bluuebunny/crossref_metadata_2025_split huggingface dataset:
La réanimation des personnes âgées
Authors: Brunet Fabrice 
Published: October 2021

L’amélioration des performances des services de réanimation a permis de prendre en charge des malades de plus en plus graves. Toutefois, le succès de toute réanimation dépend de plusieurs facteurs propres au patient et à l’organisation des soins. La prise en charge des personnes âgées dans un service de réanimation reste controversée. Toutefois, la notion de « personne âgée » ne revêt pas la même signification pour chacun et l’âge chronologique, en dehors du très grand âge (> 85-90 ans), ne suffit pas à établir un seuil discriminant. La proportion de malades âgés de plus de 65 ans admis en réanimation variait de 17 % en Nouvelle-Zélande, à 45 % aux États-Unis, avec des chiffres proches de 30 % au Japon, au Canada et en France, en 1993. Le vieillissement de la population risque de majorer ces chiffres. Cette évolution n’est pas dénuée de conséquences médicales, bien sûr, mais elle entraîne aussi des implications économiques, liées à une augmentation des dépenses de Santé publique. Il est apparu, ainsi, nécessaire de fixer des limites à l’admission de malades ne pouvant bénéficier des soins de réanimation ? Des scores évaluant la gravité initiale et la réponse au traitement au cours du séjour ont été développés dans ce but. Parmi les critères retenus dans ces scores, l’âge est considéré comme un facteur pouvant limiter l’intérêt de la réanimation. Si on juge de l’efficacité de la réanimation en termes de mortalité, une étude multicentrique française portant sur 3 867 patients a montré que celle-ci passait de 12 % pour des malades de 40 ans à 25 % à 70 ans. Cependant, selon les études, le type de service de réanimation et l’âge considéré, la mortalité varie entre 30 et 50 %. Ainsi, les chances de survie au cours d’un séjour en réanimation baissent avec l’âge, mais d’autres facteurs liés à la pathologie aiguë ou aux maladies sous-jacentes interviennent aussi et l’admission en réanimation ne saurait être refusée sur ce seul critère. La prise en charge des personnes âgées durant leur séjour en réanimation ne semble pas différente de celle des sujets jeunes dans l’indication et la réalisation des techniques de réanimation, mais les particularités physiques et psychiques liées au vieillissement doivent être considérées. L’analyse des rares études portant sur la qualité de vie des personnes âgées après un séjour en réanimation médicale ou chirurgicale fait état d’une mortalité accrue chez les personnes âgées par rapport aux sujets plus jeunes à un an, mais d’une qualité de vie comparable. La plupart de ces études soulignent l’importance de la réadaptation du sujet âgé au décours de l’hospitalisation en réanimation, indispensable à sa réinsertion sociale.
Preoperative Factors Affecting Visual Acuity Following the Implantation of Diffractive Multifocal Intraocular Lenses
Authors: Takabatake Ryu , Takahashi Makiko 
Published: October 2021

PURPOSE:
To investigate the preoperative factors affecting visual acuity after the implantation of a diffractive multifocal intraocular lens.

METHODS:
This study evaluated 774 eyes of 774 patients who underwent cataract surgery with TECNIS Multifocal ZLB00 lens (Johnson & Johnson Surgical Vision) implantation. Anterior segment optical coherence tomography (CASIA2; Tomey Corporation) was performed as a part of the preoperative eye examination. Sex, age, axial length, and CASIA2 parameters, such as crystalline lens diameter and lens tilt relative to the corneal topographic axis, were investigated. The eyes considered were classified into good (20/20 or better) or poor (worse than 20/20) far vision groups based on corrected distance visual acuity, and good (20/25 or better) or poor (worse than 20/25) near vision groups based on distance-corrected near visual acuity, respectively. Preoperative characteristics of both groups were compared to determine factors affecting postoperative visual acuity.

RESULTS:

Multivariate logistic regression analysis revealed that older age (
P
< .001), a short axial length (
P
= .010), and a large lens tilt (
P
< .001) were associated with poor near vision. There was no significant difference between the two far vision groups. There was a significant negative correlation between lens tilt and axial length (
r
= −0.513,
P
< .001).

CONCLUSIONS:
The results of this study suggest that age, axial length, and lens tilt to the corneal topographic axis may predict poor visual acuity after the implantation of a diffractive multifocal intraocular lens. Eyes with a short axial length tended to have a large degree of lens tilt and should be considered particularly carefully.

