bluuebunny/crossref_metadata_2025 huggingface dataset:
M197. SEASONAL ANTIPSYCHOTICS IN SCHIZOPHRENIA: OUTCOMES IN NATURALISTIC SETTINGS (SEASONS STUDY) OBSERVATIONAL RETROSPECTIVE MULTICENTRE CANADIAN STUDY ON 3MONTH-FORMULATION OF LONG-ACTING INJECTABLE PALIPERIDONE PALMITATE
Authors: Corbeil Olivier , Essiambre Anne-Marie , Rosebush-Mercier Raphaëlla , Rhéaume Gabrielle , Demers Marie-France , Roy Marc-André , Corbeil Olivier
Published: May 2020

Background

The 3 month-formulation of long-acting injectable paliperidone palmitate (PP3M) is available in Canada since 2016. However, there are still limited data on its use in real life setting.

Methods

This ongoing study retrospectively reviews the use of this formulation in 6 centers across Canada (targeted n=250 patients). Data on PP3M use (dosage, duration of exposure, reasons for initiating PP3M and stopping it, if applicable) are recorded, as well as its clinical impact (hospitalizations, global severity of illness as measured by Clinical Global Impression Scales), the main outcome variable being discontinuation of PP3M.

Results

Preliminary data are available for the first 35 patients coming from 3 participating centers. 31/35 are men, on average 35 years old, Caucasian (25/35), exposed to antipsychotics for an average of 7 years (sd 2 yrs) with an average 2-year exposure to the 1-month formulation of long-acting injectable paliperidone palmitate (PP1M). 21/35 had also at least one concomitant disorder (some may be combined), such as substance use disorder, personality disorder or anxious disease, and 10/35 were under a court treatment order. Clinical Remission (as defined as a CGI S score equal or less to 3) was maintained in 27/35 subjects over an average of 14 months (sd 9 months) of PP3M. However, 8 patients stopped their treatment dues to compromise stability (2 patients), side effects (2 patients: somnolence, 1 patient: pain discomfort at site of injection) or loss to follow-up (3 patients).

Discussion

In this Canadian study, preliminary observations in real life settings suggest that PP3M may be an interesting option for patient previously stabilized on PP1M, although the number of treatment cessations might suggest that the clinical effectiveness of PP3M vs. PP1M may not be similar in all subjects.
S83. MORTALITY, REVASCULARIZATION AND CARDIOPROTECTIVE PHARMACOTHERAPY AFTER ACUTE CORONARY SYNDROME IN PATIENTS WITH PSYCHOTIC DISORDERS: A POPULATION-BASED COHORT STUDY
Authors: Chung Chang Wing , Kwun Nam Chan Joe , Sau Man Wong Corine , Chi Fai Or Philip , Siu Han Hai JoJo
Published: May 2020

Background

Ischemic heart disease is the leading cause of premature mortality in psychotic disorders. The authors aimed to examine short-term mortality, cardiovascular complications, revascularization and cardioprotective medication receipt after incident acute coronary syndrome (ACS) among patients with psychotic disorders compared with patients without psychotic disorders.

Methods

This was a population-based cohort study with data retrieved from a territory-wide medical record database of public healthcare services to 7.5 million residents in Hong Kong. The study identified 67,692 patients aged ≥18 years admitted for first-recorded ACS between January 1, 2006 and December 31, 2016. The cohort was dichotomously divided by pre-ACS diagnosis of psychotic disorder. Multivariate regression (adjusted odds ratio [aOR] and 95%CI) was used to examine associations of psychotic disorders with all-cause 30-day and 1-year mortality, cardiovascular complications, 30-day and 1-year invasive cardiac procedures, and 90-day post-discharge cardioprotective medication prescription.

Results

Patients with psychotic disorders (N=703) had higher 30-day (aOR=1.99, 95%CI=1.65–2.39) and 1-year (aOR=2.13, 95%CI=1.79–2.54) mortality, and cardiovascular complication rates (aOR=1.20, 95%CI=1.02–1.41), lower receipt of cardiac catheterization (30-day: aOR=0.54, 95%CI=0.43–0.68; 1-year: aOR=0.46, 95%CI=0.38–0.56), percutaneous coronary intervention (30-day: aOR=0.55, 95%CI=0.44–0.70; 1-year: aOR=0.52, 95%CI=0.42–0.63) and reduced β-blockers (aOR=0.81, 95%CI=0.68–0.97), statins (aOR=0.54, 95%CI=0.44–0.66), and clopidogrel prescriptions (aOR=0.66, 95%CI=0.55–0.80). Effect of psychotic disorder on heightened mortality was more pronounced in younger-aged (<65 years) and male patients. Associations between psychotic disorder and increased mortality remained significant even after complications and treatment receipt were additionally adjusted.

Discussion

Psychotic disorders are associated with increased risks of short-term post-ACS mortality, cardiovascular complications and inferior treatment. Excess mortality is not substantially explained by treatment inequality. Further investigation is warranted to clarify factors for suboptimal cardiac-care and elevated mortality in psychotic disorders to enhance post-ACS outcome.
S102. DIAGNOSTIC CHALLENGES AT TIME OF INPATIENT ADMISSION: DIAGNOSTIC SHIFTS IN PATIENTS WITH FIRST EPISODE PSYCHOSIS
Authors: Koch Marlene , Trimmel Melanie , Baumgartner Josef , Hinterbuchinger Barbara , Litvan Zsuzsa , Friedrich Fabian , Mossaheb Nilufar
Published: May 2020

Background

First episode psychoses (FEP) may present with diffuse symptoms and a broad range of clinical phenotypes, leading to difficulties in the early detection of the different pluripotent trajectories and consequently to instability of the diagnoses. The aim of this study was to assess the stability of diagnoses at time of admission compared to discharge in patients with FEP at a newly established early psychosis inpatient unit within a general psychiatric service in a general hospital.

