bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment of chronic and extreme ocular hypotension following glaucoma surgery with intraocular platelet-rich plasma: A case report
Authors: Abdalrahman Omneya , Rodriguez Alejandra E , Alio Del Barrio Jorge L , Alio Jorge L 
Published: October 2018

Purpose: To report a new approach for the treatment of severe ocular hypotony secondary to glaucoma filtering surgery with mitomycin C by injecting autologous eye platelet-rich plasma (E-PRP) in the anterior chamber to block excessive diffuse filtration through an abnormally thinned sclera. Methods: A 49-year-old patient with the Axenfeld–Rieger syndrome and severe chronic hypotony and corneal edema following filtering glaucoma surgery with mitomycin C received an isolated injection of 0.3 mL of autologous platelet-rich plasma in the anterior chamber. Results: Intraocular pressure measured by Goldman’s applanation tonometry 6 h after the procedure improved to 18 mmHg. Intraocular pressure remained stable along the full follow-up period of 6 month. No filtration or hypotony or any other complications were observed. Conclusion: Intracameral platelet-rich plasma (E-PRP) injection was an effective, rapidly effective, and safe procedure for treatment of severe chronic ocular hypotony following glaucoma filtrating surgery.
First look into the eye
Authors: Ivanišević Milan 
Published: October 2018

Purpose: Until Helmholtz’s discovery of the ophthalmoscope, it was not possible to visualize the posterior pole of the eye in a living subject. The aim of this work is to emphasize the importance of the invention of the ophthalmoscope because the new era in ophthalmology began with it. Methods: Available literature concerning this topic was studied, especially by getting in contact with institutes for history of medicine as well as medico-historians in Germany and other countries. Results: Hermann von Helmholtz, German physician and physicist, presented and published his invention of the ophthalmoscope in 1851. Albrecht von Graefe was the first to use ophthalmoscope routinely. He said: ‘Helmholtz has opened a new world to us’. The first ophthalmoscope was not easy to use. Some ophthalmologists even thought that ophthalmoscopy is harmful for the eye, particularly for a diseased eye. First, it was used in Germany (A von Graefe), Austria (E Jäger), and Netherlands (FC Donders). In England, it was used only at Moorfields till 1855 (W Bowman). At the First International Congress of Ophthalmology in Brussels 1857, the importance of ophthalmoscopy was stressed. FC Donders said that every view with the ophthalmoscope into the living eye was a new discovery. Among retinal diseases, first were discovered pigment retinopathy (FC Donders) and retinal detachment (A Coccius) in 1853. Conclusion: Helmholtz inaugurated modern era in ophthalmology with his magnificant instrument which revolutionized the development of ophthalmology. Von Graefe popularized it. Because of the new findings, ophthalmology was definitely separated from surgery in the middle of 19th century.
Prognostic Value of White Blood Cells Detected for the First Time After Adjuvant Chemotherapy in Primary Operable Non-Small Cell Lung Cancer
Authors: Hao Ligang , Zhang Junjie , Di Yonghui , Tan Zhenbo 
Published: October 2018

