bluuebunny/crossref_metadata_2025_split huggingface dataset:
REDUCED CHORIOCAPILLARIS FLOW IN EYES WITH TYPE 3 NEOVASCULARIZATION AND AGE-RELATED MACULAR DEGENERATION
Authors: Borrelli Enrico , Souied Eric H. , Freund K. Bailey , Querques Giuseppe , Miere Alexandra , Gal-Or Orly , Sacconi Riccardo , Sadda SriniVas R. , Sarraf David 
Published: May 2018

Purpose:
To study choriocapillaris (CC) flow in eyes with Type 3 neovascularization (NV) and age-related macular degeneration, using optical coherence tomography angiography analysis.

Methods:
In this multicenter, retrospective, observational study, we collected data from 21 patients with unilateral Type 3 NV and age-related macular degeneration, based on clinical examination, structural optical coherence tomography, and fluorescein angiography when available. An additional group of 20 nonneovascular age-related macular degeneration eyes with unilateral Type 1 or Type 2 NV due to age-related macular degeneration was included for comparison. En face optical coherence tomography angiography imaging (3 × 3 mm scans) with quantitative microvascular analysis of the CC was performed. Main outcome measures were: 1) the percent nonperfused choriocapillaris area; and 2) the average CC signal void size.

Results:
We included 21 patients with unilateral Type 3 NV (15 female, 71.5%) and 20 patients with unilateral Type 1 or 2 NV (9 female, 45.0% P = 0.118). Mean ± SD age was 82.1 ± 7.4 years in the unilateral Type 3 patients and 78.3 ± 8.1 in unilateral Type 1/2 NV subjects (P = 0.392). The percent nonperfused choriocapillaris area was 56.3 ± 8.1% in eyes with Type 3 NV and 51.9 ± 4.3% in the fellow eyes (P = 0.016). The average signal void size was also increased in those eyes with Type 3 NV (939.9 ± 680.9 μm2), compared with the fellow eyes (616.3 ± 304.2 μm2, P = 0.039). The number of signal voids was reduced in the Type 3 NV eyes (604.5 ± 282.9 vs. 747.3 ± 195.8, P = 0.046). The subfoveal choroidal thickness was 135.9 ± 54.2 μm in eyes with Type 3 NV and 167.2 ± 65.4 μm in the fellow eyes (P = 0.003). In addition, the fellow eyes of patients with unilateral Type 3 NV displayed more significant CC flow abnormalities versus the fellow eyes with unilateral Type 1/2 NV (percent nonperfused choriocapillaris area = 51.9 ± 4.3% vs. 46.0 ± 2.1%, respectively, P < 0.0001; and average signal void size 616.3 ± 304.2 μm2 versus 351.4 ± 65.5 μm2, respectively, P < 0.0001; and number of signal voids 747.3 ± 195.8 vs. 998.5 ± 147.3, respectively, P < 0.0001).

Conclusion:
Eyes with unilateral Type 3 NV illustrated increased CC nonperfusion versus fellow nonneovascular eyes. These results suggest that choroidal ischemia may play an important role in the development of Type 3 NV.
RAPID PROGRESSION OF FOVEOMACULAR RETINOSCHISIS IN YOUNG MYOPICS
Authors: Sun Zhongcui , Gao Hua , Wang Min , Chang Qing , Xu Gezhi 
Published: May 2018

Purpose:
To describe a foveomacular retinoschisis that has not been described.

Methods:
Patients with foveomacular retinoschisis were included. Exclusion criteria included refractive error over −6.00 diopters, presence of posterior staphyloma, positive RS1-gene mutation, family history of retinoschisis, optic disk abnormalities, or glaucoma. Vitrectomy was performed on eyes with functional or structural deterioration.

Results:
Seventeen eyes from 10 patients (15–30 years old, 8 females and 2 males) with foveoschisis were recruited, with bilateral involvement in 7 patients and unilateral in 3 patients. Vitrectomy was performed in 13 eyes (13/17, 76.5%). Seven eyes (6 patients) were operated soon after the first presentation because of poor vision and severe foveoschisis. Six eyes (6 patients) were operated 2 weeks to 13 months later because of deterioration of vision and foveoschisis. Preoperative vision was 20/134 ± 20/165, and postoperative vision was 20/25 ± 20/57, with visual improvement of 6.9 (4–14) lines. The mean postoperative follow-up period was 36.5 (15–69) months. Four eyes (4 patients) were asymptomatic, despite progression of foveoschisis. Three eyes (3 patients) maintained normal macula structures.

