bluuebunny/crossref_metadata_2025_split huggingface dataset:
Irregular Astigmatism Management Using SPOT Scleral Lenses in the Treatment of Corneal Ectasia and Penetrating Keratoplasty
Authors: Navel Valentin , Barriere Jean-Vincent , Joubert Romain , Coutu Adrien , Watson Stephanie L. , Lambert Céline , Dutheil Frédéric , Chiambaretta Frédéric 
Published: May 2021

Purpose:
To evaluate the outcome of SPOT scleral lenses in the management of irregular astigmatism in patients with corneal ectasia and penetrating keratoplasty. Second, we analyzed patients' characteristics and tolerance, comfort, and geometries of fitted lenses.

Method:
Over a 5-year period, we included patients experiencing irregular astigmatism fitted with SPOT scleral contact lenses, from the University Hospital of Clermont-Ferrand, France. Data collected included corneal diseases, refractive error, best-corrected visual acuity (VA) with SPOT lenses, geometry of the lens, number of adjustment consultations, and the duration of follow-up. Comfort, quality of vision, less handling, and satisfaction were evaluated using visual analog scales after a 6-month follow-up period.

Results:
Sixty-five patients were included, analyzing 107 eyes. Eighty percent of patients still daily wore lenses after a follow-up of 22.3±13.8 months. Visual acuity improved by 0.47±0.51 logarithm of the minimum angle of resolution (average increase of 5 lines) (P<0.001) after wearing scleral lenses. Comfort, quality of vision, less handling, and satisfaction of contact lenses were excellent (>75/100). Contact lenses were daily worn 10.0±4.1 hr/day. Most patients wore size M (17 mm) lenses (53.3% of patients), with an average sagittal height of 5.2±1.2 mm. Internal toricity was used in 30% of cases. Best geometry was found after 2.69±0.87 consultations.

Conclusion:
SPOT scleral contact lenses are an effective and well tolerated method to improve the VA of patients with irregular astigmatism.
Comparison of corneal surgically induced astigmatism calculations based on keratometry measurements made by 2 biometric devices
Authors: Abulafia Adi , Rein Adi Porat , Weill Yishay , Zadok David , Mourits Maarten P. , Lapid-Gortzak Ruth 
Published: May 2021

Purpose:
To compare calculated corneal surgically induced astigmatism (SIA) by means of anterior-based keratometry (K) and total keratometry (TK) measurements made by 2 biometric devices.

Setting:
Ophthalmology Department, Shaare Zedek Medical Center, Jerusalem, Israel.

Design:
Retrospective, consecutive case series.

Methods:
The medical records of patients who had undergone cataract surgery through a 2.4 mm temporal clear corneal incision by a single surgeon between March 2018 and November 2020 were retrospectively reviewed. Patients for whom there were preoperative and postoperative K measurements assessed by 2 biometric devices, optical low-coherence reflectometry (OLCR) (Lenstar LS900, Haag-Streit, software v. eye suite i/9.1.0.0) and swept-source optical coherence tomography (SS-OCT) (IOLMaster700, Carl Zeiss Meditec AG, software v. 1.80.6.60340), were identified. Corneal SIA (mean vector value) was calculated by vector analysis for 3 groups: SS-OCT(K), SS-OCT(TK), and OLCR(K). Bivariate analyses were applied for comparisons.

Results:
147 eyes of 123 patients (73 right eyes and 74 left eyes) were enrolled in the study. The right eye corneal SIA values were 0.09 diopters (D) @ 136 degrees, 0.09 D @ 141 degrees, and 0.07 D @ 123 degrees for the SS-OCT(K), SS-OCT(TK), and OLCR, respectively. The corresponding left eye corneal SIA values were 0.13 D @ 120 degrees, 0.11 D @ 123 degrees, and 0.08 D @ 120 degrees. There were no statistically significant differences between the mean vector value and variance of the corneal SIA for the right (P = .78 and P = .65) and the left (P = .75 and P = .37) eyes of the 3 groups.

Conclusions:
Corneal SIA values were low (0.07 to 0.13 D) and similar for the SS-OCT and the OLCR biometric devices with standard K measurements. TK measurements yielded similar corneal SIA values compared with anterior corneal-based measurements.
Visual outcome after rhegmatogenous retinal detachment repair surgery in patients with multifocal vs monofocal intraocular lenses
Authors: Freissinger Sigrid , Vounotrypidis Efstathios , Stetzer Eva , Bayer Iris , Shajari Mehdi , Kreutzer Thomas , Keidel Leonie , Kern Christoph , Priglinger Siegfried , Wolf Armin 
Published: May 2021

Purpose:
To evaluate functional outcome after retinal detachment (RD) repair surgery in eyes with a multifocal intraocular lens (mIOL).