Methods

Charts of all patients admitted to the early psychosis inpatient unit of the Clinical Division of Social Psychiatry of the Medical University of Vienna between 01.01.2016 and 31.03.2017 were reviewed. FEP was defined as a first presentation of affective, schizophreniform, acute polymorphic, organic or substance-related psychosis according to ICD-10.

Results

127 patients were admitted during the said period, among whom 92 (72,4%) were diagnosed with a psychotic disorder at time of admission. 39,1% (n=36) of those had a FEP, whereof 58,3% (n=21) were diagnosed with schizophrenia spectrum psychosis, 27,8% (n=10) with affective psychosis, 11,1% (n=4) with substance-related psychosis and 2,8% (n=1) with organic psychosis as main diagnosis at time of discharge. In 50% (n=18) of FEP patients, diagnosis at time of admission was not maintained. 54,2% (n=13) of FEP patients who were admitted with a schizophrenia spectrum diagnosis had a shift in diagnosis at time of discharge, whereof 46,2% (n=6) were adjusted to another diagnosis of the same spectrum and 53,8% (n=7) to a diagnosis of either affective spectrum, substance-related psychosis or organic psychosis. 100% (n=2) of those with a persistent delusional disorder had a different diagnosis at discharge, as well as 56,3% (n=9=) of those admitted with a diagnosis of acute and transient psychotic disorders. Changes in the admission diagnoses of affective psychosis were necessary in 44,4% (n=4), whereof one half was adjusted to another diagnosis of the same spectrum and the other half to a diagnosis of the schizophrenia spectrum.

Discussion

The diagnostic instability in this study underlines the concept of the highly dynamic and changeable nature of psychopathology in the early stages and the pluripotent trajectories of psychosis. Furthermore, inadequate information available for specific diagnosis at time of admission as well as diagnostic uncertainty at the onset of psychosis could be implicated in the described diagnostic instability. The broad range of clinical phenotypes of early psychosis and the limitations of current diagnostic risk and identification approaches for the assessment of first episode psychosis indicate psychopathology conformed to a more dimensional rather than categorical model, as well as the need of a more dynamic model of prediction, such as the clinical staging model.
S107. RANDOMIZED CONTROL TRIAL OF A MOBILE APP-BASED INTERVENTION FOR ADOLESCENTS WITH FIRST-EPISODE PSYCHOSIS: THE THINK APP
Authors: Calvo Ana , Sanchez-Gutierrez Teresa , Barbeito Sara , Mayoral Maria , Moreno Miguel , Arango Celso
Published: May 2020

Background

Technological advances in psychiatric treatment is relatively recent. Previous studies have shown an improvement, in the access to treatment, for patients with first-episode psychosis (FEP). This new therapeutic approach may provide patients with personalized, flexible, and evidence-based interventions in their communities and even in their own homes. The aim of this study is to develop and test the effectiveness of a mobile app–based intervention to improve community functioning in adolescents with FEP.

Methods

We designed a single-blind randomized clinical trial (RCT) to study the effectiveness of a mobile app–based intervention for adolescents with FEP aged 14–19 years recruited from Gregorio Marañón Hospital, Madrid, Spain.

Patients were randomly assigned to an intervention group, which received treatment as usual plus ﬁve modules of a psychological intervention through the mobile app (psychoeducation, recognition of symptoms and prevention of relapses, problem solving, mindfulness, and contact wall), or to a control group (standard care).

Results

The effectiveness of the intervention were assessed by means of an extensive battery of clinical tests at baseline and at 3 months of follow-up. The primary outcome was reduction in psychotic and depressive symptoms; secondary outcomes comprise adherence, awareness, use of drugs, and quality of life. Also, will report the usefulness, user experience (UX) and security perceived by adolescents with a PEP: frequency of application use, average time of use, quantitative use, etc.

Discussion

To our knowledge, this is the ﬁrst randomized online treatment for adolescent with early psychosis comparison with treatment as usual. The main novelty of our approach is the integration of new technologies with traditional psychoeducation, cognitive behavioral therapy techniques, mindfulness and social skills development.
S108. AUTOMATED DETECTION OF INCREASED METAPHOR PRODUCTION IN OPEN-ENDED SPEECH IN SCHIZOPHRENIA AND ITS RISK STATES
Authors: Bilgrami Zarina , Gutierrez Elkin , Sarac Cansu , Corcoran Cheryl , Cecchi Guillermo
Published: May 2020

Background

Clinicians have long observed peculiarities in the use of figurative language by individuals with schizophrenia, as part of larger expressive deficits. Natural language processing has been used to predict psychosis onset (Bedi et al., 2015; Corcoran et al., 2018), identifying classifiers such as semantic coherence. Here we examine use of metaphor across the psychosis spectrum.

Methods

Participant groups across the psychosis spectrum (healthy controls, clinical high risk for psychosis and individuals with schizophrenia) participated in open-ended interviews lasting approximately one hour and encouraged to express themselves narratively. Each interview was transcribed, then deidentified and run through the metaphor analysis algorithm. The results were then used to determine an overall metaphor frequency rate for each participant/transcript.