[
J Refract Surg
. 2021;37(10):674–679.]
Large Axis Difference Between Topographic Anterior Corneal Astigmatism and Manifest Refractive Astigmatism: Can Topography-Guided LASIK Target the Manifest Axis?
Authors: Wallerstein Avi , Gauvin Mathieu , Ruyu Qi Susan , Cohen Mark 
Published: October 2021

PURPOSE:
To investigate whether the degree of astigmatism axis discrepancy between preoperative manifest refractive astigmatism and anterior corneal astigmatism impacts refractive and visual outcomes of primary topography-guided laser in situ keratomileusis (LASIK) targeting the refractive astigmatism, and to provide guidance on treating eyes with very large axis discrepancy.

METHODS:
Comparative retrospective analysis of 25,396 consecutive eyes treated with topography-guided LASIK on the manifest refractive astigmatism. Standard outcomes of the 14,534 eyes with small axis discrepancy (SAD) (Δ in axis ⩽ 10°) were compared to the 2,222 eyes with very large axis discrepancy (VLAD) (Δ in axis ⩾ 45°). Pearson correlation coefficient was used to assess relationships between selected variables.

RESULTS:

The mean axis discrepancy was 4.47 ± 2.92° in SAD eyes, and 65.0 ± 13.4° in VLAD eyes. An equivalent number of eyes achieved a cumulative postoperative unilateral uncorrected distance visual acuity of 20/20 in both the SAD and VLAD groups (93.02% vs 93.42%;
P
= .4892). The efficacy index (0.98 ± 0.13 vs 0.98 ± 0.07;
P
= .3931) and the safety index (1.00 ± 0.11 vs 1.00 ± 0.03;
P
= .4757) were identical between groups. There was no clinically meaningful correlation between the preoperative axis discrepancy and preoperative total root mean square anterior corneal coma, postoperative refractive astigmatism, defocus equivalent, spherical equivalent, and angle of error, all with weak correlation coefficients (
R
= −0.02, −0.03, −0.02, 0.01, and 0.05).

CONCLUSIONS:
Large preoperative axis discrepancy (45° to 90°) between refractive astigmatism and topography-measured anterior corneal astigmatism does not negatively impact topography-guided LASIK, having identical refractive and visual outcomes compared to eyes with small (0° to 10°) discrepancy. There is no basis to exclude eyes with large axis discrepancy from topography-guided LASIK, and these eyes should be treated on the manifest refractive astigmatism.

[
J Refract Surg
. 2021;37(10):662-673.]
Relifting Flap Enhancement Procedure After Primary Allogenic Refractive Lenticule Implantation
Authors: Wu Jiawei , Xiong Lu , Wang Zheng 
Published: October 2021

PURPOSE:
To describe the results of a relifting flap enhancement procedure for correction of residual refractive error after primary lenticule intrastromal keratoplasty (LIKE).

METHODS:
Case report.

RESULTS:
One year after a LIKE procedure in the left eye, the patient (uncorrected distance visual acuity [UDVA]: 20/25; corrected distance visual acuity [CDVA]: 20/20; manifest refraction: −1.00 +1.00 × 105°) underwent flap relifting. The WaveLight EX500 excimer laser platform (Alcon Laboratories, Inc) was used for the topography-guided enhancement procedure to correct the residual refractive error and corneal irregularities. During the 1-year follow-up period, the cornea remained clear, the UDVA increased to 20/20 (reaching the level of preoperative CDVA), and manifest refraction was −0.25 +0.75 × 90°.

CONCLUSIONS:
The enhancement procedure described in this case report was effective for correction of residual refractive error and improvement of visual acuity following the LIKE procedure. The enhancement was stable for at least 15 months after the procedure.

[
J Refract Surg
. 2021;37(10):715–719.]
Outcomes of Rhegmatogenous Retinal Detachment Repair When Comparing Surgeon Continuity in a Team-Based Practice
Authors: Raevis Joseph J. , Oakey Zackery , Altaweel Michael , Nork T. Michael , Gottlieb Justin , Ip Michael , Downie Elaine , Lasarev Michael , Chang Jonathan S. 
Published: October 2021

BACKGROUND AND OBJECTIVE:
To facilitate timely surgery and efficient use of operating room time, our practice uses a team-based approach so patients may undergo primary rhegmatogenous retinal detachment (RRD) surgery with a different surgeon instead of the diagnosing surgeon.

PATIENTS AND METHODS:
This was a retrospective cohort study of 331 eyes that underwent RRD surgery. Patients were divided into two groups: RRD surgery performed by the diagnosing surgon, and RRD surgery performed by a different surgeon.

