bluuebunny/crossref_metadata_2025_split huggingface dataset:
Genitourinary syndrome of menopause symptom severity and impact outcome measures: are they reliable and correlated?
Authors: Mercier Joanie , Morin Mélanie , Reichetzer Barbara , Lemieux Marie-Claude , Khalifé Samir , Dumoulin Chantale 
Published: December 2018

Abstract

Objective:
The Most Bothersome Symptom Approach (MBSA) assesses symptom severity of genitourinary syndrome of menopause (GSM), and identifies the symptom with the greatest burden. The Atrophy Symptoms Questionnaire (ASQ) assesses the impact of GSM symptoms on the activities of daily living. The psychometric properties of these outcomes remain to be completely assessed. This study aimed to assess the test-retest reliability of the MBSA and the ASQ and their convergent validity.

Method:
One evaluator administered the outcomes twice 2 weeks apart to postmenopausal women with GSM and urinary incontinence. MBSA reliability was assessed with the graphical analysis of paired differences, Kappa coefficients and intraclass correlation coefficient (ICC), and the ASQ reliability, with paired t test and ICC. The convergent validity of both outcomes was investigated through their association with the Pearson correlation coefficient.

Results:
Thirty-one women participated in the study. For the MBSA, the severity of the most bothersome symptom obtained a good reliability with 80% observed agreement between sessions, a substantial kappa (0.67 ± 0.12) and excellent ICC (0.88 [95% confidence interval 0.75-0.94]). For the ASQ, no significant difference was found between sessions (P = 0.146) and ICC indicated excellent reliability (0.85 [95% confidence interval 0.69-0.93]). There was a large, positive correlation between the severity of the most bothersome symptom selected by the participants in the MBSA and the ASQ total score for the two measurement sessions (T1: r = 0.587, P = 0.001 and T2: r = 0.601, P < 0.001).

Conclusions:
The MBSA and the ASQ are reliable outcome measures in postmenopausal women with GSM and urinary incontinence. Our findings support good convergent validity of those two outcomes as they showed a significant positive correlation between the severity of GSM symptoms and their impact on activities of daily living.
CHOROIDAL NEOVASCULAR AREA AND VESSEL DENSITY COMPARISON BETWEEN TWO SWEPT-SOURCE OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY DEVICES
Authors: Ohayon Avi , Sacconi Riccardo , Semoun Oudy , Corbelli Eleonora , Souied Eric H. , Querques Giuseppe 
Published: December 2018

Purpose:
To compare choroidal neovascularization (CNV) area and vessel density (VD) measurements between two different swept-source optical coherence tomography angiography (SS-OCTA) devices.

Methods:
En face optical coherence tomography angiography (OCTA) images of patients affected by neovascular age-related macular degeneration were collected prospectively from two devices: Zeiss PLEX Elite 9000 (Carl Zeiss Meditec, Dublin, CA) and Topcon DRI OCT Triton SS-OCTA (Topcon, Tokyo, Japan). Choroidal neovascularization area and VD of images were measured and analyzed with ImageJ software by two readers to evaluate the agreement between two devices, with respect to different image size (3 × 3 and 6 × 6 mm) and different image segmentation (automatic vs. manual), and a Topcon equivalent Zeiss segmentation as control (i.e., the equivalent anatomical slab given by Topcon device on the Zeiss device).

Results:
A total of 30 eyes (30 patients) were analyzed. There was an excellent agreement between the two readers in CNV area measurements intraclass correlation coefficient >0.9 in all analyses. We found excellent agreement in CNV area measurements (manual and automatic segmentations) when comparing 3 × 3-mm or 6 × 6-mm images both for each single device and between the two devices (overall intraclass correlation coefficient > 0.9). Vessel density measurements between manual to automatic segmentation within the same device and same image size had a high intraclass correlation coefficient value, but there was a poor agreement in VD between different image sizes (3 × 3 mm vs. 6 × 6 mm) in the same device and also comparing the two devices (3 × 3 Topcon vs. 3 × 3 Zeiss; 6 × 6 Topcon vs. 6 × 6 Zeiss). There was a poor agreement between the Topcon equivalent Zeiss segmentation and all other segmentations.

