bluuebunny/crossref_metadata_2025_split huggingface dataset:
Netarsudil for the Treatment of Open-Angle Glaucoma and Ocular Hypertension: A Literature Review
Authors: Gonzalez Lipton E. , Boylan Paul M. 
Published: November 2020

Objective: To evaluate netarsudil’s role as first-line therapy for the treatment of open-angle glaucoma (OAG) and ocular hypertension (OHT). Data Sources: A literature search utilizing MEDLINE and CINAHL was performed using netarsudil and AR-13324 as keywords. Studies published from January 1970 to September 2020 were eligible. Study Selection and Data Extraction: For inclusion, articles were required to be published in English and participants enrolled in phase I, II, or III clinical trials. Articles were excluded if netarsudil was coformulated with another medication. Preclinical research, case reports, case series, review articles, citations without an abstract, and newsletters were excluded. Literature Review: The search retrieved 97 unique citations; 90 results were excluded, and 7 studies were included for analysis. Relevance to Patient Care and Clinical Practice: In all, 20 years elapsed between the Food and Drug Administration’s approvals of distinct medications to treat OAG. Existing first-line therapies target the uveoscleral pathway, which is responsible for a small amount of aqueous humor outflow. Rho kinase inhibitors target the trabecular pathway, which is responsible for 90% of aqueous humor outflow; thus, Rho kinase inhibitors may significantly reduce intraocular pressure and improve clinical outcomes for patients with OAG or OHT. Conclusions: Evidence demonstrates that netarsudil is inferior to prostaglandin analogues and noninferior to topical β-blockers in the treatment of OAG and OHT. Hyperemia is a common adverse drug reaction, which often resolves after medication discontinuation. Additional phase III clinical trials and evidence-based guidelines are necessary to determine netarsudil’s position in OAG and OHT management.
The Role of Weightbearing Computed Tomography Scan in Hallux Valgus
Authors: Mahmoud Karim , Metikala Sreenivasulu , Mehta Samir D. , Fryhofer George W. , Farber Daniel C. , Prat Dan 
Published: November 2020

Background: Hyperpronation of the first metatarsal in hallux valgus (HV) is poorly understood by conventional weightbearing radiography. We aimed to evaluate this parameter using weightbearing computed tomography (WBCT) and to understand its association with other standard measurements. Methods: Retrospective evaluation of WBCT and weightbearing radiographs (WBXRs) was performed for 20 patients with HV feet and 20 controls with no such deformity. Axial computed tomography images of both groups were compared for the first metatarsal pronation angle (alpha angle) and tibial sesamoid subluxation (TSS) grades. The HV angle (HVA), first-second intermetatarsal angle (IMA), first metatarsal-medial cuneiform angle (MMCA), Meary’s angle, and calcaneal pitch (CP) angle of the study and control groups were compared on both WBXR and the corresponding 2-dimensional images of WBCT. All measurements were independently performed by 1 musculoskeletal radiology fellow and 1 foot and ankle surgical fellow. Measurements were averaged and interobserver reliability was calculated. Results: The HV group demonstrated significantly higher values for TSS grade ( P < .001) but not for alpha angle ( P = .121) compared with controls. Likewise, significantly elevated HVA and IMA were noted in the HV group on both imaging modalities, while no such differences were observed for the CP angle. Higher MMCA and Meary’s angle in the HV group were evident only on WBXR (MMCA, P = .039; Meary’s, P = .009) but not on WBCT (MMCA, P = .183; Meary’s, P = .171). Among all, the receiver operating characteristic (ROC) curves demonstrated the greatest area under the curve (AUC) for HVA, followed by IMA. The alpha angle performed only just outside the range of chance (AUC, 0.65; 95% CI, 0.52-0.69). The Pearson’s correlations of the alpha angle, in the HV group, revealed a significant linear relationship with TSS grade and with HVA on WBXR, and only trended toward a weak linear relationship with IMA and with HVA on WBCT. Conclusion: The alpha angle, a measure of abnormal hyperpronation of the first metatarsal, was an independent factor that may coexist with other parameters in HV, but in isolation had limited diagnostic utility. “Abnormal” alpha angles were even observed in individuals without HV. Increases in IMA and MMCA were not necessarily associated with similar increases in alpha angle, despite moderate correlations with TSS grade and HVA on WBXR. Nevertheless, the WBCT was a useful method for assessing hyperpronation and guiding surgical management in individual cases. Level of Evidence: Level III, retrospective comparative study.
Preoperative Patient-Reported Outcome Measures Relationship With Postoperative Outcomes in Flexible Adult-Acquired Flatfoot Deformity
Authors: Conti Matthew S. , Caolo Kristin C. , Nguyen Joseph T. , Deland Jonathan T. , Ellis Scott J. 
Published: November 2020

