understanding of recent crop yield trends is necessary for improving the yield and maintaining food security. Several possible mechanisms have been investigated recently in order to explain the steady growth in maize yield over the US Corn-Belt, but a substantial fraction of the increasing trend remains elusive. In this study, trends in grain filling period (GFP) were identified and their relations with maize yield increase were further analyzed. By using satellite data from 2000 to 2015, an average lengthening of GFP of 0...
June 14, 2018: Global Change Biology
Michael Karsy, Christian A Bowers, Jonathan Scoville, Bornali Kundu, Mohammed Atef, J Michael Gee, Jian Guan, William T Couldwell
BACKGROUND: Pituitary adenomas are among the most common primary brain tumors. Recently, overlapping surgery has been curbed in many institutions because of the suggestion there might be more significant adverse events, despite several studies showing that complication rates are equivalent. OBJECTIVE: To assess complications and costs associated with overlapping surgery during the transsphenoidal resection of pituitary adenomas. METHODS: A single-center, retrospective cohort study was performed to evaluate the cases of patients who underwent a transsphenoidal approach for pituitary tumor resection...
June 12, 2018: Neurosurgery
Frank Kloprogge, Lesley Workman, Steffen Borrmann, Mamadou Tékété, Gilbert Lefèvre, Kamal Hamed, Patrice Piola, Johan Ursing, Poul Erik Kofoed, Andreas Mårtensson, Billy Ngasala, Anders Björkman, Michael Ashton, Sofia Friberg Hietala, Francesca Aweeka, Sunil Parikh, Leah Mwai, Timothy M E Davis, Harin Karunajeewa, Sam Salman, Francesco Checchi, Carole Fogg, Paul N Newton, Mayfong Mayxay, Philippe Deloron, Jean François Faucher, François Nosten, Elizabeth A Ashley, Rose McGready, Michele van Vugt, Stephane Proux, Ric N Price, Juntra Karbwang, Farkad Ezzet, Rajesh Bakshi, Kasia Stepniewska, Nicholas J White, Philippe J Guerin, Karen I Barnes, Joel Tarning
BACKGROUND: The fixed dose combination of artemether-lumefantrine (AL) is the most widely used treatment for uncomplicated Plasmodium falciparum malaria. Relatively lower cure rates and lumefantrine levels have been reported in young children and in pregnant women during their second and third trimester. The aim of this study was to investigate the pharmacokinetic and pharmacodynamic properties of lumefantrine and the pharmacokinetic properties of its metabolite, desbutyl-lumefantrine, in order to inform optimal dosing regimens in all patient populations...
June 2018: PLoS Medicine
Anouk Bokslag, Constantijn Franssen, Lisa J Alma, Igor Kovacevic, Floortje van Kesteren, Pim W Teunissen, Otto Kamp, Wessel Ganzevoort, Peter L Hordijk, Christianne J M de Groot, Walter J Paulus
BACKGROUND: Systemic inflammation, endothelial dysfunction and deficient vascularization of either uterus or myocardium are mechanistic hallmarks of early-onset preeclampsia and heart failure with preserved ejection fraction (HFpEF). HFpEF is especially prevalent in elderly women and preceded in middle age by preclinical left ventricular (LV) diastolic dysfunction. To detect if preeclampsia predisposes to HFpEF at later age, echocardiographic indices of LV function and of LV structure and biomarkers of systemic inflammation and of endothelial dysfunction were compared in middle-aged women with a history of early-onset preeclampsia or uncomplicated pregnancy...
2018: PloS One
Zhengdong Zhang, Zheng Li, Jun Li, Lei Liu
Our objective was to evaluate the efficacy and safety of natural hirudin and low molecular weight heparin (LMWH) in the prevention of perioperative deep venous thrombosis (DVT) in elderly patients with intertrochanteric fracture. From June 2014 to June 2017, 96 patients with intertrochanteric fractures were treated with proximal femoral nail antirotation (PFNA) were randomly divided into two groups. For DVT prevention, 45 patients were treated with oral natural hirudin and subcutaneous LMWH-calcium (test group) and 51 patients were treated with subcutaneous LMWH-calcium (control group)...
June 11, 2018: Scientific Reports
Dave R Shukla, Matthias K D Vanhees, James S Fitzsimmons, Kai-Nan An, Shawn W O'Driscoll
PURPOSE: A simple overlay device (SOD) was developed to measure radial head implant length. The purpose of this study was to determine the accuracy and reliability of this device for measuring experimental radial head implant length. METHODS: Five fresh frozen cadavers were implanted with sequentially longer implants, adjusted by neck length (0, 2, 4, and 8 mm). Fluoroscopic images were obtained in 4 forearm positions: anteroposterior in supination in full extension, anteroposterior in pronation in full extension, supinated in 45° of flexion, and neutral in 45° of flexion...