Conclusion:
There was an excellent agreement in CNV area measurements for both swept-source optical coherence tomography angiography devices in automatic and manual segmentations. However, the Topcon equivalent Zeiss segmentation was not comparable with any of the preset segmentations of Topcon and Zeiss devices. There was a poor agreement in CNV VD between different image size and different devices. For these reasons, it seems that, for accurate longitudinal analysis of VD, it is better to use the same device for each individual, even if both devices can be used interchangeably for CNV area measurements using automatic or manual segmentations.
Contralateral Eye Comparison Between 2 Cap Thicknesses in Small Incision Lenticule Extraction: 110 Versus 130 μm
Authors: Wu Fang , Yin Houfa , Yang Yabo 
Published: December 2018

Purpose:
To evaluate the posterior corneal elevation (PCE) and biomechanical changes after small incision lenticule extraction (SMILE) at depths of 110 μm and 130 μm.

Methods:
One hundred sixteen eyes from 58 consecutive patients who underwent SMILE were included in this prospective study. Each patient underwent SMILE in one eye to a depth of 110 μm and in the other eye to a depth of 130 μm. A Scheimpflug camera and Hartmann-Shack WASCA aberrometer were used to assess the PCE and wavefront aberrations, respectively, before SMILE and at 1 and 3 months after surgery. The PCE was analyzed along 3 optical zones (apex and 2 and 4 mm diameters) as a function of the meridian. Dynamic Scheimpflug imaging was used to evaluate the biomechanics preoperatively and at 1 day, 1 month, and 3 months postoperatively.

Results:
No significant difference was found in either vision correction or corneal biomechanics between the 2 groups. In both groups, the PCE became significantly flattened at the apex and at 2 mm annulus 1 month postoperatively, especially for the 110-μm cap group. Three months postoperatively, the 110-μm cap group was still flattened significantly, whereas the displacement at the apex in the 130-μm cap group had disappeared. There was no significant difference in wavefront aberrations between the groups after surgery, except in the vertical coma (P < 0.001).

Conclusions:
The differences in corneal biomechanics between the 110-μm cap group and 130-μm cap group were small; however, the superficial lenticule might cause displacement of the PCE to be more persistent in one eye than in the other.
Reports of Post-keratoplasty Infections for Eye Bank-prepared and Non–Eye Bank-prepared Corneas: 12 Years of Data From a Single Eye Bank
Authors: Mathes Kristin J. , Tran Khoa D. , Mayko Zachary M. , Stoeger Christopher G. , Straiko Michael D. , Terry Mark A. 
Published: December 2018

Purpose:
To examine postoperative reports of infection rates for eye bank-prepared and non–eye bank-prepared corneas from January 1, 2006 to December 31, 2017, from a single eye bank.

Method:
A retrospective review of reported fungal and bacterial infections with corneal transplant surgeries using corneas distributed by our eye bank was conducted. The reported number of infections for corneas that underwent eye bank preparation (pre-cut and pre-stripped corneas) and for those distributed without eye bank preparation was quantified. The potential association between infection rates in tissue prepared by the eye bank and those in corneas that had no additional eye bank processing was also examined.

Results:
Four of 17,035 corneas distributed during the study period were associated with fungal infections (1 eye bank-prepared and 3 non–eye bank-prepared corneas) and were attributed to the tissue after investigation by eye bank medical directors. There was no ascending trend of infections reported with eye bank-prepared corneas in the first 3 years (2 of 1054 corneas, 0.19%) compared with that in the last 3 years of the study period (6 of 3500 corneas, 0.17%; P = 0.901) when the eye bank distributed 3 times more prepared corneas than non–eye bank-prepared corneas. A significant increase in the numbers of reported infections for non–eye bank-prepared corneas was observed between these 3-year intervals (0.1% in the first 3 years to 1.58% in the last 3 years; P = 0.001).

Conclusions:
Reports of infections remained low despite increased use of eye bank-prepared tissue. These results suggest that factors other than eye bank tissue preparation should be considered when investigating potential sources of pathogen contamination in donor corneas.
Relationship Between Ocular Surface Epithelial Damage, Tear Abnormalities, and Blink in Patients With Dry Eye
Authors: Kato Hiroaki , Yokoi Norihiko , Watanabe Akihide , Komuro Aoi , Sonomura Yukiko , Sotozono Chie , Kinoshita Shigeru 
Published: December 2018

Purpose:
Considering that tears play the role of a lubricant, it is speculated that in the pathophysiology of dry eye, increased friction during blinking results in corneal and conjunctival damage, which may subsequently affect the blink. The purpose of this study was to investigate the relationship between ocular surface epithelial damage, tear abnormalities, and blinks in patients with dry eye.

