bluuebunny/crossref_metadata_2025_split huggingface dataset:
Asthma and anaphylaxis
Authors: Tanno Luciana Kase , Gonzalez-Estrada Alexei , Olivieri Bianca , Caminati Marco 
Published: June 2019

Purpose of review
Both asthma and anaphylaxis are recognized noncommunicable hypersensitivity conditions, which should be correctly diagnosed and treated/controlled in order to decrease avoidable deaths. Nevertheless, their association is not completely clear. We here propose to review the current and new evidence-based data of asthma and anaphylaxis in the view of the new knowledge in the field that can support the quality practice and empower allergists and health professionals in treating symptoms and preventing death.

Recent findings
Hypersensitivity life-threatening conditions, such as anaphylaxis and asthma can coexist, mimic or worse each other. Asthma itself is not a strong predictor of more severe anaphylaxis. However, poor asthma control associated with more severe anaphylaxis reactions in all ages. In children, asthma is associated with the severity and recurrences of anaphylactic reactions.

Summary
Although recent data point for the association between asthma and anaphylaxis, we still do not have harmonized evidence to confirm if we are dealing with two independent comorbidities one worsening each other. However, as far as this review is covering two relevant public health problems in the field of allergy, it is mandatory put in place decisions supporting recommendations to better manage the affected patients and reduce the risk.
General strategies should include regular notification of this association, optimization of the classification and coding for anaphylaxis and asthma (new ICD 11 allergy codes) in order to harmonize epidemiological stratified data, early diagnosis of asthma in childhood, regular investigation of asthma in cases of anaphylaxis and optimization of the asthma control and lung function for all patients with indication to provocation tests, desensitization or allergen immunotherapy regardless to the trigger. Implementation of these strategies will involve national and international support for ongoing efforts in relationship with networks of centres of excellence to provide personalized management for the most at-risk patients and prevent death.
A Prospective Randomized Trial Comparing Topical Intranasal Lidocaine and Levobupivacaine in Patients Undergoing Endoscopic Binostril Transnasal Transsphenoidal Resection of Pituitary Tumors
Authors: Konay Arun S. , Williams Aparna , Chacko Ari G. , Singh Georgene 
Published: June 2019

Introduction:
Local anesthetic intranasal packing is used in transnasal surgery to reduce hemodynamic fluctuations. We hypothesized that the long acting local anesthetic levobupivacaine would provide superior hemodynamic stability and postoperative analgesia compared with lidocaine in endoscopic transnasal transsphenoidal (TNTS) surgery.

Materials and Methods:
In this prospective, randomized, double-blind trial, 48 patients undergoing TNTS surgery were allocated to the 2 groups to receive preoperative intranasal packing with 15 mL of 1.5% lidocaine or 0.5% levobupivacaine each mixed with 60 mg ephedrine. Heart rate and mean arterial blood pressure were recorded immediately before induction of anesthesia, at various time points throughout surgery, and at tracheal extubation. Bleeding in the surgical field, time to extubation, and postoperative pain were also assessed.

Results:
There was no significant difference in heart rate between the lidocaine and levobupivacaine groups at any point. Mean arterial pressure was also similar between the 2 groups during surgery, whereas at extubation blood pressure was lower in the lidocaine compared with levobupivacaine group (85±10 vs. 96±16 mm Hg; P=0.0010). There were no differences between the 2 groups in the other outcome variables.

Conclusions:
Preoperative intranasal packing with 1.5% lidocaine or 0.5% levobupivacaine provide similar hemodynamic stability throughout TNTS. Lidocaine packing may be more advantageous for hemodynamic stability during extubation.
Semiextended Tibial Nail Insertion Using an Extraarticular Lateral Parapatellar Approach: A 24-Month Follow-up Prospective Cohort Study
Authors: Stella Marco , Santolini Emmanuele , Felli Lamberto , Santolini Federico , Horwitz Daniel S. 
Published: June 2019

Objective:
To analyze the outcomes of tibial shaft fractures treated with a lateral parapatellar approach in the semiextended position for intramedullary nail insertion.

Design:
Prospective cohort study.

Setting:
Level I trauma center.

