bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment Trajectories During and After a Medication Trial for Opioid Use Disorder: Moving from Research as Usual to Treatment as Usual
Authors: Fishman Marc , Vo Hoa T. , Burgower Rachael , Ruggiero Michael , Rotrosen John , Lee Josh , Nunes Edward 
Published: January 2020

Objectives:
The effectiveness of treatment incorporating relapse prevention medications for opioid use disorder (OUD) is typically examined in research using rigidly predefined endpoints of success versus failure, usually over a single episode of care. But this perspective may not adequately portray the nonlinear trajectories typical of real-world treatment courses in this chronic, remitting, and relapsing disorder.

Methods:
This descriptive study examined 12-month treatment trajectories of n = 60 patients enrolled at a single site of a larger multisite randomized controlled trial examining the comparative effectiveness of buprenorphine versus extended-release naltrexone. While the parent study provided medication treatment through the research protocol for 6 months, this study documents treatment up to 12 months, including medications, provided through standard community resources (treatment as usual) outside of the protocol.

Results:
Some patients continued medications past the end of the study intervention, whereas others did not. Some patients initiated medications other than the one assigned by the study. Some patients switched from 1 medication to the other. Many patients returned to treatment after 1 or more periods of dropout and/or relapse. Patients utilized multiple episodes of bed-based care, including short-term acute residential and long-term residential treatment, and also recovery housing supports. Described trajectories are also depicted graphically. At 12 months, while rates of continuous treatment retention were low (8%), rates of cross-sectional treatment engagement including return to treatment after drop out were higher (35%).

Conclusions:
This description of nonlinear treatment trajectories highlights the potential benefits of flexibility and optimism in the promotion of re-engagement, despite interim outcomes that might traditionally be considered “failure” endpoints.
Novel Phenethylamines and Their Potential Interactions With Prescription Drugs: A Systematic Critical Review
Authors: Inan Funda , Brunt Tibor M. , Contrucci Ramon R. , Hondebrink Laura , Franssen Eric J. F. 
Published: January 2020

Background:
The novel phenethylamines 4-fluoroamphetamine (4-FA) and 2,5-dimethoxy-4-bromophenethylamine (2C-B) fall in the top 10 most used new psychoactive substances (NPSs) among high-risk substance users. Various phenethylamines and NPS are also highly used in populations with mental disorders, depression, or attention deficit hyperactivity disorder (ADHD). Moreover, NPS use is highly prevalent among men and women with risky sexual behavior. Considering these specific populations and their frequent concurrent use of drugs, such as antidepressants, ADHD medication, and antiretrovirals, reports on potential interactions between these drugs, and phenethylamines 4-FA and 2C-B, were reviewed.

Methods:
The authors performed a systematic literature review on 4-FA and 2C-B interactions with antidepressants (citalopram, fluoxetine, fluvoxamine, paroxetine, sertraline, duloxetine, bupropion, venlafaxine, phenelzine, moclobemide, and tranylcypromine), ADHD medications (atomoxetine, dexamphetamine, methylphenidate, and modafinil), and antiretrovirals.

Results:
Limited literature exists on the pharmacokinetics and drug–drug interactions of 2C-B and 4-FA. Only one case report indicated a possible interaction between 4-FA and ADHD medication. Although pharmacokinetic interactions between 4-FA and prescription drugs remain speculative, their pharmacodynamic points toward interactions between 4-FA and ADHD medication and antidepressants. The pharmacokinetic and pharmacodynamic profile of 2C-B also points toward such interactions, between 2C-B and prescription drugs such as antidepressants and ADHD medication.

Conclusions:
A drug–drug (phenethylamine-prescription drug) interaction potential is anticipated, mainly involving monoamine oxidases for 2C-B and 4-FA, with monoamine transporters being more specific to 4-FA.
RETINAL DYSTROPHY IN JEUNE SYNDROME: A MULTIMODAL IMAGING CHARACTERIZATION
Authors: Pilotto Elisabetta , Midena Edoardo , Longhin Evelyn , Frizziero Luisa 
Published: January 2020

Purpose:
To report multimodal imaging findings in a patient affected by Jeune syndrome-associated retinal dystrophy.

Methods:
Observational case report.