Background: Previous studies have demonstrated that procedure-specific thresholds using preoperative patient-reported outcome scores may be used to predict postoperative outcomes. The primary purpose of this study was to determine if preoperative Patient-Reported Outcomes Measurement Information System (PROMIS) thresholds could be used to predict which patients would clinically improve at 2 years postoperatively following reconstruction of their flexible adult-acquired flatfoot deformity (AAFD). Methods: PROMIS physical function, pain interference, and depression scores were prospectively collected preoperatively and at a minimum of 2 years postoperatively for 75 feet with flexible AAFD. Minimal clinically important differences (MCIDs) were calculated to establish significant postoperative improvement. Receiver operating characteristic curves and area under the curve analyses were employed to determine whether preoperative PROMIS scores could be used to predict postoperative outcomes. Results: The PROMIS physical function receiver operating characteristic curve analysis (area under the curve = 0.913, P < .001) found that a preoperative PROMIS physical function score greater than 45.7 resulted in a 14.3% probability of achieving the MCID, whereas a preoperative score of less than 40.8 had a 97.7% probability of achieving the MCID. A preoperative PROMIS pain interference score (area under the curve = 0.799, P < .001) less than 54.1 had only a 23.1% probability of achieving the MCID at 2 years postoperatively. Conclusions: Preoperative PROMIS physical function and pain interference scores could be used to predict postoperative improvement in patients with flexible AAFD. These results may help surgeons counsel patients regarding the anticipated benefit of surgery. Level of Evidence: Level III, retrospective comparative series.
Improving direct pharmacist counseling rates for oral oncolytic medications at an outpatient oncology clinic
Authors: Hayes Dylan J , Moore John E 
Published: November 2020

Background Due to the increasing prevalence of oral oncolytic utilization for patients with malignancy, implementation of strategies for increased monitoring and patient safety have become a necessity. Our focus was on the American Society of Clinical Oncology’s Quality Oncology Practice Initiative (QOPI) standards of care, standard 2.3, and its requirement for patient counseling prior to first administration of oral oncolytic therapy. Objective To assess the implementation of a workflow improvement strategy to determine its effect on the number of patients reached for pharmacist counseling prior to first dose of oral oncolytic medications. Methods In this quasi-experimental quality improvement study, we formed a multidisciplinary group to develop and implement a workflow improvement process. This process was focused on a redistribution of workflow and the implementation of new technology within EPIC Beacon. Results A total of 86 patients were identified as eligible for counseling (38 pre-intervention, 48 post-intervention). There was a statistically significant increase in number of eligible patients counseled in the post-intervention period as compared to the pre-intervention period (100% vs. 86.84%; 95% CI = –0.212, –0.205; P = 0.017). There were no significant differences observed in the number of patients counseled in-person or patients counseled prior first dose. Conclusion Our intervention showed a 100% rate of counsel in the post-intervention period. Further work needs to be done to improve the number of these patients we reach prior to them taking their first dose of medication, as well as the number of patients we are able to counsel face-to-face.
Improved Executive Function in Adults Diagnosed With Attention-Deficit/ Hyperactivity Disorder as Measured by the Brown Attention-Deficit Disorder Scale Following Treatment With SHP465 Mixed Amphetamine Salts Extended-Release: Post Hoc Analyses From 2 Randomized, Placebo-Controlled Studies
Authors: Brown Thomas E. , Chen Jie , Robertson Brigitte 
Published: November 2020