Results

The algorithm detected a significantly higher proportion of the words in transcripts of patients with schizophrenia as metaphorical (6.5%) than in healthy controls’ transcripts (5.7%) (p < 0.01, t57 = 2.68). Patients in the CHR group also produced more metaphorical words tagged by the algorithm (6.6%; p < 0.01, t95 = 3.69).

Discussion

These results demonstrate that metaphor usage, as measured using automated algorithms, is a robust and powerful indicator of symptoms, whether defined via current schizophrenia diagnosis or by clinical high-risk status. The ability to estimate metaphoric content in speech and written samples can be a significant contribution to the systemization of psychosis symptoms and and may be useful as a screen for the general population to identify individuals who may be at risk for psychosis.
S132. SAMPLING BIAS IN STUDIES OF FIRST-EPISODE PSYCHOSIS – A FOLLOW-UP STUDY
Authors: Walta Maija , Laurikainen Heikki , Armio Reetta-Liina , From Tiina , Salokangas Raimo K R , Hietala Jarmo
Published: May 2020

Background

Attrition rates and sampling bias in controlled clinical studies are a concern when evaluating the relevance of the results to a specific patient population in a real-life clinical / treatment setting. Dropout rates in studies on psychotic disorders are high and many eligibility criteria may lead to bias in study samples. We wanted to analyze how representative are the patient samples typically included in first-episode psychosis studies such as the Turku Early Psychosis (TEPS) study by using a platform of 3772 consecutive admissions to clinical psychiatric services of Turku Psychiatry.

Methods

TEPS study was started in 2011 as a part of a larger study on psychosis treatment processes in Turku Psychiatric services. Each patient, inpatient and outpatient, went through initial clinical screening by the treatment group which was followed by a structured evaluation if the screen for first-episode psychosis was positive. Between Oct 2011 and June 2016 there were 195 patients with first-episode psychosis (FEP) suitable to the TEPS study. Of them 102 were willing and 93 were not willing to participate or were not reached in a baseline structured evaluation. Using patient records, we compared if these two groups differed in terms of clinical variables, treatment or prognosis during a 1-year follow-up. Time of hospital stay, involuntary vs. voluntary admission, coercive measures during the hospital care, re-hospitalizations and drop-out from the clinical care during the follow-up were used as outcomes.

Results

Non-participating (NTP) group had higher rate of involuntary care than participating (TP) group (70 % vs 62 %) as well as higher rate of coercion during the treatment and higher rate of re-admissions during the follow-up than the TP group (36 % vs 22 % and 41 % vs 34 %, respectively) but these differences did not reach statistical significance. During the one-year follow-up NTP group had a significantly higher rate of dropping out from the clinical care than participating TP group (48 % vs 30 %, p=0.01). NTP group had also higher rate of dropping out of clinical treatment mainly because of patient non-adherence (33 % vs 16 %, p=0.03).

Discussion

Nearly half (47 %) of the intent-to-study FEP patients were not reached or declined to participate in our study. Non-participating patients had a slightly more severe illness and poorer treatment adherence during one-year follow-up. The clinical differences were not as marked as we expected. E.g. involuntary care, inpatient care and more coercion during the follow-up were not significantly different between NTP and TP groups. Nevertheless, the data suggest considerable differences between participating and non-participating patients with first-episode psychosis which should be taken in to account when evaluating the generalizability of the results for an unselected group of psychotic patients in ‘real-life’ clinical care.
S185. IMPACT OF GENETIC LIABILITY TO SCHIZOPHRENIA ON IMPAIRED MIGRATION OF AUTOLOGOUS INDUCED NEURAL STEM CELLS
Authors: Lee Junhee , Song Sehyeon , Young Lee Tae , Chang Mi-Sook , Soo Kwon Jun
Published: May 2020

Background

Since previous studies which presented the direct evidences of neurodevelopmental abnormality in schizophrenia using stem cell techniques, recent studies have demonstrated that induced neural stem cells (iNSCs) derived from patients with schizophrenia resembling their fetal brain tissue indeed shows aberrant migration and maintains the gene signature. However, the origin and nature of these abnormalities remain unresolved and no study examined unaffected individuals (UIs) with multiple relatives with schizophrenia.

Methods

Three patients diagnosed as schizophrenia (SZs), 3 UIs who has multiple relatives diagnosed as schizophrenia including at least one first-degree relative, and 3 healthy controls (HCs), all males, were recruited from Seoul National University Hospital (SNUH), Korea. iNSCs were generated from human adipose-derived stem cells (hADSCs) using small molecule-based lineage switch technique. The NSC marker expressions in iNSCs were analysed by real-time polymerase chain reaction (qPCR). The migration of iNSCs was analysed by CytoSelect 96-well cell migration assay.

Results

Demographic characteristics were not significantly different among the groups. Level of functioning was significantly lower in SZs. Either mRNA levels of NSC markers or NCAM protein levels were not significantly different among the groups. Doubling time among the groups were not significantly different. Migration capability of iNSCs from not only SZs, but also UIs were significantly smaller than HCs.

