bluuebunny/crossref_metadata_2025_split huggingface dataset:
Novel Targets to Treat Depression: Opioid-Based Therapeutics
Authors: Browne Caroline A. , Jacobson Moriah L. , Lucki Irwin 
Published: January 2020

Learning objectivesAfter participating in this activity, learners should be better able to:• Identify the effects of dysregulated opioid signalling in depression• Evaluate the use of opioid compounds and ketamine in patients with depressionAbstractMajor depressive disorder (MDD) remains one of the leading causes of disability and functional impairment worldwide. Current antidepressant therapeutics require weeks to months of treatment prior to the onset of clinical efficacy on depressed mood but remain ineffective in treating suicidal ideation and cognitive impairment. Moreover, 30%–40% of individuals fail to respond to currently available antidepressant medications. MDD is a heterogeneous disorder with an unknown etiology; novel strategies must be developed to treat MDD more effectively. Emerging evidence suggests that targeting one or more of the four opioid receptors—mu (MOR), kappa (KOR), delta (DOR), and the nociceptin/orphanin FQ receptor (NOP)—may yield effective therapeutics for stress-related psychiatric disorders. Furthermore, the effects of the rapidly acting antidepressant ketamine may involve opioid receptors. This review highlights dysregulated opioid signaling in depression, evaluates clinical trials with opioid compounds, and considers the role of opioid mechanisms in rapidly acting antidepressants.
ATTENUATION OUTER RETINAL BANDS ON OPTICAL COHERENCE TOMOGRAPHY FOLLOWING MACULAR EDEMA
Authors: Paques Michel , Rossant Florence , Finocchio Lucia , Grieve Kate , Sahel José-Alain , Pedinielli Alexandre , Mrejen Sarah 
Published: January 2020

Purpose:
Macular edema is a common retinal disease which may leave important anatomical and functional sequelaes. Directional fundus imaging consists of comparing on- and off-axis images to reveal angle-dependent reflectance properties of fundus structures, which may be related to misaligned photoreceptors. Here, we analyzed directional optical coherence tomography (OCT) and flood-illumination adaptive optics ophthalmoscopy images to detect evidence of misaligned photoreceptors following macular edema.

Methods:
Transversal, observational study. Nine patients having recovered a normal macular profile after macular edema due to retinal vein occlusion were included. For each patient, a reference OCT scan (i.e., with the incident beam normal to the fovea) was acquired, and off-axis scans were then acquired by laterally shifting the entry pupil. In addition, in four of these eyes, directional adaptive optics ophthalmoscopy documented the directional variations of cone metrics.

Results:
Included patients comprised two women and seven men (age range, 19–76 years). Reference OCT scans showed patchy attenuation of the cone outer segment tips and to a lesser extent of the inner segment/outer segment lines in all, but two eyes; these. Increased intensity of the cone outer segment tips and inner segment/outer segment lines could be observed on off-axis scans. Accordingly, fusion images showed 66% average reduction of the length of cone outer segment tips attenuation. In two cases, although reference scans showed continuity of outer bands, focal attenuation was evidenced in off-axis images. Directional adaptive optics ophthalmoscopy imaging showed a strong directional variability of cone counts in these areas, ranging from near absence to roughly two-third of reference values. In each case, directional variations of cone counts paralleled those of the reflectance of outer bands.

Conclusion:
After macular edema, focal attenuations of the inner segment/outer segment and of the cone outer segment tips lines may be present on OCT. These areas may show a strong directional variability by both OCT and adaptive optics ophthalmoscopy, suggesting that misaligned photoreceptor outer segments contribute to such features. The evaluation of outer retinal damage following macular edema should therefore take into account the optical Stiles–Crawford effect to disambiguate missing from misaligned cones.
SURGICAL OUTCOMES OF 25-GAUGE PARS PLANA VITRECTOMY USING AIR AS AN INTERNAL TAMPONADE FOR PRIMARY RHEGMATOGENOUS RETINAL DETACHMENT
Authors: Li Yunyun , Cheung Ning , Jia Liyun , Zhang Hui , Liu Ningpu 
Published: January 2020

Purpose:
To report surgical outcomes of 25-gauge pars plana vitrectomy using air as an internal tamponade for patients with primary rhegmatogenous retinal detachment (RRD).

Methods:
A retrospective clinical study of 59 eyes of 59 consecutive patients presented with primary RRD at the Beijing Tongren Eye Center in China. From August 2016 to May 2018, medical records of the patients who underwent 25-gauge pars plana vitrectomy with air tamponade for RRD were reviewed. The main outcome measures were primary and final anatomical success (retinal re-attachment) rates, and postoperative complications.