Objective: Assess executive function (EF) improvement with SHP465 mixed amphetamine salts (MAS) extended-release in adults with attention-deficit/hyperactivity disorder (ADHD) using responder analyses of the Brown Attention-Deficit Disorder Scale (BADDS). Methods: Post hoc analyses examined data from placebo-controlled SHP465 MAS dose-optimization (12.5–75 mg) and fixed-dose (25–75 mg) studies. Treatment response was assessed using two definitions (BADDS total score at endpoint <50 [no EF impairment] vs. ≥50 [impaired]; BADDS total score at endpoint relative to the in-treatment 90% CI range for baseline total score [below the range = improved]). Results: Response rates (SHP465 MAS vs. placebo) favored SHP465 MAS (all nominal p < .0001) in the dose-optimization (BADDS <50: 41.9% vs. 19.2%; below 90% CI range: 57.4% vs. 29.6%) and fixed-dose (BADDS <50: 51.9% vs. 16.7%; below 90% CI range: 70.6% vs. 32.3%) studies. Conclusion: Improvement in EF measured by BADDS response rates was approximately 2-fold greater with SHP465 MAS than placebo.
Renting Poorer Housing: Ecological Relationships Between Tenure, Dwelling Condition, and Income and Housing-Sensitive Hospitalizations in a Developed Country
Authors: Telfar Barnard Lucy , Howden-Chapman Philippa , Pierse Nevil 
Published: November 2020

Background Previous research has shown two-way associations between rental tenure, poorer housing quality, and health outcomes, but little research has looked at relative housing contributions to health outcomes. Aims We investigated whether tenure and/or dwelling condition were associated with housing-sensitive hospitalizations and whether any association differed by income. Method Using a data set of housing characteristics matched to hospitalization records, rental tenure data, and income quintiles, we modeled differences in housing-sensitive hospitalization rates by ecological-level tenure and housing condition, controlling for age-group and mean temperatures. Results There were clear associations between income, tenure, and house condition, and winter-associated hospitalization risk. In the adjusted model, the largest risk differences were associated with neighborhoods with low income (risk ratio [ RR] = 1.48) and high rental tenure ( RR = 1.41). There was a nonsignificant difference for housing condition ( RR = 1.04). Discussion Rental tenure and poor housing condition were risks for housing-sensitive hospitalization, but the association with income was stronger. Higher income households may be better able to offset quality and tenure-related health risks. This research illustrates the inverse housing law: Those most vulnerable, with most need for good-quality housing, are least likely to have it. Income inequity is inbuilt in tenure, quality, and health burden relationships. Conclusion These findings suggest that measures to address health inequities should include improvements to both tenure security and housing quality, particularly in low-income areas. However, policymakers aiming to reduce overall hospitalization rates should focus their efforts on reducing fuel poverty and improving the affordability of quality housing.
Oculocerebrocutaneous syndrome (Delleman Oorthuys syndrome) associated with congenital glaucoma: A case report
Authors: Jamjoom Hanan , Osman Mohamed , AlMoallem Basamat , Osman Essam A 
Published: November 2020

Introduction: Oculocerebrocutaneous syndrome (Delleman Oorthuys syndrome) (OMIM 164180) is a rare syndrome affecting eyes, skin, and central nervous system, and it is usually associated with microphthalmia. Case Description: A 4-day old baby boy was referred to our hospital for the evaluation of buphthalmos in the left eye. His clinical evaluation was remarkable for oculocerebrocutaneous syndrome with congenital glaucoma in the left eye and microphthalmos in the right eye. Conclusion: Our report represents the first case of oculocerebrocutaneous syndrome associated with unilateral congenital glaucoma so far in the literature.
Antiphospholipid antibodies may be associated with uveitis
Authors: Shapira Yinon , Ben-Arie-Weintrob Yael , Gilburd Boris , Reuter Sandra , Sánchez-Castañón María , López-Hoyos Marcos , Agmon-Levin Nancy 
Published: November 2020