Results:
An 18-year-old girl affected by Jeune syndrome was referred to our low vision unit. She presented with bilateral high myopia, reduced visual acuity, exotropia, and nystagmus. Fundus examination detected posterior myopic staphyloma and diffuse retinal dystrophy confirmed using a full-field electroretinogram as a cone-rod dystrophy. Spectral domain optical coherence tomography detected a thick anomalous hyperreflective band located beneath an irregular and disrupted external limiting membrane, showing the primary involvement of the photoreceptors outer segment with relative sparing of the retinal pigment epithelium, as confirmed by fundus autofluorescence.

Conclusion:
This is a case of Jeune syndrome with retinal abnormalities studied with fundus autofluorescence and optical coherence tomography. Retinal noninvasive multimodal imaging could provide significant insight in the retinal involvement of patients affected by Jeune syndrome and should have an essential role in the multidisciplinary diagnostic approach and follow-up.
ANATOMIC AND FUNCTIONAL IMPROVEMENT OF A DRUSENOID PIGMENT EPITHELIAL DETACHMENT: A CASE REPORT
Authors: Csaky Karl G. , Christie Abigail H. 
Published: January 2020

Background/Purpose:
Age-related macular degeneration is the most prevalent cause of permanent vision loss in the developed world. Drusenoid pigment epithelial detachments are a biomarker of age-related macular degeneration disease progression and typically result in poor visual prognosis. Low luminance visual acuity (LLVA) has been previously been shown to correlate with the severity of age-related macular degeneration. However, the degree of spontaneous improvement of this functional outcome is still under investigation.

Methods:
Observational clinical case report.

Results:
A drusenoid pigment epithelial detachment that increased in size with the development of hyperreflective foci spontaneously improved with restoration of normal foveal contour over the span of 41 months without progression to geographic atrophy or choroidal neovascularization. Although best-corrected visual acuity remained stable both before and after the pigment epithelial detachment resolution, low luminance visual acuity decreased from a baseline of 59 (20/63 −1) to 39 (20/160 −1) letters over 17 months. However, over the subsequent 24 months, low luminance visual acuity improved by 35 letters to 74 letters (20/32 −2).

Conclusion:
Drusenoid pigment epithelial detachments can resolve without treatment. Low luminance visual acuity seems to correlate with the anatomic improvement and can improve spontaneously by more than six lines of vision.
Evaluation of 2 ultrasonic indicators as predictors of difficult laryngoscopy in pregnant women
Authors: Xu Lili , Dai Shaobing , Sun Lihong , Shen Jianjun , Lv Changcheng , Chen Xinzhong 
Published: January 2020

Abstract

Background:
Ultrasonic measurements of tongue thickness and condylar translation were recently introduced to predict difficult laryngoscopy in non-obstetric patients. We designed the present study to evaluate the performance of these two ultrasonic indicators in predicting difficult laryngoscopy in healthy parturients.

Methods:
The 119 parturients undergoing elective cesarean delivery were enrolled. Tongue thickness and condylar translation measured by ultrasonography, and Modified Mallampati test (MMT) score, inter-incisor distance (IID) and modified Cormack-Lehane grading system (MCLS) were measured and recorded before anesthesia. The primary outcome was difficult laryngoscopy defined as MCLS 3 or 4. The association between these variables and difficult laryngoscopy were analyzed by using multivariable logistic regression and receiver operating characteristic (ROC) curve.

Results:
Compared to the Easy Laryngoscopy Group, the tongue thickness was significantly higher and the condylar translation and IID were significantly lower in the Difficult Laryngoscopy Group. Tongue thickness and condylar translation but not MMT score and IID were proved to be two independent predictors for difficult laryngoscopy by multivariate logistic regression, with the odds ratios of 2.554 (95% confidence interval (CI), 1.715 to 3.802) and 0.457 (95% CI, 0.304 to 0.686). The area under the ROC curve to predict difficult laryngoscopy for tongue thickness was 0.93 (95% CI, 0.88–0.98) and for condylar translation was 0.77 (95% CI, 0.67–0.86), which were significantly higher than those for MMT score (0.67, 95% CI, 0.56–0.77) and IID (0.65, 95% CI, 0.55–0.76).