Methods:
This study involved 45 eyes of 45 female patients with dry eye (mean age: 57.6 years). In all eyes, tear meniscus radius (mm), spread grade of the tear film lipid layer (SG: 1-5: 1 being the best), fluorescein breakup time (FBUT, seconds), corneal and bulbar conjunctival epithelial damage (CED: 15 points maximum and CONJUNCTIVAL EPITHELIAL DAMAGE (CjED): 6 points maximum, respectively), and Schirmer I test (ST1, mm) were evaluated. Blink rate (BR, blinks per minute), palpebral aperture height (mm), upper-eyelid opening-phase amplitude/upper-eyelid closing-phase amplitude (mm), upper-eyelid opening-phase duration/upper-eyelid closing-phase duration (ms), and upper-eyelid opening-phase maximum velocity/upper-eyelid closing-phase maximum velocity (mm/s) were measured using a custom-made high-speed blink analyzer. Finally, the factors that determine CED and CjED were investigated by multiple regression analysis, in which the parameters were chosen using the stepwise procedure.

Results:
CED and CjED were found to be described as 2.687 + (1.816 × SG) − (0.937 × FBUT) (R2 = 0.656, P < 0.0001) and 0.684 + (0.801 × SG) − (0.526 × FBUT) − (0.041 × ST1) + (0.010 × upper-eyelid closing-phase maximum velocity) (R2 = 0.714, P < 0.0001), respectively.

Conclusions:
Although CED was significantly related to only tear abnormalities, CjED was significantly related to tear abnormalities and blinking.
Accuracy of Tonopen Versus iCare in Human Cadaveric Eyes With Edematous Corneas Over a Wide Range of Intraocular Pressures
Authors: Ruland Kelly , Olayanju Jessica , Borras Terete , Grewal Dilraj S. , Fleischman David 
Published: December 2018

Purpose:
The purpose of this study was to compare the accuracy of 2 portable tonometers, Tonopen and iCare, in extreme corneal edema, while also accounting for the location of pressure measurement over a wide range of intraocular pressure (IOP).

Methods:
Utilizing an experimental laboratory investigation, IOP measurements were obtained with iCare and Tonopen against an internal digital manometer in 2 enucleated human cadaveric eyes with edematous corneas. Pachymetry was used to measure central corneal thickness in each eye. Each eye was then mounted on an upright-positioned mannequin, and a 30-G needle connected to a digital manometer was introduced into the anterior chamber at the limbus. Pressures were maintained at 0, 10, 20, 30, 40, and 50 mmHg using the digital manometer. Three measurements were taken with the tonometers at the central cornea, limbal cornea, and sclera, for a total of 9 measurements per device per eye at each manometric pressure reading.

Results:
Comparing the mean absolute error of Tonopen versus iCare measurements at the central cornea for each manometric pressure reading, both devices underestimated the control at pressures >10 mmHg, with mean error increasing as IOP increased [mean absolute error (MAE) ranged from 1.67 to 13.33 with Tonopen and 3.67 to 21.00 with iCare]. Tonopen more accurately estimated pressure with an average MAE of 5.72 at the central cornea, compared with MAE of 10.83 at the central cornea for iCare (P<0.03). Comparing MAE between the devices at the limbus, there was no significant difference between the 2 (P=0.91), with average MAE for the Tonopen 5.47 and average MAE for the iCare 5.22. There was no significant difference between average MAE for Tonopen measurements at the central cornea versus the limbus (P=0.89), while the iCare was more accurate at the limbus with average MAE of 5.22 than the central cornea with average MAE of 10.83 (P<0.03). When measuring at the sclera, there was no statistically significant difference between average MAE for Tonopen (18.03) versus iCare (10.39) (P=0.24).

Discussion:
Tonopen was more accurate than iCare when measuring at the central cornea, but consistently underestimated the control. MAE for both devices increased linearly with increasing true IOP. With limbus measurements in an edematous cornea, Tonopen and iCare performed similarly. The iCare performed better at the limbus than at the central cornea. Scleral measurements for both Tonopen and iCare were poor. In this experimental model, Tonopen performed superiorly to iCare with central cornea measurements in a grossly edematous cornea. Both devices underestimated true IOP.
The Relationship Between Long-term Use of Intranasal Corticosteroid and Intraocular Pressure
Authors: Mohd Zain Ayesha , Md Noh Umi K. , Hussein Salina , Che Hamzah Jemaima , Mohd Khialdin Safinaz , Md Din Norshamsiah 
Published: December 2018

Purpose:
The purpose of this study was to investigate the association between long-term intranasal steroid use and intraocular pressure (IOP) elevation.

