bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long-term Results of Corneal Wedge Resection for High Postkeratoplasty Astigmatism
Authors: Mejía Luis F. , Gil Juan C. , Naranjo Santiago 
Published: October 2019

Purpose:
To present the results of corneal wedge resection in postkeratoplasty astigmatism, performed by the same surgeon using the same nomogram over a 25-year period.

Methods:
This is a retrospective observational study. The sample was obtained from the medical records of all patients who underwent penetrating or deep lamellar keratoplasty, performed by a single surgeon from 1993 to 2018. All surgeries were performed using a diamond knife, on the flat meridian, involving the keratoplasty scar and closed with five 10-0 nylon sutures.

Results:
A total of 39 eyes were included. The keratometry measured cylinder improved from 7.99 ± 0.25 to 2.5 ± 0.3 D at 12 months and remained stable thereafter (a mean follow-up of 76.3 months). Best spectacle corrected visual acuity increased from 0.35 ± 0.01 to 0.57 ± 0.02 at 12 months and remained stable thereafter. There was a coupling ratio of 0.08 ± 0.03 D at 12 months. There were no corneal graft rejections or loss of best spectacle corrected visual acuity on this series.

Conclusions:
Corneal wedge resection is a valuable resource for the management of high postkeratoplasty astigmatism. It is a safe and reproducible procedure, with stable results at 12 months and thereafter.
The effect of inspiratory muscle training on swimming performance, inspiratory muscle strength, lung function, and perceived breathlessness in elite swimmers: a randomized controlled trial
Authors: Cunha Marisa , Mendes Francisca , Paciência Inês , Rodolfo Ana , Carneiro-Leão Leonor , Rama Tiago , Rufo João , Delgado Luís , Moreira André 
Published: October 2019

Abstract

Background:
According to studies performed on terrestrial sports athletes, inspiratory muscle training (IMT) may improve athletes’ performance. However, evidence of its effects in elite swimmers is lacking. Therefore, we aimed to assess the effect of 12-week IMT on swimming performance, inspiratory muscle strength, lung function, and perceived breathlessness in elite swimmers.

Methods:
Elite swimmers from the main FC Porto swimming team (in competitive training for a minimum period of 3 years) were invited to participate and were randomly allocated into intervention or control groups. The intervention group performed 30 inspiratory efforts, twice a day, 5 times a week, against a pressure threshold load equivalent to 50% of maximal inspiratory pressure, whereas the control group performed inspiratory efforts at the same frequency but against a 15% load. Swimming performance was assessed through time trials, converted into points according to International Swimming Federation Points Table. Outcomes were evaluated before and following the 12-week study period.

Results:
A total of 32 participants (22 girls) were included. The median age was 15 and 14 years old for the intervention (n = 17) and control (n = 12) groups, respectively. No differences were found in swimming performance (P = .271), inspiratory muscle strength (P = .914), forced vital capacity (P = .262), forced expiratory volume in 1st second (P = .265), peak expiratory flow (P = .270), and perceived breathlessness (P = .568) between groups after 12 weeks of intervention.

Conclusion:
Twelve weeks of IMT had no effect on swimming performance, lung function, and perceived breathlessness in elite swimmers. These results may be related to swimming-specific factors and/or an applied load insufficient to achieve training overload that could induce further improvements.
Hepatitis B virus infection and the risk of liver disease progression in type 2 diabetic patients with potential nonalcoholic fatty liver disease: a retrospective, observational, cohort study in the United Kingdom Clinical Practice Research Datalink
Authors: Ferreira Germano , Stuurman Anke L. , Horsmans Yves , Cattaert Tom , Verstraeten Thomas , Feng Yang , Rosillon Dominique , Guignard Adrienne 
Published: October 2019

Objective
Assess the risk of progression to cirrhosis and hepatocellular carcinoma (HCC) due to hepatitis B virus (HBV)-infection in patients with nonalcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM).