Results:
Of the 59 patients, aged 54.47 ± 11.81 years, 31 (52.5%) were men. Vitrectomy was performed 3 to 40 (averaged 16.98 ± 10.17) days after the onset of symptoms, and the mean follow-up period was 12.90 ± 5.92 months (ranging 6.07–26.10 months). Forty-two eyes (71.2%) had RRD with retinal breaks in the superior half of the retina, and the mean number of retinal breaks was 1.75 ± 0.94. Three eyes (5.1%) had RRD with giant retinal tears. Of the 59 eyes, 35 (59.3%) had RRD with inferior quadrants involved. Proliferative vitreoretinopathy (PVR) gradings were C1 in 2 (3.4%) eyes and B or below in 57 (96.6%) eyes. The primary and final anatomical success rates were 94.9% (56/59) and 98.3% (58/59), respectively. Of the three eyes which developed re-detachment of the retina, one eye had postoperative progression of PVR and two eyes were RRD associated with macular hole in high myopia. Postoperative complications included 5 eyes (8.5%) with serous choroidal detachment within 3 days after surgery and 4 eyes (6.8%) with macular epiretinal membrane formation 1 to 8 months after surgery. Secondary cataract surgery was performed in 13 of the 53 phakic eyes (24.5%) during follow-up.

Conclusion:
Small-gauge pars plana vitrectomy with air tamponade may be effective in treating selected cases of relatively simple primary RRD. Additional studies are needed to verify the efficacy of this surgical approach for more complicated cases such as those with giant retinal tears.
INTRAVITREAL RANIBIZUMAB INJECTION AND RETINAL LASER PHOTOCOAGULATION TREATMENT FOR ADULT-ONSET COATS DISEASE
Authors: Plaza-Laguardia Carlos , Pascual-Camps Isabel , Bayón-Porras María Rosa , Sánchez-Cañizal Jorge , Gallego-Pinazo Roberto 
Published: January 2020

Purpose:
To describe the evolution of a case of adult-onset Coats disease and the results of treatment with intravitreal ranibizumab and laser photocoagulation.

Methods:
Observational case report.

Case report:
A 17-year-old girl presented with vision loss in her right eye (20/50) showing aneurysmatic and abnormal telangiectatic vessels associated with profuse lipid exudation and serous retinal detachment within the temporal posterior pole. The diagnosis of Coats disease was established and therapy with intravitreal injections of ranibizumab and photocoagulation was initiated achieving control of the exudative manifestations leading to restoration of visual acuity (20/20).

Conclusion:
Treatment with antiangiogenic agents before laser photocoagulation may be useful for treatment of adult-onset Coats disease.
SWEPT-SOURCE OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY FINDINGS IN A CASE OF PACHYCHOROID NEOVASCULOPATHY IN RETINITIS PIGMENTOSA
Authors: Attanasio Marcella , Maggio Emilia , Arena Fabrizio , Pertile Grazia 
Published: January 2020

Purpose:
To report a rare case of pachychoroid neovasculopathy in retinitis pigmentosa (RP) and to describe its features and changes after treatment with bevacizumab as documented by swept-source optical coherence angiography.

Methods:
A case report of a 69-year-old man with a history of RP who presented at our clinic with an acute decrease in visual acuity (Best corrected visual acuity) in his left eye.

Results:
Upon the first examination, best-corrected visual acuity in the left eye was 20/50. Fundus examination and fundus autofluorescence showed bilaterally typical features of RP, and enhanced depth imaging–optical coherence tomography revealed a pachychoroid pattern. Fluorescein angiography and indocyanine green angiography suggested the presence of a choroidal neovascularization in the left eye, although no clear evidence of any neovascular network could be identified. Swept-source optical coherence angiography was performed, confirming the presence of a choroidal neovascularization network. The patient was treated with 2 monthly intravitreal injections of bevacizumab. After treatment, BVCA improved to 20/25, and no evidence of the vascular network was detectable on swept-source optical coherence angiography.