Discussion

We report a novel finding of defective ability of the iNSCs of UIs to reach the target along with those of SZs which is the first explicit demonstration of the postulation that neurodevelopmental abnormality might be present in UIs, using iNSCs directly derived from living subjects.
S192. EFFECTS OF NICOTINE INTAKE ON NEUROPLASTICITY IN SMOKING AND NON-SMOKING PATIENTS WITH SCHIZOPHRENIA
Authors: Pross Benjamin , Schulz Patrick , Güler Duygu , Papazova Irina , Wagner Elias , Maurus Isabel , Löhrs Lisa , Strube Wolfgang , Padberg Frank , Falkai Peter , Hasan Alkomiet
Published: May 2020

Background

Cortical plasticity – the ability to reorganize synaptic connections and adapt to environmental changes – appears to be impaired in schizophrenia patients. Results suggest the dysfunctional plasticity to be a key pathophysiological mechanism. Different non-invasive brain stimulation (NIBS) techniques have been used to modulate and induce cortical plasticity. In healthy subjects, nicotine was shown to play an important role in plasticity induction and is capable to alter cortical excitability and plasticity, induced by NIBS techniques. Our goal was to investigate the promising effects of a nicotine receptor activation done by Varenicline and the combination with anodal transcranial direct current stimulation (a-tDCS) on neuroplastic changes in schizophrenia patients.

Methods

Our sample consisted out of twenty-four individuals with schizophrenia, twelve smokers and twelve non-smokers. Every participant received Varenicline and Placebo, combined with anodal transcranial direct current stimulation (a-tDCS), to induce non-focal plasticity. We inferred plasticity changes by monitoring changes in cortical excitability. This was done via motor-evoked potentials (MEPs) elicited by transcranial magnetic stimulation (TMS). The MEPs were recorded before and three hours after Varenicline/Placebo intake. Following the direct current stimulation, we monitored excitability changes for up to one hour.

Results

Significant effects through the mere Varenicline consumption or withdrawal effects could not be found in any group. However, we observed a numeric temporary decrease of excitability after a-tDCS in non-smokers following Varenicline intake. This decrease compared to the placebo condition was visible 20 minutes after a-tDCS but vanished over time.

Smokers did not show any excitability changes after a-tDCS and the nicotinic receptor stimulation did not show any influence.

Excitability changes after stimulation in contrast to the baseline measurement were not evident.

Discussion

Our results show that an activation of nicotinic receptors in schizophrenia patients does not induce excitability changes. The modulating effect of nicotine in plasticity induction via anodal transcranial direct current stimulation could not be confirmed for patients with schizophrenia. We could show that chronic nicotine consumption in patients with schizophrenia or nicotine withdrawal does not lead to fundamental excitability changes. Acute nicotine consumption has only small effects on cortical excitability in non-smokers.
The Evolution of a Hospital-Based Cancer Registry in Northwest Cameroon from 2004 to 2015
Authors: Afungchwi Glenn M , Kruger Mariana , Wharin Paul D , Bardin Richard , Kouya Francine N , Hesseling Peter B
Published: May 2020

Effective cancer registration is required for the development of cancer management policies, but is often deficient in the developing world. In 2008 cancer registration was set up Banso Baptist Hospital and Mbingo Baptist Hospital in the Northwest region of Cameroon, using the Pediatric Oncology Networked Database (POND). The objective of this study was to analyze the POND registry data for patients with cancer aged 0–15 years for the period 2004–15. A total of 1029 malignancies were recorded in children 0–15 years in the study period. The male-to-female ratio was 1.4:1. The median age at diagnosis was 7.22 years. The most common malignancies were lymphomas followed by nephroblastoma, retinoblastoma, rhabdomyosarcoma and Kaposi sarcoma. There were more Burkitt lymphomas cases between 2004 and 2009 than between 2010 and 2015, while the number of cases rose for other diagnoses like retinoblastoma and nephroblastoma. This report has demonstrated how pediatric oncology registration can be implemented, improved and sustained in a low- and middle-income country setting with limited resources. Using the data, these hospitals can improve their treatment planning and ensure the availability of essential chemotherapy for childhood cancers.
An Infant with Acute Bloody Diarrhea and Gastrointestinal Basidiobolomycosis: An Unusual Presentation of a Rare Disease
Authors: Mousavi Mohammad Reza , Pouladfar Gholamreza , Taherifard Erfan , Badiee Parisa , Anbardar Mohammad Hossein
Published: May 2020

Basidiobolomycosis is a fungal infection caused mainly by Basidiobolus ranarum, a filamentous fungus of the order Entomophthorales and the family Basidiobolaceae. This infection typically involves the skin and soft tissue; however, visceral organ involvement has also been reported. Here, we report a case of gastrointestinal basidiobolomycosis in a young child who presented with acute bloody diarrhea which was initially misdiagnosed as intussusception.
Evaluation of the Cytotoxicity of Various Hand Disinfectants and Ozonated Water to Human Keratinocytes in a Cultured Epidermal Model
Authors: Kashiwazaki Jun , Nakamura Kiwamu , Hara Yasuka , Harada Rie , Wada Ikuo , Kanemitsu Keiji
Published: May 2020

OBJECTIVE

To evaluate the cytotoxicity of various hand disinfectants and ozonated water to human keratinocytes using a cultured epidermal model.

DESIGN

Using a test protocol from the Organization for Economic Co-operation and Development, investigators applied hand disinfectants containing either 83% ethanol, 0.2% benzalkonium chloride, 0.5% povidone-iodine, 1% chlorhexidine, 1% chlorhexidine ethanol, or ozonated water to a cultured human epidermal model. Surface morphology and histologic changes were evaluated by scanning electron microscopy and hematoxylin-eosin staining.

MAIN OUTCOME MEASURES

Production of inflammatory cytokine interleukin 1α by keratinocytes and cell death rate.

MAIN RESULTS

Electron microscopic analysis revealed the creation of small holes on the stratum corneum, and hematoxylin-eosin staining revealed perinuclear vacuolation of keratinocytes and cells with a condensed nucleus. Interleukin 1α was detected in the culture supernatants. More than 80% of keratinocytes did not survive after a 15-minute application of disinfectants. However, no significant damage was detected with ozonated water.