Methods
Retrospective cohort study in the UK Clinical Practice Research Datalink with three cohorts: subjects with T2DM and HBV infection (T2DM+HBV cohort; N = 297), with T2DM without HBV-infection (T2DM cohort; N = 261 865), and with HBV-infection without T2DM (HBV cohort; N = 3630). Primary analyses were performed on the three cohorts and secondary analyses on subcohorts including patients with NAFLD diagnosis code (N = 6599). Case/outcome definitions were formulated with International Classification of Diseases/Read codes/laboratory results and classified using validated algorithms. Adjusted incidence rate ratios (IRR) were estimated with a Poisson regression model.

Results
When comparing the T2DM+HBV and T2DM cohorts, adjusted IRRs were 14.06 (95% confidence interval: 4.47–44.19) for cirrhosis and 2.83 (1.06–7.55) for HCC. When comparing the T2DM+HBV and HBV cohorts, adjusted IRRs were 0.68 (0.21–2.27) for cirrhosis and 1.39 (0.46–4.20) for HCC. No cirrhosis cases were identified in T2DM+NAFLD+HBV patients; IRs were 16.92/10 000 person-years (12.97–21.69) and 85.24/10 000 person-years (10.32–307.91) in the T2DM+NAFLD and NAFLD+HBV cohorts.

Conclusion
HBV-infection increased significantly the risk for cirrhosis among T2DM patients, however, not beyond the expected incremental risk among infected non-T2DM subjects. Our approach to evaluate the role of T2DM/NAFLD and HBV-infection in liver disease progression could be applied to other settings with higher HBV prevalence.
Increased odds of cholangiocarcinoma in Hispanics: results of a nationwide analysis
Authors: Ruiz Jorge Nicolas , Kröner Paul T. , Wijarnpreecha Karn , Corral Juan E. , Harnois Denise M. , Lukens Frank J. 
Published: October 2019

Objective
Cholangiocarcinoma (CCA) affects all ethnicities worldwide. The Hispanic population being the leading ethnic minority in the United States, its importance to the healthcare system cannot be understated. This study aims to assess the occurrence and outcomes of CCA in Hispanic patients in the United States.

Methods
This is a case-control study using the National Inpatient Sample 2014. All patients with ICD-9 CM codes for CCA were included. Hispanic patients were identified from the ethnic categories within the database. The primary outcomes were the occurrence and odds of CCA in the Hispanic population when compared with other ethnicities. Secondary outcomes were inpatient mortality, morbidity, ICU stay, multiorgan failure, and resource utilization.

Results
A total of 13 965 patients with CCA were identified, of which 2750 were propensity-matched to controls (1480 Hispanic). The inpatient occurrence of CCA in Hispanics relative to the national population was 2.73/100 000 persons, compared to 4.82/100 000 persons (39.9/100 000 relative to inpatient population) of all other ethnicities. After adjusting for confounders on multivariate analysis, Hispanic patients displayed adjusted propensity-matched odds of 1.28 (P < 0.01) of having CCA when compared with other ethnicities. Hispanics did not display different propensity-matched odds of inpatient mortality, morbidity, hospital length of stay, or resource utilization compared to non-Hispanic patients.

Conclusion
This study demonstrated that the odds of CCA in admitted patients are higher for the Hispanic population. This difference with the prevalence potentially suggests the presence of social factors such as disparities in cancer prevention or detection in this group.
Recurrence of spontaneous bacterial peritonitis in cirrhosis: novel predictors
Authors: Abdel-Razik Ahmed , Abdelsalam Mostafa , Gad Doaa F. , Abdelwahab Ahmed , Tawfik Mona , Elzehery Rasha , Elhelaly Rania , Hasan Ahmad S. , El-Wakeel Niveen , Eldars Waleed 
Published: October 2019

Background and aims
Recurrence of spontaneous bacterial peritonitis (SBP) is still a matter of debate. We conducted this study to evaluate the probable factors that predict the recurrence of SBP in patients who recovered from the first episode of SBP and the long-term outcomes of SBP recurrence.