Patients and Methods:
Seventy patients treated from March 2012 to July 2015 with intramedullary nailing (IMN) using an extraarticular lateral parapatellar approach in the semiextended position were reviewed. Patients were clinically and radiographically checked at a minimum follow-up of 24 months, and the following data were recorded: fracture healing, any residual deformity, nail–apex distance, range of motion of the treated knee together with the contralateral side, knee functional outcome, and residual knee pain.

Results:
Twenty-four months after surgery, all patients were clinically and radiographically healed, with 2 cases of malalignment (angular deformity <10 degrees). The average range of motion of the treated knee was 0–130.6 degrees (±8.6 degrees) compared with 0–131.1 degree (±7.9 degrees) of the contralateral. Lysholm knee score was excellent for 57 patients, good for 11, and fair for 2. The mean residual pain was 0.6 (±1.1) according to the visual analogue scale.

Conclusions:
The described technique represents an effective option for IMN of tibial fractures. It is suitable for all tibial fractures, including proximal and distal. The results of our series demonstrate the effectiveness of this technique with nearly complete recovery of knee function and negligible incidence of anterior knee pain at a minimum follow-up of 24 months.

Level of Evidence:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Enablers and Barriers to Implementing ICU Follow-Up Clinics and Peer Support Groups Following Critical Illness: The Thrive Collaboratives*
Authors: Haines Kimberley J. , McPeake Joanne , Hibbert Elizabeth , Boehm Leanne M. , Aparanji Krishna , Bakhru Rita N. , Bastin Anthony J. , Beesley Sarah J. , Beveridge Lynne , Butcher Brad W. , Drumright Kelly , Eaton Tammy L. , Farley Thomas , Firshman Penelope , Fritschle Andrew , Holdsworth Clare , Hope Aluko A. , Johnson Annie , Kenes Michael T. , Khan Babar A. , Kloos Janet A. , Kross Erin K. , Mactavish Pamela , Meyer Joel , Montgomery-Yates Ashley , Quasim Tara , Saft Howard L. , Slack Andrew , Stollings Joanna , Weinhouse Gerald , Whitten Jessica , Netzer Giora , Hopkins Ramona O. , Mikkelsen Mark E. , Iwashyna Theodore J. , Sevin Carla M. 
Published: June 2019

Objectives:
Data are lacking regarding implementation of novel strategies such as follow-up clinics and peer support groups, to reduce the burden of postintensive care syndrome. We sought to discover enablers that helped hospital-based clinicians establish post-ICU clinics and peer support programs, and identify barriers that challenged them.

Design:
Qualitative inquiry. The Consolidated Framework for Implementation Research was used to organize and analyze data.

Setting:
Two learning collaboratives (ICU follow-up clinics and peer support groups), representing 21 sites, across three continents.

Subjects:
Clinicians from 21 sites.

Measurement and Main Results:
Ten enablers and nine barriers to implementation of “ICU follow-up clinics” were described. A key enabler to generate support for clinics was providing insight into the human experience of survivorship, to obtain interest from hospital administrators. Significant barriers included patient and family lack of access to clinics and clinic funding. Nine enablers and five barriers to the implementation of “peer support groups” were identified. Key enablers included developing infrastructure to support successful operationalization of this complex intervention, flexibility about when peer support should be offered, belonging to the international learning collaborative. Significant barriers related to limited attendance by patients and families due to challenges in creating awareness, and uncertainty about who might be appropriate to attend and target in advertising.

Conclusions:
Several enablers and barriers to implementing ICU follow-up clinics and peer support groups should be taken into account and leveraged to improve ICU recovery. Among the most important enablers are motivated clinician leaders who persist to find a path forward despite obstacles.
Diagnosis and Treatment of Developmental Dyslexia and Specific Learning Disabilities: Primum Non Nocere
Authors: Cainelli Elisa , Bisiacchi Patrizia Silvia 
Published: June 2019

