bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rezidivprophylaxe der Zytomegalievirus-Uveitis mit topischem Ganciclovir
Authors: Hänsli Christof , Meier Fabio , Barthelmes Daniel , Böni Christian 
Published: February 2019

Zusammenfassung
Ziel Das Zytomegalievirus (CMV) kann bei immunkompetenten Patienten eine rezidivierende oder chronische hypertensive anteriore Uveitis verursachen. Antivirale Therapieoptionen beinhalten topisches Ganciclovir oder systemisches Valganciclovir. Allerdings sind Rezidive nach Therapiestopp häufig. Wir evaluierten die Effektivität einer topischen Langzeittherapie mit Ganciclovir als Rezidivprophylaxe.
Methoden und Patienten Retrospektive Analyse konsekutiver CMV-Uveitis-Patienten, die zwischen 2011 und 2018 in unserer Institution gesehen wurden. Einschlusskriterien waren die Präsenz einer anterioren Uveitis und CMV-Nachweis mittels PCR (polymerase chain reaction) aus der Vorderkammerpunktion. Bei CMV-Nachweis wurde topisch mit Ganciclovir-Gel 5 × täglich therapiert und die Dosis aktivitätsabhängig reduziert. Topische Steroide und drucksenkende Medikation wurden gemäß klinischer Notwendigkeit appliziert. Eine aktive Episode war definiert als Anstieg des Vorderkammerreizes und/oder ein Intraokulardruckanstieg über 25 mmHg. Die Episoden wurden vor und nach Beginn der Ganciclovir-Therapie analysiert.
Resultate Sechs Patienten, median 51 Jahre (Range 24 – 62), wurden eingeschlossen. Alle Patienten hatten eine hypertensive unilaterale anteriore Uveitis mit feinen bis mittelgroßen Endothelpräzipitaten und 0,5+ bis 2+ Vorderkammerzellreiz. Die mediane Tensio bei Vorstellung lag am betroffenen Auge bei 43 mmHg (Range 36 – 60). Die mediane Zeit zur Diagnose betrug 19,5 Monate (Range 5 – 193) mit median 4 (Range 2 – 20) aktiven Schüben und einer mittleren Häufigkeit von 3,04 jährlichen Episoden. Das mediane Follow-up betrug 26 Monate (Range 4 – 62), mit median 1 (Range 0 – 6) aktiven Schüben und einer mittleren Häufigkeit von 0,19 jährlichen Episoden (p = 0,04, 2-seitiger gepaarter t-Test). Die individuell ermittelte mediane prophylaktische Dosis betrug für Ganciclovir 2 × täglich (Range 0 – 4 ×) sowie für Steroide 1 × täglich (0 – 2 ×). Niedrigere Dosierungen führten bei 3 Patienten (50%) zu Rezidiven. Glaukom- und Kataraktoperationen waren bei 2 Patienten (33%) notwendig.
Konklusion Obwohl die CMV-Uveitis eine seltene Entität darstellt, ist sie aufgrund des hypertensiven und rezidivierenden Charakters bedeutend. In den aufgearbeiteten Fällen war topisches Ganciclovir eine wirksame Behandlung. Die Häufigkeit von Aktivitätsepisoden konnte durch eine langfristige niedrig dosierte topische Therapie reduziert werden. Größere Studien sind zur Beurteilung der Langzeitprophylaxe wünschenswert.
The Heimann-Bielschowsky Phenomenon: A Retrospective Case Series and Literature Review
Authors: Nguyen Audrey , Borruat François-Xavier 
Published: February 2019