RESULTS:

Of 331 eyes, 200 eyes (60.4%) were repaired by the diagnosing surgeon and 131 eyes (39.6%) were repaired by a different surgeon. Primary anatomic success (PAS) rates at 3 months postoperatively were equivalent between the two groups (87.0% and 87.8% in the diagnosing surgeon and different surgeon groups, respectively [
P
= .83]). There was no significant difference in preoperative (
P
= .08) or final (
P
= .28) visual acuity between the groups. Time between diagnosis and RRD repair was shorter in the different surgeon group (median of 1.5 days [IQR: 1.0–3.6] in the surgeon group versus 2.2 days [IQR: 0.8–5.7] in the diagnosing surgeon group) (
P
= .03). Logistic regression analysis gave no evidence to suggest that PAS rates depended on day of week, time of day surgery was performed, group, or the interaction between those factors (
P
= .93).

CONCLUSIONS:
Visual and anatomic success in RRD repair are equivalent when surgery is performed by either the diagnosing surgeon or a surgical colleague because time to surgery is reduced. Neither time of day nor day of the week had any influence on the outcomes.

[
Ophthalmic Surg Lasers Imaging Retina
. 2021;52:560–566.]
Lithostratigraphy and lithogeochemistry of Ediacaran alkaline basaltic rocks of the Musgravetown Group, Bonavista Peninsula, northeastern Newfoundland, Canada: an extensional volcanogenic basin in the type-Avalon terrane
Authors: Mills Andrea , Sandeman Hamish 
Published: October 2021

Volcanic rocks of the Ediacaran Musgravetown Group on Bonavista Peninsula, Avalon terrane, Newfoundland, include basal ca. 600 Ma calc-alkaline basalt succeeded by continental tholeiite and alkaline rhyolite of the ca. 592 Ma Plate Cove volcanic belt (Bull Arm Formation), indicating a change from subduction-related to extensionrelated tectonic regimes during that interval. Alkalic basalts on northeastern (Dam Pond area) and southwestern (British Harbour area) Bonavista Peninsula occur below and above, respectively, the ca. 580 Ma glacial Trinity facies. Dam Pond basalt occurs in a structural dome intercalated with and flanked by fine-grained, siliciclastic deposits (Big Head Formation) overlain by Trinity facies. The British Harbour basalt occurs above the Trinity facies, in an upward- coarsening sandstone sequence (Rocky Harbour Formation) overlain by red beds of the Crown Hill Formation (uppermost Musgravetown Group). The Rocky Harbour and Big Head formations are likely stratigraphically interfingered proximal and distal deposits, respectively, derived from erosion of the Bull Arm Formation and older Avalonian assemblages.The Big Head basalts have lower SiO2, Zr, FeOT, P2O5, TiO2 and higher Mg#, Cr, V, Co and Ni contents, and are therefore more primitive than the more FeOT-, TiO2-, and P2O5-rich British Harbour basalts. Large-ionlithophile and rare-earth-element concentrations and ratios indicate that both suites originated from low degree partial melts of deep, weakly garnet-bearing, undepleted asthenospheric peridotite sources, with magma conduits likely focused along regional extensional faults. The protracted and episodic extension-related volcanic activity is consistent with a geodynamic setting that evolved from a mature arc into extensional basins with slowly waning magmatism, possibly involving slab rollback and delamination followed by magmatic underplating. The duration and variation of both volcanism and sedimentation indicate that the Musgravetown Group should be elevated to a Supergroup in order to facilitate future correlation of its constituent parts with other Avalonian basins.
Case Report: The First Borrelia yangtzensis Infection in a Human in Korea
Authors: Kim Choon Mee , Yun Na Ra , Kim Dong-Min 
Published: October 2021

ABSTRACT.
Borrelia yangtzensis has been identified in rodents and ticks in China and Japan. A 57-year-old woman with bite mark was diagnosed with B. yangtzensis infection via molecular and serological testing. Here, we report the first case of human infection caused by B. yangtzensis in Korea.
Nutrition, Inflammation, and the Gut Microbiota among Outpatients with Active Tuberculosis Disease in India
Authors: Huey Samantha L. , Yu Elaine A. , Finkelstein Julia L. , Glesby Marshall J. , Bonam Wesley , Russell David G. , Mehta Saurabh 
Published: October 2021

