bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Challenge of Managing Bilateral Acute Angle-closure Glaucoma in the Presence of Active SARS-CoV-2 Infection
Authors: Krawitz Brian D. , Sirinek Portia , Doobin David , Nanda Tavish , Ghiassi Maryam , Horowitz Jason D. , Liebmann Jeffrey M. , De Moraes Carlos G. 
Published: December 2020

Purpose:
To report a case of bilateral acute angle-closure glaucoma associated with hyponatremia in the setting of chlorthalidone use and SARS-CoV-2 infection, and to demonstrate the challenges of managing this patient given her infectious status.

Methods:
This was a case report.

Case:
A 65-year-old woman taking chlorthalidone for hypertension presented to the emergency room with headache, pain, and blurry vision in both eyes and was found to be in bilateral acute angle closure. On laboratory investigation, she was severely hyponatremic and also tested positive for SARS-CoV-2. B-scan ultrasound demonstrated an apparent supraciliary effusion in the right eye. Following stabilization of her intraocular pressures with medical management, she ultimately underwent cataract extraction with iridectomies and goniosynechiolysis in both eyes.

Conclusions:
We report a rare case of bilateral acute angle-closure glaucoma associated with hyponatremia. Chlorthalidone use and perhaps SARS-CoV-2 infection may have contributed to this electrolyte abnormality and unique clinical presentation. In addition, we discuss the challenges of managing this complex patient with active SARS-CoV-2 infection during the pandemic.
Ciguatera poisoning: the role of high-voltage-activated and store-operated calcium channels in ciguatoxin-induced sensory effects
Authors: L’Herondelle Killian , Misery Laurent , Le Gall-Ianotto Christelle , Philippe Reginald , Talagas Matthieu , Mignen Olivier , Lewis Richard J. , Le Garrec Raphaele 
Published: December 2020

Introduction:
Ciguatera fish poisoning (CFP), the most common seafood poisoning worldwide, is caused by the consumption of seafood contaminated with ciguatoxins (CTXs). Pruritus is one of the most distressing symptoms, associated with other cutaneous sensory disorders, including paresthesia and cold dysesthesia. No specific treatment exists. CTXs are known to primarily activate voltage-gated sodium channels, but the downstream molecular events that lead to sensory disturbances remain poorly defined. Peptidergic sensory neurons were recently identified as major players in CFP sensory disturbances.

Methods:
In this study, we examined the role of molecular actors in 2 effects induced by Pacific CTX-2 (P-CTX-2): the increase in cytosolic calcium levels in rat primary sensory neurons; and the release of the neuropeptide substance P (SP) in sensory neurons co-cultured with keratinocytes.

Results:
Our results (i) rule out the involvement of the Na+/Ca2+ exchanger (NCX) and the transient receptor potential channels transient receptor potential ankyrin 1 and and transient receptor potential vanilloid 1; (ii) show that N-type voltage-gated calcium (Cav) channels contribute to the initiation of the calcium signal elicited by P-CTX-2 in rat sensory neurons, while N-type and L-type Cav channels play equal parts in the SP release in the co-culture; and (iii) identify store-operated calcium entry supported by Orai calcium release-activated calcium modulator 1 (ORAI1) as a critical effector of the late phase of the calcium signal and the subsequent SP release elicited by P-CTX-2.

Discussion:
Our in vitro findings indicate that Cav and ORAI1 channels may be promising pharmacological targets for specifically relieving the sensory effects of CTXs.
Comparison of an upgraded optical biometer with 2 validated optical biometers
Authors: Kanclerz Piotr , Hoffer Kenneth J. , Przewłócka Katarzyna , Savini Giacomo 
Published: December 2020

Purpose:
The Revo NX is a new optical biometer, based on spectral-domain optical coherence tomography and able to obtain high-definition scans of both the anterior and posterior segment of the eye. A previous study found that its measurements of axial length (AL) were not interchangeable with those provided by a validated optical biometer; so, the manufacturer updated the instrument to improve agreement of AL values. This study aimed to prospectively compare the measurements by the updated Revo NX (version 9.5.0, biometry module) with those by 2 validated devices, the IOLMaster 700 and Lenstar LS-900.

Setting:
Optopol Technologies, Zawiercie, Poland.

Design:
Prospective evaluation of diagnostic test.

Methods:
Comparison between the devices was performed using repeated measures analysis of variance (ANOVA) with Bonferroni posttest, correlation coefficients, and the Bland-Altman method.

