bluuebunny/crossref_metadata_2025_split huggingface dataset:
Post-Breast Surgery Pain Syndrome: Shifting a Surgical Paradigm
Authors: Beederman Maureen , Bank Jonathan 
Published: July 2021

Summary:
Post-mastectomy pain syndrome and the less well-described post-breast surgery pain syndrome are long-term neuropathic pain conditions that may affect more than 50% of patients after mastectomy and breast surgery. While the etiology, risk factors, and management have been reviewed in our literature, we offer here a focused outline that will gear the plastic surgeon with tools to lead a multidisciplinary, algorithmic approach to the care of patients with post-mastectomy pain syndrome/post-breast surgery pain syndrome. After reading this article, we hope the reader will have improved awareness of post-mastectomy pain syndrome/post-breast surgery pain syndrome, and thus be able to incorporate appropriate treatments and preventative steps into their primary surgical routine.
RETINAL TOXICITY FOLLOWING PRESUMED INADVERTENT INTRAOCULAR INJECTION OF MITOMYCIN C DURING TRABECULECTOMY
Authors: Desai Ria , Jampol Lee M. 
Published: July 2021

Purpose:
To describe a case of postoperative retinal toxicity following the use of mitomycin C during a routine trabeculectomy.

Methods:
Case report of a single patient who underwent complete ophthalmic examination and multimodal imaging, including color fundus photos, optical coherence tomography, fundus autofluorescence, and fluorescein angiography. The study was declared exempt by the Institutional Review Board of Northwestern University. This research followed the tenets of the Declaration of Helsinki.

Results:
The patient developed profound vision loss and retinal damage during the postoperative course. Posterior segment findings include loss of vascular perfusion, diffuse loss of the outer, then inner, retinal layers, and subsequent total retinal detachment.

Conclusion:
Although mitomycin C is commonly used in glaucoma filtering surgeries, reports of postoperative posterior segment toxicity are rare. The etiology of postoperative toxicity in this case is probable inadvertent intraocular injection of mitomycin C.
Retrobulbar Hyaluronidase Injection: Does It Reach the Eye?
Authors: Rudraprasad Dhanwini , Gagan Satyashree , Joseph Joveeta , Vasanthapuram Varshitha Hemanth , Naik Milind N. 
Published: July 2021

Purpose:
To determine if retrobulbar injection of hyaluronidase reaches the vitreous cavity, and to determine its concentration in the vitreous.

Methods:
Prospective case-control study. Patients undergoing evisceration with implant for noninfective blind eyes were enrolled in the study. Before the evisceration, a retrobulbar injection of 3,000 IU of hyaluronidase (2 ml) was injected. Time from injection to in vivo sampling of posterior vitreous was noted. Vitreous samples from controls were obtained from patients undergoing vitrectomy for retinal detachment or diabetic retinopathy. Concentration of hyaluronidase was assessed in all 30 samples. An ELISA-based microtiter-technique was used to evaluate the activity of hyaluronidase by an avidin-peroxidase-based procedure using an ELISA reader. Incubations were carried out at room temperature and at 37°C. All the samples were analyzed in duplicates, and the mean of each sample was plotted on a scatter plot.

Results:
Total of 30 vitreous samples were analyzed, of which 15 were controls and 15 were test samples. Of the 15 test samples, injection-to-sampling time was 0 to 20 minutes in 4 samples, 20 to 40 minutes in 6 samples, and 40 to 60 minutes in 5 samples. The highest concentration of hyaluronidase detected in control and test samples were 2.9 and 3.0 µg/ml, and the lowest concentration was 1.7 and 1.5 µg/ml (SD 0.3), respectively. There was no significant difference between control and test groups.

Conclusion:
Retrobulbar injection did not result in higher concentration of hyaluronidase in the posterior vitreous compared with controls when measured up to 60 minutes following injection.
The Management of Orbital Roof Fractures and Defects: A Review
Authors: Sandhu Pavandeep Singh , Bucur Sorin , Good Catriona , Cutler Mark , Rajak Saul 
Published: July 2021

Purpose:
To explore the anatomy, etiopathogenesis, diagnosis and classification, current evidence on intervention and the surgical management of orbital roof fractures and defects (ORFD) for oculoplastic surgeons presented with such cases.