Abstract
Background The Heimann-Bielschowsky phenomenon (HBP) is an unusual form of monocular vertical pendular nystagmus and is usually asymptomatic. It always occurs in an eye with longstanding, profound visual loss. Reports of HBP are few and HBP is probably underdiagnosed. Recognition of HBP could prevent unnecessary and potentially harmful investigations. The purpose of this study was to report a series of patients with HBP and to summarise the international literature on the subject in order to better define the clinical presentation of HBP.
Patients and Methods The study was approved by the local ethics committee. Medical records of patients diagnosed with HBP and examined by one of us (F. X. B.) were retrieved. Eye movements were quantified, either from video or eye tracking recordings, in all patients. The international literature on HBP was reviewed using the keywords “Heimann-Bielschowsky” or “monocular nystagmus”.
Results From 2007 to 2017, we retrieved seven patients with HBP. In the literature, we found only 8 publications, accounting for 66 cases. In both our cases and those from the literature, VA was worse in the eye with HBP and was usually ≤ 20/200. Visual loss was either congenital or acquired and resulted from a variety of aetiologies. The eye movement was strictly monocular, pendular, mostly vertical, but sometimes oblique. Characteristically, its frequency was irregular but low (0.2 to 2.6 Hz in our cases, 0.05 to 5 Hz in the literature) and its amplitude very variable (1 to 9° and 1.5 to 50°, respectively). Extraocular movements were always preserved.
Conclusions HBP is a benign monocular eye movement disorder that is always secondary to severe visual loss. Being asymptomatic, HBP is still under-recognised and easily overlooked. Furthermore, both amplitude and frequency of HBP may be small and irregular. Recognition of HBP is mandatory in order to prevent costly, unnecessary, and potentially hazardous investigations, and caution is advised, as cataract surgery might be responsible for postoperative oscillopsia.
Unterlappenektomie acht Jahre nach Aspiration einer Pinnnadel
Authors: Herrmann D. , Volmerig J. , Wolf R. , Neuhaus G. , Schwamborn M. , Ewig S. , Hecker E. 
Published: February 2019

ZusammenfassungEin Patient entwickelt 8 Jahre nach Aspiration eines Fremdkörpers Hämoptysen. Die initiale Diagnostik des damals 14-Jährigen erfolgte in der Notaufnahme eines Hauses der Basisversorgung. Von einer Bronchoskopie und einer radiologischen Diagnostik wurde in dem Fall abgesehen. Bronchoskopisch lässt sich ein Fremdkörper im rechten Unterlappenbronchus darstellen. Aufgrund der entstandenen Vernarbung waren die bronchoskopischen Versuche der Fremdkörper-Bergung frustran. Bei einer chronischen Atelektase des rechten Unterlappens und rezidivierenden bronchopulmonalen Infektionen in den letzten Jahren wurde die Indikation zur Lobektomie gestellt.
Disagreement between high confidence endoscopic adenoma prediction and histopathological diagnosis in colonic lesions ≤ 3 mm in size
Authors: Ponugoti Prasanna , Rastogi Amit , Kaltenbach Tonya , MacPhail Margaret , Sullivan Andrew , Thygesen John , Broadley Heather , Rex Douglas 
Published: February 2019

Abstract
Background Diminutive colorectal polyps resected during colonoscopy are sometimes histologically interpreted as normal tissue. The aim of this observational study was to explore whether errors in specimen handling or processing account in part for polyps ≤ 3 mm in size being interpreted as normal tissue by pathology when they were considered high confidence adenomas by an experienced endoscopist at colonoscopy.
Methods One endoscopist photographed 900 consecutive colorectal lesions that were ≤ 3 mm in size and considered endoscopically to be high confidence conventional adenomas. The photographs were reviewed blindly to eliminate poor quality images. The remaining 644 endoscopy images were reviewed by two external experts who predicted the histology while blinded to the pathology results.
Results Of 644 consecutive lesions ≤ 3 mm in size considered high confidence conventional adenomas by a single experienced colonoscopist, 15.4 % were reported as normal mucosa by pathology. The prevalence of reports of normal mucosa in polyps removed by cold snare and cold forceps were 15.2 % and 16.0 %, respectively. When endoscopy photographs were reviewed by two blinded outside experts, the lesions found pathologically to be adenomas and normal mucosa were interpreted as high confidence adenomas by endoscopic appearance in 96.9 % and 93.9 %, respectively, by Expert 1 (P = 0.15), and in 99.6 % and 100 %, respectively, by Expert 2 (P = 0.51).
Conclusion Retrieval and/or processing of tissue specimens of tiny colorectal polyps resulted in some lesions being diagnosed as normal tissue by pathology despite being considered endoscopically to be high confidence adenomas. These findings suggest that pathology interpretation is not a gold standard for lesion management when this phenomenon is observed.
Endoscopic surveillance after surgical or endoscopic resection for colorectal cancer: European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Digestive Oncology (ESDO) Guideline
Authors: Hassan Cesare , Wysocki Piotr , Fuccio Lorenzo , Seufferlein Thomas , Dinis-Ribeiro Mário , Brandão Catarina , Regula Jaroslaw , Frazzoni Leonardo , Pellise Maria , Alfieri Sergio , Dekker Evelien , Jover Rodrigo , Rosati Gerardo , Senore Carlo , Spada Cristiano , Gralnek Ian , Dumonceau Jean-Marc , van Hooft Jeanin , van Cutsem Eric , Ponchon Thierry 
Published: February 2019