Conclusion:
Our case reports the uncommon association of RP with pachychoroid neovasculopathy. Swept-source optical coherence angiography proved to be a useful imaging technique for the diagnosis and follow-up of this condition. Intravitreal bevacizumab represents an effective treatment for choroidal neovascularization associated with RP.
Tempestuous Course of Enterococcus Infective Endocarditis — From Daptomycin Lung Toxicity to Successful Treatment With Surgery and Fosfomycin Combination Therapy
Authors: Gupta Neha , Sah Ranjit , Chawla Sony , Kasliwal Ravi R. , Tarique Ahmar , Mehta Yatin , Trehan Naresh 
Published: January 2020

Abstract
Management of enterococcal infective endocarditis (IE) is one of the intriguing challenges in infectious diseases. Ampicillin with gentamicin is the standard therapy for susceptible Enterococcus faecalis. However, in presence of β-lactam-resistant isolates, nephroxicity, or allergy to β-lactams, alternatives like glycopeptides and daptomycin have been used for the treatment of enterococcus IE. We report a patient with E. faecalis IE who had allergy to β-lactam and during treatment had developed daptomycin lung toxicity. He was subsequently treated with intravenous fosfomycin and surgery with aortic valve replacement.
Clinical and Microbiologic Profile of Patients With Staphylococcus aureus Infection
Authors: Tambuwal Sirajo Haliru , Iliyasu Garba , Muhammad Dayyab Farouq , Habib Zaiyad Garba , Tiamiyu Abdulwasiu Bolaji , Muhammad Liman Hamid , Habib Abdulrazaq Garba 
Published: January 2020

Background
Invasive Staphylococcus aureus infection (ISA) is increasingly being recognized as an important cause of morbidity and mortality in developing countries. This problem is confounded by the increasing prevalence of antibiotic-resistant S. aureus. The aim of the study was to describe the clinical presentation and antibiotic susceptibility profile of ISA infection in a tertiary hospital in North West Nigeria.

Materials and Methods
This study was a prospective cohort study carried out on patients with ISA infection who were seen at a regional referral tertiary hospital in North West Nigeria. One hundred forty patients with ISA infection were studied. Clinical evaluation and relevant laboratory investigations were conducted. Antibiotic susceptibility tests were carried out by disk diffusion method according to Clinical and Laboratory Standard Institute guidelines.

Results
The mean age of the patients was 40.7 ± 15.6 years, with male-to-female ratio of 1.4:1. Skin and soft tissue infections (108 [77.1%]) and primary bacteremia (17 [12.1%]) were the most common diagnoses. Most infections were community-acquired infections (94 [67.1%]). Risk factors were identified in 112 (80%), of which diabetes mellitus (40 [35.7%]) and chronic kidney diseases (33 [29.5%]) predominate. Eighty-two (52.2%) of the isolates were methicillin-sensitive S. aureus, and 75 (47.8%) were methicillin-resistant S. aureus (MRSA). More cases of MRSA compared with methicillin-sensitive S. aureus were seen among patients with pneumonia and primary bacteremia. The overall mortality was 25 (19.7%) at 1-month follow-up. On multiple logistic regression analysis, the only factors predictive of mortality were sepsis (odds ratio, 6.723; 95% confidence interval, 1.431–31.585) and infection with MRSA (odds ratio, 5.523; 95% confidence interval, 1.506–20.250).

Conclusions
This study shows high burden of ISA with high prevalence of MRSA. This underscores the need for antimicrobial stewardship program and strengthening of infection control practices in our hospital.
Treatment of Infantile Blount's Disease (Infantile Tibia Vara) with a Novel Brace: Preliminary Results
Authors: Lehman Wallace B. , Sheikh Taha Abdel Majid , Sala Debra A. , Sanchez Jessica , Chu Alice 
Published: January 2020

ABSTRACT

Introduction
Over the years, several types of braces have been used to treat the proximal tibial varus deformity of infantile Blount's disease. The purpose of this study was to evaluate the effectiveness of the JMMR Blount's KAFO (JMMR Inc, Ridgewood, NJ, USA) in correcting infantile tibia vara.

Methods
From November 2011 to June 2014, four patients with Blount's disease completed treatment with JMMR Blount's KAFOs. The dynamic quality of the brace differentiates it from the standard orthotic treatment of Blount's disease. The active movement of the swivel hinge located on the posterior of plastic lower leg cuff and the telescoping lateral ankle hinge facilitate the application of the valgus stress force below the knee. This, in turn, permits full knee and ankle motion. As the corrective forces are produced during weight bearing, the orthosis is worn only during waking hours. Prebracing and postbracing anterioposterior radiographs were reviewed by an examiner who was blinded to patient's name and date of the radiograph.

Results
The four patients (two males, two females) had a mean age of 23 months (range, 21–27) at initiation of bracing. Two were bilateral and two were unilateral. Prebracing to postbracing comparison demonstrated Langenskiöld stage improved by at least one stage and metaphyseal-diaphyseal angle decreased from a mean of 15° to 4.3°. The mean tibiofemoral angle was 19.2° varus prebracing and 0.7° valgus postbracing. The mean duration of brace use was 11 months (range, 7–15).