CONCLUSIONS

Ozonated water did far less damage to keratinocytes than the tested disinfectants. Although the ability of ozonated water to disinfect hands of medical staff members requires further study, it might serve as an alternative with minimum cytotoxicity.
Pyoderma Gangrenosum and Superimposed Infection: A Case Report
Authors: Gavioli Elizabeth M. , Casias Michael , Ngo Linda
Published: May 2020

Pyoderma gangrenosum (PG) is a rare, ulcerating, inflammatory disease that is often misdiagnosed as a skin and soft tissue infection. If PG is identified, it is treated with topical or systemic immunosuppressants to reduce inflammation and induce remission. However, the use of immunosuppressants has been linked to a higher risk of superimposed infections. The authors report the case of a 24-year-old female patient with bilateral lower extremity PG with a superimposed infection of Pseudomonas aeruginosa and Bacteroides fragilis after intralesional corticosteroid therapy.
Pressure Injuries in the Pediatric Population: Analysis of the 2008–2018 International Pressure Ulcer Prevalence Survey Data
Authors: Delmore Barbara , VanGilder Catherine , Koloms Kimberly , Ayello Elizabeth A.
Published: May 2020

Pediatric pressure injuries continue to be a worldwide healthcare problem. Studying pediatric pressure injury point prevalence may provide more insight into the problem and drive prevention strategies for at-risk pediatric patients, a truly vulnerable population. This article reports 10 years of longitudinal pediatric pressure injury prevalence data and demographics from around the world.
Sparking Change: How a Shift to Step 1 Pass/Fail Scoring Could Promote the Educational and Catalytic Effects of Assessment in Medical Education
Authors: Kogan Jennifer R. , Hauer Karen E.
Published: May 2020

This Invited Commentary explores the implications of the upcoming shift to pass/fail scoring for the United States Medical Licensing Examination Step 1 that was announced in February 2020. Using the frameworks of validity and growth/mastery mindset, the authors describe how this change in Step 1 score reporting presents an opportunity to advance the meaningful assessment of medical students and improve the transition from undergraduate medical education (UME) to graduate medical education (GME). The authors explore the potential risks and consequences associated with a narrow implementation of pass/fail scoring. Alternatively, with a shift in scoring, educators can leverage consequential validity, particularly the educational and catalytic effects of assessment. The authors emphasize the importance of assessment that motivates learners to prepare in a fashion that benefits their learning and that provides results and feedback that motivate all stakeholders to create, enhance, and support education. The authors suggest that this use of assessment will require a culture change from fixed mindset to growth mindset among both students and educators, a shift from static to dynamic testing, and a transition to assessment that focuses on a learner’s trajectory. The authors conclude by emphasizing the importance of work-based assessment and the need for improved transparency across the UME–GME continuum.
Hop test does not correlate with neuromuscular control during drop vertical jump test: A prognostic comparative study utilizing healthy subjects
Authors: Gulbrandsen Trevor R. , Willis Brad W. , Guess Trent M. , Gray Aaron D. , Sherman Seth L.
Published: May 2020

Background:

A functional hop test is an established tool used to assess performance prior to return to sport. The effect of demographics, limb strength and flexibility, and neuromuscular control on hop test performance is not fully understood. Our hypothesis is that successful hop testing strongly (r>0.7) correlates with increased strength and neuromuscular control in a healthy athletic population.

Methods:

In this prospective clinical performance evaluation, 25 asymptomatic, active individuals participated. Flexibility measurements were recorded with a standard goniometer, strength measurements were recorded with a handheld dynamometer, and kinematic data were collected during a drop vertical jump (DVJ) using a 14-camera 3D markerless motion analysis system. Frontal plane knee abduction angle and hip rotation were measured during DVJ. Each participant underwent triple hop, cross hop, and timed 6-m hop tests. Pearson product moment correlation (moderate correlation: r value 0.4–0.7, strong correlation: r>0.7) analysis was used to assess the relationship between performance on hop tests and gender, body mass index, strength and flexibility, and frontal plane knee abduction angle and hip rotation on DVJ.

Results:

Hip abduction strength, external rotation strength, quadriceps and hamstring strength each had moderate correlations to the triple hop test (r values=0.52, 0.62, 0.46, 0.50, respectively) and the cross-hop test (r values=0.56, 0.65, 0.54, 0.55, respectively). Hop test performance did not strongly correlate with frontal plane projection angle and hip internal rotation.

Conclusions:

Functional hop tests correlated with strength but had weak to minimal correlation with neuromuscular control. Individuals with neuromuscular deficits may still do well on standard hop tests.

Level of Evidence:

Level III.
Post-exercise leg compartment pressure measurements in asymptomatic collegiate distance runners: a prospective study
Authors: Miller Timothy L. , Early Nicholas A. , Kaeding Christopher C.
Published: May 2020

Background:

Chronic exertional compartment syndrome (CECS) is an uncommon cause of leg pain in running athletes. Post-exercise compartment pressure measurements are an invasive test that many clinicians use for making the diagnosis of CECS. We sought to determine if intracompartmental pressures in anterior leg compartments of asymptomatic collegiate distance runners meet established criteria for diagnosis of exertional compartment syndrome.

Methods:

Thirty collegiate running athletes underwent 1-minute post-exercise compartment pressure measurements of bilateral anterior leg compartments. Each was asked to run for 15 min at a moderately intense pace, and then underwent measurements performed at 1-minute postexertion with a needle manometer. Fifteen male and 15 female collegiate running athletes from age 18 to 23 yr (average 20.8 yr) underwent post-exercise compartment pressure testing of the legs.