Conclusion:
We report a foveomacular retinoschisis characterized by young age of onset, female predominant, no highly myopia, mostly bilateral involvement, and rapid progression of foveoschisis and visual acuity. Vitrectomy is effective in restoring anatomical structure and stabilize vision.
Pediatric Corneal Transplants: Review of Current Practice Patterns
Authors: Zhu Angela Y. , Marquezan Maria Carolina , Kraus Courtney L. , Prescott Christina R. 
Published: May 2018

Purpose:
To facilitate development of standardized guidelines for management of pediatric patients undergoing keratoplasty, particularly the youngest cohort, through a comprehensive survey assessing recent trends in practice patterns of corneal specialists and pediatric ophthalmologists.

Methods:
A cross-sectional, observational study of current practices pertaining to pediatric keratoplasty was performed by designing a 20-question survey focused on preoperative indications, surgical techniques, and postoperative management. This survey was sent electronically to corneal specialists and pediatric ophthalmologists. Results were compared with the findings of previous studies regarding pediatric keratoplasty.

Results:
Of the 80 ophthalmologists who responded, 51.3% currently perform pediatric keratoplasty; only 20% have performed >50 cases. The majority (73.8%) completed solely corneal fellowships; all perform penetrating keratoplasty, 35.2% also perform endothelial keratoplasty, and 37% also perform lamellar keratoplasty. Peters anomaly was the most common indication for transplantation (34.3%). The majority believe that 1 to 3 months is the optimal age range to perform keratoplasty for both monocular and binocular congenital corneal opacities, although 13% stated that they would never perform keratoplasty in a patient with a monocular opacity. All surgeons report modifying their intraoperative techniques for pediatric patients, but specific practices and postoperative management protocols vary. There is a consensus regarding the importance of amblyopia therapy in these patients.

Conclusions:
Our results were consistent with the published literature regarding the indication and types of surgery performed. Variability among surgical techniques and postoperative management protocols highlights the necessity of creating standardized guidelines to optimize management of pediatric patients undergoing keratoplasty. Collaborative efforts between corneal and pediatric specialists are crucial for defining visual rehabilitation protocols to enhance visual outcomes.
Novel Gonioscopy Score and Predictive Factors for Intraocular Pressure Lowering After Phacoemulsification
Authors: Perez Claudio I. , Chansangpetch Sunee , Feinstein Max , Mora Marta , Nguyen Anwell , Badr Mai , Masis Marisse , Lin Shan C. 
Published: May 2018

Purpose:
To evaluate a novel gonioscopy score as a potential predictor for intraocular pressure (IOP) reduction after cataract surgery.

Materials and Methods:
This was a prospective study that included consecutive patients with or without glaucoma, either with open or narrow angles but without peripheral anterior synechiae, who underwent phacoemulsification. Eyes with intraoperative complications and secondary glaucoma were excluded. A preoperative gonioscopy score was created, summing the Shaffer gonioscopy grading in 4 quadrants (range, 0 to 16). To determine variables associated with IOP change at 6 months, univariate and multivariate linear mixed-effects regression analysis was performed adjusting for age, sex, and preoperative IOP.

Results:
In total, 188 eyes from 137 patients were enrolled. The mean age of the patients was 75.0 (±8.5) years and the average preoperative IOP was 15.6 (±3.6) mm Hg with 0.7 (range, 0 to 4) glaucoma medications. The mean IOP reduction after phacoemulsification was 3.0 (±2.6) mm Hg at postoperative month 6. After multivariate analysis, preoperative IOP [β=0.49 (0.41-0.58), P<0.0001], gonioscopy score [β=−0.17 (−0.24 to −0.09), P<0.0001], anterior chamber depth (ACD) [β=−0.88 (−1.64 to −0.14), P=0.02], and IOP/ACD ratio [β=0.45 (0.07 to 0.83) P=0.021] were associated with IOP reduction at 6 months.

Conclusions:
Preoperative predictors for IOP reduction after cataract surgery were preoperative IOP, ACD, gonioscopy score, and IOP/ACD ratio. The IOP/ACD ratio and gonioscopy score can be easy parameters to obtain and may help clinicians to estimate the IOP reduction after phacoemulsification.
Visual Field Tests for Glaucoma Patients With Initial Macular Damage: Comparison Between Frequency-doubling Technology and Standard Automated Perimetry Using 24-2 or 10-2 Visual Fields
Authors: Park Hae-Young Lopilly , Lee Jiyoung , Park Chan Kee 
Published: May 2018

Purpose:
The purpose of this study was to compare standard automated perimetry (SAP) and frequency-doubling technology (FDT) perimetry for detecting macular damage in glaucoma.