Methods
One hundred twenty-four patients diagnosed with liver cirrhosis, SBP and did not receive secondary prophylaxis either with norfloxacin or other antibiotics were included in this prospective cohort pilot study. Clinical, biochemical and ascitic fluid analysis parameters were evaluated. Ascitic fluid interferon-γ-induced protein (IP-10), calprotectin, interleukin-6 and tumor necrosis factor-α were measured by ELISA.

Results
Of these, 76 patients survived with an in-hospital mortality rate of 38.7%. The survivors were classified into two groups according to recurrence and nonrecurrence of SBP and survival time, clinical parameters and cause of death were investigated. Thirty-one participants had one or more attacks of SBP, with a recurrence rate of 40.8% within one-year follow-up. Before discharge, multivariate analysis showed that ascitic IP-10 (≥1220 pg/ml), ascitic calprotectin (≥550 ng/ml), serum albumin (≤2.5 g/dl), nonuse of prophylactic β-blockers and use of proton-pump inhibitors (PPIs) were the independent variables in predicting recurrent SBP. Sepsis-related organ failure was the most common etiology of mortality in the recurrent SBP group within 3 and 6 months.

Conclusion
Increased ascitic calprotectin and IP-10, hypoalbuminemia, nonuse of prophylactic β-blockers and use of PPI were independently associated with increased SBP recurrence rate. Sepsis-related organ failure was the most common etiology of mortality.
Cluster Randomized Trial of a Patient-Centered Contraceptive Decision Support Tool, My Birth Control
Authors: Dehlendorf Christine , Fitzpatrick Judith , Fox Edith , Holt Kelsey , Vittinghoff Eric , Reed Reiley , Campora Maria Paula , Sokoloff Abby , Kuppermann Miriam 
Published: October 2019

(Abstracted from Am J Obstet Gynecol 2019;220:565.e1–565.e12)
More than 50% of sexually active women of reproductive age in the United States have reported receiving birth control–related care in the past 12 months. Contraceptive counseling is a common experience for these women.
Placental Growth Factor Testing to Assess Women With Suspected Preeclampsia: A Multicenter, Pragmatic, Stepped-Wedge Cluster-Randomized Controlled Trial
Authors: Duhig Kate E. , Myers Jenny , Seed Paul T. , Sparkes Jenie , Lowe Jessica , Hunter Rachael M. , Shennan Andrew H. , Chappell Lucy C. 
Published: October 2019

(Abstracted from Lancet 2019;393(10183):1807–1818)
Hypertension affects 10% of pregnant women, and approximately 3% of singleton pregnancies are complicated by preeclampsia. Preeclampsia often presents ambiguously, and the risks for women with suspected preeclampsia are complex.
Repeat Episodes of Symptomatic Urethritis Due to a Uropathogenic Meningococcal Clade
Authors: Bazan Jose A. , Tzeng Yih-Ling , Stephens David S. , Carter Alexandria M. , Brown Morgan A. , Snyder Brandon , Prince Devlin J. , Turner Abigail Norris 
Published: October 2019

Abstract
In 2015, we identified a non-groupable clade of Neisseria meningitidis that causes urethritis in men (the US_NmUC). Because repeat infection is common with Neisseria gonorrhoeae, we examined whether reinfection also occurs with the US_NmUC. We provide evidence that men are susceptible to repeat episodes of urethritis from the US_NmUC.
Attenuation of capsaicin-induced ongoing pain and secondary hyperalgesia during exposure to an immersive virtual reality environment
Authors: Hughes Sam W. , Zhao Hongyan , Auvinet Edouard J. , Strutton Paul H. 
Published: October 2019

Abstract

Introduction:
There is growing evidence that virtual reality (VR) can be used in the treatment of chronic pain conditions. However, further research is required to better understand the analgesic mechanisms during sensitised pain states.