Setting:
Ludwig-Maximilians-University, Munich, Germany.

Design:
Single-center case control study.

Methods:
52 pseudophakic eyes with successful anatomical outcome after surgical RD repair were included. Retrospectively, 21 mIOL eyes were compared with a matched group of 21 monofocal eyes over 6 weeks. Prospectively, corrected distance visual acuity (CDVA) was evaluated over 12 months in these eyes. Furthermore, uncorrected distance, intermediate, and near visual acuity (UDVA, UIVA, and UNVA, respectively), defocus curves, and patient-reported outcomes were evaluated at 1 year in 24 mIOL eyes.

Results:
52 eyes of 48 patients comprised the study. The mean CDVA (logMAR) improved significantly from 1.35 ± 1.38 to 0.29 ± 0.37 at 6 weeks and remained stable at 12 months postoperatively in monofocal eyes (P = .001) and from 1.16 ± 1.2 to 0.37 ± 0.29 (6 weeks) and 0.20 ± 0.36 (12 months) in mIOL eyes (P = .001). Univariate factorial analysis of variance showed no statistically significant differences in CDVA at 6 weeks or 12 months postoperatively for IOL type or for preoperative macular status (P > .05). In the prospective cohort of 24 mIOL eyes, a mean CDVA of 0.13 ± 0.33 logMAR, UDVA of 0.21 ± 0.34 logMAR, UIVA of 0.17 ± 0.28 logMAR, and UNVA of 0.23 ± 0.32 logMAR was achieved. Macular status did not affect final outcome significantly (P > .05). Most patients stated they usually did not need spectacles; no patient wanted mIOL replacement.

Conclusions:
1 year after successful anatomical repair after 23-gauge vitrectomy with gas tamponade, functionality of mIOL was restored, and CDVA was comparable with that of patients with monofocal IOL.
Sympathectomy decreases pain behaviors and nerve regeneration by downregulating monocyte chemokine CCL2 in dorsal root ganglia in the rat tibial nerve crush model
Authors: Zhu Xiaoyan , Xie Wenrui , Zhang Jingdong , Strong Judith A. , Zhang Jun-Ming 
Published: May 2021

Abstract
Peripheral nerve regeneration is associated with pain in several preclinical models of neuropathic pain. Some neuropathic pain conditions and preclinical neuropathic pain behaviors are improved by sympathetic blockade. In this study, we examined the effect of a localized “microsympathectomy,” ie, cutting the gray rami containing sympathetic postganglionic axons where they enter the L4 and L5 spinal nerves, which is more analogous to clinically used sympathetic blockade compared with chemical or surgical sympathectomy. We also examined manipulations of CCL2 (monocyte chemoattractant protein 1), a key player in both regeneration and pain. We used rat tibial nerve crush as a neuropathic pain model in which peripheral nerve regeneration can occur successfully. CCL2 in the sensory ganglia was increased by tibial nerve crush and reduced by microsympathectomy. Microsympathectomy and localized siRNA-mediated knockdown of CCL2 in the lumbar dorsal root ganglion had very similar effects: partial improvement of mechanical hypersensitivity and guarding behavior, reduction of regeneration markers growth-associated protein 43 and activating transcription factor 3, and reduction of macrophage density in the sensory ganglia and regenerating nerve. Microsympathectomy reduced functional regeneration as measured by myelinated action potential propagation through the injury site and denervation-induced atrophy of the tibial-innervated gastrocnemius muscle at day 10. Microsympathectomy plus CCL2 knockdown had behavioral effects similar to microsympathectomy alone. The results show that local sympathetic effects on neuropathic pain may be mediated in a large part by the effects on expression of CCL2, which in turn regulates the regeneration process.
First Annual Conference on New Health Practitioners
Authors: Sadler Alfred M. , Piemme Thomas E. 
Published: May 2021