Objective: To investigate the prognostic value of white blood cells detected for the first time after adjuvant chemotherapy in primary operable non-small cell lung cancer. Methods: From January 2010 to May 2016, data from 208 patients who underwent surgery for non-small cell lung cancer were retrospectively analyzed. Results: A white blood cell count detected for the first time after adjuvant chemotherapy greater than 7.00 was an independent predictor of poor disease-free survival (Hazard ratio: 1.736, 95% confidence interval: 1.267-2.378; P = .001) and overall survival (Hazard ratio: 1.802, 95% confidence interval: 1.305-2.471; P = .000). In a further study, after myelosuppression, survival analysis indicated that the patients with white blood cell counts <2.5 had poorer survival than patients with blood cell counts 2.5 to 4.0, P = .031. When the analysis was stratified by the type of histology, patients with a white blood cell count >7.00 and increased white blood cell after chemotherapy compared to pretreatment had a poorer prognosis than patients with white blood cell ≤7.00 and no increase in white blood cell, P = .000 and P = .002, respectively. We further evaluated the prognosis of the 2 groups in different levels of white blood cell. In the group of patients with white blood cell ≤4.0, patients with chemotherapy cycles ≤2, and >2 showed no differences (Hazard ratio: 2.346, 95% confidence interval: 0.288-19.073, P = .425). In the group of patients with white blood cell of 4.0 to 7.0, the prognosis of patients with chemotherapy cycles ≤2 and patients with chemotherapy cycles >2 showed no difference (Hazard ratio: 0.560, 95% confidence interval: 0.248-1.261, P = .161). In the group of patients with white blood cell >7.0, patients with >2 chemotherapy cycles had a better prognosis than patients with chemotherapy cycles ≤2 (Hazard ratio: 0.573, 95% confidence interval: 0.338-0.971, P = .037) Conclusions: The level of white blood cells detected for the first time after adjuvant chemotherapy is an independent risk factor for non-small cell lung cancer, especially for patients with nonadenocarcinoma. In addition, the level of white blood cells after postoperative adjuvant chemotherapy and its change compared with pretreatment might also provide useful information regarding the best choice of cycles of adjuvant chemotherapy.
Critical Appraisal of the Treatment Planning Performance of Volumetric Modulated Arc Therapy by Means of a Dual Layer Stacked Multileaf Collimator for Head and Neck, Breast, and Prostate
Authors: Cozzi Luca , Fogliata Antonella , Thompson Stephen , Franzese Ciro , Franceschini Davide , de Rose Fiorenza , Tomatis Stefano , Scorsetti Marta 
Published: October 2018

Purpose: To ascertain whether a new delivery system (the Halcyon system) equipped with dual-layer stacked multileaf collimator operating in a mode, which allows independent, fully interdigitating motion of both layers and 6 flattening filter free energy, could generate plans of high clinical quality compared to a well-established delivery system with single layer multileaf collimator. Methods: Twenty patients in each of the 3 groups (advanced head and neck, breast, and high-risk prostate) were selected for an in silico planning study. For each patient, reference plans were developed for volumetric modulated arc therapy technique with 6 MV photon beams from a TrueBeam linear accelerator and compared against the corresponding plans for the Halcyon system. Plan comparison was performed in terms of dose volume histogram quantitative analysis. Results: Concerning the planning target volumes, with identical dose calculation and optimization algorithms and with identical planning techniques, no clinically relevant difference in coverage (D98%), hot spot (D2%), or homogeneity was observed. Similarly, for all the organs at risk, the dosimetric findings showed that (1) all planning constraints were met by the 2 delivery systems and (2) although statistical significant differences were reported for most of the parameters but none of these were judged of potential clinical relevance. Conclusion: The data presented confirmed that the new delivery system can generate treatment plans for volumetric modulated arc therapy with the same dosimetric quality of what is achievable with other systems routinely used in the clinics without significantly changing the current practice. Additional studies which customize the optimization parameters for each delivery device would complement the spectrum of investigations.
Remote post-conditioning and allopurinol reduce ischemia-reperfusion injury in an infra-renal ischemia model
Authors: Brandão Rafael Inácio , Gomes Ricardo Zanetti , Lopes Luana , Linhares Filipe Silva , Vellosa José Carlos Rebuglio , Paludo Katia Sabrina 
Published: October 2018