Conclusions:
Compared with MMT and IID, tongue thickness and condylar translation measured by ultrasonography appear to be better indicators for predicting difficult laryngoscopy in parturients.
The trial was registered at the Chinese Clinical Trial Registry (ChiCTR)(www.chictr.org), registration number ChiCTR-ICR-1800019991.
Better outcomes are associated with cementless fixation in primary total knee arthroplasty in young patients
Authors: Wang Kun , Sun Han , Zhang Kaifeng , Li Shuxiang , Wu Guofeng , Zhou Jian , Sun Xiaoliang 
Published: January 2020

Abstract

Background:
The use of cemented and cementless fixations in primary total knee arthroplasty (TKA) in young patients is controversial. Previous reviews predominantly relied on data from retrospective studies. This systematic review and meta-analysis of randomized controlled trials (RCTs) evaluated the optimal fixation mode in TKA for young patients.

Methods:
The PubMed, Embase, Medline, Web of Science, and full Cochrane Library electronic databases were searched from inception to July 2018. The outcome measurements consisted of functional outcomes (Knee Society Score [KSS], range of motion [ROM]), radiolucent lines, aseptic loosening, total complications, and reoperation rate. Study data were pooled using a random-effects model.

Results:
Six RCTs were included in the systematic review and meta-analysis. The mean follow-up period was 12 years (range, 2–16.6 years). Cementless TKA was associated with higher KSS-function (P < .0001), higher KSS-pain (P = .005), better ROM recovery (P = .01), and fewer radiolucent lines (<1 mm) (P = .04) compared with cemented TKA. No significant intergroup differences were observed for KSS-knee, total complications, aseptic loosening, or reoperation rate. These results based on a random-effects model were unchanged by sensitivity analysis assumptions.

Conclusion:
Cementless TKA was substantially superior to cemented TKA in young patients. Although the complication and survival rates were similar between groups, better clinical outcomes were obtained with cementless fixation. Further well-designed studies with long follow-up durations are necessary to confirm our findings.
Efficacy and safety of erlotinib combined with bevacizumab in the treatment of non-small cell lung cancer
Authors: Zhou Kenan , Zhao Shishun , Guo Wenlai , Ding Lei 
Published: January 2020

Abstract

Background:
Non-small cell lung cancer (NSCLC) has a poor prognosis despite conventional treatments of surgery, radiotherapy, and chemotherapy. Small-molecule tyrosine kinase inhibitors acting on epidermal growth factor receptor (EGFR) have shown high efficacy and low toxicity for NSCLC. In particular, combining erlotinib with the VEGF antibody bevacizumab has therapeutic value in NSCLC, but the drugs’ separate effects as monotherapy and any adverse outcomes of combination therapy remain unclear.

Objectives:
To determine the efficacy and safety of erlotinib and bevacizumab for NSCLC, we conducted a meta-analysis and systematic review of randomized controlled trials.

Data sources:
PubMed, Embase, Web of Science, and Cochrane databases were searched using keywords and manual review.

Study eligibility criteria, participants, and interventions:
We reviewed randomized controlled trials on the use of erlotinib combined with bevacizumab in adult patients with NSCLC, including data on outcome measures of overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and adverse events.

Study appraisal and synthesis methods:
After quality assessment, datasets were evaluated for heterogeneity. In the event of significant heterogeneity, a random-effects model was used to assess the overall outcome measures as a result of treatments. Subgroup analysis was conducted to evaluate the source of heterogeneity on PFS.

Results:
Compared with erlotinib or bevacizumab alone, the combined treatment did not significantly prolong OS (95% confidence interval [CI] = 0.84–1.11; P = .62) or increase the ORR (95% CI = 0.91–1.20; P = .52), but significantly improved PFS (95% CI = 0.58–0.73; P < .001). This improvement was especially notable in patients with the following characteristics: Eastern Cooperative Oncology Group Performance Status score of 0 or 1, female, no smoking history, adenocarcinoma, and EGFR Exon19 deletion or Exon21 Leu858Arg mutation. Combination therapy significantly increased incidence of grade 1–2 hypertension (20.3% vs 6.3%, 95% CI 1.73–5.88; P < .01) and severe diarrhea (10% vs 3.2%, 95% CI 1.36–6.60; P = .01).

Limitations:
The low number of available randomized controlled trials could influence interpretation.