Abstract
The First National Conference on New Health Practitioners was a seminal event in the development of the fledgling PA profession. Sponsored by the Association of Physician Assistant Programs and the American Academy of Physician Assistants, it was achieved by the cooperation of leaders committed to the success of the new profession. This article reveals, in a manner never before detailed, how this conference milestone was planned and what took place, and emphasizes its importance to the field. The meeting, held in April of 1973, was groundbreaking, attracting, among the 252 participants, the leadership of the American Medical Association, the National Board of Medical Examiners, the Federation of State Medical Boards, the Association of American Medical Colleges, the American Nurses Association, and federal agencies within the Department of Health, Education and Welfare, responsible for promoting and funding PA education, as well as PAs and PA educators. This remarkable participation, and conference program, have long deserved a more explicit accounting than they have had to date. Details for this article were enhanced when one of the authors (Piemme) discovered, among his archive of personal documents (from almost 50 years ago), 2 items originally generated by the US Air Force that provide more insight into details of the conference. One is a robust conference planning document outlining in detail both the organizational elements and the programmatic elements of the conference. The other is a final financial statement from the conference organizing committee.
Survival Outcomes of Acinar Cell Pancreatic Cancer
Authors: Shaib Walid L. , Zakka Katerina , Huang Weixing , Chen Zhengjia , Alese Olatunji B. , Wu Christina , Akce Mehmet , El-Rayes Bassel F. 
Published: May 2021

Objectives
Acinar cell pancreatic carcinomas (ACPCs) are rare neoplasms accounting for 1% to 2% of pancreatic tumors in adults. The objective of this study is to evaluate the benefit of chemotherapy in the adjuvant setting in resected ACPC and in the palliative setting for metastatic ACPC.

Methods
Data were obtained from all US hospitals that contributed to the National Cancer Database between 2004 and 2014. Cases were identified using the histology code 8550.

Results
A total of 593 patients with ACPC were identified. The mean age was 64.4 years (range, 18–90 years), with a male preponderance (72.8%, n = 432). Localized stage disease comprised 52.3% (n = 310) of patients. Among localized ACPC patients, 88.0% (n = 191) underwent surgery and 50.6% (n = 91) received adjuvant chemotherapy. The 5-year overall survival in those who received adjuvant treatment was slightly higher than those who did not receive adjuvant treatment (46.7% vs 44.8%, P = 0.3271). Among advanced-stage ACPC patients, 67.6% received chemotherapy, which translated into improved 5-year overall survival compared with no chemotherapy (8.1% vs 0%, P < 0.0001).

Conclusions
Chemotherapy in the palliative setting for advanced-stage ACPC patients was associated with improved survival. Adjuvant therapy did not translate into significant survival benefit.
The Clinical Applicability of Primary Thromboprophylaxis in Ambulatory Patients With Pancreatic Cancer
Authors: Sandow Lyndsey Paige , Cannon Laura A. , Weston Natalie Rose , Aung Kyaw Lwin , Oo Thein Hlaing 
Published: May 2021

Abstract
Thromboembolism is a leading cause of death in ambulatory patients with cancer. Patients with pancreatic adenocarcinoma have a very high risk of developing venous thromboembolism, especially within the first 6 months of diagnosis. Although primary thromboprophylaxis could reduce this risk, there are unresolved questions concerning choice of agents for anticoagulation, duration of anticoagulation treatment, and criteria for patient selection. Furthermore, the current clinical guidelines on primary thromboprophylaxis in ambulatory patients with pancreatic cancer are ambiguous. This review seeks out to understand and critically appraise the evidence supporting the use of primary thromboprophylaxis in patients with pancreatic cancer and its clinical applicability.
Diagnostic Accuracy of Computed Tomography Scores in Chronic Pancreatitis
Authors: Nordaas Ingrid Kvåle , Dimcevski Georg , Gilja Odd Helge , Havre Roald Flesland , Haldorsen Ingfrid S. , Engjom Trond 
Published: May 2021

Objectives
Computed tomography (CT) is the most commonly used imaging modality when diagnosing chronic pancreatitis (CP). We aimed to evaluate the diagnostic accuracy of CT scores for diagnosing CP.

Methods
One hundred eighteen patients were retrospectively included from an observational cohort study that comprised patients referred because of suspected CP. Patients were categorized as CP or non-CP using a modified Mayo score based on biochemistry, clinical presentation, and findings on endoscopic ultrasound and/or transabdominal ultrasound. The CT scans were scored according to the modified Cambridge classification and the unweighted CT score. Diagnostic performance indices were calculated using the modified Mayo score as reference standard.

Results
Seventy-six of the 118 patients fulfilled the CP diagnostic criteria (Mayo score ≥4). The modified Cambridge classification and the unweighted CT score yielded sensitivities of 63% and 67% and specificities of 91% and 91%, respectively, and similar areas under the receiver operating characteristic curves (95% confidence interval) of 0.79 (0.71–0.88)/0.81 (0.73–0.89), respectively (P, not significant).

