bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of Body Dysmorphic Disorder with Leptin Levels in Patients with Normal Weight Undergoing Liposuction: A Matched Case Study
Authors: Pruksapong Chatchai , Chamnanchanunt Supat , Thanachartwet Vipa , Desakorn Varunee , Nakawiro Daochompu , Sahassananda Duangjai , Rojnuckarin Ponlapat 
Published: November 2019

Background:
Liposuction is the most common aesthetic surgical procedure performed globally. Some of the patients with normal weight who seek liposuction may suffer from body dysmorphic disorder (BDD). Leptin, which is mainly produced by adipose tissue, may be associated with this condition. The aim of this study was to determine the prevalence of BDD and leptin levels in patients with normal weight seeking liposuction.

Methods:
Thirty-two nonobese women who sought liposuction were matched with 32 healthy volunteers by age and body mass index. Blood biochemistry, leptin levels, and BDD-Yale–Brown Obsessive-Compulsive Scale (BDD-YBOCS) questionnaires were evaluated and compared between the groups.

Results:
Patients who underwent liposuction had significantly higher median (interquartile range) of total BDD-YBOCS scores than healthy volunteers [25 (22–27) versus 12 (8–20); P < 0.001]. Overall, 28 (87.5%) patients had total BDD-YBOCS scores of >20, whereas 10 (31.5%) volunteers had scores of >20. Patients with total BDD-YBOCS scores of >20 had significantly lower levels of serum leptin [12.43 (7.15–16.98) ng/ml versus 15.57 (9.59–22.28) ng/ml; P = 0.043].

Conclusions:
Patients who underwent liposuction had a significantly higher total score of BDD-YBOCS than healthy volunteers matched by sex, age, and body mass index. Subjects with higher BDD-YBOCS scores had significantly lower serum leptin levels.
The Impact of Social Stigma for Children with Cleft Lip and/or Palate in Low-resource Areas: A Systematic Review
Authors: Chung Karen Y. , Sorouri Kimia , Wang Lily , Suryavanshi Tanishq , Fisher David 
Published: November 2019

Summary:
There are still children with cleft lip and/or palate (CLP) in low-resource areas who face social rejection. This stigma disadvantages children in education, employment, marriage, and community, and is exacerbated by barriers to care. Our study objective was to conduct a systematic review of the impact of social stigma of CLP for children in low-resource areas. We followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. A systematic search was conducted of 3 databases: Ovid Embase, Ovid Medline, and the African Journal Online from 2000 to October 5 2018. Common themes were identified using a grounded theory approach and quantitatively summarized. The Joanna Briggs Institute criteria were used to evaluate the risk-of-bias assessments. Four hundred seventy-seven articles were screened; 15 articles were included that focused on the impact of social stigma on CLP in low-resource areas. This was limited to English articles. The majority of studies originated in Nigeria or India. Themes were reported as follows: societal beliefs (n = 9; 60%), social impact (n = 7; 46%), marriage (n = 7; 46%), education (n = 6; 40%), employment (n = 5; 33%), and psychological distress (n = 3; 20%). Causes include the effect of “God’s will,” supernatural forces, evil spirits or ancestral spirits, exposure to an eclipse, black magic, or a contagion. Further, children with CLP may not be worth a full name or considered human and killed. Awareness of the impact of social stigma for children with CLP in low-resource areas generates support toward national education and awareness in low-resource areas.
Optic Canal Decompression with a Lateral Approach for Optic Nerve Injury Associated with Traumatic Optic Canal Fracture
Authors: Hokazono Yu , Umezawa Hiroki , Kurokawa Yuta , Ogawa Rei 
Published: November 2019