Materials and Methods:
A total of 112 glaucomatous eyes with localized retinal nerve fiber layer defects on red-free photographs and corresponding macular ganglion cell/inner plexiform layer (mGC/IPL) thinning on the deviation map of macular optical coherence tomography, and 35 healthy eyes were enrolled in the study. All participants underwent SAP 24-2, SAP 10-2, FDT 24-2, and FDT 10-2 visual field (VF) tests. Significantly depressed points, with confidence limits of 5% and 1%, were checked for in the pattern deviation plots of the VF tests. Detection rate of the macular damage, sensitivity, and specificity were compared among various VF tests. Patients were divided into eyes with mGC/IPL thinning within the normative database, depressed <5% or <1%. Comparison of VF parameters between various VF tests were performed according to the degree of mGC/IPL thinning.

Results:
All of the macular damage in glaucoma were detected using FDT 10-2 and 83.3% to 90.0% were detected using FDT 24-2 when the mGC/IPL thickness was <5%. Even when mGC/IPL thickness was within normal range, the detection rate of macular damage were 96% for FDT 10-2 and 80% for FDT 24-2. FDT 10-2 had the best diagnostic ability (areas under the receiver operating characteristics curve, 0.96) followed by FDT 24-2 (areas under the receiver operating characteristics curve, 0.76) for discriminating normal controls from glaucoma patients with macular damage. Comparing 10-2 and 24-2 tests with same strategy showed that FDT 10-2 was more sensitive than FDT 24-2 (P=0.004), with better specificity (P=0.010). Also, SAP 24-2 had similar specificity with SAP 10-2 (P=0.373), which was better than FDT 24-2 (P=0.016). The mean deviation of SAP 10-2 and the pattern standard deviation of SAP 10-2 were significantly related to mGC/IPL thickness.

Conclusions:
We found the detection rate of functional depression related to early macular damage were significant using FDT and parameters of SAP significantly predicted the degree of mGC/IPL thinning in glaucoma patients.
Pattern Scanning Laser (PASCAL) for Peripheral Iridoplasty in Eyes With Plateau Iris Syndrome: A Novel Application
Authors: Midha Neha , Hoskens Kirsten , Mansouri Kaweh 
Published: May 2018

Purpose:
The purpose of this study was to evaluate safety and efficacy of pattern scanning laser (PASCAL) for peripheral iridoplasty in eyes with plateau iris syndrome.

Materials and Methods:
This study was a retrospective review of cases that underwent PASCAL laser peripheral iridoplasty. Eyes with plateau iris syndrome confirmed on gonioscopy and ultrasound biomicroscopy were included in the study. Primary and secondary outcome measures were angle widening on gonioscopy and magnitude of intraocular pressure (IOP) reduction, respectively.

Results:
Twelve eyes of 8 patients that completed 1-year follow-up were analyzed. Angle widening was noted in 46% of treated quadrants by at least 1 grade (Shaffer classification) at 1-month follow-up. A statistically significant IOP reduction was noted at 1 year from 20.6±4.8 to 17.8±3.8 mm Hg (P=0.01). At 1 month, 8 of 12 eyes (66.6%) achieved gonioscopic success (widening of the angle by at least 1 grade in 2 of 4 quadrants). At 1 year, 6 of 12 eyes (50%) achieved tonometric success (20% reduction or 3 mm Hg IOP reduction from the baseline without addition of new antiglaucoma medications). No adverse effects associated with PASCAL laser peripheral iridoplasty were observed.

Conclusions:
PASCAL laser iridoplasty can be a safe and effective alternative to argon laser peripheral iridoplasty in the management of eyes with plateau iris syndrome. Our findings need to be further validated on larger sample size and in different ethnicities.
Direct Saliva Real-time Polymerase Chain Reaction Assay Shows Low Birth Prevalence of Congenital Cytomegalovirus Infection in Urban Western India
Authors: Viswanathan Rajlakshmi , Bafna Sanjay , Mergu Ravikanth , Deshpande Gururajrao , Gunjikar Rashmi , Gaikwad Shivshankar , Mullick Jayati 
Published: May 2018

Background:
Congenital cytomegalovirus (cCMV) infection is the leading infectious cause of mental retardation, developmental delay and sensorineural deafness. Nonprimary infection plays a major role in transmission of this infection in countries with high maternal seroprevalence. Noninvasive sampling and testing is a useful alternative to traditional methods of laboratory detection of congenital CMV infection. The present study was conducted to understand birth prevalence of cCMV infection using molecular techniques, in an urban setting of a developing country with evidence of high maternal seroprevalence.