Conclusions
Both CT scores had similar, moderate accuracies for diagnosing CP. The limitation in diagnostic accuracy makes CT ineligible as a single method to diagnose CP, supporting that the diagnostic process for CP needs to incorporate other imaging methods and/or markers for better diagnostics.
Genetic Variants in Patients With a Family History of Pancreatic Cancer
Authors: Zhu Huili , Welinsky Sara , Soper Emily R. , Brown Karen L. , Abul-Husn Noura S. , Lucas Aimee L. 
Published: May 2021

Objectives
Up to 15% of pancreatic cancer is hereditary. We aim to study the prevalence of pathogenic germline variants (PGVs) in patients referred for genetic counseling with a family history (FH) of pancreatic cancer.

Methods
We performed a retrospective single institution cohort study of individuals who underwent cancer genetic counseling with a FH of pancreatic cancer.

Results
We identified 314 patients. Genetic testing was performed in 291 (92.7%) and 187 (59.6%) underwent expanded multigene panel testing. Fifty-four PGVs were found in 53 (16.9%) individuals; PGVs in BRCA1/2 (37%) were most common. Seventy-two variants of uncertain significance (VUS) were found in 58 (18.5%) individuals; VUS in ATM (16.7%) were the most common. Of the 112 (35.4%) with a first-degree family member with pancreatic cancer, 14 PGVs were identified in 14 (12.5%) individuals and 28 VUS were identified in 21 (18.8%) individuals. After genetic testing, 47 (15.0%) individuals met International Cancer of the Pancreas Screening criteria and 67 (21.3%) met American College of Gastroenterology criteria for pancreatic surveillance.

Conclusions
Genetic testing of individuals with a FH of pancreatic cancer represents an opportunity to identify individuals who may be candidates for pancreatic surveillance.
Heat Shock Protein 90 Inhibitor Effects on Pancreatic Cancer Cell Cultures
Authors: Gulla Aistė , Kazlauskas Egidijus , Liang Hong , Strupas Kestutis , Petrauskas Vytautas , Matulis Daumantas , Eshleman James R. 
Published: May 2021

Objectives
Pancreatic ductal adenocarcinoma is one of the deadliest cancers for which few curative therapies are available to date. Heat shock protein 90 (Hsp90) inhibitors have shown activity against numerous cancers in vitro; therefore, we tested whether they could be used to target pancreatic ductal adenocarcinoma.

Methods
Inhibitors of Hsp90 ATPase activity were applied on low-passage pancreatic cell line cultures (Panc10.05, Panc215, A6L) in a dose-response manner, and the inhibitor in vitro effect on cell growth was evaluated. Seven of novel Hsp90 inhibitors based on resorcinol fragment and 5 commercially available Hsp90 inhibitors (17-AAG, AT-13387, AUY-922, ganetespib, and rifabutin) as well as control compound triptolide were tested yielding IC50 values in 2- and 3-dimensional assays.

Results
The novel Hsp90 inhibitors exhibited strong effects on all 3 tested pancreatic cell line cultures (Panc10.05, Panc215, A6L) reaching the IC50 of 300 to 600 nM in 2- and 3-dimensional assays.

Conclusions
Novel Hsp90 inhibitors can be developed as antipancreatic cancer agents. Their chemical structures are simpler, and they are likely to exhibit lower side effects than the much more complex inhibitors used as controls.
Autoimmune Pancreatitis
Authors: Javed Ammar A. , Wright Michael J. , Ding Ding , Javed Zunaira N. , Faghih Mahya , Rozich Noah S. , Fishman Elliot K. , Burns William R. , Cameron John L. , Weiss Matthew J. , He Jin , Singh Vikesh K. , Wolfgang Christopher L. , Burkhart Richard A. 
Published: May 2021

Objective
The aim of this study was to critically analyze the surgical experience of managing autoimmune pancreatitis (AIP) in an era of modern diagnostics and compare these patients with those who were managed conservatively.

Methods
Two prospectively maintained databases were used to retrospectively identify patients with AIP who were either managed conservatively or underwent pancreatectomy.

Results
Eighty-eight patients were included in the study, of which 56 (63.6%) underwent resection and 32 (36.4%) were managed conservatively. Patients who underwent resection were more likely to present with jaundice (64.3% vs 18.1%, P < 0.001) and weight loss (53.6% vs 15.6%, P = 0.005). The cohort who underwent resection had a significantly higher median carbohydrate antigen 19-9 (40.0 vs 18.6 U/mL, P = 0.034) and was less likely to have elevated immunoglobulin G4 (26.1% vs 50.0%, P < 0.001). The most frequent initial diagnosis in the cohort who underwent resection was ductal adenocarcinoma (82.1%). Nine patients (28.1%) in the conservatively managed cohort experienced AIP relapse compared with 6 patients (10.7%) in the cohort who underwent resection.