Conclusions
When the treatment of Blount's disease was started before 3 years of age, the JMMR Blount's KAFO corrected the tibia vara.
Metformin Potential Impact on the Growth of Vestibular Schwannomas
Authors: Feng Austin Y. , Enriquez-Marulanda Alejandro , Kouhi Ali , Ali Noor-E-Seher , Moore Justin M. , Vaisbuch Yona 
Published: January 2020

Objective:
Previous work has suggested that metformin may possess antineoplastic properties. This study aims to assess the effect of metformin on the growth of sporadic vestibular schwannomas.

Methods:
A retrospective cohort study was performed on patients presenting with radiologically confirmed vestibular schwannomas to Stanford medical center between January 1990 and October 2018. Patients who received metformin during the follow-up period were included and were compared with the control group who were not receiving metformin. Tumor progression and hearing loss are primary and secondary outcomes, respectively.

Results:
A total of 149 patients were analyzed, with 42 patients receiving metformin. The mean age at presentation is 69.6 (±11.7) years. There are 69 (46.3%) females and 80 (53.7%) males and there is no significant age difference between the groups. Tumor size at presentation is similar between both groups, 8 mm (4–13) in control group and 7.5 mm (4–14) in metformin group. The average follow-up period is 34.2 months (18.3–57.8) and 30.3 months (13.6–69.8) in the metformin and control cohorts, respectively, and they are not significantly different. No significant differences between both groups were found in final American Academy of Otolaryngology - Head and Neck Surgery hearing outcome or poor audiogram outcome. Metformin users are significantly less likely to present with tumor growth at final follow-up compared with nonmetformin users (28.6 versus 49.5%, respectively; p = 0.02).

Conclusions:
This preliminary result suggests metformin may reduce vestibular schwannoma tumor growth rate and shows potential promise as a novel chemotherapeutic agent. Further studies are needed to validate this finding.
Long-term outcomes of percutaneous coronary intervention for unprotected left main coronary artery according to the synergy between percutaneous coronary intervention with taxus and cardiac surgery (SYNTAX) score
Authors: Shiyovich Arthur , Perl Leor , Vaknin-Assa Hana , Greenberg Gabriel , Samara Abed , Kornowski Ran , Assali Abid 
Published: January 2020

Background
Percutaneous coronary intervention (PCI) of unprotected left-main coronary artery (uLMCA) is increasingly performed. Although it is recommended to calculate the SYNTAX score, if uLMCA PCI is considered, data of outcomes by the SYNTAX score are scarce, particularly among patients with high score (SYNTAX ≥ 33).

Objective
To evaluate long-term outcomes of uLMCA PCI according to SYNTAX score in real-world practice.

Methods
Patients following PCI of uLMCA throughout 2006–2018, in a tertiary hospital, were included and classified into three groups according to the SYNTAX I score. The primary outcome was three-year major adverse cardiac event (MACE) comprising all-cause mortality, myocardial infarction (MI), target vessel revascularization (TVR), or coronary artery bypass surgery (CABG).

Results
Overall 632 patients were analyzed, mean age 72.8 ± 11.5, males: 69%, classified as following: SYNTAX <22 (n = 225); SYNTAX 22–32 (n = 250) and SYNTAX ≥33 (n = 157). Patients with greater SYNTAX score had higher prevalence of diabetes mellitus, renal failure, peripheral arterial disease and stroke. Additionally, they had lower ejection fraction, greater EuroScore, and number of vessels involved. Procedural success rates were very high (>95%) and did not depend on the SYNTAX score. The rates of MACE and its components were significantly higher in patients with higher SYNTAX score. Multivariate analysis showed that SYNTAX score is an independent predictor of three-year MACE following uLMCA PCI [HRSYNTAX22-32 = 3 (95% confidence interval [CI]: 1.2–11.5), HRSYNTAX≥33 = 3.4 (95% CI: 1.8–13.3].

Conclusions
Despite the high success rates of uLMCA PCI in real-world patients with high SYNTAX score, the latter was significantly associated with worse three-year outcomes.
Comparison between abdominal ultrasound and nuclear magnetic resonance imaging detection of placenta accreta in the second and third trimester of pregnancy
Authors: Xia Hui , Ke Shu-Cheng , Qian Rong-Rong , Lin Ji-Guang , Li Yang , Zhang Xia 
Published: January 2020