Background: The aim of this study was to evaluate the effects of the antioxidant allopurinol and ischemic post-conditioning on the deleterious effects of ischemia followed by reperfusion (I/R) in a standardized model of ischemia involving infra-renal aortic occlusion in rats. Methods: The animals were randomly divided into five groups: (A) animals not subjected to ischemia; (B) animals subjected to 2 h of ischemia and reperfusion only once; (C) animals given an allopurinol dose by gavage, then subjected to 2 h of ischemia and reperfusion only once; (D) animals subjected to 2 h of ischemia and post-conditioning and (E) animals that received allopurinol, then subjected to 2 h of ischemia and post-conditioning. The blood samples and small intestine segments were harvested for analysis after 3 days. Results: The protective effects of the use of allopurinol and ischemic post-conditioning were observed by measuring aspartate aminotransferase, alanine aminotransferase and lactate levels. The benefits of post-conditioning were evident from the total antioxidant capacity and creatinine levels, but these could not ascertain any positive effects of allopurinol. The histological analysis of mesentery revealed that both methods were effective in minimizing the harmful effects of the ischemia and reperfusion process. Conclusion: Individual protocols significantly reduced I/R systemic injuries, but no additional protection was observed when the two strategies were combined.
3D versus 2D laparoscopic radical prostatectomy for organ confined prostate cancer: Our experience
Authors: Benelli Andrea , Varca Virginia , Rosso Marco , Peraldo Francesca , Gregori Andrea 
Published: October 2018

Objective: Three-dimensional (3D) laparoscopy was developed to overcome the main limitations of traditional laparoscopy. The aim of our study was to compare operative, functional and oncological results of 3D and two-dimensional (2D) laparoscopic radical prostatectomy. Materials and methods: A total of 102 consecutive patients with clinically localised prostate cancer underwent laparoscopic radical prostatectomy. Patients were randomly assigned into two groups, 2D high definition (HD) camera (50 patients) for the first and 3D HD camera (52 patients) for the second group. Total operative time, anastomosis time, blood loss, complications and pentafecta rates for both groups were compared. All patients had at least one year of follow-up. Results: Total operative time was, respectively, 143 ± 17 and 118 ± 15 minutes, with a mean anastomosis time of 31± 12 and 23 ± 12 minutes. Mean blood loss was 230 ± 30 ml with 2D vision and 175 ± 40 with 3D vision. Pentafecta was reached, respectively, by 46% and 50% of patients at 3 months and 60% and 67.3% at 12 months. 3D vision offers an increased speed if compared with traditional vision ( P=0.02). Pentafecta results were significantly better in the 3D group ( P=0.03). Conclusion: We believe that 3D laparoscopy offers important advantages for surgeons and patients; its use should be encouraged. Level of evidence: 1c
Augmentation of a Locking Plate System Using Bioactive Bone Cement—Experiment in a Proximal Humeral Fracture Model
Authors: Kuang Guan-Ming , Wong Tak Man , Wu Jun , Ouyang Jun , Guo Haihua , Zhou Yapeng , Fang Christian , Leung Frankie K. L. , Lu William 
Published: October 2018

Introduction: The purpose of this study was to test whether local filling of a novel strontium-containing hydroxyapatite (Sr-HA) bone cement can augment the fixation of a locking plate system in a cadaveric proximal humeral facture model. Materials and Methods: Twelve pairs of formalin-treated cadaveric humeri were used. One side in each pair was for cemented group, while the other side was for the control group. The bone mineral density (BMD) of the samples was tested. A 3-part facture model was created and then reduced and fixed by a locking plate system. In the cemented group, the most proximal 4 screw holes were filled with 0.5 mL bone cement. In the control group, the screw holes were not filled by cement. Locking screws were inserted in a standard manner before the cement hardened. X-ray was taken before all the specimens being subjected to mechanical study, in which 6 pairs were used for axial loading (varus bending) test, while other 6 pairs were used for axial rotational test. Results: There is no difference in BMD between the cemented side and the control side. The X-ray shows that the implant is in position. Cement filling was noted in the most proximal 4 screws in the cemented group. Better mechanical outcome was seen in the cemented groups, in terms of less maximal displacement per cycle and higher failure point and stiffness in varus bending test. However, no difference was found between the cemented group and the control group in the axial rotation test. Discussion: In similarity with the previous studies, our results showed better mechanical results in the cemented group. However, due to the limitations (e.g. sample size, fracture model, testing protocol, etc), we still cannot directly extrapolate current mechanical results to clinical practice at the present moment. Furthermore, it is still unknown whether better primary outcome may lead to better long-term results, even though the local release of strontium may enhance the local bone formation. Conclusion: The local filling of Sr-HA bone cement augments the fixation of the locking plate system in current proximal humeral fracture model.
Results of tenorrhaphy with early rehabilitation for acute tear of Achilles tendon
Authors: Ryu Chang Hyun , Lee Ho Seong , Seo Sang Gyo , Kim Ho Yeon 
Published: October 2018