Main Recommendations
1 We recommend post-surgery endoscopic surveillance for CRC patients after intent-to-cure surgery and appropriate oncological treatment for both local and distant disease.Strong recommendation, low quality evidence.
2 We recommend a high quality perioperative colonoscopy before surgery for CRC or within 6 months following surgery.Strong recommendation, low quality evidence.
3 We recommend performing surveillance colonoscopy 1 year after CRC surgery.Strong recommendation, moderate quality evidence.
4 We do not recommend an intensive endoscopic surveillance strategy, e. g. annual colonoscopy, because of a lack of proven benefit.Strong recommendation, moderate quality evidence.
5 After the first surveillance colonoscopy following CRC surgery, we suggest the second colonoscopy should be performed 3 years later, and the third 5 years after the second. If additional high risk neoplastic lesions are detected, subsequent surveillance examinations at shorter intervals may be considered.Weak recommendation, low quality evidence.
6 After the initial surveillance colonoscopy, we suggest halting post-surgery endoscopic surveillance at the age of 80 years, or earlier if life-expectancy is thought to be limited by comorbidities.Weak recommendation, low quality evidence.
7 In patients with a low risk pT1 CRC treated by endoscopy with an R0 resection, we suggest the same endoscopic surveillance schedule as for any CRC.Weak recommendation, low quality evidence.
Psychosomatische Urologie – wie therapiere ich chronische urologische Erkrankungen?
Authors: Hohenfellner Ulrike 
Published: February 2019

ZusammenfassungIn urologischen Facharztpraxen weisen 50 – 70 % der Patienten chronische urologische Erkrankungen auf, nämlich rezidivierende Harnwegsinfekte, die somatoforme überaktive Blase und die Enuresis des Erwachsenen und des Kindes, das chronische Beckenschmerzsyndrom und die psychosomatisch bedingte Form der Post-Prostatektomie-Harninkontinenz. Denn die 12-Monats-Prävalenz psychischer Störungen in der erwachsenen Allgemeinbevölkerung beträgt 28 % 1. Bereits 20 % der Kinder und Jugendlichen zeigen psychische Auffälligkeiten 2. Häufig findet sich eine begleitende somatoforme Beschwerdesymptomatik, oftmals eine psychosomatische Miktionsstörung mit konsekutiv komplexer Beckenboden-Dysfunktion 3
4
5
6. Die meisten Patienten berichten über einen langjährigen Leidensweg, da sowohl der funktionelle Charakter als auch die psychosoziale Belastung bisher unerkannt geblieben sind, aus denen die Entstehung und Aufrechterhaltung der Beschwerden resultieren. So haben sie meist diverse Therapieversuche erlebt, die nicht indiziert waren, entsprechend frustran und evtl. gar von Komplikationen begleitet. Dadurch wurden die Somatisierung und die Symptomatik i. d. R. noch verstärkt.Zur ursächlichen Behandlung ist die Beseitigung der zugrundeliegenden psychosomatischen Miktionsstörung und Beckenboden-Dysfunktion notwendig. Dieses erfordert eine multimodale Therapie wie z. B. PELVICFIT®, die ein körperorientiertes Training auf dem Boden der progressiven Muskelrelaxation mit Schulung der Körperwahrnehmung und eine ärztliche psychotherapeutische Begleitung miteinander vereint. Denn sowohl das (Wieder-)Erlernen der Willkürkontrolle über den externen urethralen Sphinkter und die Herstellung eines physiologischen Miktionsverhaltens als auch die Reduktion der psychosozialen Belastung sind erforderlich, um einen Therapieerfolg der so chronifizierten Symptomatik erreichen zu können 7
8
9.
Extralymphatischer Organbefall eines Hodgkin-Lymphoms
Authors: Einwaller Pierre 
Published: February 2019