Conclusions:
Compared with erlotinib or bevacizumab monotherapy, their combination effectively prolongs PFS but increases incidence of adverse events in NSCLC patients.
Quality of postoperative recovery after upper-arm vascular surgery for hemodialysis in patients with end-stage renal disease: A prospective comparison of cervical epidural anesthesia vs general anesthesia
Authors: Cho Hobum , Kwon Hyerim , Song Sanghoon , Yoo Jaehwa , Kim Mungyu , Park Sunyoung , Chung Jiwon , Kim Sangho , Park Suyeon , Ok Siyoung 
Published: January 2020

Abstract
Cervical epidural anesthesia (CEA) is generally not used during upper-arm vascular surgery for hemodialysis in end-stage renal disease (ESRD) patients, despite its advantages. The Quality of Recovery-40 questionnaire (QOR-40) has been validated as a tool for assessing the degree of recovery after surgery. We hypothesized that CEA could provide a better outcome on the QOR-40 than general anesthesia after upper-arm vascular surgery for hemodialysis in ESRD patients.
We divided anesthetic methods into general anesthesia and CEA. The QOR-40 was administered to 70 patients on the night before surgery and at 24 hours after surgery. Additional data, including consumption of opioid analgesics, occurrence of postoperative nausea and vomiting, and scores on a numeric rating scale (NRS) were collected.
The total QOR-40 scores of the two groups differed significantly (P = .024) on postoperative day 1. Opioid consumption (P = .005) and occurrence of postoperative nausea (P = .019) in the post-anesthesia care unit (PACU) were significantly lower in the CEA group, whose NRS scores were significantly lower in the PACU (P < .001) and at postoperative day 1 (P = .016).
Assessment of postoperative quality of recovery after upper-arm vascular surgery in ESRD patients showed that the CEA group had significantly better total QOR-40 and NRS scores. CEA could be used as an alternative anesthetic technique for upper-arm vascular surgery for hemodialysis in ESRD patients to improve the quality of recovery.
Gastric and adrenal metastasis from breast cancer
Authors: Tang Tiantian , Zhang Lina , Li Chunxiao , Zhou Tao 
Published: January 2020

Abstract

Rationale:
Breast cancer is the most commonly diagnosed malignancies in females. The most common sites of metastasis are bone, lung, liver, and brain. Gastrointestinal and adrenal gland metastasis from breast cancer are rare. Simultaneous metastases are extremely rare. Therefore, it is critically important to choose proper examination and treatment since the rapid diagnosis and primary treatment can significantly affect the survival of patients. To the best of our knowledge, this was the first case of initial dual metastasis.

Patient concerns:
The patient had a history of left breast cancer, and she underwent left breast-conserving surgery with sentinel lymph node biopsy 2 years ago. She was hospitalized in our center with the complaints of a stomach and lower back pain, which started suddenly and was progressively increased for half a month.

Diagnosis:
Computed tomography, gastroscopy, and immunohistochemical staining, especially GATA3 and mammaglobin, confirmed that there was simultaneous gastric and adrenal metastases.

Interventions:
She was eligible for the IMpassion131 clinical trials, a Phase 3 randomized, double-blind, placebo-controlled trial under treatment with atezolizumab/palcebo plus paclitaxel as adjuvant-therapy.

Outcomes:
She was still undergoing the therapy and waiting for the further evaluation.

Lessons:
In order to better understand metastatic pathways of breast carcinoma, publications of individual patient cases diagnosed with rare metastatic sites should be encouraged, especially for the simultaneous rare metastatic sites. This might improve our understanding of metastatic behavior of breast cancer and promote further clinical research.
Clinical and histopathological characterization of root resorption in replanted teeth
Authors: Liu Huimin , Peng Xiaoxing , Sun Hongchen , Li Xiangwei 
Published: January 2020

Abstract

Rationale:
The frequency of tooth avulsion is on the rise due to increasing rates of maxillofacial trauma. Avulsed teeth present with varying degrees of root resorption, and are generally asymptomatic; therefore, they often go undiagnosed. The etiopathogenesis of root resorption in replanted teeth following avulsion remains unclear.

Patient concerns:
In case 1, the left upper lateral incisor became loose after 10 years of replantation. In case 2, the patient underwent tooth replantation after external root canal treatment due to tooth dislocation caused by trauma 8 years ago.

Diagnosis:
According to the medical history, clinical manifestations and imaging studies of the 2 patients, root resorption after replantation was diagnosed.

Interventions:
The teeth extraction was given to one patient. Besides the histological examination of extracted teeth was performed.

Outcomes:
Teeth that underwent pulp treatment presented with external resorption. On the other hand, the tooth that had received no pulp treatment showed both external and internal resorption; residual vital pulp tissue was detected within the pulp cavity.

