bluuebunny/crossref_metadata_2025_split huggingface dataset:
Circulating Secretoneurin Concentrations After Cardiac Surgery: Data From the FINNish Acute Kidney Injury Heart Study
Authors: Brynildsen Jon , Petäjä Liisa , Myhre Peder L. , Lyngbakken Magnus N. , Nygård Ståle , Stridsberg Mats , Christensen Geir , Ottesen Anett H. , Pettilä Ville , Omland Torbjørn , Røsjø Helge 
Published: February 2019

Objectives:
Secretoneurin is associated with cardiomyocyte Ca2+ handling and improves risk prediction in patients with acute myocardial dysfunction. Whether secretoneurin improves risk assessment on top of established cardiac biomarkers and European System for Cardiac Operative Risk Evaluation II in patients undergoing cardiac surgery is not known.

Design:
Prospective, observational, single-center sub-study of a multicenter study.

Setting:
Prospective observational study of survival in patients undergoing cardiac surgery.

Patients:
A total of 619 patients undergoing cardiac surgery.

Interventions:
Patients underwent either isolated coronary artery bypass graft surgery, single noncoronary artery bypass graft surgery, two procedures, or three or more procedures. Procedures other than coronary artery bypass graft were valve surgery, surgery on thoracic aorta, and other cardiac surgery.

Measurements and Main Results:
We measured preoperative and postoperative secretoneurin concentrations and adjusted for European System for Cardiac Operative Risk Evaluation II, N-terminal pro-B-type natriuretic peptide, and cardiac troponin T concentrations in multivariate analyses. During 961 days of follow-up, 59 patients died (9.5%). Secretoneurin concentrations were higher among nonsurvivors compared with survivors, both before (168 pmol/L [quartile 1–3, 147–206 pmol/L] vs 160 pmol/L [131–193 pmol/L]; p = 0.039) and after cardiac surgery (173 pmol/L [129–217 pmol/L] vs 143 pmol/L [111–173 pmol/L]; p < 0.001). Secretoneurin concentrations decreased from preoperative to postoperative measurements in survivors, whereas we observed no significant decrease in secretoneurin concentrations among nonsurvivors. Secretoneurin concentrations were weakly correlated with established risk indices. Patients with the highest postoperative secretoneurin concentrations had worse outcome compared with patients with lower secretoneurin concentrations (p < 0.001 by the log-rank test) and postoperative secretoneurin concentrations were associated with time to death in multivariate Cox regression analysis: hazard ratio lnsecretoneurin 2.96 (95% CI, 1.46–5.99; p = 0.003). Adding postoperative secretoneurin concentrations to European System for Cardiac Operative Risk Evaluation II improved patient risk stratification, as assessed by the integrated discrimination index: 0.023 (95% CI, 0.0043–0.041; p = 0.016).

Conclusions:
Circulating postoperative secretoneurin concentrations provide incremental prognostic information to established risk indices in patients undergoing cardiac surgery.
Peripheral Blood Mononuclear Cells Demonstrate Mitochondrial Damage Clearance During Sepsis
Authors: Kraft Bryan D. , Chen Lingye , Suliman Hagir B. , Piantadosi Claude A. , Welty-Wolf Karen E. 
Published: February 2019

Objectives:
Metabolic derangements in sepsis stem from mitochondrial injury and contribute significantly to organ failure and mortality; however, little is known about mitochondrial recovery in human sepsis. We sought to test markers of mitochondrial injury and recovery (mitochondrial biogenesis) noninvasively in peripheral blood mononuclear cells from patients with sepsis and correlate serial measurements with clinical outcomes.

Design:
Prospective case-control study.

Setting:
Academic Medical Center and Veterans Affairs Hospital.

Patients:
Uninfected control patients (n = 20) and septic ICU patients (n = 37).

Interventions:
Blood samples were collected once from control patients and serially with clinical data on days 1, 3, and 5 from septic patients. Gene products for HMOX1, NRF1, PPARGC1A, and TFAM, and mitochondrial DNA ND1 and D-loop were measured by quantitative reverse transcriptase-polymerase chain reaction. Proinflammatory cytokines were measured in plasma and neutrophil lysates.