Objectives:
We examined the effects of an immersive polar VR environment on capsaicin-induced ongoing pain and secondary hyperalgesia. We also investigated whether the degree of analgesia was related to baseline conditioned pain modulation (CPM) responses.

Methods:
Nineteen subjects had baseline CPM and electrical pain perception (EPP) thresholds measured before the topical application of capsaicin cream. Visual analogue scale ratings were measured to track the development of an ongoing pain state, and EPP thresholds were used to measure secondary hyperalgesia. The effects of a passive polar VR environment on ongoing pain and secondary hyperalgesia were compared with sham VR (ie, 2D monitor screen) in responders to capsaicin (n = 15).

Results:
Virtual reality was associated with a transient reduction in ongoing pain and an increase in EPP thresholds in an area of secondary hyperalgesia. Baseline CPM measurements showed a significant correlation with VR-induced changes in secondary hyperalgesia, but not with VR-induced changes in ongoing pain perception. There was no correlation between VR-induced changes in pain perception and VR-induced changes in secondary hyperalgesia.

Conclusion:
Virtual reality can reduce the perception of capsaicin-induced ongoing pain and secondary hyperalgesia. We also show that CPM may provide a means by which to identify individuals likely to respond to VR therapy.
18F-Fluorocholine PET/CT Imaging of Brown Tumors in a Patient With Severe Primary Hyperparathyroidism
Authors: Zhang-Yin Jules , Gaujoux Sébastien , Delbot Thierry , Gauthé Mathieu , Talbot Jean-Noël 
Published: October 2019

Abstract
Brown tumors are rare skeletal anomalies occurring in patients with hyperparathyroidism and exposing patients to pathological fractures. We report the case of a 26-year-old woman with severe primary hyperparathyroidism (calcemia, 2.9 mmol/L; parathyroid hormone, 59 pmol/L) who underwent 18F-fluorocholine (FCH) PET/CT before parathyroidectomy. FCH PET localized the hyperfunctioning parathyroid gland and showed multiple foci in correspondence with bone lytic lesions on CT. Those lesions were not visible on the 99mTc-MIBI dual-phase scintigraphy. The pathology of one of the FCH-positive bone lesions corresponded to a brown tumor related to hyperparathyroidism.
Endoscopic Transethmosphenoid Optic Canal and Orbital Apex Decompression for Patients With Traumatic Orbital Apex Syndrome
Authors: Zhou GuangMing , Yu Bo , Tu YunHai , Shi JieLiang , Wu WenCan 
Published: October 2019

Purpose:
The aim of this study was to evaluate the efficacy, feasibility, and safety of the endoscopic optic canal and orbital apex decompression for patients with traumatic orbital apex syndrome.

Design:
Retrospective, noncomparative case series.

Method:
Thirty-one patients (31 eyes) with traumatic orbital apex syndrome underwent endoscopic transethmosphenoid optic canal and orbital apex decompression at the Eye Hospital of Wenzhou Medical University from May 1st, 2012 to May 1st, 2018. In each case, the indication of surgery was that patient with traumatic orbital apex syndrome failed to respond to corticosteroids. Patients were followed up to 6 months after surgery. Best corrected visual acuity, visual field, ptosis, ophthalmoplegia, hypoesthesia, and pupil before and after surgery were compared.

Result:
All patients presented visual decline (including 5 patients with no light perception), ptosis, ophthalmoplegia, diplopia, pupil dysfunction, and visual field defect, and 20 of them also presented hypoesthesia. Nineteen of 31 (61.3%) patients gained improvement of best-corrected visual acuity after surgery, 7 of them gained 20/20 BCVA, and visual field showed improvement in 20 patients. Ptosis and ophthalmoplegia of all patients recovered in various degree; diplopia also relieved relatively. The function of the pupil was also improved in most patients (27/31, 87.1%). The improvement of hypoesthesia was also observed in most patients. No serious complications occurred.