Abstract
This study is to determine accuracy of abdominal ultrasound and nuclear magnetic resonance imaging (MRI) for placenta accreta in the second and third trimester of pregnancy and to define the most relevant features of abdominal ultrasound and MRI for placenta accreta prediction.
Between September 2012 and September 2018, 245 high risk of placenta accreta in the second trimester of pregnancy were prenatal diagnosed by abdominal ultrasound and MRI and they were followed up until the end of pregnancy.
Forty-six patients at the second trimester of pregnancy and 40 patients at the third trimester of pregnancy were confirmed as placenta accreta. For the second and third trimester of pregnancy, the sensitivity (Se), specificity (Sp), positive and negative predictive value (PPV and NPV) of abdominal ultrasound were 95.65% versus 97.50%, 91.78% versus 90.70%, 88% versus 83%, and 97% versus 99%, respectively, while the Se, Sp, PPV, and NPV of MRI were 89.13% versus 92.50%, 87.67% versus 8721%, 82% versus 77%, and 93% versus 96%, respectively. Five features having significant statistical differences between normal placentation women and placenta accreta patients in second or third trimester of pregnancy, including loss of the normal retroplacental clear space, thinning or disappearance of the myometrium, increased vascularization at the uterine serosa-bladder wall interface, and vascularization perpendicular to the uterine wall on abdominal ultrasound, and uterine bulging and dark intraplacental bands on MRI.
Abdominal ultrasound and MRI for placenta accreta in the second and third trimester of pregnancy could provide meaningful imaging evidences.
Clinical and anatomical study of foramen locations in jaw bones and adjacent structures
Authors: Wu Bo , Li Hui , Fan Yuxiang , Wang Xinhui , Li Weihang , Zhong Sheng , Ren Jiaxin , Chen Yong , Zhang Lei , Zhao Gang 
Published: January 2020

Abstract
This study aims to find and locate foramens exactly in maxilla and mandible in case of complications during surgeries.
Computer topographic angiography (CTA) images of 120 cases were reviewed. The measurements were performed on coronal, sagittal and axial planes after the 3 dimension volume reconstruction. The distances among foramens, bony landmarks, teeth, and facial artery were all measured with the angles as adjustments.
The incisive foramen (IF) was measured 20.55 ± 2.81 mm to margo inferior of incisor, and 45.27 ± 5.27 degree from the axial midline. The greater palatine foramen located 43.17 ± 2.55 mm from the IF, while 21.08 ± 3.75 degree from the midline in axial plane. The lesser palatine foramina located 44.56 ± 5.74 mm from the IF and 20.05 ± 3.59 degree to the midline. The Mandibular foramen (MBF) was 91.15 ± 1.86 mm horizontally to the margo inferior of incisor. The angle that the MBF-margo inferior of incisor line made with the axial midline was 31.25 ± 2.89 degree. The shortest horizontal distance from the mental foramen (MF) to the facial artery in sagittal plane was 21.90 ± 1.86 mm, while it became 13.00 ± 2.05 mm in coronary section. The horizontal distance from the MF to the margo inferior of incisor in sagittal plane was 22.04 ± 3.22 mm. It turned out to be 25.78 ± 5.23 mm between MF and mid-sagittal line in coronary section. The vertical distance was 25.20 ± 3.06 mm from the upper margin of the second premolar to the MF.
The foramens were clearly seen through CTA. Moreover, linear and angular measurements were presented, which makes it safer and wiser for surgeons to consider the biometric data before operations.
Human growth hormone level decreased in women aged <60 years but increased in men aged >50 years
Authors: Wang Ximei , Wang Shuyi , Wu Huan , Jiang Mingfei , Xue Hui , Zhu Yangqi , Wang Chenxu , Zha Xiaojuan , Wen Yufeng 
Published: January 2020

Abstract
To investigate the relationship amongst human growth hormone (HGH), sex, and age groups.
A cross-sectional study was conducted on a health check-up population from Wannan area of China from 2014 to 2016. The study involved 6843 individuals aged 23 to 85 years. Logistic regression analysis and smooth curve were applied to determine the relationship amongst age, sex, and HGH.
The average level of HGH in the population was 0.37 ± 0.59 ng/mL. There were significant differences in sex, age, body mass index (BMI), triglycerides (TG), total cholesterol (TC), systolic blood pressure (SBP), diastolic blood pressure (DBP), and glucose (GLU) amongst different quartiles of HGH (P < .001). A U-shape relationship was established between HGH and age. After sex stratification, the results showed that the thresholds of age were 60 years in women, and 50 years in men, after adjusting for body mass index, triglycerides, total cholesterol, blood pressure, and blood glucose. Logistic regression showed that HGH level decreased in women aged <60 years (OR = 1.472, P < .001) and increased in men aged >50 years (OR = 0.711, P < .001). So the distributive characteristics of HGH concentration vary with sex and age group.