Measurements and Main Results:
Median (interquartile range) Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment scores were 21 (8) and 10 (4), respectively, and 90-day mortality was 19%. Transcript levels of all four genes in peripheral blood mononuclear cells were significantly reduced in septic patients on day 1 (p < 0.05), whereas mitochondrial DNA copy number fell and plasma D-loop increased (both p < 0.05), indicative of mitochondrial damage. D-loop content was directly proportional to tumor necrosis factor-α and high-mobility group protein B1 cytokine expression. By day 5, we observed transcriptional activation of mitochondrial biogenesis and restoration of mitochondrial DNA copy number (p < 0.05). Patients with early activation of mitochondrial biogenesis were ICU-free by 1 week.

Conclusions:
Our findings support data that sepsis-induced mitochondrial damage is reversed by activation of mitochondrial biogenesis and that gene transcripts measured noninvasively in peripheral blood mononuclear cells can serve as novel biomarkers of sepsis recovery.
TIMING INFLUENCE ON OUTCOMES OF VITRECTOMY FOR OPEN-GLOBE INJURY
Authors: He Yan , Zhang Ling , Wang Fang , Zhu Meidong , Wang Yi , Liu Yong 
Published: February 2019

Purpose:
To compare the impact of surgical timing on anatomical and functional outcomes of vitrectomy for open-globe injury.

Methods:
Fifty-three patients were entered into this prospective open-label study, with 26 patients randomized into early surgery group (vitrectomy conducted within 4 days) and 27 into delayed surgery group (vitrectomy performed between 10–14 days after injury). Six-month data were available for 46 patients and 7 were lost to follow-up. The main outcome measures were incidence of traumatic proliferative vitreoretinopathy assessed intraoperatively and postoperatively, reattachment of retina, eye enucleation, improvement of the best-corrected visual acuity, and complications.

Results:
Patient demographics and surgical intervention were similar in both groups. Final analysis of 46 patients demonstrated higher rates of traumatic proliferative vitreoretinopathy assessed both intraoperatively and postoperatively in the delayed group (P = 0.000; P = 0.054). In the early surgery group, 18 of 21 patients had retinal detachment, of which 15 patients (83%) achieved retinal reattachment by the first vitreoretinal surgery, 2 patients (11%) by a second surgery, and 1 (6%) received enucleation. In the delayed surgery group, 22 of 25 patients had retinal detachment. Retinal reattachment was achieved in 7 (32%) and 8 (36%) with the first and the second surgery, respectively, and 7 patients (32%) received enucleation (P = 0.005). In the early surgery group, best-corrected visual acuity improved significantly, moderately, and decreased in 8 patients (38%), 11 eyes (52%) and 2 eyes (10%), respectively. In the delayed surgery group, best-corrected visual acuity improved significantly, moderately, and worsened in 3 eyes (12%), 12 eyes (48%), and 10 eyes (40%) (P = 0.041), respectively. No statistically significant difference was observed in the rate of postoperative complications between the two groups.

Conclusion:
Early vitrectomy after open-globe injury leads to better anatomical and functional outcomes.
GENETICS OF LARGE PIGMENT EPITHELIAL DETACHMENTS IN NEOVASCULAR AGE-RELATED MACULAR DEGENERATION
Authors: Mouallem-Beziere Alexandra , Blanco-Garavito Rocio , Richard Florence , Miere Alexandra , Jung Camille , Rozet Jean-Michel , Souied Eric H. 
Published: February 2019

Purpose:
We hypothesized that severe forms of neovascular age-related macular degeneration (AMD) such as large pigment epithelial detachments poorly responding to anti–vascular endothelial growth factor therapy might present a distinct genotype compared with overall series of neovascular AMD.

Methods:
This is a multicenter genetic association study. Sixty-eight patients presenting pigment epithelial detachments resistant to ranibizumab (issued from ARI2 study, register number NCT02157077 on clinicaltrials.gov) were compared with two series of patients derived from previously published clinical studies, presenting neovascular AMD (NAT2 study n = 300 and PHRC study n = 1,127), and with healthy controls (n = 441). The phenotype of neovascular AMD groups was based on visual acuity measurement, fundus examination, spectral-domain optical coherence tomography, and angiographic data. All samples were genotyped for three single-nucleotide polymorphisms: CFH (rs1061170), ARMS2 (rs10490924), and C3 (rs2230199). Significant difference in allele frequency between participants with neovascular AMD and control was the main outcome measurement.