Methods:
Universal newborn screening for cCMV was performed for 750 infants born at a tertiary care center in Western India. Real-time polymerase chain reaction was directly carried out on saliva samples. Follow-up laboratory testing of saliva, urine and blood was performed for neonates identified as positive. Sequential clinical follow-up was offered to the affected infants.

Results:
A birth prevalence of 0.4% (95% CI: 0.13–1.2) was observed with 3 of 750 babies confirmed to be positive for cCMV infection. All 3 babies were born to seropositive mothers (anti-CMV immunoglobulin G positive). One of the babies detected was symptomatic with sepsis like features. All of them survived and did not develop any sequelae up to 1 year of age.

Conclusion:
The use of direct real-time polymerase chain reaction of saliva samples can be considered as a feasible option for newborn screening of congenital CMV infection in developing countries. Relatively low birth prevalence of cCMV infection was observed in our study, which needs to be corroborated through further studies.
Neruodevelopmental Outcomes in Preschool Children Living With HIV-1 Subtypes A and D in Uganda
Authors: Ruiseñor-Escudero Horacio , Sikorskii Alla , Familiar-Lopez Itziar , Persaud Deborah , Ziemniak Carrie , Nakasujja Noeline , Opoka Robert , Boivin Michael 
Published: May 2018

Background:
HIV is a neuropathogenic virus that may result in detrimental neurodevelopmental (ND) outcomes early in life. This is the first study to evaluate the effect of HIV-1 subtype on neurodevelopment of Ugandan preschool children.

Methods:
Neurodevelopment of 87 HIV-1 infected and 221 HIV exposed uninfected Ugandan children 1.8–4.9 years of age was assessed using 4 scales of the Mullen Scales of Early Learning (MSEL), 2 scales of the Color Object Association Test (COAT), and 1 score of the Early Childhood Vigilance Test. HIV-1 subtype was defined by phylogenetic analyses. General linear models were used to relate test scores to HIV-1 subtype (A versus D) while adjusting for relevant covariates. The scores were benchmarked against HIV exposed uninfected group to facilitate the interpretation.

Results:
Seventy-one percentage of children infected with subtype A versus 60% of children with subtype D were currently on antiretroviral therapy (P = 0.49). Children with HIV-1 subtype A infection were older when compared with subtype D (3.29 vs. 2.76 years, respectively, P = 0.03), but similar regarding sex, socioeconomic status, weight-for-age z-score, CD4+ and CD8+ (% and total), viral load. No statistically significant differences by HIV-1 subtype were observed in the MSEL, COAT and Early Childhood Vigilance Test. Differences ≥ 0.33 of the SD were observed for the MSEL Composite Score, Receptive Language (MSEL) and Total Memory (COAT).

Conclusions:
In contrast to previously reported differences in ND outcomes of school-age children by HIV-1 subtype, ND scores among preschool children were similar for subtypes A and D, with few potential differences on language production and memory outcomes that favored subtype A. Further investigation with larger sample sizes and longitudinal follow-up is needed.
Acute Encephalitis Syndrome in Gorakhpur, Uttar Pradesh, 2016
Authors: Mittal Mahima , Bondre Vijay , Murhekar Manoj , Deval Hirawati , Rose Winsley , Verghese Valsan Philip , Mittal Mahim , Patil Gajanan , Sabarinathan Ramsamy , Vivian Thangaraj Jeromie Wesley , Kanagasabai Kaliaperumal , Prakash John Antony Jude , Gupta Nivedita , Gupte Manish M. , Gupte Mohan D. 
Published: May 2018

Background:
Seasonal outbreaks of acute encephalitis syndrome (AES) with high fatality have been occurring in Gorakhpur, Uttar Pradesh, India, for several years. We conducted investigations during the 2016 outbreak to identify the etiology.

Methods:
We included 407 hospitalized AES patients with cerebrospinal fluid pleocytosis (>5 cells/mm3) in our study. These patients were clinically examined; their blood and cerebrospinal fluid samples were collected and investigated for scrub typhus (ST), Japanese encephalitis virus (JEV), dengue virus and spotted fever group of Rickettsia by serology and/or polymerase chain reaction.