Results:
The investigation evaluated the results of 63 patients. For AL, anterior chamber depth (ACD), and lens thickness (LT), the differences were not clinically significant because they were less than 0.01 mm. Repeated measures ANOVA, however, detected a statistically significant difference for AL (P < .0001) and central corneal thickness (P < .0001) but not for ACD (P = .0630) or LT (P = .2667). The results obtained with all 3 biometers manifested a high level of agreement in the Bland-Altman analysis and very strong correlation.

Conclusions:
The measurements by the updated Revo NX had high agreement with the other optical biometers; a clear improvement was detected than the previous analysis between the original Revo NX (version 8.0.3) and the Lenstar LS-900.
Comparisons of intraocular lens power calculation methods for eyes with previous myopic laser refractive surgery: Bayesian network meta-analysis
Authors: Wei Ling , Meng Jiaqi , Qi Jiao , Lu Yi , Zhu Xiangjia 
Published: December 2020

Purpose:
To compare the accuracy of the methods for calculation of intraocular lens (IOL) power in eyes with previous myopic laser refractive surgery.

Setting:
EENT Hospital of Fudan University, Shanghai, China.

Design:
Network meta-analysis.

Methods:
A literature search of MEDLINE and Cochrane Library from January 2000 to July 2019 was conducted for studies that evaluated methods of calculating IOL power in eyes with previous myopic laser refractive surgery. Outcomes measurements were the percentages of prediction error within ±0.50 diopters (D) and ±1.00 D of the target refraction (% ±0.50 D and % ±1.00 D). Traditional and network meta-analysis were conducted.

Results:
Nineteen prospective or retrospective clinical studies, including 1217 eyes and 13 calculation methods, were identified. A traditional meta-analysis showed that compared with the widely used Haigis-L method, the Barrett True-K formula, optical coherence tomography (OCT), and Masket methods showed significantly higher % ±0.50 D, whereas no difference was found in the % ±1.00 D. A network meta-analysis revealed that compared with the Haigis-L method, the OCT, Barrett True-K formula, and optiwave refractive analysis (ORA) methods performed better on the % ±0.50 D, whereas the Barrett True-K formula and ORA methods performed better on the % ±1.00 D. Based on the performances of both outcomes, the Barrett True-K formula, OCT, and ORA methods showed highest probability to rank the top 3 among the 13 methods.

Conclusions:
The Barrett True-K formula, OCT, and ORA methods seemed to offer greater accuracy than others in calculating the IOL power for postrefractive surgery eyes.
A Systematic Review on the Efficacy of Intravenous Racemic Ketamine for Bipolar Depression
Authors: Joseph Boney , Parsaik Ajay K. , Ahmed Ahmed T. , Erwin Patricia J. , Singh Balwinder 
Published: December 2020

Abstract

Background
Ketamine, a glutamate N-methyl-d-aspartate receptor antagonist, has shown rapid antidepressant effects in treatment-resistant depression. We conducted a systematic review of studies evaluating the efficacy of intravenous ketamine augmentation in treatment-resistant depression patients with bipolar disorder.

Methods
Major databases were searched for open-label and randomized controlled trials (RCT). Two independent reviewers screened and selected the studies that met the inclusion criteria. Studies were selected following the standard Cochrane methodology, and the findings are reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Methodological quality of the included studies was assessed using standardized measures.

Results
A total of 1442 articles were screened. Five studies were included in the systematic review (3 RCTs and 2 open-label studies) enrolling 110 subjects (mean age, 45.54 ± 12.65 years; 68.18% female). All the RCTs and open-label studies showed improvement in depressions symptoms after receiving a single infusion of ketamine. Included studies also suggested improvement in suicidal ideation and anhedonia after ketamine infusion. Dissociation and transient increase in blood pressure were the most common reported adverse effects with ketamine. Ketamine infusions did not increase mania symptoms.

Conclusions
Limited data show efficacy and feasibility of intravenous racemic ketamine in treatment-resistant bipolar depression. Further studies with larger sample size are required to strengthen the evidence.
Finding Early Improvement Threshold to Predict Response After 8 Weeks of Treatment Using Risperidone in First-Episode Psychosis
Authors: Subeesh Viswam , Maheswari Eswaran , Singh Hemendra , Neha Reddy , Mazhar Faizan 
Published: December 2020

Abstract

Purpose/Background
The study aims to assess whether the early response can predict the outcome at the endpoint for the treatment of first-episode psychosis with risperidone and identify the relationship between initial symptom reduction and late response.