Results:
The GG genotype of the C3 rs2230199 was significantly more frequent in the ARI2 group (55.9%) than the PHRC group (6.0%, P < 0.0001; odds ratio = 24.0 [95% confidence interval 10.4–55.0]) and the NAT2 group (5.1%, P < 0.0001; odds ratio = 16.1 [95% confidence interval 5.0–51.9]). The repartition of patients carrying a T allele of the ARMS2 (rs10490924) or patients carrying a C allele of the CFH (rs1061170) was similar in the ARI2 group when compared with the NAT2 and PHRC groups.

Conclusion:
In our series, the genotype GG of C3 rs2230199 was more significantly associated with the phenotype of large vascularized pigment epithelial detachment poorly responding to anti–vascular endothelial growth factor therapy than in global AMD series.
ONE-YEAR OUTCOMES OF A NOVEL SURGICAL APPROACH FOR FIXATION OF A POSTERIOR CHAMBER INTRAOCULAR LENS USING GORE-TEX SUTURE
Authors: Bonnell Alyssa C. , Mantopoulos Dimosthenis , Fine Howard F. , Shah Sumit P. , Wheatley H. Matthew , Prenner Jonathan L. 
Published: February 2019

Purpose:
To report the 1-year outcomes of a novel surgical technique for the fixation of a CZ70BD intraocular lens with Gore-Tex suture using cow-hitch knots.

Methods:
A retrospective chart review of 15 patients (13 men and 2 women) who underwent fixation of a posterior chamber intraocular lens with Gore-Tex suture was performed. Short- and long-term outcomes data were collected 1 month and 1 year after surgery, respectively.

Results:
Fourteen of the 15 patients met inclusion criteria and were included in the analysis. Mean visual acuity improved significantly from Snellen 20/491 preoperatively to Snellen 20/59 at postoperative month 12 (P = 0.002). The most common short-term complications included increased intraocular pressure (n = 6) and cystoid macular edema (n = 4). The most common long-term complications included increased intraocular pressure (n = 2) and iris capture of the intraocular lens (n = 2).

Conclusions:
One-year outcome data suggest that this technique is a reasonable surgical option for secondary intraocular lens placement in patients who lack capsular support.
OPTICAL COHERENCE TOMOGRAPHY LEAKAGE IN NEOVASCULAR AGE-RELATED MACULAR DEGENERATION
Authors: Farinha Cláudia , Santos Torcato , Santos Ana Rita , Lopes Marta , Alves Dalila , Silva Rufino , Cunha-Vaz José 
Published: February 2019

Purpose:
To test optical coherence tomography leakage in the identification and quantification of choroidal neovascularization–related fluid, its change after anti–vascular endothelial growth factor therapy in neovascular age-related macular degeneration eyes and its relation to functional outcome.

Methods:
Prospective analysis of a cohort of neovascular age-related macular degeneration cases treated with 2.0-mg intravitreal aflibercept. Eyes included were analyzed before, 1-week, and 1-month after one injection. Best-corrected visual acuity was assessed using Early Treatment Diabetic Retinopathy Study method. Optical coherence tomography leakage maps depicting low optical reflectivity (LOR) sites were acquired with OCT Cirrus AngioPlex (Zeiss, Dublin, CA). The LOR area ratio was correlated to retinal thickness and best-corrected visual acuity. Optical coherence tomography angiography was simultaneously performed.

Results:
Twenty-two eyes of 18 patients with neovascular age-related macular degeneration were included. The LOR ratio of the full retina scan and retinal pigment epithelium–Bruch layer decreased from baseline to Month 1 (P < 0.05). Changes in retinal thickness and LOR ratio were positively correlated (P < 0.05). Best-corrected visual acuity change correlated with the outer segment layer LOR change (rho = −0.53, P = 0.014), and LOR was inferior in better responders (P = 0.021). Optical coherence tomography leakage identified eyes with recurrent fluid in the external layers.