Conclusion:
Endoscopic transethmosphenoid optic canal and orbital apex decompression seems to be a feasible, efficient, and safe approach for traumatic orbital apex syndrome patients.
Hydrogen Gas Inhalation Attenuates Endothelial Glycocalyx Damage and Stabilizes Hemodynamics in a Rat Hemorrhagic Shock Model
Authors: Tamura Tomoyoshi , Sano Motoaki , Matsuoka Tadashi , Yoshizawa Joe , Yamamoto Ryo , Katsumata Yoshinori , Endo Jin , Homma Koichiro , Kajimura Mayumi , Suzuki Masaru , Kobayashi Eiji , Sasaki Junichi 
Published: October 2019

ABSTRACT

Background:
Hydrogen gas (H2) inhalation during hemorrhage stabilizes post-resuscitation hemodynamics, improving short-term survival in a rat hemorrhagic shock and resuscitation (HS/R) model. However, the underlying molecular mechanism of H2 in HS/R is unclear. Endothelial glycocalyx (EG) damage causes hemodynamic failure associated with HS/R. In this study, we tested the hypothesis that H2 alleviates oxidative stress by suppressing xanthine oxidoreductase (XOR) and/or preventing tumor necrosis factor-alfa (TNF-α)-mediated syndecan-1 shedding during EG damage.

Methods:
HS/R was induced in rats by reducing mean arterial pressure (MAP) to 35 mm Hg for 60 min followed by resuscitation. Rats inhaled oxygen or H2 + oxygen after achieving shock either in the presence or absence of an XOR inhibitor (XOR-I) for both the groups. In a second test, rats received oxygen alone or antitumor necrosis factor (TNF)-α monoclonal antibody with oxygen or H2. Two hours after resuscitation, XOR activity, purine metabolites, cytokines, syndecan-1 were measured and survival rates were assessed 6 h after resuscitation.

Results:
H2 and XOR-I both suppressed MAP reduction and improved survival rates. H2 did not affect XOR activity and the therapeutic effects of XOR-I and H2 were additive. H2 suppressed plasma TNF-α and syndecan-1 expression; however, no additional H2 therapeutic effect was observed in the presence of anti-TNF-α monoclonal antibody.

Conclusions:
H2 inhalation after shock stabilized hemodynamics and improved survival rates in an HS/R model independent of XOR. The therapeutic action of H2 was partially mediated by inhibition of TNF-α-dependent syndecan-1 shedding.
Venous Thromboembolism Prediction in Postoperative Urogynecology Patients: The Utility of Risk Assessment Tools
Authors: Heft Jessica , Goulder Alison , Schneiter Mali , Adam Rony 
Published: October 2019

Objectives
The aim of the study was to evaluate the utility of risk assessment tools (Rogers and Caprini Score models) in predicting venous thromboembolism (VTE) in a urogynecology patient population.

Methods
All surgical patients underwent a procedure in the operating room with 1 of 7 female pelvic medicine and reconstructive surgery.
Attendings from January 1 to December 31, 2015, were investigated. Rogers and Caprini Scores were calculated for each patient as well as the occurrence of any VTE in the 30 days after surgery. Patients were then grouped into risk categories based on the American College of Chest Physicians guidelines.

Results
A total of 783 patients were identified and included in this study. The average patient age was 58 years (range = 18–89 years). The average operative time was 109 minutes (range = 4–491 minutes). Most patients obtained a Rogers Score of 5 (32%) and a Caprini Score of 4 (34%). Based on Caprini scoring, the American College of Chest Physicians category distribution was as follows: 10% low risk, 61% moderate risk, and 29% high risk. Based on Rogers scoring, this distribution was as follows: 96.8% very low risk, 3.1% low risk, and 0.1% moderate risk. Two VTE events were identified in the cohort. Overall, the incidence of VTE was 0.26%.