ZusammenfassungIn dem vorliegenden Fallbericht wird der seltene Befund einer extralymphatischen Organmanifestation eines Hodgkin-Lymphoms beschrieben. Zum Ausschluss eines Zweitmalignoms führten wir urologischerseits eine TUR-B durch und sicherten zeitgleich den histologischen Befund. Der Patient erhielt nachfolgend onkologischerseits die leitliniengerechte Therapie.
Health Technology Assessments in Radiology in Germany: Lack of Demand, Lack of Supply
Authors: Winkelmann Carolin , Neumann Thomas , Zeidler Jan , Prenzler Anne , Vogt Bodo , Wacker Frank K. 
Published: February 2019

Background Health technology assessments (HTAs) are an interdisciplinary method to support sustainable, evidence-based healthcare decisions. They systematically assess medical products, procedures, and technologies with respect to medical, economic, legal, social, and ethical aspects.
Method This review analyzes the current use of HTAs in radiology in Germany and discusses challenges associated with HTAs. In particular, incentive structures of various players in the healthcare field involved in HTA implementation are considered for both the inpatient and outpatient sectors. Taking into account that the Joint Federal Committee (G-BA) has different authority between sectors ("ban reservation” for inpatients and “authorization right” for outpatients), we focus on the repercussions on reimbursement for new diagnosis or treatment methods by statutory health insurance companies.
Results The G-BA’s authority implicitly creates a paradox in terms of incentives to implement and finance HTAs: in the outpatient sector HTAs are considered necessary to evaluate new medical services while players may not have sufficient incentive to implement and finance HTAs in the inpatient sector.
Conclusion Characteristics of HTAs differ widely with respect to the items to be assessed. Therefore, an HTA for drug effectiveness is not easily transferable to radiological procedures. Within radiology, each method must be assessed individually (e. g. according to tumor stage). Despite these challenges, systematic compilation and critical assessment (regarding both cost and medical effectiveness) of available evidence should be a basic component of evidence-based radiology. As companies in healthcare fail to invest in studies that advance evidence-based radiology and considering the lack of incentive for such investments, public funding institutions need to accept the challenge to support studies that assess the benefit of radiological procedures.
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Citation Format
Biomechanical Comparison of Four Methods of Fixation of a Polymeric Cranial Cruciate Ligament in the Canine Femur and Tibia
Authors: Bufkin Brian , Litsky Alan , Barnhart Matthew 
Published: February 2019