Background: For the treatment of acute Achilles tendon rupture, early rehabilitation after surgical repair is believed to be a useful method. The purpose of this study was to evaluate the outcome of open tenorrhaphy followed by early rehabilitation. Methods: A total of 112 patients who underwent open repair and early rehabilitation for acute Achilles tendon rupture from January 2003 to March 2015 were retrospectively reviewed. These 112 patients (80 men, 32 women) had an average age of 43.1 years (22–62 years), and the mean follow-up period was 91.8 months (12–171 months). A short leg cast was applied postoperatively for an average of 16.5 days (12–20 days). The mean duration of bracing was 6.9 weeks (6–8 weeks). Each patient was assessed based on range of motion, single heel raising test, calf circumference compared to the contralateral limb, ability to return to previous activity, the Arner–Lindholm scale, and the American orthopaedic foot and ankle society (AOFAS) hind foot scale. Isokinetic plantar flexion power was also checked. Results: All patients were fully satisfied (AOFAS ≥ 90) with the treatment results, and 96 patients were able to return to their previous athletic activities. As assessed by the Arner–Lindholm scale, 103 cases were rated as excellent and the other 9 cases were rated as good. At the 1-year follow-up period, single heel raise and hopping was possible in every patient. Compared to the contralateral side, 10 subjects (8.9%) had minor limitation of dorsiflexion motion, and an average of 1.6 cm calf circumference difference without functional disabilities. There were no major complications such as re-rupture, nerve injury, or infection. Conclusion: For acute Achilles tendon ruptures, open surgical repair with optimal length restoration, followed by earlier rehabilitation results in good functional outcomes and a successful return to pre-injury levels of physical activity without major complications. Level of evidence: Level IV.
Stress Fractures of the Elbow in the Throwing Athlete: A Systematic Review
Authors: Smith Shelby R. , Patel Nirav K. , White Alex E. , Hadley Christopher J. , Dodson Christopher C. 
Published: October 2018

Background: Stress fractures of the elbow are rare in throwing athletes and present a challenge from both a management and rehabilitation perspective. Although the incidence of stress fractures of the elbow is increasing, there is a lack of data in the literature focused on throwers. Purpose: To evaluate studies regarding the management and outcomes of stress fractures of the elbow in throwing athletes. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review was conducted by searching the Scopus, PubMed, and Cochrane Library electronic databases to identify studies reporting on the management and outcomes of stress fractures in overhead-throwing athletes. Management data included nonoperative and operative modalities, and outcome data included return to play, encompassing the timing and level of activity. Studies were excluded if the stress fracture of the elbow was not a result of a sport injury attributed to throwing or if the study failed to report whether an athlete returned to play. Results: Fourteen studies met the inclusion criteria and were included in this analysis. There were 52 patients in total (50 male, 2 female) with a mean age of 19.7 years (range, 13-29.1 years). The olecranon was the most common location of the stress fracture (51 patients; 98.1%), followed by the distal humerus (1 patient; 1.9%). The majority of patients (n = 40; 76.9%) were treated operatively. Of the 40 patients who were treated surgically, 14 (35.0%) underwent a period of conservative treatment preoperatively that ultimately failed because of persistent nonunion or continued elbow pain. A total of 50 patients (96.2%) returned to sport either at or above their preinjury level. Of the 2 patients (3.8%) who did not return to sport, 1 did not return because of continued elbow pain postoperatively, and the other was lost to follow-up. Complications occurred in 9 patients (17.3%), all of whom were treated surgically. Conclusion: On the basis of this systematic review, the majority of elbow stress fractures were treated operatively and approximately one-third after a period of failed nonoperative management. The return-to-sport rate was high. Further, higher level studies are needed to optimize management and return-to-sport rates in this population.
Aneurysm characteristics and risk of rebleeding after subarachnoid haemorrhage
Authors: Koopman Inez , Greving Jacoba P , van der Schaaf Irene C , van der Zwan Albert , Rinkel Gabriel JE , Vergouwen Mervyn DI 
Published: October 2018