Methods/Procedures
A prospective observational study with 4 points follow-up (weeks 2, 3, 4, and 8) was conducted in 48 adult first-episode psychosis patients. Symptoms were quantified by the Positive and Negative Syndrome Scale (PANSS) score. The initial recommended dose was 2 mg of risperidone once daily before sleep. The PANSS score on day 1 (before initiation of drug therapy) was considered as the baseline score. Treatment responses were considered as a reduction of more than 20%, 25%, 30% and 50% from the baseline score on first, second, third, and final follow-up, respectively. Receiver operating characteristic curves were generated for predicting response at the endpoint.

Findings/Results
Thirty-one (65%) patients achieved more than 50% reduction (responders) in PANSS score. The mean total PANSS score of the study population after 8 weeks of therapy was found to be 49.77 (95% confidence interval, 46.10–53.43). The mean percentage reduction in PANSS score after 8 weeks of therapy was found to be 52.92% (95% confidence interval, 48.83–57.01). Week 2 response can be taken as the early response (area under the curve = 81.9, P < 0.001). However, the more accurate prediction was possible with week 4 response (area under the curve = 88.7%, P < 0.001).

Implications/Conclusions
Our study suggests that patients with an early response at week 2 are likely to achieve positive response after 8 weeks.
Cost of the Illness of Treatment-Resistant Schizophrenia
Authors: Verma Meha , Grover Sandeep , Chakrabarti Subho 
Published: December 2020

Abstract

Purpose/Background
This study aimed to evaluate and compare the cost of illness in patients with treatment-resistant schizophrenia (TRS) during 3 months before starting clozapine and for the initial 3 months of treatment with clozapine.

Methods/Procedures
Fifty-two patients with TRS were evaluated for the cost of illness (direct, indirect, and provider cost) by using a structured questionnaire for the period of 3 months before starting clozapine and then at the end of the 3 months of clozapine therapy.

Findings/Results
Total treatment cost for the period of 3 months before starting clozapine was Indian rupees (INR) 40,372 (560.72 US dollars), and the total treatment cost for the first 3 months of clozapine therapy was INR 40,553 (563.23 US dollars). At both the assessments, indirect cost formed the main bulk of the total cost, with no significant difference in the indirect cost. The total direct treatment cost reduced from INR 13,931.6 (193.49 US dollars) to INR 8756 (121.61 US dollars), and the difference between the 2 assessments was statistically significant, with an advantage for clozapine. Overall, after starting clozapine, the total direct cost reduced from 34.5% to 21.6%, and the total indirect cost reduced from 54.3% to 40.2%. After starting clozapine, total provider cost increased from 11.2% to 38.2% of the totalcost.

Implications/Conclusions
Treatment with clozapine is not associated with a significant increase in the overall treatment cost, in the short term. However, there is a significant reduction in direct treatment costs.
Clinical Utility of Intraoperative Electrocochleography (ECochG) During Cochlear Implantation: A Systematic Review and Quantitative Analysis
Authors: Yin Linda X. , Barnes Jason H. , Saoji Aniket A. , Carlson Matthew L. 
Published: December 2020

Objective:
To evaluate the utility of intraoperative electrocochleography (ECochG) as a predictive tool for preservation of residual acoustic hearing after cochlear implantation.

Data Sources:
A systematic review employing a multi-database search strategy (Ovid MEDLINE, Embase, EBM Cochrane, and Scopus) was conducted from inception to August 1, 2019. English language studies in humans were included.

Study Selection:
All articles were independently reviewed by two authors according to Preferred Reporting Items of Systematic Reviews and Meta-analysis (PRISMA) guidelines. Studies without intraoperative ECochG obtained during cochlear implantation were excluded.

Data Extraction:
Extracted variables included number of patients, ECochG recording technique, success rate of obtaining ECochG potentials, intraoperative changes in ECochG signal, and postoperative hearing preservation outcomes.