Results:

Eleven (six men, five women) demonstrated 1-minute post-exercise compartment pressure measurements that met criteria for diagnosis of exertional compartment syndrome in at least one leg based on established criteria (>30 mmHg). Of these 11, four demonstrated positive measurements bilaterally (two men, two women). Intracompartmental pressure measurements ranged from 16 mmHg to 88 mmHg (average 27.5 mmHg). Measurements of anterior leg compartments performed at 1-minute post-exercise were indicative of exertional compartment syndrome in more than one-third of the asymptomatic running athletes tested (11/30, 36.7%).

Conclusions:

Elevated anterior leg compartment pressures were prevalent in collegiate distance runners despite a lack of symptoms. Post-exercise compartment pressure measurements should be viewed only as an indicator of exertional compartment syndrome and not relied upon as a confirmatory test.

Level of Evidence:

Level IV.
Intra-Articular Sacroiliac Joint Injection
Authors: Boody Barrett , Caballero Jesse , Macadaeg Caleb , Funk Robert , Macadaeg Kevin
Published: May 2020

Sacroiliac (SI) joint pathology has been an increasingly discussed pathology as a potential etiology for significant low back and lower extremity pain. While patient history and examination maneuvers can assist with identifying the SI joint as a potential cause of pain, an intra-articular SI joint injection is critical to properly diagnose the SI joint as a clinically relevant pain generator. In addition to the diagnostic information from the injection, SI joint intra-articular injections can be performed for therapeutic benefit as part of a multi-modal, conservative treatment approach for SI joint pathology. We discuss our technique for safe and effective SI joint intra-articular injections as a both diagnostic and therapeutic aid for SI joint pathology.
Geraniin inhibits proliferation and induces apoptosis through inhibition of phosphatidylinositol 3-kinase/Akt pathway in human colorectal cancer in vitro and in vivo
Authors: Zhou Long-an , Liu Tong-bo , Lü Hong-na
Published: May 2020

Geraniin, a polyphenolic component isolated from Phyllanthus amarus, has been reported to possess diverse biological activities, including antitumor, antiinflammatory, antihyperglycemic, antihypertensive, and antioxidant. However, the role and underlying mechanisms of geraniin in colorectal cancer still remain unclear. In the present study, we found that geraniin notably inhibited cell proliferation and clonogenic formation of colorectal cancer cell SW480 and HT-29 in a dose-dependent manner by Cell Counting Kit 8, EdU, and colony formation assays, respectively. Additionally, geraniin remarkably induced apoptosis of SW480 and HT-29 cells in a dose-dependent way by Hoechst 33342 staining, flow cytometric analysis, and TdT-mediated dUTP nick-end labeling assays and increased the expressions of Bax, caspase-3, and caspase-9, while decreased the level of Bcl-2. Besides, wound healing, transwell migration, and invasion assays demonstrated that geraniin obviously inhibited the migration and invasion of SW480 and HT-29 cells. Moreover, it also inhibited the levels of phospho (p)-phosphatidylinositol 3-kinase and p-Akt. Furthermore, in-vivo animal study revealed that geraniin had the significant inhibitory effects on tumor growth and promoted cancer cell apoptosis remarkably, which further confirmed the antitumor effect of geraniin. Taken together, the present study exhibited the positive role of geraniin in inhibiting proliferation and inducing apoptosis through suppression of phosphatidylinositol 3-kinase/Akt pathway in colorectal cancer cells in vitro and in vivo, which might provide new insights in searching for new drug candidates of anticolorectal cancer.
The influence of the duration of chronic unpredictable mild stress on the behavioural responses of C57BL/6J mice
Authors: Pałucha-Poniewiera Agnieszka , Podkowa Karolina , Rafało-Ulińska Anna , Brański Piotr , Burnat Grzegorz
Published: May 2020

The chronic unpredictable mild stress (CUMS) model of depression in mice is a model commonly used to investigate stress-induced depressive-like behaviours. The duration of the stress-inducing procedure is variable, thus making it difficult to compare results and draw general conclusions from different protocols. Here, we decided to investigate how the duration of the CUMS procedure affects behavioural changes, body weight as well as the level of plasma corticosterone in stressed and nonstressed C57BL/6J mice subjected to CUMS for 18 or 36 days. We found that 18 days of CUMS induced a robust decrease in grooming time in the splash test and a significant increase in the immobility time in the tail suspension test (TST) and the forced swim test (FST). All of these stress-induced depression-related behavioural effects diminished or even disappeared after 36 days of CUMS. Plasma corticosterone levels were increased in the CUMS mice compared to those in the nonstressed mice. However, this effect was more pronounced in mice stressed for 18 days. On the other hand, a gradual decline in weight loss in the stressed animals was observed as the duration of the CUMS procedure increased. Altogether, the results indicate that 18 days of CUMS did not affect body weight but caused significant behavioural effects as well as a robust increase in corticosterone levels, while 36 days of CUMS induced significant reduction in weight gain but only slight or even non-significant behavioural effects. These results may indicate the presence of adaptive changes to the long-term CUMS procedure in C57BL/6J mice.
Reconstitution of Injectable Poly-d,l-lactic Acid: Efficacy of Different Diluents and a New Accelerating Method
Authors: Chen Se-Yi , Chen Szu-Ting , Lin Jui-Yu , Lin Chuan-Yuan
Published: May 2020

Background:

Injectable poly-d,l-lactic acid (PDLLA) is a new collagen-stimulating filler containing PDLLA microspheres and carboxymethyl cellulose. It is available as a lyophilized powder that must be reconstituted with a diluent before administration. The aims of this study were to investigate the efficacy of different diluents and a new accelerating “back-and-forth” method.