Introduction Knowledge of risk factors for rebleeding after aneurysmal subarachnoid haemorrhage can help tailoring ultra-early aneurysm treatment. Previous studies have identified aneurysm size and various patient-related risk factors for early (≤24 h) rebleeding, but it remains unknown if aneurysm configuration is also a risk factor. We investigated whether irregular shape, aspect- and bottleneck ratio of the aneurysm are independent risk factors for early rebleeding after aneurysmal subarachnoid haemorrhage. Patients and methods From a prospectively collected institutional database, we investigated data from consecutive aneurysmal subarachnoid haemorrhage patients who were admitted ≤24 h after onset between December 2009 and January 2015. The admission computed tomographic angiogram was used to assess aneurysm size and configuration. With Cox regression, we calculated stepwise-adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) for irregular shape, aspect ratio ≥1.6 mm and bottleneck ratio ≥1.6 mm. Results Of 409 included patients, 34 (8%) patients had in-hospital rebleeding ≤24 h after ictus. Irregular shape was an independent risk factor for rebleeding (HR: 3.9, 95% CI: 1.3–11.3) after adjustment for age, sex, PAASH score, aneurysm location, aneurysm size and aspect- and bottleneck ratio. Aspect ratio ≥1.6 mm (HR: 2.3, 95% CI: 0.8–6.5) and bottleneck ratio ≥1.6 mm (HR: 1.7, 95% CI: 0.8–3.6) were associated with an increased risk of rebleeding, but were not independent risk factors after multivariable adjustment. Conclusions Irregular shape is an independent risk factor for early rebleeding. However, since the majority of subarachnoid haemorrhage patients have an irregular aneurysm, additional risk factors have to be found for aneurysm treatment prioritisation.
Oral dexamethasone for the prevention of acute migraine recurrence in pediatric patients presenting to the emergency department with migraine
Authors: Orr Serena L , Richer Lawrence , Barrowman Nick , Zemek Roger 
Published: October 2018

Objective: To assess the feasibility of a randomized controlled trial protocol that aims to determine the efficacy and safety of oral dexamethasone compared to placebo for the prevention of migraine recurrence in children and adolescents visiting the pediatric emergency department (ED) with migraine. Methods: This study was a two-arm, parallel-group, randomized, placebo-controlled, double-blind pilot trial of patients presenting to the pediatric ED with migraine. Eligible participants were randomized at 1:1 ratio to receive either oral dexamethasone 0.6 mg/kg (maximum 15 mg) or matched placebo as a single dose. Efficacy and safety outcomes were assessed at discharge, 48 h and 7 days after discharge. The primary outcome of the trial was feasibility and was assessed through participant recruitment rate, follow-up completion rates, participant satisfaction ratings and comparison of enrolled versus non-enrolled participants. Efficacy and safety outcomes were not analyzed given that this was a pilot study. Results: Twelve participants were enrolled over the 6-month recruitment period. This represents 60% of the planned sample size and a 10.5% recruitment rate. No other feasibility issues were identified and patients expressed high satisfaction rates with their treatment: 90.9% were satisfied with their treatment at discharge and at 48-h follow-up and 81.8% were satisfied with their treatment at 7-day follow-up (81.8%). There were no significant differences observed when comparing enrolled participants to those not enrolled. Conclusion: This pilot randomized controlled trial is the first to assess dexamethasone in the pediatric ED for the prevention of migraine recurrence. The protocol is feasible but recruitment in a single center was lower than expected. Future pediatric ED migraine studies may use innovative or pragmatic trial designs to maximize feasibility from a recruitment standpoint.