ABSTRACT:
Specific learning disabilities (SLDs) are increasingly being addressed by researchers, schools, and institutions, as shown by the increasing number of publications, guidelines, and incidence statistics. Although SLDs are becoming a major topic in education with the final goal of inclusive schools, consistent drawbacks may emerge, resulting in disadvantages instead of benefits for some children. Overdiagnosis and unnecessary interventions may harm children's neurodevelopment and families' quality of life more than previously thought. In this commentary, we discuss recent understandings, their practical and educational applications, and some considerations of the effects of these choices on children.
Reduction in N-Desmethylclozapine Level Is Determined by Daily Dose But Not Serum Concentration of Valproic Acid—Indications of a Presystemic Interaction Mechanism
Authors: Smith Robert L. , Kyllesø Lennart , Haslemo Tore , Andreassen Ole Andreas , Molden Espen 
Published: June 2019

Background:
Valproic acid (VPA) is frequently used together with clozapine (CLZ) as mood-stabilizer or for the prevention of seizures in patients with psychotic disorders. VPA is known to reduce levels of the pharmacologically active CLZ-metabolite N-desmethylclozapine (N-DMC), but factors determining the degree of this interaction are unknown. Here, we investigated the relationship between VPA dose and serum concentration on N-DMC levels in a large patient population adjusting for sex, age, and smoking habits as covariates.

Methods:
A total of 763 patients with steady-state serum concentrations of CLZ and N-DMC concurrently using VPA (cases, n = 76) or no interacting drugs (controls, n = 687) were retrospectively included from a therapeutic drug monitoring service at Diakonhjemmet Hospital, Oslo, between March 2005 and December 2016. In addition to information about prescribed doses, age, sex, smoking habits, and use of other interacting drugs were obtained. The effects of VPA dose and serum concentration on dose-adjusted N-DMC levels were evaluated by univariate correlation and multivariate linear mixed-model analyses adjusting for covariates.

Results:
The dose-adjusted N-DMC levels were approximately 38% lower in VPA users (cases) versus nonusers (controls) (P < 0.001). Within the VPA cases, a negatively correlation between VPA dose and dose-adjusted N-DMC levels was observed with an estimated reduction of 1.42% per 100-mg VPA dose (P = 0.033) after adjusting for sex, age, and smoking. By contrast, there was no correlation between VPA serum concentration and dose-adjusted N-DMC levels (P = 0.873).

Conclusions:
The study shows that VPA dose, not concentration, is of relevance for the degree of reduction in N-DMC level in clozapine-treated patients. Presystemic induction of UGT enzymes or efflux transporters might underlie the reduction in N-DMC level during concurrent use of VPA. Our findings indicate that a VPA daily dose of 1500 mg or higher provides a further 21% reduction in N-DMC concentration. This is likely a relevant change in the exposure of this active metabolite where low levels are associated with implications of CLZ therapy.
Chinese Patients With Heart Valve Replacement Do Not Benefit From Warfarin Pharmacogenetic Testing on Anticoagulation Outcomes
Authors: Hao Yexia , Yang Jun , Zheng Xuan , Hu Yuanping , Yan Xinsheng , Zhang Litao 
Published: June 2019

Background:
Genotype-guided warfarin dosing has been shown in some randomized trials to improve anticoagulation outcomes in individuals of European ancestry; yet, its utility in Chinese patients with heart valve replacement remains unresolved.

Methods:
A total of 2264 patients who underwent heart valve replacement at Wuhan Asia Heart Hospital were enrolled in this study. Patients were randomly divided into 2 groups, namely, a genotype-guided and a traditional clinically guided warfarin dosing group. In the genotype-guided group (n = 1134), genotyping for CYP2C9 and VKORC1 (−1639 G→A) was performed using TaqMan genotyping assay. Warfarin doses were predicted with the International Warfarin Pharmacogenetics Consortium algorithm. Patients in the control group (n = 1130) were clinically guided. The primary outcome was to compare the incidence of adverse events (major bleeding and thrombotic) during a 90-day follow-up period between 2 groups. Secondary objectives were to describe effects of the pharmacogenetic intervention on the first therapeutic-target-achieving time, the stable maintenance dose, and the hospitalization days.

Results:
A total of 2245 patients were included in the analysis. Forty-nine events occurred during follow-up. Genotype-guided dosing strategy did not result in a reduction in major bleeding (0.26% versus 0.63%; hazard ratio, 0.44; 95% confidence interval, 0.13–1.53; P = 0.20) and thrombotic events (0.89% versus 1.61%; hazard ratio, 0.56; 95% confidence interval, 0.27–1.17; P = 0.12) compared with clinical dosing group. Compared with traditional dosing, patients in the genotype-guided group reached their therapeutic international normalized ratio in a shorter time (3.8 ± 2.0 versus 4.4 ± 2.0 days, P < 0.001). There was no difference in hospitalization days (P = 0.28).