ABSTRACT.
India has the highest rates of tuberculosis (TB) globally and a high prevalence of malnutrition; however, the interplay between host nutritional status, inflammation, and the gut microbiome in active tuberculosis disease (ATBD) is less well-studied. We examined differences in gut microbial composition and diversity based on undernutrition and inflammation status among outpatients with ATBD at the time of treatment initiation. During this exploratory cross-sectional study, outpatients (N = 32) with ATBD (confirmed by Xpert MTB/RIF) were enrolled in anti-TB treatment initiated at a hospital in rural southern India. The 16S rRNA sequencing was used to assess the composition of the gut microbiome. We assessed multiple markers of nutritional status, including micronutrient status concentrations (vitamin D [25(OH)D], vitamin B12, ferritin), anthropometry (body mass index, mid-upper arm circumference, and height), and C-reactive protein (CRP), as indicators of inflammation. We found that 25(OH)D was positively associated with the relative abundance of Oscillospira spp., a butyrate-producing genus linked with anti-inflammation effects, and that ferritin was positively associated with Proteobacteria taxa, which have been associated with worse inflammation in other studies. Finally, we found a greater abundance of inflammation-associated taxa from the Proteobacteria phylum and lower alpha-diversity indices among those who were underweight or who had low mid-upper arm circumference or short stature. In summary, we found differences in the gut microbiota composition and diversity among those with undernutrition compared with those with adequate nutrition status at the time of initiation of treatment among patients with ATBD in India. Clinical implications of these findings will need to be examined by larger longitudinal studies.
Modeled Impact of Seasonal Malaria Chemoprevention on District-Level Suspected and Confirmed Malaria Cases in Chad Based on Routine Clinical Data (2013–2018)
Authors: Richardson Sol , Moukenet Azoukalne , Diar Mahamat Saleh Issakha , de Cola Monica Anna , Rassi Christian , Counihan Helen , Roca-Feltrer Arantxa 
Published: October 2021

ABSTRACT.
Sulfadoxine-pyrimethamine plus amodiaquine is delivered to children aged 3–59 months as seasonal malaria chemoprevention (SMC) in areas where transmission is highly seasonal such as Chad and other Sahelian countries. Although clinical trials show a 75% reduction in malaria cases, evidence of SMC’s impact at scale remains limited. Using data from the Chadian National Health Management Information System, we analyzed associations between SMC implementation during July–October and monthly district-level malaria incidence (suspected and confirmed outpatient cases) among children aged 0–59 months at health facilities in 23 health districts with SMC implementation during 2013–2018. Generalized additive models were fitted with separate cyclic cubic spline terms for each district to adjust for seasonality in cases. SMC implementation in Chad was associated, compared with no implementation, with lower monthly counts of both suspected (rate ratio [RR]: 0.82, 95% CI: 0.72–0.94. P = 0.006) and confirmed malaria cases (RR: 0.81, 95% CI: 0.71–0.93, P = 0.003), representing around 20% reduction in malaria incidence. Sensitivity analyses showed effect sizes of up to 28% after modifying model assumptions. Caution should be exercised in interpreting our findings, which may not be comparable with other studies, and may over- or underestimate impact of SMC; not all malaria cases present at health facilities, not all suspected cases are tested, and not all facilities report cases consistently. This study’s approach presents a solution for employing readily available routine data to evaluate the impact of health interventions at scale without extensive covariate data. Further efforts are needed to improve the quality of routine data in Chad and elsewhere.
Proximity of Residence to Irrigation Determines Malaria Risk and Anopheles Abundance at an Irrigated Agroecosystem in Malawi
Authors: Mangani Charles , Frake April N. , Chipula Grivin , Mkwaila Wezi , Kakota Tasokwa , Mambo Isaac , Chim'gonda Jerome , Mathanga Don , Mzilahowa Themba , Zulu Leo , Walker Edward 
Published: October 2021