Patients and Methods:
In total, 100 eyes from 50 patients on long-term intranasal steroids (>2 y) for allergic rhinitis and 90 eyes from 45 controls were included in this study. Patients on other forms of steroids and risk factors for glaucoma were excluded. IOP was measured and nonmydriatic stereoscopic optic disc photos were taken for each eye. The vertical cup-to-disc ratio and the status of the optic disc were evaluated.

Results:
The mean IOP for intranasal steroids group was significantly higher (15.24±2.31 mm Hg) compared to the control group (13.91±1.86 mm Hg; P=0.000). However, there were no significant differences in the vertical cup-to-disc ratio and the status of glaucomatous optic disc changes between the groups.

Conclusions:
Prolonged use of intranasal steroids cause statistical significant increase in IOP in patients with allergic rhinitis although no significant glaucomatous disc changes were seen. We suggest patients on long-term use of intranasal steroid have a yearly eye examination to be monitored for IOP elevation and those with additional risk factors for glaucoma is closely monitored for glaucoma.
Multimodality Management of Complex Periorbital Venolymphatic Malformations
Authors: Ramesh Sathyadeepak , Duckwiler Gary , Goldberg Robert A. , Rootman Daniel B. 
Published: December 2018

Purpose:
To review a representative case series and share a stepwise approach to the diagnosis and treatment of periorbital venolymphatic malformations.

Methods:
A case series of 9 patients with representative periorbital venolymphatic malformations. All patients managed at the University of California, Los Angeles Orbital Center for a vascular malformation over the last 5 years were reviewed. Cases representative of the varied pathologic findings and techniques were selected. The clinical, radiologic, and intraoperative findings are presented and a survey of techniques composed.

Results:
Venolymphatic malformations can have protean manifestations. Characteristics vital to the understanding and management of these lesions are the classification and vascular composition of the lesion, internal flow and drainage patterns, anatomic localization and association with distant components. Options for treatment include sclerotherapy, biologic therapy, embolization, surgical excision, or some combination thereof.

Conclusions:
A comprehensive understanding of each patient’s unique lesion is critical to a rational treatment approach. Teamwork and creativity are key to effectively managing these lesions.
A New Safety Scoring System for the Use of Psychotropic Drugs During Lactation
Authors: Uguz Faruk 
Published: December 2018

Background:
Psychotropic drugs are frequently used to treat postpartum women with psychiatric diagnoses, especially psychotic disorder, major depression, and bipolar mood episodes. Pharmacotherapy in breastfeeding mothers is a major challenge.

Study Question:
This article presents a new safety scoring system for the use of psychotropic drugs during lactation.

Study Design:
The scoring system is based on the following 6 safety parameters: reported total sample, reported maximum relative infant dose, reported sample size for relative infant dose, infant plasma drug levels, prevalence of reported any adverse effect, and reported serious adverse effects. The total score ranges from 0 to 10. Higher scores represent a higher safety profile.

Results:
According to this scoring system, sertraline and paroxetine, respectively, had the highest scores representing “very good safety profile.” Citalopram, olanzapine, and midazolam were assigned to “good safety profile.” Among drugs evaluated in this article, trifluoperazine, aripiprazole, amisulpride, clozapine, doxepin, zaleplon, and zolpidem are not recommended owing to safety scores ≤3.

Conclusions:
Most psychotropic drugs examined in this article have “moderate” or “low” safety profile.
Development of a Core Outcome Set for Infant Gastroesophageal Reflux Disease
Authors: Singendonk Maartje M.J. , Rexwinkel Robyn , Steutel Nina F. , Gottrand Frederic , McCall Lisa , Orsagh‐Yentis Danielle K. , Rosen Rachel , Strisciuglio Caterina , Thapar Nikhil , Vandenplas Yvan , Benninga Marc A. , Tabbers Merit M. 
Published: December 2018