Conclusion:
Optical coherence tomography leakage identified and quantified the fluid related to choroidal neovascularization activity. Low optical reflectivity change in the outer segment layer correlates with functional outcome and increasing LOR in the external layers may be a marker of early recurrence. Combining optical coherence tomography angiography and optical coherence tomography leakage allows both for choroidal neovascularization morphology and activity analysis.
Cervical Vestibular Evoked Myogenic Potentials in Menière's Disease: A Comparison of Response Metrics
Authors: Noij Kimberley S. , Herrmann Barbara S. , Guinan John J. , Rauch Steven D. 
Published: February 2019

Objective:
The cervical vestibular evoked myogenic potential (cVEMP) has been used to evaluate patients with Menière's disease (MD). Studied cVEMP metrics include: amplitude, threshold, frequency tuning, and interaural asymmetry ratio (IAR). However, few studies compared these metrics in the same set of MD patients, and methodological differences prevent such a comparison across studies. This study investigates the value of different cVEMP metrics in distinguishing one set of MD patients from age-matched controls.

Study Design:
Prospective study.

Setting:
Tertiary care center.

Patients:
Thirty patients with definite unilateral MD and 23 age-matched controls were prospectively included. All underwent cVEMP testing at 500, 750, 1000, and 2000 Hz on each side. Ears were separated into three groups: affected MD, unaffected MD, and control.

Main Outcome Measures:
Sound level functions were obtained at each frequency, and normalized peak-to-peak amplitude (VEMPn), VEMP inhibition depth (VEMPid), threshold, frequency-tuning ratio, and IAR were calculated. For all metrics, the differentiation between MD and control ears was compared using receiver operating characteristic (ROC) curves.

Results:
500 Hz cVEMP threshold, VEMPn, and VEMPid were similarly good at distinguishing affected MD ears from healthy ears, with ROC area under the curves (AUCs) of more than 0.828 and optimal sensitivities and specificities of at least 80 and 70%. Combinations of these three metrics yielded slightly larger AUCs (>0.880). Tuning ratios and IAR were less effective in separating healthy from affected ears with AUCs ranging from 0.529 to 0.720.

Conclusion:
The cVEMP metrics most useful in distinguishing MD patients from healthy controls are threshold, VEMPn, and VEMPid, using 500 Hz stimuli.
Isolated Traumatic Fracture of the Malleus Handle Causing Hearing Fluctuation
Authors: Cavada Marina Neves , Patel Nirmal 
Published: February 2019

Introduction:
Handle of malleus fracture is a rare condition with <100 cases having been reported. The clinical presentation is conductive hearing loss following a history of trauma, typically, during manipulation of the external auditory canal. The diagnosis of the condition is clinical and radiological. The options for treatment are either a hearing aid or ossiculoplasty. We describe an isolated case of malleus handle fracture after trauma associated with manipulation of the external auditory canal.

Case report:
A 56-year-old female, reported a right ear trauma. She suffered immediate otalgia, hearing loss and nonpulsatile tinnitus. An indistinct umbo was identified on endoscopic inspection and a hypermobile right tympanic membrane during Valsalva. Clinical testing of hearing revealed a mild-to-moderate conductive hearing loss. Computed Tomography scan revealed a fracture of the right malleus handle. A decision for surgical treatment was made based on continuing symptomatology as well as audiology and CT findings. A tragal composite cartilage graft was harvested and placed over the remaining superior part of the malleus and under the inferior fragment of the malleus attached to the tympanic membrane. The patient had immediate improvement of fluctuating hearing loss and tinnitus in the postoperative period.

Conclusion:
A fracture of the malleus handle should be included in the etiologies of conductive hearing loss after trauma. A careful history, thorough otology examination, and a meticulous analysis of the CT will usually confirm this rare condition and exclude other ossicular abnormalities.
Remote Programming of Cochlear Implants
Authors: Slager Heidi K. , Jensen Jamie , Kozlowski Kristin , Teagle Holly , Park Lisa R. , Biever Allison , Mears Megan 
Published: February 2019

Objective:
This study investigated the safety and efficacy of remote programming of cochlear implants.

Study Design:
Single-subject design

Setting:
Four North American clinical sites

Patients:
Forty cochlear implant recipients aged 12 years or older

Intervention:
Subjects had their cochlear implants programmed at a location that was remote from their audiologist using telecommunication with and without the support of a facilitator.

Main Outcome Measures:
Consonant-Nucleus-Consonant (CNC) word scores and the Speech, Spatial, and Qualities of Hearing Scale-C (SSQ-C) were compared using the subject's in-office MAP (program) and MAPs programmed remotely with and without the assistance of a facilitator. Additional subjective preference data were gathered from subjects and audiologists via questionnaires.