Summary:
Optic canal fracture (OCF) is a traumatic injury that requires urgent intervention because it can induce optic nerve damage and visual impairment. Despite the severity of OCF, a standard treatment method has not been established. In this article, we report a case of OCF and traumatic optic nerve injury in which visual acuity was recovered by releasing the optic canal using an unconventional lateral approach. A 43-year-old man presented with right lateral ethmoid fracture, right orbit blowout fracture, and OCF. The visual acuity was “hand motion” before surgery. Decompression was performed 10 hours after injury by approaching the right optic canal laterally from a coronal incision in front of the right ear, cutting along the border of the sphenoid bone, and scraping away some of the sphenoid wing and zygomatic bone. Steroid pulse therapy was added. Eventually, the visual acuity improved to 0.2 and the intraocular pressure decreased to 16.0 mm Hg. Compared with conventional methods, this method associates with better safety because (1) it causes relatively little bleeding and cerebrospinal fluid leak; (2) once the sphenozygomatic suture is identified, the distance to the optic canal is relatively short; and (3) if the fracture point is on the outer optic canal, the fracture line can be observed directly. Steroid pulse therapy may also have contributed to the good visual outcome. This is the first report of a novel lateral approach to OCF that is safe, effective, and only requires plastic surgery skills.
The Performance of Patient-Worn Actigraphy Devices to Measure Recovery after Breast Reconstruction
Authors: Thuman Jenna M , McMahon Heather , Chow Philip , Gerber Matthew , Dassoulas Kasandra , Barnes Laura , Campbell Chris A 
Published: November 2019

Introduction:
Annually, over 250,000 women are diagnosed with breast cancer with over one-third undergoing mastectomy and contemplating reconstruction. Surgical breast reconstructive options vary in post-operative recovery, yet with a paucity of objective data to inform women of their expected recovery after flap or implant-based reconstruction. As a result, patient decision-making is based primarily on surgeon preference and subjective data regarding perceived invasiveness of surgical options. This study aims to identify recovery outcomes of interest to breast cancer patients and to determine the feasibility of objectively measuring patient recovery after mastectomy and reconstruction using patient-worn actigraphy devices.

Methods:
Three survivorship focus groups for patients after mastectomy with and without reconstruction were used to identify recovery outcomes they considered relevant. Cloud storage systems and actigraphy devices were piloted to determine performance. Actigraphy devices were worn by patients peri-operatively to measure post-operative sleep quality and steps taken, normalized to individual patient pre-operative control data.

Results:
Focus groups identified sleep quality, return to activity (measurable with actigraphy), and driving as variables impacting surgical decision-making. We prospectively measured outcomes for four women undergoing immediate pre-pectoral tissue expander placement and four women undergoing immediate free flap reconstruction. Actigraphy data demonstrated an initial decrease in activity, increase in sleep variability and increased heart rate that approached the patients’ pre-operative normalized data as they recovered over time.

Conclusions:
These data demonstrate that actigraphy data would be of interest to patients making breast reconstruction decisions and that the data can be successfully collected to inform decision-making.
Improvement of a Radon Dosimetry System for Miners by Replacing Reference Dosimeters with Radonproof Boxes Containing Activated Carbon Cartridges
Authors: Dehnert Jörg , Guhr Andreas , Engelhardt Jörg 
Published: November 2019

Abstract
In 1168, the first silver was found in the Saxon Erzgebirge. Mining began shortly thereafter and continues to this day at varying intensities. About 250 miners are permanently engaged in rehabilitation work at old mining sites so that houses and roads are safe and the mine water can drain through galleries. The radon potential in the Erzgebirge is high. Despite radiation protection measures, exposures to more than 6 mSv occurred among 22 miners in 2016 alone. For this reason, the miners are monitored with personal radon dosimetry. The dosimeters consist of diffusion chambers with CR-39 nuclear track detectors. Outside the miners’ working hours, the dosimeters must be stored together with a reference dosimeter. After a 3 mo wearing period, the dosimeters are replaced and the miners’ exposures are determined. For this purpose, the exposures of the reference dosimeters that have occurred outside working hours are subtracted from the exposures of the miners’ dosimeters. In mining practices, this method has caused problems. The conditions of use (storing dosimeters along with a reference dosimeter) were often not met by the miners. To solve the problems, reference dosimeters were replaced by radonproof boxes with activated carbon cartridges inside. The miners stored their dosimeters in the boxes outside working hours. A uniform reference value for the radon activity concentration of 50 Bq m−3 was used for all boxes to determine the exposure of miners during working hours. The associated error was small. In future, reference dosimeters and the measurement of a reference value will not be necessary.
Pressure-Induced Interlamellar Stromal Keratitis After Small-Incision Lenticule Extraction Procedure: A Case Report
Authors: Moshirfar Majid , Somani Anisha N. , Vaidyanathan Uma , Ronquillo Yasmyne C. , Hoopes Phillip C. 
Published: November 2019

Purpose:
To report a case of pressure-induced interlamellar stromal keratitis (PISK) after small-incision lenticule extraction (SMILE) for the correction of myopic astigmatism in the United States.