Purpose: To evaluate the prevalence of a spectrum of autoantibodies in adult patients with non-infectious uveitis compared to healthy controls. Methods: This is a case-control study conducted in a tertiary referral center. Serum positivity to auto-antibodies directed at membranous phospholipids (aPL), nuclear antigens, and cytoplasmic (ANCA) antigens were assessed in sera from 63 non-infectious uveitis patients, and 78 healthy controls. Uveitis patients’ demographic and clinical data were collected retrospectively from their medical charts. Results: Of the spectrum of antibodies evaluated only aPL were linked with uveitis (OR 11.2, CI 1.4–92.1), as 13 (20.6%) uveitis patients were positive to at least one of the screened aPL, namely either anti-cardiolipin (aCL), anti-β2-glycoprotein (aβ2GPI), or anti-phosphatidylserine/prothrombin (aPS/PT). aCL antibodies were detected in 5/63 (7.9%) of uveitis patients and in none of controls ( p = 0.016). Positivity to either aCL or aβ2GPI was noted in 8/63 (12.7%) of uveitis patients and in 1 (1.3%) of the controls ( p = 0.011). Of the 13 uveitis patients positive to any of the aPL antibodies, 8 (62%) had exclusively anterior uveitis, 9 (69%) were idiopathic, and none had evidence of posterior vaso-occlusive involvement or systemic thrombotic manifestations. Conclusion: An association between aPL and uveitis among an unselected population of patients with no evidence of thrombosis or presence of the antiphospholipid syndrome was documented in this study. This link was observed, alike the general population of uveitis patients, mainly in patients with anterior eye inflammation. A possible interaction between aPL and uveitis, mediated by non-thrombotic mechanisms, requires further studies.
Outcomes of symmetric bilateral medial rectus recession in large-angle esotropic Duane syndrome
Authors: Nabie Reza , Manouchehri Vahideh , Azad Beheshteh 
Published: November 2020

Purpose: To evaluate the efficacy of symmetric bilateral medial rectus recession in large-angle esotropic Duane retraction syndrome (DRS) with moderate to severe globe retraction. Methods: In a retrospective study, medical reports of 30 patients with esotropia of equal or more than 20 prism diopters (pd) and moderate to serve globe retraction due to unilateral DRS who underwent symmetric bilateral medial rectus recession were reviewed. Age, gender, laterality, amblyopia, length of follow-up, pre- and postoperative measurements of primary position deviation, ocular ductions and severity of globe retraction and abnormal head posture were evaluated. A successful result was defined as decreasing esotropia to equal or less than 8 pd or equal or less than 8 pd of consecutive exotropia. Results: The mean age of patients at surgery was 13.7 ± 8.5 years old (range: 3–38). The mean preoperative esotropia measured 28.9 ± 9.1 pd in distance and 25.7 ± 7.2 pd in near, which decreased to 4.9 ± 6.1 pd in distance and 3.9 ± 8.8 pd in near postoperatively. The mean bilateral medial rectus recession was 4.9 ± 0.9 mm (range: 3–6 mm). The mean abnormal head posture improved from 19.1 ± 6.9 degrees (range: 10–30 degrees) to 3.3 ± 4.7 degrees (range: 0-15 degrees) postoperatively. At the last follow-up visit, 23 patients (76.7%) had a successful outcome. Conclusions: In the large-angle esotropic DRS patients with moderate to severe globe retraction, symmetric bilateral medial rectus recession, can be conducted to successfully resolve primary position deviation and abnormal head posture.
Multimodal imaging of a retinal cavernous hemangioma
Authors: Mazzini Cinzia , Vicini Giulio , Nicolosi Cristina , Pieretti Giulia , Bacherini Daniela , Giattini Dario , Giansanti Fabrizio 
Published: November 2020