Methods:
A review of the current literature through the MEDLINE database using the following search terms: “orbital roof fracture (+treatment/management),” “orbital roof defect (+treatment/management),” “orbital roof erosion (+treatment/management),” “orbital roof repair,” “orbital roof,” “orbital fracture,” “pediatric orbital roof (defect/fracture/erosion),” “orbital anatomy,” and “orbital roof anatomy” was conducted. As relatively little has been published on this topic, inclusion criteria were broad and peer-reviewed articles judged to be of clinical importance, relevant to the aims of this review, were included. Non-English abstracts were also included if relevant. Year of publication was not a strict exclusion criterion, and older articles were judged for their suitability based on clinical importance and relevance to current practice. Additional references were obtained from citations in key articles and recommendations from the coauthors based on their areas of expertise.

Results:
The etiopathogenesis of ORFD varies. Classification systems have been formulated to guide management decisions and can range from conservative management to complex neurosurgery. Eyelid approaches have also been described. This review provides a summary of the evidence for each and a management framework oculoplastic surgeons can use when presented with ORFD.

Conclusion:
Oculoplastic surgeons can be involved, either alone or as part of a multidisciplinary team, in the management of ORFD, and for some, conduct orbital approach reconstructive surgery.
Tocilizumab for the Management of Thyroid-Associated Orbitopathy
Authors: Smith Loreley D. , Moscato Eve E. , Seiff Stuart R. 
Published: July 2021

Purpose:
To describe the efficacy of tocilizumab in the treatment of a cohort of patients with active thyroid-associated orbitopathy.

Methods:
Patients were identified with active thyroid-associated orbitopathy who were intolerant of or had progression of disease despite systemic corticosteroids and subsequently were treated with tocilizumab between January 2015 and December 2020. Clinical Activity Score, Thyroid-Associated Ophthalmopathy Scale score, and thyroid-stimulating immunoglobulin levels were assessed prior to initiation of tocilizumab, following the first dose, and after the completion of treatment.

Results:
Eleven patients were candidates for and underwent treatment with tocilizumab, 9 of which met criteria for analysis. Average age was 55.6 years. Average time between onset of active thyroid-associated orbitopathy and completion of tocilizumab was 6.5 months. Average number of infusions was 4.2. There was a statistically significant reduction in Clinical Activity Score, Thyroid-Associated Ophthalmopathy Scale score, and thyroid-stimulating immunoglobulin levels when comparing pre-treatment values (mean Clinical Activity Score 6.78 ± 1.09, mean Thyroid-Associated Ophthalmopathy Scale score 10.2 ± 1.92, mean thyroid-stimulating immunoglobulin level 440.6 [%]) to values immediately following completion of treatment (mean Clinical Activity Score 0.44 ± 0.53, mean difference 6.3 points, p < 0.001 [95% CI, 5.5–7.2]; mean Thyroid-Associated Ophthalmopathy Scale score 1.2 ± 1.09, mean difference 9.0 points, p < 0.001 [95% CI, 7.2–10.8]; mean thyroid-stimulating immunoglobulin level 200.7 [%], mean difference 239.9 [%], p = 0.001 [95% CI, 124.3–355.4]). One patient had elevation of cholesterol following therapy induction. Patients were followed for an average of 23.6 months after treatment. No patients had recurrence of active disease after completion of tocilizumab.

Conclusions:
This study supports the use of tocilizumab as a therapy for the inflammatory phase of thyroid-associated orbitopathy.
Executive Functions and Attention in Patients With Psychogenic Nonepileptic Seizures Compared With Healthy Controls: A Cross-Sectional Study
Authors: Hamouda Karim , Senf-Beckenbach Philine Anna , Gerhardt Carola , Irorutola Freddy , Rose Matthias , Hinkelmann Kim 
Published: July 2021

ABSTRACT

Objective
Psychogenic nonepileptic seizures (PNESs) are considered functional neurological symptoms and are highly prevalent in specialized epilepsy clinics. The underlying mechanisms of PNES are not fully understood. Recent findings point toward possible alterations in attention and executive functions. This study aimed to extend the current knowledge of attention and executive function in patients with PNES and to assess possible relationships between seizures and dissociation, childhood trauma, and cognitive function.