Methods:
We report the case of a 27-year-old man who underwent uneventful SMILE surgery and presented with pressure-induced stromal keratitis. Anterior and posterior segment examination, uncorrected distance visual acuity, refraction, intraocular pressure, and pachymetry values are reported from this time period.

Results:
Three weeks postoperatively, examination revealed new-onset central corneal haze and edema in both eyes, more significant in the right eye. The patient was given a presumptive diagnosis of diffuse lamellar keratitis. Intensive corticosteroid treatment was administered, causing a significant decline in uncorrected distance visual acuity OD from 20/25 to 20/250 and OS from 20/20 to 20/60, with a significant myopic shift of −3.0 D and −1.0 D, respectively. In our case, pachymetry measurements revealed 78 μm OD and 43 μm OS of additional corneal thickness. Pressure readings were 25 mm Hg OD and 19 mm Hg OS, respectively. He was diagnosed with PISK, and after 4 days of steroid discontinuation and Brimonidine-Timolol administration, his symptoms had improved with resolution of corneal edema.

Conclusions:
Clinicians should be aware that PISK is a potential complication of SMILE. Postoperative intraocular pressure measurements are an important aspect of the management of postcorneal refractive surgery patients because the differentiation of PISK from diffuse lamellar keratitis, as well as the early detection and treatment of PISK, can avoid severe complications.
Efficacy and Safety of Repeated Ultrasound Cycloplasty Procedures in Patients With Early or Delayed Failure After a First Procedure
Authors: Aptel Florent , Tadjine Mehdi , Rouland Jean-François 
Published: November 2019

Precis:
Repeated ultrasound cycloplasty (UCP) procedures are valuable options in patients with early or delayed intraocular pressure (IOP) increase after a first procedure. The safety of a second procedure is similar to that of the first one.

Purpose:
The purpose of this study was to evaluate the efficacy and safety of repeated UCPs in patients with early or delayed IOP increase after a first procedure.

Patients and Methods:
Thirty-one eyes with open-angle glaucoma, with an IOP decrease,>20% after a first UCP procedure (1 and/or 2 mo visit), and with an early or delayed IOP increase (IOP decrease<20% compared with baseline before or after the first 6 mo, respectively), underwent a second UCP procedure. Examinations were performed at 1 day, 1 week, 1, 2, 3, 6, and 12 months. Primary outcomes were surgical success (IOP reduction≥20% and IOP>5 mm Hg) at the last follow-up and vision-threatening complications. Secondary outcomes were mean IOP at each visit, medication use, and other surgical interventions.

Results:
In the group with early IOP increase, IOP was reduced (P<0.05) from a mean value of 29.8±8.2 mm Hg before retreatment (n=3.3 medications) to 18.5±7.4 mm Hg at the last follow-up (n=3.5 medications) (−34%). Success was achieved in 52.6% of eyes (10/19) at the last follow-up visit. In the late IOP increase group, IOP was reduced (P<0.05) from a mean value of 31.9±6.6 mm Hg before retreatment (n=4.0 medications) to 16.2±5.2 mm Hg at the last follow-up (n=4.0 medications) (−43%). Success was achieved in 55.5% of eyes (5/9) at the last follow-up visit. No major intraoperative or postoperative complications occurred.

Conclusion:
A second UCP procedure could be considered in subjects with early or delayed failure after a first procedure.
A Case of Recurrent Pericarditis in Association With Asymptomatic Urethral Chlamydia trachomatis Infection
Authors: Czeresnia Jonathan Mamber , Alsaggaf Mohammed , Akselrod Hana 
Published: November 2019

Abstract
Extragenital manifestations of Chlamydia trachomatis infection can be challenging to diagnose. A previously healthy 33-year-old man presented with pericarditis recurring despite anti-inflammatory therapy and progressing to cardiac tamponade. Pericardiocentesis yielded bloody-appearing fluid with increased neutrophils and negative standard cultures. The patient reported recent unprotected sexual exposure, and urine nucleic acid amplification test detected C. trachomatis. He had no urogenital, ocular, or joint symptoms. The result of an extensive workup for other causes of pericarditis was negative, including HLA-B27 testing. He was treated with an extended course of doxycycline with full resolution of symptoms. We found 4 previously reported cases of chlamydial myopericardial disease, all of which shared key features with ours. Differentiating disseminated C. trachomatis from reactive phenomena is currently difficult owing to the limited availability of molecular tests and lack of their validation for clinical use. The diagnosis remains one of the clinical suspicions and circumstantial pieces of evidence, and further diagnostic developments are needed.
Epidemiology and Outcome of Hospitalized Infants With Pertussis
Authors: Beltramo Fernando , Raszynski Andre , Totapally Balagangadhar R. 
Published: November 2019