Methods:

Six different diluents, sodium bicarbonate, sterile water for injection (SWFI), normal saline, lidocaine, lidocaine with epinephrine (lidocaine + E), and mannitol, were tested. The recommended “vortex” method for preparation of thin suspensions and a new back-and-forth method suitable for both thin and thick suspensions were compared. Gross and microscopic views of the prepared suspensions were examined.

Results:

Using the vortex method, only mannitol and SWFI are found to be effective reconstitution diluents for injectable PDLLA. Using the back-and-forth method, all six diluents can be used for reconstitution of injectable PDLLA. Moreover, the time needed for reconstitution of injectable PDLLA by this back-and-forth method is very short, regardless of the thickness of the suspension.

Conclusions:

Clinically, only SWFI can be used for reconstitution of injectable PDLLA by “hand-shaking” or vortex method. To accelerate the reconstitution time especially when using small amount of SWFI, back-and-forth is the method of choice. Besides, when SWFI is not available, other diluents such as normal saline, lidocaine, or lidocaine + E can be used by this novel back-and-forth reconstitution method.
Comparing Image Segmentation Techniques for Determining 3D Orbital Cavernous Hemangioma Size on MRI
Authors: Boparai Ranjodh S. , Maeng Michelle M. , Dunbar Kristen E. , Godfrey Kyle J. , Tooley Andrea A. , Maher Mary , Kazim Michael
Published: May 2020

Purpose:

To measure orbital cavernous hemangioma size using 3 segmentation methods requiring different degrees of subjective judgment, and to evaluate interobserver agreement using these methods.

Methods:

Fourteen patients with orbital cavernous hemangiomas were included in the study. Pretreatment T2-weighted MRIs were analyzed by 2 observers using 3 methods, including 1 user-dependent image segmentation method that required high degrees of subjective judgment (ellipsoid) and 2 parameter-dependent methods that required low degree of subjective judgment (GrowCut and k-means clustering segmentation). Interobserver agreement was assessed using Lin’s concordance correlation coefficients.

Results:

Using the ellipsoid method, the average tumor sizes calculated by the 2 observers were 1.68 ml (standard deviation [SD] 1.45 ml) and 1.48 ml (SD 1.19 ml). Using the GrowCut method, the average tumor sizes calculated by the 2 observers were 3.00 ml (SD 2.46 ml) and 6.34 ml (SD 3.78 ml). Using k-means clustering segmentation, the average tumor sizes calculated by the 2 observers were 2.31 ml (SD 1.83 ml) and 2.12 ml (SD 1.87 ml). The concordance correlation coefficient for the ellipsoid, GrowCut, and k-means clustering methods were 0.92 (95% CI, 0.83–0.99), 0.12 (95% CI, –0.21 to 0.44), and 0.95 (95% CI, 0.90–0.99), respectively.

Conclusions:

k-means clustering, a parameter-dependent method with low degree of subjective judgment, showed better interobserver agreement compared with the ellipsoid and GrowCut methods. k-means clustering clearly delineated tumor boundaries and outlined components of the tumor with different signal intensities.
Orbital and Ocular Adnexal Manifestations of Adult T-Cell Leukemia/Lymphoma: a Case Report and Systematic Review
Authors: Henry Roger K. , Bagg Adam , Wu Connie , Eagle Ralph C. , Milman Tatyana
Published: May 2020

Purpose:

To describe a patient with orbital adult T-cell leukemia/lymphoma (ATLL) and to review the literature on presentation, diagnostics, management, and clinical course of this rare disease.

Methods:

A systematic literature review. PubMed/MEDLINE and Google Scholar databases were searched for all well-documented cases of orbital/ocular adnexal ATLL.

Results:

Sixteen patients were included in the final analysis. The median age at diagnosis was 47 years (range, 20–85), 9/16 patients (56%) were male, and patients were of Japanese (10/16, 63%), Caribbean (5/16, 31%), or African (1/16, 6%) origin. Proptosis (6/15, 40%) and visual loss (5/15, 33%) were the most common presenting signs. Involvement of adjacent structures was documented in 8 of 16 (50%) patients. All patients had evidence of systemic ATLL, which was identified concurrently with orbital/ocular adnexal disease in 9 of 15 (60%) patients. Management included multi-agent chemotherapy with steroids (9/13, 69%), antivirals (2/13, 15%), biologic agents (4/13, 31%), and umbilical cord blood transplantation (1/13, 8%). Most patients (8/12, 67%) experienced at least partial remission with disease relapse occurring in 6 of 8 patients (75%). The median survival time was 28 months (95% CI, 5.5–50.5 months).