ABSTRACT.
As countries of sub-Saharan Africa expand irrigation to improve food security and foster economic growth, it is important to quantify the malaria risk associated with this process. Irrigated ecosystems can be associated with increased malaria risk, but this relationship is not fully understood. We studied this relationship at the Bwanje Valley Irrigation Scheme (800 hectares) in Malawi. Household prevalence of malaria and indoor Anopheles density were quantified in two cross-sectional studies in 2016 and 2017 (5,829 residents of 1,091 households). Multilevel logistic regression was used to estimate the association between distance to the irrigation scheme and malaria infection and mosquito density. The prevalence of malaria infection was 50.2% (2,765/5,511) by histidine-rich protein 2–based malaria rapid diagnostic tests and 30.1% (1,626/5,403) by microscopy. Individuals residing in households within 3 km of the scheme had significantly higher prevalence of infection (adjusted odds ratio [aOR] = 1.41; 95% confidence interval [CI] 1.18, 1.68); school-aged children had the highest prevalence among age groups (aOR = 1.34; 95% CI 1.11, 1.63). Individuals who reported bed net use, and households with higher socioeconomic status and higher level of education for household head or spouse, had lower odds of malaria infection. Female Anopheles mosquitoes (2,215 total; Anopheles arabiensis, 90.5%, Anopheles funestus, 9.5%) were significantly more abundant in houses located within 1.5 km of the scheme. Proximity of human dwellings to the irrigation scheme increased malaria risk, but higher household wealth index reduced risk. Therefore, multisectoral approaches that spur economic growth while mitigating increased malaria transmission are needed for people living close to irrigated sites.
Assessment of Commercial Real-Time PCR Assays for Detection of Malaria Infection in a Non-Endemic Setting
Authors: Ramírez Alexandra Martín , Tang Thuy Huong Ta , Suárez Marta Lanza , Fernández Ana Álvarez , García Carlota Muñoz , Hisam Shamilah , Rubio José M. 
Published: October 2021

ABSTRACT.
Malaria control and elimination require prompt diagnosis and accurate treatment. Conventional methods such as rapid diagnostic tests (RDTs) and microscopy lack the characteristics to detect low parasitemias, commonly found in asymptomatic parasitemias and/or submicroscopic malaria carriers. On the contrary, molecular methods have higher sensitivity and specificity. This study evaluated the performance of two commercial real-time polymerase chain reaction (PCR) assays, RealStar® Malaria PCR (RealStar-genus) and RealStar Malaria Screen&Type PCR (RealStar-species), compared with the reference Nested Multiplex Malaria PCR, for the detection of the main five Plasmodium species affecting humans. A total of 121 samples were evaluated. Values of sensitivity (98.9% and 97.8%) and specificity (100% and 96.7%) of the RealStar-genus and the RealStar-species assays, respectively, were very good. The limit of detection (LoD) for the RealStar-genus assay showed a mean value of 0.28 parasites/µL with Plasmodium falciparum samples; while, the LoD of the RealStar-species assay ranged from 0.09 parasites/µL for P. vivax to two parasites/µL for P. ovale. The time to complete a diagnosis was established in 4 hours. Our findings showed a very good concordance of both assays compared with the reference method, with a very good analytical sensitivity. RealStar-species assay was able to correctly characterize double and triple infections. Therefore, these RealStar assays have shown to be useful tools in malaria diagnosis in non-endemic countries and even endemic countries, and for malaria control in general, detecting low parasitemias with sensitivity similar to the most sensitive methods as nested PCR, but with lower time to get the results.
The Applicability of Commonly Used Severity of Illness Scores to Tropical Infections in Australia
Authors: Salaveria Kris , Smith Simon , Liu Yu-Hsuan , Bagshaw Richard , Ott Markus , Stewart Alexandra , Law Matthew , Carter Angus , Hanson Josh 
Published: October 2021

ABSTRACT.
Many patients with leptospirosis, melioidosis, and rickettsial infection require intensive care unit (ICU) admission in tropical Australia every year. The multi-organ dysfunction associated with these infections results in significantly elevated severity of illness (SOI) scores. However, the accuracy of these SOI scores in predicting death from these tropical infections is incompletely defined. This retrospective study was performed at Cairns Hospital, a tertiary-referral hospital in tropical Australia. All patients admitted to ICU with laboratory-confirmed leptospirosis, melioidosis, and rickettsial disease between January 1, 1999 and June 30, 2020, were eligible for the study. The ability of Acute Physiology and Chronic Health Evaluation (APACHE) II, APACHE III, Simplified Acute Physiology Scores (SAPS) II, and Sequential Organ Failure Assessment (SOFA) scores to predict death before ICU discharge was evaluated. Overall, 18 (12.1%) of the 149 included patients died: 15/74 (20.3%) with melioidosis, 2/54 (3.7%) with leptospirosis and 1/21 (4.8%) with rickettsial disease. However, the APACHE II, APACHE III, SAPS II, and SOFA scores significantly overestimated the case-fatality rate of all the infections; the disparity between the predicted and observed mortality was most marked in the cases of leptospirosis and rickettsial disease. Commonly used SOI scores significantly overestimate the case-fatality rate of melioidosis, leptospirosis, and rickettsial infections in Australian ICU patients. This may be at least partly explained by the unique pathophysiology of these infections, particularly leptospirosis and rickettsial disease. However, SOI scores may still be useful in facilitating the comparison of disease severity in clinical trials that examine patients with these pathogens.