Data Synthesis:
Among 537 eligible articles, 22 met inclusion criteria encompassing 498 unique patients. Ten studies featured extracochlear measurements, eight featured intracochlear measurements, and four featured both. Extracochlear ECochG had an average (SD) recording success rate of 94.9% (12.7%) while intracochlear ECochG had an average (SD) recording success rate of 91.8% (9.8%). One hundred forty five unique patients from six studies had complete intraoperative ECochG data with postoperative behavioral audiometry. After accounting for study-specific definitions of ECochG signal disturbance, worsening changes in intraoperative ECochG signal predicted postoperative hearing loss with limited sensitivity and specificity and notable heterogeneity across studies.

Conclusions:
Intraoperative ECochG recordings can be obtained in over 90% of patients, but accuracy in predicting postoperative hearing loss remains limited. Standardization of intraoperative ECochG monitoring technique and data interpretation are necessary to more robustly investigate outcomes and refine technique.
The Knowledge About Celiac Disease Among Healthcare Professionals and Patients in Central Europe
Authors: Riznik Petra , De Leo Luigina , Dolinsek Jasmina , Gyimesi Judit , Klemenak Martina , Koletzko Berthold , Koletzko Sibylle , Koltai Tunde , Korponay‐Szabó Ilma Rita , Krencnik Tomaz , Milinovic Marina , Not Tarcisio , Palcevski Goran , Sblattero Daniele , Werkstetter Katharina Julia , Dolinsek Jernej 
Published: December 2020

ABSTRACTObjectives:Celiac disease (CD) remains undiagnosed for a long time in many adult and pediatric patients. We assessed the knowledge about CD among healthcare professionals (HCPs) and CD patients in Central Europe (CE).Methods:HCPs and CD patients from 5 CE countries were asked to complete the web‐based questionnaire about CD. The questions were divided into subsections on epidemiology, clinical presentation, diagnostics, treatment, and follow‐up. Achieved scores of different specialists managing patients with CD were compared and regional differences in patients’ knowledge were analyzed.Results:Questionnaire was completed by 1381 HCPs and 2262 CD patients or their caregivers from Croatia, Hungary, Germany, Italy, and Slovenia. Mean score achieved by HCPs was 50.9%, and by CD patients 56.4%. Pediatric gastroenterologists scored the highest (69.4%; P < 0.001). There were significant differences in knowledge of patients from different CE regions with German participants scoring the highest (58.3%). Members of CD societies scored higher compared with nonmembers (mean score 58% vs 53.2%; P < 0.001) and patients diagnosed less than 5 years ago scored higher compared with those diagnosed more than 10 years ago (mean score 57.3% vs 54.6%; P < 0.001).Conclusions:The knowledge about CD among HCPs and CD patients is not satisfactory. Further awareness‐raising and learning activities are needed to improve HCPs‘ knowledge and to minimize the number of unrecognized patients and unnecessary diagnostic delays. Patients should be better informed about their disease to reach higher compliance with the gluten‐free diet.
Early Motor Repertoire in Infants With Biliary Atresia
Authors: Rodijk Lyan H. , Bos Arend F. , Verkade Henkjan J. , de Kleine Ruben H. , Hulscher Jan B.F. , Bruggink Janneke L.M. 
Published: December 2020

ABSTRACTObjectives:The aim of the study was to assess the neurological status in infants with biliary atresia (BA) at time of diagnosis, using Prechtl's validated General Movement Assessment.Methods:Infants diagnosed with BA were prospectively included in a nationwide cohort study. From birth to approximately 46 weeks of postmenstrual age (PMA), general movements (GMs) are defined as “writhing movements.” At 46 to 49 weeks PMA, “‘fidgety movements” emerge. The infant's early motor repertoire was recorded on video before Kasai portoenterostomy. We scored GM optimality scores (min–max 5–42) or motor optimality scores (MOS, min–max 5–28) as appropriate. We defined GM optimality scores <36 and MOS <26 as atypical, and compared the results with 2 reference groups of healthy peers.Results:We assessed GMs in 35 infants with BA (11/35 boys, gestational age 40 weeks [36–42], birth weight 3370 g [2015–4285]). At time of diagnosis (PMA 47 weeks [42–60]), 16 infants (46%) showed atypical GMs. The proportion of infants with atypical GMs was significantly higher in BA (46%) than in 2 reference groups of healthy infants (vs 10%, P < 0.001; vs 18%, P < 0.001). Total and direct bilirubin levels were 165 μmol/L (87–364) and 134 μmol/L (72–334), respectively, height z score was 0.05 (–2.90, 1.75), weight z score −0.52 ([−2.50, −0.20) and mean upper arm circumference z score −1.80 (−2.50, −0.20). We found no statistically significant relation between atypical GMs and clinical variables.Conclusions:Almost half of the infants with BA showed atypical GMs at time of diagnosis, suggesting neurological impairment. Close monitoring of these infants is warranted to determine their individual neurodevelopmental trajectories.
Evaluation of Nonalcoholic Fatty Liver Disease in Pediatric Patients With Inflammatory Bowel Disease
Authors: Cohen Mallory E. , Deepak Parakkal , Khanna Geetika , Samson Charles M. 
Published: December 2020