Conclusions:

Adult T-cell leukemia/lymphoma should be considered in the differential diagnosis of orbital and ocular adnexal space-occupying lesions, particularly in male patients from endemic regions. Orbital disease is frequently locally aggressive and presents concurrently with systemic ATLL, highlighting the importance of comprehensive multimodal work-up and multidisciplinary management. Emerging targeted therapies and hematopoietic stem cell transplant may prolong survival.
Spontaneous Orbital Wall Decompression in Thyroid Eye Disease: A Rare Feature
Authors: Vasanthapuram Varshitha Hemanth , Naik Milind N
Published: May 2020

Spontaneous orbital decompression is an incidental radiological finding in patients of thyroid eye disease. It is rare with few case reports in ophthalmic literature. The authors describe a 48-year-old female with thyroid eye disease who was found to have a spontaneous orbital decompression on computed tomography imaging.
Adult Versus Pediatric Relapse and Recurrence in Orbital Inflammatory Syndrome
Authors: Keen Jamie A. , Kennedy Brandon J. , Mishulin Aleksey , Winkler Kathryn , Fernandez-Ruiz Maria , Black Evan H. , Roarty John
Published: May 2020

Purpose:

Orbital inflammatory syndrome (OIS) is a diagnosis of exclusion that has a variable presentation and unpredictable course. Many studies report incomplete or lack of OIS resolution with high recurrence and relapse rates. No studies to date have investigated the characteristics of both recurrence and relapse in OIS. We sought to determine this in both pediatric and adult patients.

Methods:

A retrospective chart review of 56 patients with OIS was performed between 2004 and 2018. Forty-one patients were identified as adults greater than 18 years of age and 15 were identified as pediatric patients less than 18 years of age.

Results:

Among 56 (41 adult and 15 pediatric) cases of OIS, 18 cases of recurrent disease (32.1%) were identified and 15 (26.8%) patients experienced relapses. All 6 (100%) pediatric patients that had recurrent disease initially suffered from relapses. In contrast, only 1 of the 12 (8.3%) recurrent adult cases initially experienced relapse. Of the 18 patients with recurrent disease, 9 (50%) had multiple recurrences. Underlying etiologies were confirmed in 5 of 18 recurrent cases (27.8%) and 5 of 38 (13.2%) non-recurrent cases. Of the 5 patients with recurrent OIS and an identified etiology, all 5 (100%) demonstrated multiple recurrences.

Conclusions:

In pediatric cases, relapse was more common and prior episodes of relapse were predictive of later recurrence. Recurrence was relatively common in both groups with half of the patients having multiple recurrences. Identifiable underlying etiologies were more common in patients with recurrent OIS and those cases all demonstrated multiple recurrences.
Changes in Field of Binocular Single Vision and Ocular Deviation Angle After Balanced Orbital Decompression in Thyroid Eye Disease
Authors: Vaidya Aric , Kakizaki Hirohiko , Takahashi Yasuhiro
Published: May 2020

Purpose:

To evaluate influential factors for changes in the binocular single vision (BSV) and ocular deviation angle in the medial direction after bilateral balanced orbital decompression in thyroid eye disease.

Methods:

This retrospective study included 41 patients. The areas of BSV and the angles of medial ocular deviation on the Hess chart were measured. The percentages of pre- and postoperative areas against the normal area (%BSV) and the change in BSV after surgery were calculated. Postoperative change in the angle was calculated by subtraction of the preoperative angle from the postoperative one. Influential factors for the change in BSV and that in the medial deviation angle were evaluated via multivariate linear regression analysis.

Results:

The maximum cross-sectional area of the medial rectus muscle, preoperative %BSV, and preoperative medial ocular deviation angle were significant factors of change in BSV (adjusted r
2 = 0.449, p < 0.001), although age, history of anti-inflammatory treatment, volume of removed orbital fat, findings on CT images, maximum cross-sectional areas of the other rectus muscles, and presence or absence of a periosteal flap did not affect change in BSV (p > 0.050). On the contrary, all variables did not influence postoperative changes in the medial ocular deviation angle (p > 0.050).

Conclusions:

In balanced orbital decompression, the maximum cross-sectional area of medial rectus muscle, preoperative field of BSV, and medial ocular deviation were significant influential factors for postoperative changes in field of BSV.
Nicotinamide riboside relieves paclitaxel-induced peripheral neuropathy and enhances suppression of tumor growth in tumor-bearing rats
Authors: Hamity Marta V. , White Stephanie R. , Blum Christopher , Gibson-Corley Katherine N. , Hammond Donna L.
Published: May 2020

Nicotinamide riboside (NR) is a vitamin B3 precursor of NAD+ that blunts diabetic and chemotherapy-induced peripheral neuropathy in preclinical models. This study examined whether NR also blunts the loss of intraepidermal nerve fibers induced by paclitaxel, which is associated with peripheral neuropathy. The work was conducted in female rats with N-methyl-nitrosourea (MNU)-induced tumors of the mammary gland to increase its translational relevance, and to assess the interaction of NR with paclitaxel and NR's effect on tumor growth. Once daily oral administration of 200 mg/kg NR p.o. beginning with the first of 3 i.v. injections of 6.6 mg/kg paclitaxel to tumor-bearing rats significantly decreased paclitaxel-induced hypersensitivity to tactile and cool stimuli, as well as place-escape avoidance behaviors. It also blunted the loss of intraepidermal nerve fibers in tumor-bearing rats, as well as a separate cohort of tumor-naive rats. Unexpectedly, concomitant administration of NR during paclitaxel treatment further decreased tumor growth; thereafter, tumor growth resumed at the same rate as vehicle-treated controls. Administration of NR also decreased the percentage of Ki67-positive tumor cells in these rats. Once daily administration of NR did not seem to alter tumor growth or the percentage of Ki67-positive tumor cells in rats that were not treated with paclitaxel and followed for 3 months. These results further support the ability of NR to play a protective role after nerve injury. They also suggest that NR may not only alleviate peripheral neuropathy in patients receiving taxane chemotherapy, but also offer an added benefit by possibly enhancing its tumor-suppressing effects.