Conclusions:
Warfarin pharmacogenetic testing according to the International Warfarin Pharmacogenetics Consortium algorithm cannot improve anticoagulation outcomes in Chinese patients with heart valve replacement.
Ophthalmic Manifestations of Mycoplasma-Induced Rash and Mucositis
Authors: Shah Parth R. , Williams Andrew M. , Pihlblad Matthew S. , Nischal Ken K. 
Published: June 2019

Purpose:

Mycoplasma pneumoniae is a common cause of pediatric respiratory infections, with a quarter having extrapulmonary complications, most commonly a mucocutaneous eruption involving the ocular surface. A detailed description of the ophthalmic manifestations in Mycoplasma-induced rash and mucositis (MIRM) is currently lacking in the scientific literature.

Methods:
This is a retrospective chart review of consecutive cases of MIRM at a tertiary referral children's hospital between October 1 and December 1, 2018, with up to 2 months of follow-up. Main outcomes and measures were demographic information, clinical examination findings including visual acuity, detailed anterior segment findings, and course of both ophthalmic and systemic disease.

Results:
Five patients were included. Age range was 8 to 17 years (mean age 11.9 years, median 11 years), with a strong male preponderance (4:1). All patients had inflammatory conjunctivitis. One patient had recurrent conjunctival pseudomembrane formation, whereas 2 patients had lid margin and conjunctival ulceration. No cases had corneal involvement and visual outcomes were excellent.

Conclusions:
MIRM is associated with ocular involvement in almost all cases. Although this is generally mild, conjunctival epithelial defects and pseudomembrane formation can occur. We recommend that pediatric ophthalmologists follow children who are hospitalized with MIRM as closely as they would those diagnosed with other mucocutaneous syndromes, such as Stevens–Johnson syndrome or toxic epidermal necrolysis.
Lateral Antebrachial Cutaneous Nerve as Autologous Graft for Mini-Invasive Corneal Neurotization (MICORNE)
Authors: Bourcier Tristan , Henrat Carole , Heitz Antoine , Kremer Samira Fafi , Labetoulle Marc , Liverneaux Philippe 
Published: June 2019

Purpose:
We describe the first case of a novel surgical technique of mini-invasive corneal neurotization (MICORNE) using the lateral antebrachial cutaneous nerve as a graft nerve and the contralateral supraorbital nerve as a donor nerve in a herpetic patient with a neurotrophic keratopathy (NK).

Methods:
A MICORNE procedure was performed in a 32-year-old man with a 5-year history of herpes simplex virus (HSV)-related NK in the right eye (RE). Visual acuity and corneal sensation were assessed over 9 months of follow-up. HSV-1 and HSV-2 genomes were screened preoperatively and postoperatively in the patient's tears using the quantitative polymerase chain reaction technique. A high does of the oral antiviral prophylaxis was prescribed during the follow-up.

Results:
Preoperative best-corrected visual acuity was 20/200 in the RE. A Cochet–Bonnet esthesiometer revealed complete corneal anesthesia (<5 mm ie, >15.9 g/mm2) in all quadrants in a scarred and neovascularized cornea. Twelve months after the procedure, the visual acuity of the RE was 20/80 and corneal sensitivity had increased to 40 mm, that is, 0.8 g/mm2 (superior quadrant), 35 mm, that is, 1 g/mm2 (inferior quadrant), 40 mm (temporal quadrant), 35 mm, that is, 1 g/mm2 (nasal quadrant), and 40 mm (centrally). We observed no clinical recurrence of herpes, and HSV was not detected in tears during the follow-up period.