Conclusions
The standard VTE risk assessment tools grade urogynecology patients very differently. Although the Caprini Scale seems to appropriately differentiate individual patient VTE risk, the Rogers Scale does not adequately stratify this risk, thus potentially limiting its use within this population.
Changes in Central Motor Conduction Time and Its Implication on Dysfunction of Distal Upper Limb in Distal-Type Cervical Spondylotic Amyotrophy
Authors: Zheng Chaojun , Nie Cong , Zhu Yu , Yu Qing , Zhu Dongqing , Lu Feizhou , Weber Robert , Jiang Jianyuan 
Published: October 2019

Purpose:
Distal-type cervical spondylotic amyotrophy (CSA) is an uncommon syndrome associated with cervical spondylosis. The pathogenic mechanism of distal-type CSA is still unclear. The aim of the current study was to analyze central motor conduction time (CMCT) in the cases with distal-type CSA and to investigate the role of cervical cord compressive injury in the distal-type CSA.

Methods:
Both 28 cases with distal-type CSA and 21 healthy subjects accepted CMCT measures, motor unit number estimation, handgrip strength examination, and magnetic resonance imaging evaluation.

Results:
In this study, nine (9/28, 32.1%) cases with CSA presented with prolonged CMCT, and both reduced number of motor units and decreased handgrip strength were found in these 9 cases (P < 0.05). Magnetic resonance imaging evaluation showed that 7 of these 9 patients presented with proximal cervical cord compression with or even without distal selective compression consistent with segmental atrophy. A negative relationship between CMCT and both number of motor units and handgrip strength was found on the symptomatic side (P < 0.05), and there was a positive correlation between CMCT and amplitude of single motor unit potentials on the less symptomatic side (P < 0.05).

Conclusions:
Corticospinal tract damage caused by proximal spinal cord compression may induce distal motor unit loss to worsen in some cases with distal-type CSA, which may contribute to the dysfunction of the distal upper limb in some cases with distal-type CSA. Therefore, treatment and rehabilitation efforts should account for both distal selective compression and proximal cord compression in distal-type CSA.
Mirror Readmission Study of the Association of Electroconvulsive Therapy With 1-Year Mood Disorder Readmissions in a Tertiary Mood Disorder Unit
Authors: Tor Phern-Chern , Bin Abdin Edimansyah 
Published: October 2019

Objectives
Electroconvulsive therapy (ECT) is one of the most effective treatments for severe mood disorders and may reduce psychiatric readmissions. However, the effect on ECT on mood disorder readmissions in Asia is unclear. We embarked to assess the relationship between inpatient ECT and 1-year psychiatric readmissions for patients with mood disorders.

Methods
A retrospective database analysis of patients admitted to a tertiary Mood Disorders Unit in a developed Asian city was analyzed to investigate the association of inpatient ECT with psychiatric readmission using a 1-year mirror-image method with major depressive disorder and bipolar mania patients acting as their own controls. Covariates of age, sex, number of outpatient visits, and outpatient ECT were analyzed to account for confounders. t Tests were done to compare number and duration of psychiatric admissions and significance set at P < 0.05.

Results
Patients with major depressive disorder and bipolar mania (N = 121) receiving inpatient ECT had a 35% mean reduction from the baseline mean of number of admissions in the 1-year after ECT. Maintenance ECT (between 30 days and 1 year after discharge) was associated with the protective effect (β = −0.116, t = −2.044, P = 0.043). In major depressive disorder, there was a trend association between the number of 1-year postdischarge outpatient visits and decreased 1-year readmissions with an opposite association seen in bipolar mania.

Conclusions
Electroconvulsive therapy may be associated with decreased 1-year readmissions for mood disorders in Asia, and this effect may be mediated by maintenance ECT.