June 8, 2018: Journal of Hand Surgery
Malick Bachabi, Anna McClung, Jeff B Pawelek, Ron El Hawary, George H Thompson, John T Smith, Michael G Vitale, Behrooz A Akbarnia, Paul D Sponseller
BACKGROUND: Distraction-based techniques allow spinal growth until skeletal maturity while preventing curve progression. METHODS: Two multicenter early-onset scoliosis databases were used to identify patients with idiopathic spine abnormalities treated with traditional growing rods (TGR) or vertically expandable titanium ribs (VEPTR). Patients underwent at least 4 lengthenings and had at least 5-year follow-up. Significance was set at P<0.05. RESULTS: In total, 50 patients treated with TGR and 22 treated with VEPTR were included...
June 8, 2018: Journal of Pediatric Orthopedics
Santiago Haase, María Belén Garcia-Fabiani, Stephen Carney, David Altshuler, Felipe J Núñez, Flor M Méndez, Fernando Núñez, Pedro R Lowenstein, Maria G Castro
ATRX is a chromatin remodeling protein whose main function is the deposition of the histone variant H3.3. ATRX mutations are widely distributed in glioma, and correlate with alternative lengthening of telomeres (ALT) development, but they also affect other cellular functions related to epigenetic regulation. Areas covered: We discuss the main molecular characteristics of ATRX, from its various functions in normal development to the effects of its loss in ATRX syndrome patients and animal models. We focus on the salient consequences of ATRX mutations in cancer, from a clinical to a molecular point of view, focusing on both adult and pediatric glioma...
June 11, 2018: Expert Opinion on Therapeutic Targets
A N Ahn, N Konow, C Tijs, A A Biewener
To relate in vivo behavior of fascicle segments within a muscle to their in vitro force-length relationships, we examined the strain behavior of paired segments within each of three vertebrate muscles. After determining in vivo muscle activity patterns and length changes of in-series segments within the semimembranosus muscle in the American Toad (Bufo americanus) during hopping and within the sternohyoid muscle in the rat (Rattus rattus) during swallowing, and of spatially separated fascicles within the medial gastrocnemius muscle in the rat during trotting, we measured their corresponding in vitro (toad) or in situ (rat) force-length relationships...
June 7, 2018: Integrative and Comparative Biology
Christoph Schneider, Claire E O'Leary, Jakob von Moltke, Hong-Erh Liang, Qi Yan Ang, Peter J Turnbaugh, Sridhar Radhakrishnan, Michael Pellizzon, Averil Ma, Richard M Locksley
The small intestinal tuft cell-ILC2 circuit mediates epithelial responses to intestinal helminths and protists by tuft cell chemosensory-like sensing and IL-25-mediated activation of lamina propria ILC2s. Small intestine ILC2s constitutively express the IL-25 receptor, which is negatively regulated by A20 (Tnfaip3). A20 deficiency in ILC2s spontaneously triggers the circuit and, unexpectedly, promotes adaptive small-intestinal lengthening and remodeling. Circuit activation occurs upon weaning and is enabled by dietary polysaccharides that render mice permissive for Tritrichomonas colonization, resulting in luminal accumulation of acetate and succinate, metabolites of the protist hydrogenosome...
May 23, 2018: Cell
Brendan M Striano, Christian Refakis, Sumeet Garg, Ron El-Hawary, Joshua M Pahys, Michael Vitale, Robert M Campbell, John M Flynn, Patrick J Cahill
STUDY DESIGN: Physician survey. OBJECTIVES: To identify physician practice patterns in use of prosthetic rib devices. BACKGROUND: Management of scoliosis with prosthetic ribs involves repeated expansions. Despite this, there is a paucity of literature on expansion practice. We believe that despite minimal literature, there exist surgeon practice patterns. METHODS: Thirty-seven surgeons from the Children's Spine Study Group, with prosthetic rib experience, were anonymously surveyed about their expansion practice...
July 2018: Spine Deformity
Gökhan Tosun, Abdurrahman İnan, Göksel Kanmaz, Alper Biler, Alper İleri, Emrah Beyan, Ibrahim Egemen Ertas
OBJECTIVE: The aim of this study was to determine the potential effect of fetal sex on placental delivery times. STUDY DESIGN: This was a prospective observational study of term, singleton, and primiparous pregnant women who underwent vaginal delivery and subsequently delivered a phenotypically normal live infant. Women with labor or pregnancy complications and comorbid diseases were excluded. Women with factors that could lengthen the placental delivery time were also excluded...
June 10, 2018: Journal of Maternal-fetal & Neonatal Medicine
Mei-Zhen Zou, Wen-Long Liu, Chu-Xin Li, Di-Wei Zheng, Jin-Yue Zeng, Fan Gao, Jing-Jie Ye, Xian-Zheng Zhang
Hypoxia is reported to participate in tumor progression, promote drug resistance, and immune escape within tumor microenvironment, and thus impair therapeutic effects including the chemotherapy and advanced immunotherapy. Here, a multifunctional biomimetic core-shell nanoplatform is reported for improving synergetic chemotherapy and immunotherapy. Based on the properties including good biodegradability and functionalities, the pH-sensitive zeolitic imidazolate framework 8 embedded with catalase and doxorubicin constructs the core and serves as an oxygen generator and drug reservoir...
June 7, 2018: Small
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