Objective The aim of this study was to compare the biomechanical properties of four different methods of artificial cranial cruciate ligament fixation in canine cadaveric tibias and femurs.
Methods Femurs and tibias from skeletally mature large breed canine cadavers were assigned into four fixation groups: group 1, 4.5-mm interference screw (IS); group 2, 4.5-mm IS and 4.0-mm screw and spiked washer (SW); group 3, 5.0-mm IS; group 4, 5.0-mm IS + SW.
Results The mean ultimate load was significantly greater for femur fixations than for tibias, when a SW was added, and for 5.0-mm IS compared with 4.5-mm sizes. There was also a significant interaction between SW and IS size. A SW significantly increased stiffness, a 5.0-mm IS in femurs provided more stiffness than 4.5-mm IS and was greater than 5.0-mm IS in tibias. In tibias, a 4.5-mm IS was stiffer than a 5.0-mm IS and a 4.5 IS + SW had greater stiffness than a 5.0-mm IS + SW. Groups 1 to 3 and tibias in group 4 failed by artificial ligament pullout. Nine femurs in group 4 failed by fracture, 5 by artificial ligament pullout, and 1 by artificial ligament tearing.
Clinical Significance A 5.0-mm IS + SW provided superior artificial ligament fixation strength in femurs and tibias compared with a 4.5-mm IS without SW. Overall, artificial ligament fixation with 5.0-mm IS in femurs had the mechanical characteristics that most closely matched those reported in normal canine cranial cruciate ligaments.
Percutaneous Tibial Fracture Reduction Using Computed Tomography Imaging, Computer Modelling and 3D Printed Alignment Constructs: A Cadaveric Study
Authors: Davies John , Lynch Albert 
Published: February 2019

Objective The main aim of this study was to evaluate a percutaneous method of bone alignment using a diaphyseal tibial fracture model.
Materials and Methods Mid-shaft diaphyseal fractures were created in 12 large-breed canine tibiae. Interaction pins were inserted into the proximal and distal bone segments. Computed tomography scans of the fractured tibiae and pins were imported into three-dimensional (3D) modelling software and the fractures were virtually reduced. A multi-component 3D printed alignment jig was created that encompassed the pins in their aligned configuration. Orthogonal radiographs were taken after alignment jig application. Intact and post-alignment tibial lengths and joint angles were compared. Rotational alignment was subjectively evaluated.
Results Post-alignment tibial lengths differed on the mediolateral and craniocaudal radiographs by an average of 1.55 and 1.43% respectively. Post-alignment mechanical medial proximal tibial angle, mechanical medial distal tibial angle and mechanical caudal proximal tibial angle had an average difference of 1.67°, 1.92° and 2.17° respectively. Differences in tibial length and joint angles were not significant (p > 0.05).
Clinical Significance While in vivo evaluation is necessary, this technique to align diaphyseal fractures percutaneously using computer modelling and 3D printing is technically feasible and may facilitate the clinical use of minimally invasive osteosynthesis techniques.
Intra-Abdominal Umbilical Vein Varix – A Case Report
Authors: Agrawal Sachin , Singhania Shraddha , Singhania Pooja , Vaibhav Kumar 
Published: February 2019

AbstractThe incidence of the fetal intra-abdominal umbilical vein varix condition is very rare and has been associated with fetal hydrops, IUGR and still birth A 26-year-old primigravida was referred for routine antenatal scan. The scan at 30 weeks showed an intra-abdominal ovoid structure superior to the fetal bladder. Color flow Doppler revealed venous flow in continuity with the umbilical vein. A diagnosis of umbilical varix was made. The venous flow was present throughout the lesion, suggesting the absence of thrombi. There was no evidence of fetal hydrops. Subsequent scans at regular intervals showed no increase in size of the umbilical varix. The patient had an uneventful elective cesarean section at 39 weeks. Postnatal assessment and a follow-up neonatal cardiac echo scan were normal. Our case supports the new emerging evidence that pregnancy outcome in cases of isolated fetal umbilical vein varix is generally good. Caution must be exercised against unnecessary early induction and costly preterm births
Central Corneal Thickness (CCT) Measurement in Each Trimester of Pregnancy: A Screening Parameter for a Healthy Eye During Pregnancy : A Prospective Study!
Authors: G. Sruthi , Sundaram Lalith , TC Ranjakumar , Ashraf Rahana , Alex Nimesha 
Published: February 2019