Lessons:
The dental pulp tissues may be involved in the initiation or development of internal resorption. Trauma to the periodontal ligament might play a major role in external resorption, whereas internal tooth resorption may be caused as a result of injury to the residual pulp tissue. Thus, the effective management of these tissues during the treatment of replanted teeth is essential.
Sleep Quality Associated With Motor Function Among Older Adult Survivors of Critical Illness
Authors: Elías Maya N. , Munro Cindy L. , Liang Zhan 
Published: January 2020

Background
Poor sleep is associated with worse motor function in older adults. Sleep may affect motor function specifically among older adults recovering from critical illness after transfer out of an intensive care unit (ICU).

Objectives
Describe motor function (grip strength) of older ICU survivors and explore relationships between sleep and ICU-acquired weakness in the early post-ICU transition period.

Methods
We enrolled 30 older adults who were functionally independent prior to hospitalization, mechanically ventilated while in ICU, and within 24–48 hours post-ICU discharge. Handgrip dynamometry assessed post-ICU motor function (fully corrected T score on the National Institutes of Health Motor Battery Grip Strength Test). Actigraphy estimated post-ICU sleep duration (total sleep time [TST]) and fragmentation (wake after sleep onset) over two consecutive nights from 22:00 p.m. to 06:00 a.m.. We identified differences in grip strength by history of obstructive sleep apnea (OSA) using independent-samples t tests. We examined associations between sleep duration and grip strength using exploratory multivariate regression analyses, after adjustment for clinically relevant covariates.

Results
Grip strength among this cohort of older ICU survivors was almost 2 SDs below the norm for healthy older adults, indicating considerable ICU-acquired weakness. Grip strength was lower among subjects with history of OSA than those without OSA. Greater TST was associated with worse grip strength, after adjusting for history of OSA and Pittsburgh Sleep Quality Index global score. Moreover, among the subset of male subjects (n = 19), greater TST was significantly and negatively associated with grip strength, after adjusting for Acute Physiology, Age, and Chronic Health Evaluation III score, and Pittsburgh Sleep Quality Index global score.

Discussion
Sleep promotion may be a potentially modifiable risk factor to mitigate ICU-acquired weakness in older ICU survivors. We propose that improving sleep throughout recovery from critical illness may indirectly promote better outcomes, as poor grip strength is linked to longer length of hospital stay, higher acuity of discharge disposition, and worsened functional decline in older adults.
Postoperative Complications of Panniculectomy and Abdominoplasty
Authors: Lesko Robert P. , Cheah Michael A. , Sarmiento Samuel , Cooney Carisa M. , Cooney Damon S. 
Published: January 2020

Background
Recent studies of panniculectomy outcomes have reported variable complication rates ranging from 8.65% to 56%. Meanwhile, reported abdominoplasty complication rates are considerably lower (~4%). This discrepancy may be attributable to inaccurate inclusion of abdominoplasty patients in panniculectomy cohorts. We performed the current study to better characterize panniculectomy complication rates at a large tertiary care center.

Methods
We performed a retrospective review of patients who underwent abdominoplasty or panniculectomy at the Johns Hopkins Hospitals between 2010 and 2017. Patients were identified by Common Procedural Terminology codes (15847/17999, 15830) confirmed via the operative note. We examined postoperative complication rates including surgical site infection, seroma formation, wound dehiscence, readmission/reoperation, and postoperative length of stay (LOS). We used parametric and nonparametric methods to determine differences between abdominoplasty and panniculectomy outcomes, as well as logistic regression analysis to evaluate factors associated with patient outcomes following panniculectomy.

Results
Of the 306 patients included, 103 underwent abdominoplasty while 203 underwent panniculectomy. Initial complication rates following abdominoplasty and panniculectomy were 1.94% and 12.8%, respectively (P = 0.002). Thirty-day complication rates were 9.7% for abdominoplasty and 21.2% for panniculectomy (P = 0.012). The median LOS was 1 day (interquartile range, 0–1 day) for abdominoplasty and 2 days (interquartile range, 1–4 days) for panniculectomy (P = 0.002). No statistically significant differences in complication rates at 6 months and 1 year were observed.

Conclusions
Panniculectomy offers many functional benefits including improved hygiene and enhanced mobility. However, this study demonstrates that panniculectomy patients may have significantly higher complication rates initially and 30 days postoperatively and longer LOS than individuals undergoing abdominoplasty.