Methods
We recruited 40 patients with PNES and 40 sex-, age-, and education-matched healthy controls (HCs) in this study. Participants completed self-report questionnaires to assess early life stress (Childhood Trauma Questionnaire [CTQ]), dissociation (the German version of the Dissociative Experience Scale, or Fragebogen zu dissoziativen Symptomen), and depression (Patient Health Questionnaire-9). Executive functions and attention were assessed with the Trail Making Test (TMT), Digit Span, and Attention Network Task.

Results
Compared with HCs, patients with PNES reported significantly higher levels of childhood trauma, depression, and dissociation. Patients with PNES also had reduced performance indices for Digit Span Forward (d = 0.62), Digit Span Backward (d = 0.62), and TMT (d = 0.67) but not Attention Network Task. CTQ scores positively correlated with TMT and Digit Span Backward performance in patients with PNES. Adjusting for CTQ scores attenuated the observed group difference in TMT performance. Depression and dissociation did not explain the observed findings.

Conclusions
These results contribute to the evidence of impaired executive functions in patients with PNES. Furthermore, childhood trauma scores, but not (trait) dissociation or depression scores, seem to drive group differences (HC versus patients with PNES).
Noninvasive Cervical Vagal Nerve Stimulation Alters Brain Activity During Traumatic Stress in Individuals With Posttraumatic Stress Disorder
Authors: Wittbrodt Matthew T. , Gurel Nil Z. , Nye Jonathon A. , Shandhi Md Mobashir H. , Gazi Asim H. , Shah Amit J. , Pearce Bradley D. , Murrah Nancy , Ko Yi-An , Shallenberger Lucy H. , Vaccarino Viola , Inan Omer T. , Bremner J. Douglas 
Published: July 2021

ABSTRACT

Objective
Posttraumatic stress disorder (PTSD) is a disabling condition affecting a large segment of the population; however, current treatment options have limitations. New interventions that target the neurobiological alterations underlying symptoms of PTSD could be highly beneficial. Transcutaneous cervical (neck) vagal nerve stimulation (tcVNS) has the potential to represent such an intervention. The goal of this study was to determine the effects of tcVNS on neural responses to reminders of traumatic stress in PTSD.

Methods
Twenty-two participants were randomized to receive either sham (n = 11) or active (n = 11) tcVNS stimulation in conjunction with exposure to neutral and personalized traumatic stress scripts with high-resolution positron emission tomography scanning with radiolabeled water for brain blood flow measurements.

Results
Compared with sham, tcVNS increased brain activations during trauma scripts (p < .005) within the bilateral frontal and temporal lobes, left hippocampus, posterior cingulate, and anterior cingulate (dorsal and pregenual), and right postcentral gyrus. Greater deactivations (p < .005) with tcVNS were observed within the bilateral frontal and parietal lobes and left thalamus. Compared with tcVNS, sham elicited greater activations (p < .005) in the bilateral frontal lobe, left precentral gyrus, precuneus, and thalamus, and right temporal and parietal lobes, hippocampus, insula, and posterior cingulate. Greater (p < .005) deactivations were observed with sham in the right temporal lobe, posterior cingulate, hippocampus, left anterior cingulate, and bilateral cerebellum.

Conclusions
tcVNS increased anterior cingulate and hippocampus activation during trauma scripts, potentially indicating a reversal of neurobiological changes with PTSD consistent with improved autonomic control.

Trial Registration: No. NCT02992899.
Congenital Chagas disease: progress toward implementation of pregnancy-based screening
Authors: Edwards Morven S. , Montgomery Susan P. 
Published: July 2021

Purpose of review
Lack of recognition of congenital Chagas disease in infants of mothers from endemic regions who are living in countries nonendemic for Trypanosoma cruzi infection suggests a high rate of underdiagnosis. Pregnancy is the optimal access point for identifying Chagas disease in at-risk mothers and their infants. In this review, we update progress toward implementation of pregnancy-based screening for congenital Chagas disease in nonendemic settings.

Recent findings
International organizations have updated recommendations for diagnosis, treatment and prevention of congenital Chagas disease. Reports of successful implementation of pregnancy-based screening at some centers provide a model for optimizing diagnosis of congenital Chagas disease. Screening family members of index patients may identify additional T. cruzi-infected persons. Promising tests to augment current diagnostic modalities for maternal and congenital Chagas disease are in development. Universal or risk-based screening would be cost-effective. More healthcare providers are now aware that treatment of congenital Chagas disease is curative and are promoting efforts to make pregnancy-based screening for congenital Chagas disease a standard of care.