Background
Pertussis during infancy is associated with significant morbidity and mortality. The objective of this study was to review the epidemiology and outcome of infants with pertussis.

Methods
We identified infants with diagnosis of pertussis and compared demographic and outcome data with others who did not have pertussis. Infants with pertussis were matched 1:1 with correlative propensity score using sex, hospital region, income quartiles, race, ventilation status, and All Patients Refined Diagnosis Related Groups severity score.

Results
A total of 2920 pertussis cases were identified (prevalence: 4.7/1000 discharges). Females (49% vs 43%), Hispanics (35% vs 25%), and lower income quartile group (39% vs 36%) represented more frequently among pertussis cases (P < 0.001). Mechanical ventilation (6% vs 4.7%, P = 0.001), pulmonary hypertension (PHTN) (36% vs 1%, P < 0.001), and extracorporeal membrane oxygenation (ECMO) use (0.65% vs 0.08%, P < 0.001) were common among pertussis patients. In the intubated patients with pertussis, 50% had PHTN, 10% required ECMO, and 1 patient received leukapheresis. The mortality rate was significantly higher among ventilated (10.9% vs 0.04%, P < 0.001), PHTN (1.4% vs 0.3%, P < 0.001), and ECMO (60% vs 0.3%, P < 0.01) patients with pertussis. The mean length of stay was longer (5.96 ± 8.3 vs 4.53 ± 10.6 days, P < 0.01) among pertussis patients. Comparing with matched controls, the mortality rate was higher (0.72% vs 0.34%, P = 0.048), PHTN was common (36.4% vs 0.82%, P < 0.01), and ECMO usage was more frequent (0.65% vs 0%, P < 0.01) among pertussis cases.

Conclusions
Pertussis is more prevalent among females, Hispanics, and lower income quartile groups. This large sample study shows lower mortality than recent studies in infants with pertussis.
Fecal Microbiota Transplantation After Oral Vancomycin for Recurrent Clostridium difficile Infection
Authors: Alghamdi Ahlam Ali , Tabb Deanne 
Published: November 2019

Purpose

Clostridium difficile infection (CDI) is one of the most common hospital-acquired infections in developed countries. Since 2000, there has been a significant increase in the incidence and severity of CDI. Treating recurrent CDI (rCDI) is challenging because the risk of recurrence increases with each subsequent episode. Several studies have demonstrated the benefit of fecal microbiota transplantation (FMT) in patients with rCDI with a cure rate ranging between 80% and 100%. The aims of this study were to review the FMT procedure and to identify the success rate of using 2-week oral vancomycin treatment before the FMT.

Methods
We performed a retrospective chart review for patients with rCDI who underwent an FMT procedure between 2014 and 2017. This study included patients who were diagnosed with rCDI and received 2-week oral vancomycin treatment before the FMT at Piedmont Columbus Regional Hospital.

Results
During the study period, 31 patients underwent 34 FMT procedures for rCDI. Twenty-nine patients were included in the study. Two patients (6.9%) had confirmed recurrence within 8 weeks after FMT, and 27 patients (93.1%) were considered treatment successes. No adverse events were noted. Both patients with FMT failures were offered treatment with a repeat FMT. Thirty-nine percent had mild to moderate rCDI. Most patients (69%) received upper FMT and 58.6% had fresh stool transplanted.