Results:
MAPs programmed via the three different models did not yield significantly different group mean CNC word scores. No device/procedure-related adverse events occurred. SSQ-C questionnaire results indicated that recipients received similar subjective benefit from familiar in-office, remote-facilitated, and remote-unassisted MAPs.

Conclusions:
Remote programming is an effective means of cochlear implant service delivery. The practice was approved by the FDA on November 17, 2017 supported by the results of this study.
Hearing Preservation in Pediatric Recipients of Cochlear Implants
Authors: Selleck A. Morgan , Park Lisa R. , Choudhury Baishakhi , Teagle Holly F. B. , Woodard Jennifer S. , Gagnon Erika B. , Brown Kevin D. 
Published: February 2019

Objective:
To determine factors that influence low-frequency hearing preservation following pediatric cochlear implantation and compare hearing preservation outcomes between 20 and 24 mm depth lateral wall electrodes.

Study Design:
Retrospective chart review.

Setting:
Tertiary academic referral center.

Patients:
Pediatric cochlear implant recipients (under the age of 18) who presented preoperatively with a low-frequency pure tone average (LFPTA; 125, 250 and 500 Hz) ≤ 70 dB HL.

Intervention:
Cochlear implantation

Main Outcome Measures:
Multiple logistic regression evaluating the influence of variables on change in LFPTA including preoperative low-frequency hearing, lateral wall or perimodiolar electrode, progressive vs stable hearing, side, time from surgery, and the presence or the absence of enlarged vestibular aqueduct. A second analysis reviews the 12-month postactivation hearing preservation of a subset of subjects implanted with modern lateral wall electrodes.

Results:
A total of 105 subjects were included from the last 10 years for our multiple logistic regression analysis. This demonstrated a significant correlation of poorer preoperative low-frequency hearing with change in LFPTA. A significant negative effect of electrode type, specifically perimodiolar electrodes was also seen. Forty-five subjects from the last 3 years undergoing cochlear implantation with a lateral wall electrode demonstrated an overall 12-month preservation rate (LFPTA < 90 dB) of 82%. Differences in preservation rates existed between different electrodes.

Conclusion:
Preservation of low-frequency hearing following cochlear implantation is predicted both by preoperative low-frequency hearing as well as type of electrode implanted. Consistent low-frequency hearing preservation is possible in pediatric subjects receiving lateral wall electrodes, although differences exist between electrode types.
Bilateral Cochlear Implants Using Two Electrode Lengths in Infants With Profound Deafness
Authors: Dunn Camille C. , Walker Elizabeth A. , Gogel Stephanie , Van Voorst Tanya , Hansen Marlan , Gantz Bruce J. 
Published: February 2019

Objective:
The goal of this investigation was to determine if a short electrode in one ear and standard electrode in the contralateral ear could be an option for infants with congenital profound deafness to theoretically preserve the structures of the inner ear. Similarities in performance between ears and compared with a control group of infants implanted with bilateral standard electrodes was evaluated.

Study Design:
Repeated-measure, single-subject experiment.

Setting:
University of Iowa—Department of Otolaryngology.

Participants:
Nine infants with congenital profound bilateral sensorineural hearing loss.

Intervention(s):
Short and standard implants.

Main Outcome Measure(s):
Early speech perception test (ESP), children's vowel, phonetically balanced-kindergarten (PB-K) word test, and preschool language scales-3 (PLS-3).

Results:
ESP scores showed performance reaching a ceiling effect for the individual short and standard ears and bilaterally. The children's vowel and PB-K word results indicated significant (both p < 0.001) differences between the two ears. Bilateral comparisons to age-matched children with standard bilateral electrodes showed no significant differences (p = 0.321) in performance. Global language performance for six children demonstrated standard scores around 1 standard deviation (SD) of the mean. Two children showed scores below the mean, but can be attributed to inconsistent device usage. Averaged total language scores between groups showed no difference in performance (p = 0.293).

Conclusions:
The combined use of a short electrode and standard electrode might provide an option for implantation with the goal of preserving the cochlear anatomy. However, further studies are needed to understand why some children have or do not have symmetric performance.