ABSTRACTObjective:In therapeutic trials for infant gastroesophageal reflux disease (GERD), ways to define GERD and measure and report study outcomes vary widely. The aim of this study was to develop a core outcome set (COS) for infant GERD.Methods:The COS was developed using the Delphi technique, adhering to the Outcome Measures in Rheumatology Initiative 2.0 recommendations. Healthcare professionals (HCPs) (predominantly pediatric gastroenterologists and general pediatricians) and parents of infants (age 0–12 months) with GERD, listed up to 5 primary goals of therapy from their perspective and up to 5 persistent signs or symptoms that would signify inadequate treatment. Outcomes mentioned by >10% of participants were included in 2 shortlists. Next, HCPs and parents rated and prioritized outcomes on these shortlists. Outcomes with the highest rank formed the draft COS. The final COS was created after 2 consensus meetings between an expert panel and patient representatives.Results:In total, 125 of 165 HCPs (76%) and 139 of 143 parents (97%) of infants with GERD completed the first phase. The second phase was completed by 83 of 139 HCPs (60%) and 127 of 142 different parents (89%). Outcomes of these phases were discussed during the consensus meetings and a 9‐item COS was formed: “Adequate Growth,” “Adequate Relief,” “Adverse events,”, “Crying,” “Evidence of Esophagitis,” “Feeding Difficulties,” ”Hematemesis,“ ”No Escalation of Therapy,“ and ”Sleep Problems.”Conclusions:We developed a COS for infant GERD consisting of 9 items that should minimally be measured in future therapeutic trials to decrease study heterogeneity and ease comparability of results.
Celiac Disease in Brazilian First‐degree Relatives
Authors: Lopes Letícia H.C. , Muniz Janaína G. , Oliveira Ricardo P. , Sdepanian Vera L. 
Published: December 2018

ABSTRACTFirst‐degree relatives (FDRs) of 47 outpatients with celiac disease (CD) answered a questionnaire about symptoms related to CD and were investigated for human leukocyte antigen (HLA)‐DQ2, DQB1*02 homozygosis, and DQ8 alleles. Genetically susceptible individuals were tested for antitransglutaminase antibody immunoglobulin A. Seropositive FDR underwent small bowel biopsies.From 114 FDR, 74.5% (n = 85) were positive for DQ2, DQ8, or both haplotypes. Homozygosity of DQB1*02 was found in 11.4% (n = 13) individuals. Three FDR were previously diagnosed with CD. Among the genetically susceptible individuals, 67.1% had at least 1 symptom related to CD. Seropositivity was 8/82 (9.8%), and 4/8 biopsies were compatible with CD. Therefore, the total number of FDR with CD was 6.1% (7/114), 95% confidence interval (1.71, 10.49). Three out of 7 FDR with CD were HLA DQB1*02 homozygous. The odds of being CD is 5 times, 95% confidence interval (0.99, 26.23), greater for HLA DQ B1*02 homozygous in FDR.
Measurement of Microvascular Function in Pediatric Inflammatory Bowel Disease
Authors: Winderman Rebecca , Rabinowitz Simon S. , Vaidy Katherine , Schwarz Steven M. 
Published: December 2018

ABSTRACTBackground and Aims:Altered vascular flow is known to both play a role in the pathogenesis and influence the severity of inflammatory bowel disease (IBD). This phenomenon has been described in other systemic conditions and contributes to disease progression by facilitating inflammation and thrombosis. Microvascular dysfunction may represent an early sign of generalized vascular disease (VD). It manifests by failure to achieve a normal response of vasodilation and increased blood flow following a period of vaso‐occlusion. Although thromboembolic complications are well described in IBD, their pathogenesis is not fully understood. This study sought to assess microvascular responsiveness in pediatric subjects with IBD, by recording postocclusion peripheral arterial pulsatile volume changes.Patients and Methods:A total of 32 pediatric subjects were studied, including 16 with IBD and 16 age‐matched controls. All patients with IBD were in clinical remission, and none had known VD. Vascular reactivity was evaluated using the Itamar Medical EndoPAT2000, a noninvasive device utilizing plethysmography to measure microvascular flow. Results were reported as the reactive hyperemia index (RHI), indicating post‐ to preocclusion pulsatile volume changes.Results:Baseline characteristics, including body mass index, plasma lipid levels, hemoglobin, and serum albumin, were similar in both study groups. All patients with IBD were in clinical remission, assessed by standard disease activity scoring methods. Measurements of microvascular function indicated patients with IBD exhibited a mean RHI both within the range associated with VD risk in adults (⩽1.67) and significantly lower than that in controls (IBD vs control = 1.66 vs 2.02, P = 0.036).Conclusions:Microvascular plethysmography is a safe and noninvasive method for assessing microvascular function in children with IBD. Patients with IBD in clinical remission demonstrate an attenuated, postocclusion microvascular hyperemic response, compared with the normal response in controls. These findings suggest pediatric IBD subjects with a mean RHI within the VD “at risk” range should be monitored for thromboembolic phenomena. Further studies in a larger patient population and over longer periods should be conducted to validate our findings and to determine the importance of these measurements in guiding IBD management.