Summary
Ongoing efforts to implement routine pregnancy-based screening for congenital Chagas disease in nonendemic regions will mutually benefit infants, their mothers and family members and can prevent potentially fatal Chagas cardiomyopathy.
Low-Field Magnetic Resonance Imaging
Authors: Hori Masaaki , Hagiwara Akifumi , Goto Masami , Wada Akihiko , Aoki Shigeki 
Published: July 2021

Abstract
Low-field magnetic resonance imaging (MRI) systems have seen a renaissance recently due to improvements in technology (both hardware and software). Originally, the performance of low-field MRI systems was rated lower than their actual clinical usefulness, and they were viewed as low-cost but poorly performing systems. However, various applications similar to high-field MRI systems (1.5 T and 3 T) have gradually become possible, culminating with high-performance low-field MRI systems and their adaptations now being proposed that have unique advantages over high-field MRI systems in various aspects. This review article describes the physical characteristics of low-field MRI systems and presents both their advantages and disadvantages for clinical use (past to present), along with their cutting-edge clinical applications.
Handball-Related Head and Neck Trauma: An Analysis of the 2000–2019 National Electronic Injury Surveillance System (NEISS) Database
Authors: Stanbouly Dani , Murphy Richard , Lee Kevin C. , Halepas Steve , Koch Alia 
Published: July 2021

Purpose:The purpose of this study was to report on the characteristics of head and neck injuries secondary to the sport of Handball in the United States.Materials and Methods:This is a 20-year cross-sectional study that was conducted using the National Electronic Injury Surveillance System. Handball injuries were included in the study if they involved the head, face, eyeball, mouth, ear, or neck. The primary study predictor was age group. The study outcome was the type of injury (diagnosis) and the location of injury. Chi-squared testing (χ2) was performed to compare categorical variables.Results:Males composed more than three-fourths of the sample of patients (76.2%). White patients (38.7%) composed the most common racial group. The most common anatomical location injured was the head (45.9%). The most common primary diagnoses were contusion/abrasion (22.5%). Children were most likely to injure their head (P < 0.01) among all the anatomic regions. Young adults were least likely to injure their eyeball (P < 0.05). In contrast to children, adults were least likely to injure their head (P < 0.01). In contrast to young adults, adults were most likely to injure their eyeball (P < 0.01). With regards to types of injuries, Children were least likely to incur lacerations (P < 0.01). In contrast, young adults were most likely to incur lacerations (P < 0.01); however, young adults were least likely to suffer from contusions/abrasions (P < 0.01). In contrast to young adults, adults were most likely to suffer from contusions/abrasions (P < 0.01).Conclusions:Contusions/abrasions and brain damage were the two most common injuries in this sport. The head was the most commonly injured anatomical region. Both the type of injury and the anatomical location of injury that occur during the practice of handball significantly vary depending on the age group involved in the game.
Cognitive-behavioral and related therapies for obsessive–compulsive and related disorders
Authors: Reddy Y.C. Janardhan , Arumugham Shyam Sundar , Balachander Srinivas 
Published: July 2021

Purpose of review
Cognitive behavioral therapy (CBT) with exposure and response prevention is the first-line treatment for obsessive–compulsive disorder (OCD) and related disorders such as body dysmorphic disorder (BDD). We review here recent developments in CBT and related therapies in treating OCD and related disorders.

Recent findings
Superiority of CBT over medications in treating OCD is being questioned by some recent meta-analyses, nonetheless CBT continues to be the mainstay of treatment. Web-based therapies have been shown to be beneficial in treating at least mild-to-moderately ill patients. Mindfulness-based CBT, intensive residential treatment and Bergen 4-day concentrated exposure are also proving to be useful in treating OCD. Large well designed studies have demonstrated the efficacy CBT over supportive therapy in treating BDD. Research on the efficacy of CBT in treating hoarding disorder is accumulating.