Purpose: We describe the characteristics of an isolated retinal cavernous hemangioma in a young female patient using multimodal imaging. Case description: Fundus examination of the right eye showed a large vascular mass, composed by clusters of dark red and dilated saccular angiomatous formations with superficial whitish fibroglial tissue and hemorrhages, located in the inferonasal peripheral retina, along the vascular arcade. On green-light fundus autofluorescence the lesion appeared hypoautofluorescent, with moderately hyperautofluorescent areas. On multiColor imaging it showed mainly a green pseudocolor, with knobby surface and well-defined irregular margins. Fundus fluorescein angiography showed early hypofluorescence within the tumor mass and late incomplete staining, without leakage. Ocular ultrasonography documented an elevated well-defined hyperechogenic lesion, with high internal reflectivity, without choroidal excavation, retinal detachment, or acoustic shadowing. Swept source optical coherence tomography showed multilobulated cavernous formations, varying in size, containing for the greatest part hyperreflective material, within an interconnecting fibrous scaffold and with an overlying partially adherent epiretinal membrane. Optical coherence tomography angiography documented a few highly reflective, tortuous and abnormal branching veins extending into the tumor mass, with a root-like appearance, and surrounding nodular changes, corresponding to the angiomatous formations. Conclusions: Different imaging modalities can be used in combination for a better evaluation of the pathological features of this rare vascular tumor.
Real-world keystroke dynamics are a potentially valid biomarker for clinical disability in multiple sclerosis
Authors: Lam KH , Meijer KA , Loonstra FC , Coerver EME , Twose J , Redeman E , Moraal B , Barkhof F , de Groot V , Uitdehaag BMJ , Killestein J 
Published: November 2020

Background: Clinical measures in multiple sclerosis (MS) face limitations that may be overcome by utilising smartphone keyboard interactions acquired continuously and remotely during regular typing. Objective: The aim of this study was to determine the reliability and validity of keystroke dynamics to assess clinical aspects of MS. Methods: In total, 102 MS patients and 24 controls were included in this observational study. Keyboard interactions were obtained with the Neurokeys keyboard app. Eight timing-related keystroke features were assessed for reliability with intraclass correlation coefficients (ICCs); construct validity by analysing group differences (in fatigue, gadolinium-enhancing lesions on magnetic resonance imaging (MRI), and patients vs controls); and concurrent validity by correlating with disability measures. Results: Reliability was moderate in two (ICC = 0.601 and 0.742) and good to excellent in the remaining six features (ICC = 0.760–0.965). Patients had significantly higher keystroke latencies than controls. Latency between key presses correlated the highest with Expanded Disability Status Scale ( r = 0.407) and latency between key releases with Nine-Hole Peg Test and Symbol Digit Modalities Test (ρ = 0.503 and r = −0.553, respectively), ps < 0.001. Conclusion: Keystroke dynamics were reliable, distinguished patients and controls, and were associated with clinical disability measures. Consequently, keystroke dynamics are a promising valid surrogate marker for clinical disability in MS.
High anti-JCPyV serum titers coincide with high CSF cell counts in RRMS patients
Authors: Schneider-Hohendorf Tilman , Schulte-Mecklenbeck Andreas , Ostkamp Patrick , Janoschka Claudia , Pawlitzki Marc , Luessi Felix , Zipp Frauke , Meuth Sven G , Klotz Luisa , Wiendl Heinz , Gross Catharina C , Schwab Nicholas 
Published: November 2020

Background: Progressive multifocal leukoencephalopathy (PML) can in rare cases occur in natalizumab-treated patients with high serum anti-JCPyV antibodies, hypothetically due to excessive blockade of immune cell migration. Objective: Immune cell recruitment to the central nervous system (CNS) was assessed in relapsing-remitting multiple sclerosis (RRMS) patients stratified by low versus high anti-JCPyV antibody titers as indicator for PML risk. Methods: Cerebrospinal fluid (CSF) cell counts of 145 RRMS patients were quantified by flow cytometry. Generalized linear models were employed to assess influence of age, sex, disease duration, Expanded Disability Status Scale (EDSS), clinical/radiological activity, current steroid or natalizumab treatment, as well as anti-JCPyV serology on CSF cell subset counts. Results: While clinical/radiological activity was associated with increased CD4, natural killer (NK), B and plasma cell counts, natalizumab therapy reduced all subpopulations except monocytes. With and without natalizumab therapy, patients with high anti-JCPyV serum titers presented with increased CSF T-cell counts compared to patients with low anti-JCPyV serum titers. In contrast, PML patients assessed before ( n = 2) or at diagnosis ( n = 5) presented with comparably low CD8 and B-cell counts, which increased after plasma exchange ( n = 4). Conclusion: High anti-JCPyV indices, which could be indicative of increased viral activity, are associated with elevated immune cell recruitment to the CNS. Its excessive impairment in conjunction with viral activity could predispose for PML development.