Conclusions
The most frequent reason for surgical resection of AIP is concern for malignancy. Carbohydrate antigen 19-9 elevations were more common than immunoglobulin G4 in our cohort, suggesting that this laboratory profile is suboptimal for this population.
Giant Cell Arteritis: When an Inspection Is Essential
Authors: Molins-Rojas Cristina , Vicente-Pascual Mikel 
Published: May 2021

Introduction:
The diagnosis of giant cell arteritis is based on clinical and analytical data. The definitive diagnosis is based on histopathologic study.

Case Report:
We present a patient with a typical headache, a prominent temporal artery in the examination, anemia, and elevation in erythrocyte sedimentation rate and C-reactive protein in blood analysis, and a halo sign in the sonography study, all compatible with giant cell arteritis.

Conclusion:
When dealing a patient with a typical headache, a prominent artery in the inspection, and a visualization of halo sign in ultrasound examination, this diagnosis must be considered.
Erythropoietin-Associated Posterior Reversible Encephalopathy Syndrome
Authors: White Jessica Daley , Anne Madhurima , Muralidharan Rajanandini 
Published: May 2021

Introduction:
This case demonstrates an underrecognized cause of posterior reversible encephalopathy syndrome (PRES).

Case Report:
We report a 51-year-old male with a history of essential hypertension without preexisting renal impairment who presented with 3 days of occipital headache and convulsive status epilepticus in the setting of refractory hypertension. He had been receiving outpatient human recombinant erythropoietin injections for virally mediated bone marrow suppression, which worsened his baseline hypertension. Magnetic resosnance imaging (MRI) of the brain on admission showed diffuse bilateral, symmetric signal hyperintensities and patchy enhancement involving the cortex and white matter in both cerebral hemispheres. His blood pressure and seizures were successfully treated during hospital admission, with complete resolution of his neurological deficits. MRI brain performed 6 weeks from initial scan showed normalization of his prior findings.

Conclusion:
Recombinant human erythropoietin (RhEPO) may be an underrecognized cause of PRES and should be considered in patients receiving this treatment regardless of the absence or presence of renal impairment. RhEPO-mediated precipitation/exacerbation of hypertension, alterations in cerebral blood flow, and changes in endothelial integrity may underlie this association. MRI signal changes are reversible and typical for that of PRES, and significant improvement of symptoms can be expected.
Mixed methods systematic review and metasummary about barriers and facilitators for the implementation of cotrimoxazole and isoniazid – preventive therapies for people living with HIV
Authors: Müller Pia , Velez Lapão Luís 
Published: May 2021

AbstractBackgroundCotrimoxazole and isoniazid preventive therapy (CPT, IPT) have been shown to be efficacious therapies for the prevention of opportunistic infections and tuberculosis (TB) among people living with human immunodeficiency virus (HIV). Despite governments’ efforts to translate World Health Organization recommendations into practice, implementation remains challenging. This review aimed to explore and compare CPT and IPT with respect to similarities and differences of barriers identified across high TB/HIV burden countries. A secondary objective was to identify facilitators for implementing both preventive therapies.MethodsWe searched MEDLINE, Web of Science and SCOPUS databases for peer-reviewed literature published before September 2020. We extracted and synthesized our findings using Maxqda software. We applied framework synthesis in conjunction with metasummary to compare both therapies with respect to similarities and differences of barriers identified across seven health system components (in line with the modified WHO’s Framework for action). Protocol registration: PROSPERO (CRD42019137778).FindingsWe identified four hundred and eighty-two papers, of which we included forty for review. Although most barrier themes were identical for both preventive therapies, we identified seven intervention-specific themes. Like for CPT, barriers identified for IPT were most frequently classified as ‘service delivery-related barriers’ and ‘patient & community-related barriers’. ‘Health provider-related barriers’ played an additional important role for implementing of IPT. Most facilitators identified referred to health system strengthening activities.ConclusionsFor researchers with limited working experience in high TB/HIV burden countries, this review can provide valuable insights about barriers that may arise at different levels of the health system. For policymakers in high TB/HIV burden countries, this review offers strategies for improving the delivery of IPT (or any newer therapy regimen) for the prevention of TB. Based on our findings, we suggest initial and continuous stakeholder involvement, a focus on the efficient use and reinforcement of existing resources for health.