Conclusions:
We report the first case of MICORNE, a novel surgical technique of corneal neurotization in a herpetic patient with NK. Despite the potential risk of viral recurrence, our patient showed dramatic improvement in corneal sensation and visual acuity.
Health Knowledge and Adherence as Predictors of Viral Burden and CD4+ T-Cell Count in Youth and Young Adults Living With HIV
Authors: Lynn Courtney , Chenneville Tiffany , Bradley-Klug Kathy , St. John Walsh Audra , Dedrick Robert F. , Rodriguez Carina A. 
Published: June 2019

Abstract
Health literacy influences HIV treatment for youth and, thus, is a research priority. We explored health knowledge and self-reported adherence, as indicators of health literacy, among youth living with HIV (YLWH) and the association between health literacy and health outcomes. A total of 102 YLWH ages 13–25 years participated in the study. Participants completed the Brief Estimate of Health Knowledge and Action-HIV Version; CD4+ T-cell counts and viral loads were extracted from participant medical records. Participants had a moderate amount of HIV knowledge, and most reported taking their medications under most conditions. Decreasing action scores were statistically associated with an increased likelihood of having a detectable viral load. Health literacy is an important factor that should be addressed by practitioners working with YLWH. More research is needed to determine the best way to measure and improve health literacy.
Endovascular graft exclusion for treating Stanford type B acute aortic dissection in aged population
Authors: Chen Tongyun , Jiang Nan , Zhao Feng , Xu Dong , Gao Jinyu , Chen Qingliang 
Published: June 2019

Abstract
The aim of this study was to investigate the efficiency of endovascular graft exclusion for treating Stanford type B acute aortic dissection (AAD) in aged population.
Forty-six consecutive patients aged ≥65 years with Stanford type B AAD underwent endovascular therapy in Tianjin Chest Hospital between 2010and 2015 were included in this study. All patients received echocardiography, contrast-enhanced CT, hepatic and renal functions tests, and the blood and urine routine examinations. After the procedure, annual review of the whole aortic computed tomography (CT) was performed for all patients before discharge, as well as 3 months, 6 months and12 months after surgery. All patients were followed up until December, 2015. The outcomes of the whole aortic CT and survival rate were analyzed.
Five patients (10.87%) died. Among the 5 cases, 2 showed perioperative death induced by cerebral infarction, 1 died because of newly developed AD 8 months after surgery, and 2 died because of acute myocardial infarction (n = 1) and renal/cardiac failure (n = 1). The other 41 patients (89.13%) were symptom-free with satisfactory conditions.
Endovascular stent-graft placement was effective for treating the senior patients with Stanford type B AAD.
Better prediction for FGR (fetal growth restriction) with the sFlt-1/PIGF ratio
Authors: Visan Valeria , Scripcariu Ioana Sadiye , Socolov Demetra , Costescu Amelia , Rusu Daniela , Socolov Razvan , Avasiloaiei Andreea , Boiculese Lucian , Dimitriu Cristina 
Published: June 2019

Abstract
The aim of this study was to check whether the sFlt-1/PIGF ratio, established as the biomarker for preeclampsia, reduces the false positive rate of late fetal growth restriction (FGR) detection by ultrasound biometry.
This was a prospective case-control study, conducted at one regional maternity hospital in Romania. Study participants included singleton pregnancy women for whom the estimated fetal weight (EFW) at 28 to 35 weeks was < 10 percentiles and as controls, pregnant women with EFW >10 percentiles. All pregnancies were dated in the first trimester by crown-rump-length. We also recorded maternal characteristics, pregnancy and neonatal outcomes.
The primary outcome measures were the relation between the sFlt-1/PIGF ratio and incidence of FGR. Secondary outcome was establishing a threshold for statistical significance of the marker and influence of other conditions (e.g., pre-eclampsia) on the accuracy of the marker in FGR prediction.
Included in the study were 37 pregnant women and 37 controls.
When we used ultrasound (US) biometry and maternal risk factors to estimate EFW <10 percentiles, the sensitivity was 44.4% with a specificity of 89% for an FPR (false positive result) of 10%. When we combined the US biometry and maternal risk factors with sFlt1/PIGF ratio, for a cut off of 38, the sensitivity was 84.21%, and the specificity was 84.31% for an FPR of 10%. The cut off value (36) did not change if we considered all cases of SGA, including those with associated preeclampsia or if we considered only FGR cases without associated preeclampsia.
When associated with maternal factors and US biometry, the sFlt1/PIGF ratio enhanced the sensitivity for detecting late FGR.