ABSTRACTAdult studies demonstrate the co‐existence of nonalcoholic fatty liver disease (NAFLD) and inflammatory bowel disease (IBD) without traditional risk factors. Data in children with IBD are lacking. Here, we sought to establish the prevalence of NAFLD in a single‐center pediatric IBD cohort, and identify potential risk factors. After institutional review board approval, we enrolled children with IBD who underwent routine abdominal magnetic resonance enterography. Proton density fat fraction (PDFF) was then estimated on magnetic resonance enterography. A total of 83 patients with IBD were identified and PDFF maps completed. Five (6%) were found to have PDFF >5%, meeting criteria for NAFLD. Compared to the patients with IBD without NAFLD, none of the evaluated risk factors including age, sex, diagnosis, time since diagnosis, medication, median alanine aminotransferase, and weight status were statistically significant. Our findings demonstrate the occult nature of NAFLD in pediatric IBD. The prevalence is not at variance with what is expected in general teenage populations.
Mycoplasma genitalium Infection in Young Women Without Urogenital Symptoms Presenting to a Community-Based Emergency Department in Birmingham, Alabama
Authors: Gragg Stephen D. , Gupta Kanupriya A. , Olson Kristin M. , Van Der Pol Barbara , Xiao Li , Waites Ken B. , Geisler William M. 
Published: December 2020

Abstract
We used the Food and Drug Administration–cleared Aptima Mycoplasma genitalium assay to evaluate for M. genitalium infection among young women without urogenital symptoms presenting to a community-based emergency department in Birmingham, Alabama, between August 2016 to August 2019 for evaluation of nongynecological concerns. M. genitalium was detected in 23 (14.8%) of 155 women.
Vaginal Bacteria and Risk of Incident and Persistent Infection With High-Risk Subtypes of Human Papillomavirus: A Cohort Study Among Kenyan Women
Authors: Carter Kayla A. , Srinivasan Sujatha , Fiedler Tina L. , Anzala Omu , Kimani Joshua , Mochache Vernon , Wallis Jacqueline M. , Fredricks David N. , McClelland R. Scott , Balkus Jennifer E. 
Published: December 2020

Background
Bacterial vaginosis (BV) is associated with an increased risk of high-risk human papillomavirus (hrHPV), whereas Lactobacillus-dominated vaginal microbiotas are associated with reduced burden of hrHPV. Few epidemiologic studies have prospectively investigated the relationships between vaginal bacteria and hrHPV, particularly among women from countries in Africa.

Methods
We conducted a prospective cohort study nested within the Preventing Vaginal Infections trial to evaluate associations between vaginal bacteria and hrHPV incidence and persistence. Sexually active, HIV-seronegative women aged 18 to 45 years who had a vaginal infection at screening were eligible to enroll. Analyses were restricted to participants enrolled in Kenya and randomized to placebo. At enrollment and months 2, 4, 6, 8, 10, and 12, hrHPV testing, quantitative polymerase chain reaction (measuring taxon quantity per swab), and 16S rRNA gene amplicon sequencing of the vaginal microbiota were performed. Generalized estimating equations multinomial logistic regression models were fit to evaluate associations between vaginal bacteria and incident and persistent hrHPV.

Results
Eighty-four participants were included in this analysis. Higher concentrations of Lactobacillus crispatus were inversely associated with persistent hrHPV detection. Specifically, 1 tertile higher L. crispatus concentration was associated with 50% reduced odds of persistent hrHPV detection (odds ratio, 0.50; 95% confidence interval, 0.29–0.85).

Conclusions
This study is consistent with reports that vaginal L. crispatus is associated with reduced susceptibility to hrHPV persistence. Evidence from in vitro studies provides insight into potential mechanisms by which L. crispatus may mediate hrHPV risk. Future studies should further explore in vivo mechanisms that may drive this relationship and opportunities for intervention.