Summary
Efficacy of web-based CBT has a potential public health importance in that CBT may now become accessible to all and benefit at least mild-to-moderately ill patients who form most of the clinically ill sample. Similarly, efficacy of Bergen 4-day concentrated exposure will have a huge public health implication if the findings can be replicated in other centers across the world.
Contemporary psychological perspectives of personality disorders
Authors: Marčinko Darko , Jakšić Nenad , Šimunović Filipčić Ivona , Mustač Filip 
Published: July 2021

Purpose of review
The aim of this study was to review the recent literature on contemporary psychological perspectives of personality disorders, including novel psychotherapeutic interventions aimed at these vulnerable individuals.

Recent findings
Among the various psychological theories and models of personality disorders, still the most popular and researched are psychodynamic, cognitive and interpersonal perspectives. More specifically, object relations theory, cognitive schema conceptualization and interpersonal circumplex model have produced the most empirical investigations of personality disorders in recent years. Latest work has suggested that all three perspectives have contributed to and are compatible with the dimensional personality disorders framework in DSM-5-AMPD and ICD-11 (including level of personality functioning and personality traits). These models have yielded specific psychological treatments of personality disorders; although most psychotherapies have been constructed for patients with borderline personality disorder (BPD), there is an increasing number of treatment modalities aimed at individuals with other forms of personality disorder, such as those with narcissistic or antisocial traits/disorders. More research into their effectiveness and long-term benefits is necessary.

Summary
Novel research keeps updating our knowledge on the cause, manifestations and psychological treatments of personality disorders, particularly from psychodynamic, cognitive and interpersonal perspectives.
Biallelic TET2 mutation sensitizes to 5’-azacitidine in acute myeloid leukemia
Authors: Stölzel Friedrich , Fordham Sarah E. , Lin Wei-Yu , Blair Helen , Elstob Claire , Nandana Devi , Mohr Brigitte , Ruhnke Leo , Kunadt Desiree , Dill Claudia , Allsop Daniel , Piddock Rachel , Soura Emmanouela-Niki , Park Catherine , Fadly Mohd , Rahman Thahira , Alharbi Abrar , Wobus Manja , Altmann Heidi , Röllig Christoph , Wagenführ Lisa , Jones Gail L. , Menne Tobias , Jackson Graham H. , Marr Helen J. , Fitzgibbon Jude , Onel Kenan , Meggendorfer Manja , Heidenreich Olaf , Haferlach Torsten , Villar Sara , Ariceta Beñat , Diaz Rosa Ayala , Prosper Felipe , Montesinos Pau , Martinez-Lopez Joaquin , Bornhäuser Martin , Allan James M. 
Published: July 2021

AbstractPrecision medicine can significantly improve outcomes for cancer patients, but implementation requires comprehensive characterization of tumor cells to identify therapeutically exploitable vulnerabilities. Here we describe somatic biallelic TET2 mutation (focal deletion and nonsense mutation) in an elderly patient with acute myeloid leukemia (AML) that was chemoresistant to anthracycline and cytarabine, but acutely sensitive to 5’-azacitidine (5’-Aza) hypomethylating monotherapy, resulting in long-term morphological remission (overall survival (OS) 850 days). Given the role of TET2 as a regulator of genomic methylation, we hypothesized that mutant TET2 allele dosage affects response to 5’-Aza. Using an isogenic cell model system and an orthotopic mouse xenograft, we demonstrate that biallelic TET2 mutations confer sensitivity to 5’-Aza compared to cells with monoallelic mutation. We subsequently identified 29 additional patients from the Study Alliance Leukemia biobank with chromosome 4 abnormalities and identified two further patients with complex biallelic TET2 mutations, including one with trisomy 4, homozygosity across the long arm and an inactivating point mutation. We also screened patients recruited to the PETHEMA FLUGAZA phase 3 clinical trial and identified three patients with biallelic TET2 mutations, two of whom had responded very well to single agent 5’-Aza (OS 767 and 579 days) despite having adverse risk AML and poor performance status. Our data argue in favor of using hypomethylating agents for chemoresistant disease or as first line therapy in patients with biallelic TET2-mutated AML and demonstrate the importance of considering mutant allele dosage in the implementation of precision medicine for cancer patients.Key PointsMutant TET2 allele dosage affects response to 5’-azacitidine in acute myeloid leukemia in vitro and in a xenograft model.Our data highlight the importance for screening of biallelic mutations to predict response to therapy in acute myeloid leukemia.