Results:
Of the 407 AES patients, 266 (65.4%), 42 (10.3%) and 29 (7.1%) were diagnosed to have ST, JEV and dengue infection, respectively. Four patients were diagnosed to have spotted fever group of Rickettsia infection. A significantly higher proportion of ST patients with AES had hepatomegaly, splenomegaly and facial edema. The common hematologic and biochemical abnormalities among ST-positive patients include thrombocytopenia, raised liver enzymes and bilirubin levels. The case fatality ratio was significantly higher among ST-negative AES patients (36.2% vs. 15.2%; P < 0.05).

Conclusions:
ST accounted for approximately two third of the AES case-patients. Efforts are required to identify the etiology of AES case-patients who are negative for ST, JEV and dengue fever.
Reflections on 50 Years of Neuroscience Nursing: The Growth of Stroke Nursing
Authors: Jackson Nancy , Haxton Elaine , Morrison Kathy , Markey Erin , Andreoli Linda J. , Maloney Theresa , Omelchenko Nataliya , Aroose Amanda , Stevens Lynn B. 
Published: May 2018

ABSTRACT
Over the past 50 years, the Journal of Neuroscience Nursing (JNN) has grown from a neurosurgical focus to the broader neuroscience focus alongside the professional nursing organization that it supports. Stroke care in JNN focused on the surgical treatment and nursing care for cranial treatment of conditions such as cerebral aneurysm, carotid disease, arteriovenous malformation, and artery bypass procedures. As medical science has grown and new medications and treatment modalities have been successfully trialed, JNN has brought to its readership this information about recombinant tissue plasminogen activator, endovascular trials, and new assessment tools such as the National Institute of Health Stroke Scale. JNN is on the forefront of publishing nursing research in the areas of stroke caregiver needs and community education for rapid treatment of stroke and stroke risk reduction. The journal has been timely and informative in keeping neuroscience nurses on the forefront of the changing world of stroke nursing.
Nonsurgical Admissions With Traumatic Injury: Medical Patients Are Trauma Patients Too
Authors: Nelson Laura , Kuzniewski Sally , Grossman Michael , Yelon Jay A. , Szydziak Lisa 
Published: May 2018

Nontrauma service (NTS) admissions are an increasing problem as ground-level falls in elderly patients become more common. The admission and evaluation of trauma patients to nontrauma services in trauma centers seeking American College of Surgeons (ACS) verification, must follow the ACS mandates for performance improvement requiring some method of evaluating this population when admitted to services other than trauma, orthopedics, and neurosurgery. The purpose of this study and performance improvement project was to improve our process for the definition and evaluation of trauma patients who were being admitted to nontrauma services. We designed an algorithm to evaluate appropriateness of NTS admission and evaluated outcomes for NTS admissions utilizing that algorithm.
We created a scoring algorithm and evaluated appropriateness of NTS admission over 2 years in a community-teaching ACS Level II trauma center. We reviewed trauma registry data using χ2 and Fisher exact tests to determine differences in outcome for NTS versus trauma service (TS) admissions.
From December 2014 to December 2016, NTS admission rate fell from maximum of 28% to 4% stabilizing between 8% and 10%. Mortality and overall complication rate between NTS and TS were similar (p = .40 and .66, respectively), but length of stay was lower for TS admissions (p < .0001).
A scoring system of algorithm can be used to determine appropriateness of NTS admissions, and validity of the tool can be confirmed using registry-based outcome data for TS versus NTS admissions.
The current state of long-acting growth hormone preparations for growth hormone therapy
Authors: Yuen Kevin C.J. , Miller Bradley S. , Biller Beverly M.K. 
Published: May 2018

Purpose of review
To discuss the rationale of developing long-acting growth hormone (LAGH) preparations, to describe the technologies designed to prolong GH action, and to address key issues regarding efficacy, safety, and monitoring while on treatment.

Review findings
Recombinant human GH is currently approved for daily use and has been shown to restore longitudinal growth, and improve body composition with relatively few side-effects in children and adults with GH deficiency, respectively. However, daily injections can be inconvenient, painful and distressing for some patients, resulting in decreased adherence and efficacy. Over a dozen pharmaceutical companies have designed LAGH preparations that are at various stages of development using a number of different methods to prolong GH action.

Summary
LAGH will represent an advancement over daily recombinant human GH injections because of fewer injections that may offer increased acceptance, tolerability, and therapeutic flexibility to patients that potentially can improve treatment outcomes. However, given the unphysiological profile of LAGH preparations, long-term surveillance of efficacy and safety are needed. This review summarizes recent developments of LAGH preparations, and highlights the importance of long-term surveillance registries to assess for efficacy and safety that will be essential for understanding the impact of prolonged exposure to these compounds.