Conclusions
Fecal microbiota transplantation preceded by a standard 2-week vancomycin regimen for the treatment of patients with rCDI seems to be safe and effective. Further research is needed to explore optimal pretreatment regimens before the FMT to prevent FMT failure.
Nocardia farcinica Brain Abscess Mimicking Progression of Malignancy in a Patient With Posterior Fossa Glioma
Authors: Jarrin Tejada Claudia D. 
Published: November 2019

Abstract
A patient presented with visual changes raising suspicion of progression of underlying brain cancer requiring craniotomy. Final results showed Nocardia farcinica brain infection instead. Nocardiosis should be considered in patients receiving corticosteroids as management can be lifesaving.
Perinephric Abscess and Bacteremia Due to Lactobacillus Species in a Diabetic Adult
Authors: De Freitas Gerson , Toor Amit , Bekele Yididia , Patel Neel , Kannangara Saman 
Published: November 2019

Abstract

Lactobacillus species are a group of anaerobic or facultatively anaerobic, catalase-negative, gram-positive non–spore-forming rods that are usually considered benign commensal organisms present in the human mouth and gastrointestinal and genital tracts. Given their indolent nature, the presence of Lactobacillus species in cultures is often considered contaminants. In rare occasions, however, Lactobacillus species have been reported as pathogens causing a broad range of clinically significant conditions including bacteremia, endocarditis, dental abscesses, meningitis, and intra-abdominal infections such as peritonitis, endometritis, and splenic and liver abscesses. Pyelonephritis has only been seldomly reported in literature, and perinephric abscess has never been reported in literature to date. When infection happens, it usually occurs in immunosuppressed individuals such as those with cancer, transplant recipients, chronic steroid use, or human immunodeficiency virus/AIDS. Despite being gram-positive, the bacteria are usually resistant to vancomycin, and treatment with a penicillin-based regimen is preferred. We describe a case of a diabetic and morbidly obese, but otherwise healthy man, who developed bacteremia and perinephric abscess due to Lactobacillus species.
Invasive Aspergillosis of the Liver in an Immunocompetent Patient
Authors: Nauriyal Varidhi , Ueberroth Benjamin , Zakhia Adjoa , Herc Erica 
Published: November 2019

Abstract
Invasive Aspergillus is a well-established cause of invasive fungal disease in the immunosuppressed host. The traditional risk factors identified for disseminated aspergillosis are hematological malignancies, organ transplantation, persistent neutropenia, and immunosuppressed states secondary to chronic granulomatous disease, human immunodeficiency virus/AIDS, and prolonged corticosteroid use. In recent years, there has been increased recognition of Aspergillus infection in critically ill patients and in patients with liver disease. There are rare case reports of invasive aspergillosis in immunocompetent hosts. We present a case of invasive hepatic aspergillosis in an immunocompetent patient. We aim to highlight the challenges faced in the diagnosis and management of hepatic aspergillosis in an immunocompetent host and also review the available literature.
The Effect of Valproic Acid on Olanzapine Serum Concentration
Authors: Tveito Marit , Smith Robert Løvsletten , Høiseth Gudrun , Molden Espen 
Published: November 2019

Abstract

Background
The combination of olanzapine and valproic acid (VPA) is regularly prescribed in the treatment of bipolar or schizoaffective disorders. The VPA has been shown to reduce olanzapine concentration, but the mechanism behind this interaction remains unknown. We aimed to investigate the effect of VPA on olanzapine concentration during oral versus long-acting injectable (LAI) formulation in a real-life setting.

Methods
From a therapeutic drug monitoring service, prescribed doses and serum concentrations from 2791 olanzapine-treated patients (9433 measurements) were included.

Results
The number of patients on olanzapine-LAI treatment was 328, whereas 2463 were using oral olanzapine. The frequency of patients comedicated with VPA was 9.4% for olanzapine tablets and 5.8% for olanzapine-LAI. The VPA had no effect on olanzapine dose-adjusted concentrations in LAI users (1.6 vs 1.7 [ng/mL]/[mg/d]; P = 0.38), whereas in the oral group the dose-adjusted olanzapine concentration was lower in VPA users (2.2 vs 2.7 [ng/mL]/[mg/d]; P < 0.001). For smokers in the oral olanzapine group using VPA, 8.7% of the measurements were in the subtherapeutic range (<10 ng/mL) compared with 6.0% in nonusers (P = 0.003).

Implications
These findings show that the VPA-olanzapine interaction involves a presystemic mechanism and is therefore restricted to oral olanzapine treatment. For oral treatment of olanzapine, comedication with VPA implies a risk of insufficient effect, which may be of clinical relevance in smokers in particular. Thus, it is important to be aware of the interaction potential with VPA during oral olanzapine use, whereas for LAI-treated patients fewer precautions are required from a pharmacokinetic point of view.