AIM: - To detect central corneal thickness (CCT) in each trimester of pregnancy.
Purpose: To evaluate difference in measurement of central corneal thickness due to corneal changes in each trimester of pregnancy.
METHOD: - 100 healthy pregnant women within age group ranging from 21 to 35 years were included in the study. Central corneal thickness (Ultrasound Pachymetry), Intra ocular pressure (Goldmann-Applanation Tonometer) was done. Changes in central corneal thickness (CCT) were calculated at 3 time periods: First trimester, Second trimester, Third trimester. Informed consent was taken from all patients. Patients had no systemic or ocular co-morbidities.All of the patients underwent comprehensive ophthalmologic examinations, including Refraction, Intraocular pressure (IOP), Anterior segment and Fundus examination.
RESULTS: - The mean age was 25 years in the study group. The mean CCT in the second trimester of pregnancy was measured to be higher than first trimester by 1.67% &3.13% by third trimester in right eye & increase of 1.91% in second trimester & 3.03% in third trimester left eye.The results are statistically significant confirmed by ANOVA.
CONCLUSION: - Changes during pregnancy causes corneal edema, which is observed in pregnant women resulting from increased water retention during pregnancy. Changes in corneal curvature, central, corneal thickness and steeping may also occur during pregnancy particularly during the second and third trimester. Most of the changes are reversible and resolved in the postpartum period or after cessation of breastfeeding. Awareness of the changes during pregnancy and routine screening during antenatal period should be improvised.
Aspirin-Dependent Effects on Purinergic P2Y1 Receptor Expression
Authors: Massimi Isabella , Alemanno Laura , Guarino Maria , Guerriero Raffaella , Mancone Massimo , Ceccacci Andrea , Frati Luigi , Angiolillo Dominick , Pulcinelli Fabio 
Published: February 2019

AbstractChronic treatment with aspirin in healthy volunteers (HVs) is associated with recovery of adenosine diphosphate (ADP)-induced platelet activation. The purinergic P2Y1 receptor exerts its effects via a Gq-protein, which is the same biochemical pathway activated by thromboxane-A2 receptor. We hypothesized that recovery of ADP-induced platelet activation could be attributed to increased P2Y1 expression induced by chronic aspirin exposure. We performed a multi-phase investigation which embraced both in vitro and in vivo experiments conducted in (1) human megakaryoblastic DAMI cells, (2) human megakaryocytic progenitor cell cultures, (3) platelets obtained from HVs treated with aspirin and (4) platelets obtained from aspirin-treated patients. DAMI cells treated with aspirin or WY14643 (PPARα agonist) had a significant up-regulation of P2Y1 mRNA, which was shown to be a PPARα-dependent process. In human megakaryocytic progenitors, in the presence of aspirin or WY14643, P2Y1 mRNA expression was higher than in mock culture. P2Y1 expression increased in platelets obtained from HVs treated with aspirin for 8 weeks. Platelets obtained from patients who were on aspirin for more than 2 months had increased P2Y1 expression and ADP-induced aggregation compared with patients on aspirin treatment for less than a month. Overall, our results suggest that aspirin induces genomic changes in megakaryocytes leading to P2Y1 up-regulation and that PPARα is the nuclear receptor involved in this regulation. Since P2Y1 is coupled to the same Gq-protein of thromboxane-A2 receptor, platelet adaptation in response to pharmacological inhibition seems not to be receptor specific, but may involve other receptors with the same biochemical pathway.
Sports-Related Concussion: Neurometabolic Aspects
Authors: Banks Russell E. , Domínguez Delfina C. 
Published: February 2019

AbstractConcussion is a transitory brain injury resulting from a blow to the head. Concussion is considered a mild traumatic brain injury (mTBI), which is self-limited. Repetitive mTBI has been associated with chronic, progressive neurological damage. Extreme biochemical changes occur in neuron cells as a result of mTBI. These metabolic disturbances may reflect the symptoms observed in patients who had suffered concussions. However, it has been difficult to correlate clinical signs and symptoms. Currently, there are no laboratory tests to diagnose concussion, though several biomarkers are being investigated. Further studies are needed to elucidate the biochemical details of the metabolic cascade and the associated time frame, which will help determine when an athlete can safely return to the game.